Drug Mechanisms

Front 1

sulfonamides

Back 1

inhibit the first step of folic acid synthesis via inhibiting the binding of PABA and pteridine to make dihyropteroic acid

Front 2

DHFRI's

Back 2

inhibit Fh4--> FH2

Front 3

fluoroquinolones

Back 3

against G (-) inhibition of bacterial gyrase causing supercoiling of bacterial DNA, thereby inhibition of DNA replication

Front 4

Fluorquinolones

Back 4

against Gram (+) inhibition of topoisomerase IV, thus inhibiting the separation of daughter cells during DNA replication

Front 5

aminoglycosides

Back 5

CIDAL primarily against Gram negative bacteria
Rx enters porins in Gram (-) cell wall and enter the periplasmic space which is negatively charged (polycationic, thus attracted to opposite charge)
enter through inner membrane via electrochemical gradient driven by ETC, once inside the bacteria it binds to the 30S ribosome and:
a. inhibits initiation
b. causes misreading of mRNA thus making faulty proteins that will eventually be incorporated into cell wall making it weak and subject to lysis
c. premature termination

Front 6

creatine clearance

Back 6

CLcr (ml/min)= (140-age)(lean body mass)/(72)(serum creatine)

LBM: male--> 50kg +2.3 every inch over 5 ft
female--> 45.5kg +2.3 every inch over 5 ft.

Front 7

Penicillin

Back 7

CIDAL
primarily Gram (+)
inhibits bacterial transpeptidase thereby inhibiting cell wall synthesis as the crosslinking step of NAM/NAG cannot occur

Front 8

Aminopenicillin

Back 8

primarily Gram + but also includes some Gram -
inhibits bacterial transpeptidase thereby inhibiting cell wall synthesis as the crosslinking step of NAG/NAM cannot occur
amino group better enables Rx to enter cell wall of Gram -

Front 9

tetracyclines

Back 9

bind and inhibit the binding of aminoacyl tRNA binding to ribosome

Front 10

tigecycline

Back 10

bind and inhibit the binding of aminoacyl tRNA binding to ribosome but is CIDAL
steric hindrance

Front 11

Cephalosporins

Back 11

inhibit transpeptidase thus inhibiting the removal of D-Ala from Nag and inhibiting the crosslinking of NAG/NAM
BETA LACTAMASE INHIBITION as well

Front 12

carbapenems

Back 12

broadest spectrum of beta lactamase inhibitors
includes:
G +
G-
anaerobes

Front 13

vancomycin

Back 13

CIDAL
mostly G+
blocks the removal of D-ala thus inhibiting transpeptidase from removing it and inhibiting cell wall synthesis

Front 14

bacitracin

Back 14

CIDAL: G+
inhibits dephosphorylation of bactoprenol (lipid carrier that carries NAG/NAM across the cell membrane for cross-linking)

Front 15

fosfomycin

Back 15

CIDAL Gram +
inhibition of enoypyruvate transferase which blocks the addition of phosphoenolpyruvate to UDP-NAM pentapeptide

Front 16

Telithromycin

Back 16

a ketolide, also a macrolide derivative
similar mechanism but increased G+ activity
1. inhibits translocation A to P site on ribosome
2. releases peptidyl tRNA from ribosomes
3. blocks formation of initiation complex

Front 17

Chloramphenicol (CAMP)

Back 17

STATIC
used against serious/resistant aerobes/anaerobes and G+/G-
inhibits binding of aminoacyl tRNA to its acceptor site on the ribosome

Front 18

quinupristin/Dalfopristin

Back 18

TOGETHER= CIDAL, individually they are static
QUIN: releases peptidyl-tRNA from peptidyltransferase
DALFO: inhibits the binding of aminoacyl tRNA to acceptor site on ribosome

Front 19

Linezolid

Back 19

can be static or cidal depending on the organism
**inhibits the formation of initiation complex

Front 20

Clindamycin

Back 20

inhibits the translocation of A to the P site during protein synthesis

Front 21

Polymyxin B

Back 21

CIDAL against G-
is a cidal cationic detergent that physcially interacts with the lipid membrane of organism and creates pores causing organism to LYSE