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35 Cards in this Set
- Front
- Back
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Basic principles of antimicrobial therapy
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Selective toxicity, reach site of infection at inhibitory concentration, penetrate and bind target, low propensity for resistence
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antibiotics
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natural products of fungi, actinomycetes, and bacteria which kill or inhibit the growth of microbes; e.g. penicillins, cephalosporins, tetracyclines
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Bactericidal
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kills organisms
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bacteriostatci
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prevent organisms from growing
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Pharmocokinetic considerations
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route of administration (systemic, local, parenteral, direct)), metabolism (liver), excretion (urine)
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Classes of anti-bacterial agents
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Bacterial cell wall synthesis inhibitors, Protein synthesis inhibitors, Nucleic acid synthesis inhibitors, Antimetabolites
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Parenteral route of administrations
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basically it will go via the way it is given (IV needed if not digested by gut)
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Bacterial cell wall syntheis inhibitors
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B lactam antibiotics, vancomycin, bacitracin, cycloserine, isoniazid (inhibits enzymes for synthesis of peptiodoglycan; bacterialcidal)
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Beta lactam antibiotics
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pencillins, Cephalosporins; all act by binding to pencillin-binding proteins (PBP); PBP's enzymes incolved in cross-linking bacterial cell wall components; inhibit transpeptidase*
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Penicillins characteristics
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bacteriicidal; widely used in dentistry; #1 allergenic (rash, rare anaphlyaxis); 10% of patients allergic are sensitive to cephalosporins
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Narrow spectrum Penicillin
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Penillin G; good aginst gram positive, most oral aerboes, Beta lactamse sensitive
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Broad spectrum penicillin
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ampicillin, amoxicillin; gram positive and gram negative; beta lactamse sensitive
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Penicillinase resitant penicillins
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methicillin; gram positive, beta lactamse resistant
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Cephalosporins generations
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1st - 3rd generations; 1st generations are more suseptible to beta lactamse and decreasing as goes up; 3rd generation example Ceftriaxone*; all cephalosporins start with ceph or ceft
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Beta lactamase inhibitors; combine these with drugs to make them beta lactamse reisstant
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clavulanic acid (when combined w/ amoxicillin call Augmentin); Sulbactam; Tazobactam
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Cell wall synthesis inhibtors
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Bacitracin, cycloserine, vancomycin (good spectrum)
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Vancomycin toxicity
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hypotension, red man syndomre (rash caused by release of histamin form mast cells); reversable neutropenia
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Protein synthesis inhibitors
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most are bacteristatis; except (aminoglycosides); eitehr act on 30S or 50S of ribosomes
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Aminoglycosides
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streptomycin, neomycin; bacterialcidal; bind irreverisbly to 30S ribosome; toxic to ear and kidney
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Tetracycline
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short acting and long acting; bacetrioststic; bind reversibly to 30S ribosome; borad spectrum; tooth staining when young, or pregnanet
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Macrolides
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ex - erythromycin; bacteriostatic; reversible to 50S ribosomal; 1st choice for pencillin-allergenic patients; nausea, hepatotxicity, ototoxicty
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Chloramphenicol
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bacteriostatic; binds reversible to 50S ribosomal; DOC only for typhoid; toxicity (aplastic anemia or gray baby syndrome)
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Fusidic acid
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bacterioststic; against MRSA (protein syntheiss inhibitor)
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Lincosamides
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bacteria static,protein syntheiss inhibitor; can cause colitlis
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Spectinomycon
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bacteriostatic; m-rna robosome; protein syntheiss inhibito
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Linezolid
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protein syntheiss inhibitor; binds to both 50 and 30S; bacteriocidal/static
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Quinolones
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bactericidal; inhibit DNA gyrase (a topoisomerase***); example - ciprofloxacin; side effects - rash, GI; broad spectrum
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Metronidazole
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inhibits DMA synthesis; bactercidal; DOC for ANUG; trichomonas vaginalis; toxicity - gi upset, alchohol intolerance
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Do humans syntehisze folic acid?
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no, but bacteria do so we can go after folic acid production
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Sulfonamides
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bacteriostatic; 2nd most common cause of antibitoic allergy; may cause blod dyscrasias; broadspectrum; stops folic acid
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Trimethoprim
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blocks dihydrofolate reductase; bacterioststaic; stops folic acid
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Septra
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combination of sulfonamides and trimethoprim; prevents resistant strains; DOC penumonia, most UTI (e coli)
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Mechanisms for resistance
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altered target (change enzyme that is affected), altered uptake (don’t allow drug in); drug inactivation (enzymes kill drug)
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Bench mark for sterilzation
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spores
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Benchmark for disinfection
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mycoacterium
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