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86 Cards in this Set
- Front
- Back
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Peptidoglycan synthesis inhibitors
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Vancomycin, Bacitracin, Cycloserine
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30S cell Inhibitors
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Aminoglycosides, Tetracyclines
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50S cell inhibitors
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Chloramphenicol, Clindamycin, Erithromycin (macrolides), Linezolid, Lincomycin, Streptogramins (quinupristin, dalfopristin)
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Nucleotide Inhibitors
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Trimethoprim (inhibits dihydrofolate reductase)
Sulfonamides (inhibit dihydropterorate synthetase) Pyrimethamine (inhibits dihydrofolate reductase) |
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DNA topoisomerase (gyrase) inhibitor
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Fluoroquinolones/Quinolones
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mRNA synthesis inhibitors
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Rifampin (inhibits DNA dependent RNA polymerase
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Disrupts bacterial and fungal membranes
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Polymyxins
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Block cell wall synthesis by inhibition of peoptidoglycan cross linking
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Penicillin, Ampicillin, Ticarcillin, Piperacillin, Imipenem, Aztreonam, Cephalosporins
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Bacteriostatic
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Erythromycin, Clindamycin, Sulfamethoxazole, Trimethoprim, Tetracyclines, Chloramphenicol
(ECSTaTiC about bacteriostatics) |
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Bactericidal
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Vancomycin, Fluoroquinolones, Penicillin, Aminoglycosides, Cephalosporins, Metronidazole
(Very Finely Proficient At Cell Murder) |
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Penicillin MOA
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1. Bind PBP
2. Bolck transpeptidase cross-linking of cell wall 3. Activate autolytic enzymes NOT penicillinase resistant PenG (IV) PenV (oral) |
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Penicillin Use
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Gram (+) Rods and Cocci
Gram (-) Cocci (DOC are aminoglycosides and if sensitivity use aztreonam) Spirochetes (SYPHILIS) |
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Penicillin Tox
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Hypersensitivity reaction
Hemolytic anemia |
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Penicillinase Resistant Penicillins
(Names and MOA) |
Cloxicillin, Oxicillin, Nafcillin, Dicloxacillin, Methicillin
Penicillinase-resistant (bulky 'R' group) |
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Penicillinase Resistant Penicillins Use
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S. aureus (except MRSA-resistant d/t altered PBP)
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Penicillinase Resistant Penicillins Tox
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Hypersensitivity reactions
Methicillin-interstitial nephritis |
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Aminopenicillins (names and MOA)
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Ampicillin, Amoxicillin
Wider spectrum than penicillin Combine with Clavulanic acid (penicillinase inhibitor) |
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Aminopenicillin Use
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HELPS kill Enterococci
H. influenzae, E.coli, Listeria monocytogenes, Proteus mirabilis, Salmonella, Enterococci |
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Aminopenicillin Tox
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Ampicillin Rash (seen if given to patient with mono), Pseudomembranous colitis, Hypersensitivity reaction
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Drugs that cause Pseudomembranous colitis
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Ampicillin, Amoxicillin, Clindamycin
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Treat Pseudomembranous colitis
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Metronidazole, Vancomycin
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Antipseudomonal penicillins (names)
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Ticarcillin, Carbenicillin, Piperacillin
(carboxypenicillins) Extended spectrum Susceptible to penicillinase use with clavulanic acid |
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Antipseudomonal penicillins Use
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Pseudomonas, Gram (-) rods,
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Antipseudomonal penicillins Tox
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hypersensitivity reaction
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How to become resistant to Beta-lactam antibiotics
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1. alter beta lactam targets (PBP)
2. hydrolysis of beta lactam ring 3. bacterial beta lactamase (produced by Gram (-) rods and found in periplasmic space) |
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Penicillinase resistant antibiotics
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Cover Gram (+)
1. cephalosporins 2.Cloxicillin 3.Oxacillin 4.Nafcillin 5.Dicloxacillin 6.Methicillin |
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Cephalosporins MOA
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Beta lactam drugs. Inhibit cell wall synthesis. Less susceptible to penicillinase
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1st Generation Names
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Cefazolin, Cephalexin
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1st Generation Use
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Gram (+), Proteus, E.coli, Klebsiella pneumoniae (PEcK)
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2nd Generation Names
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Cefoxitin, Cefaclor, Cefuroxime
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2nd Generation Use
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Gram (+) cocci, H. influenzae, Enterobacter, Neisseria, Proteus, E. coli, Klebsiella pneumoniae, Serratia marcescens ( HEN PEcKS)
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3rd Generation Names
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ceftriaxone, cefotaxime, ceftazidime
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3rd Generation Use
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serious Gram(-) infections resistant to other beta-lactams, Meningitis because Penetrate BBB
Ceftazidime: Pseudomonas Ceftriaxone: gonorrhea (1 dose treatment is azithromycin) |
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4th Generation Names
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Cefepime
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4th Generation Use
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Increase activity against Pseudomonas , Gram(+) bacteria.
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CephalosporinsTox
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Hypersensitivity
Cross hypersensitivity with penicillin Increase Nephrotoxicity with aminoglycosides Disulfiram-like reaction with ethanol |
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Aztreonam MOA
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Binds PBP3
monobactam. resistant to beta-lactamase. Synergistic with aminoglycosides |
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Aztreonam Use
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Gram (-) rods: Klebsiella, Pseudomonas, Serratia
Patients with penicillin allergies or with renal insufficiency who can't tolerate aminoglycosides |
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Aztreonam Tox
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Usually none.
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Imipenem/cilastatin, Meropenem MOA
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broad spectrum.
Givewith cilastatin (inhibits renal dihydropeptidase I) to decrease deactivation in renal tubules |
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Imipenem/cilastatin, Meropenem Use
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Gram (+) cocci, Gram (-) rods, Anaerobes
DOC: ENTEROBACTER Life threatening infections (toxic) |
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Imipenem, Meropenem Tox
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CNS tox (seizures): Meropenem has less risk, GI distress, Skin Rash
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Vancomycin MOA
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inhibit cell wall mucopeptide formation by binding D-ala D-ala portion
Resistance with change of D-ala D-ala to D-ala D-lac |
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Vancomycin Use
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Pseudomembranous colits (C.dif),
MRSA, serious gram (+) multidrug resistant bacteria |
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Vancomycin Tox
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Nephrotoxic
Ototoxic Thrombophlebitis Red Man Syndrome: Flushing (prevent by pretreating with antihistamine and by slow infusion) |
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Aminoglycosides MOA
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Gentamycin, Neomycin, Amikacin, Tobramycin, Streptomycin (GNATS)
inhibit formation of initiation complex - misreading of mRNA Require O2 for uptake |
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Aminoglycosides Use
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Severe Gram (-) rods,
Neomycin: bowel surgery |
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Aminoglycosides Tox
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Nephrotoxic
Ototoxic Teratogenic (Neurotoxic to fetus) |
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Tetracycline MOA
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Tetracycline, Doxycycline, Demeclocycline, Minocycline
Binds 30S, prevent attachement of aminoacyl-tRNA Can't take with MILK, ANTACIDS, IRON-Containing preperations (inhibit its absorption in the gut) |
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Tetracycline Use
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Limited CNS penetration
V. cholerae, Acne (propionylbacteria), Chlamydia, Ureaplasma Urealyticum, Mycoplasma pneumoniae, Tularemia, H.pylori, Borrelia burgdorferi, Rickettsia VACUUM THe BedRoom |
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Tetracycline Tox
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Teeth discoloration, Inhibit Bone growth in kids (may affect cartilage), Photosensitivity, contraindicated in Pregnancy, Drug Induced Pancreatitis
Fanconi Syndrome (old tetracyclines) |
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Macrolides MOA
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Erythromycin, Azithromycin, Clarithromycin
Inhibit protein synthesis by blocking translocation Bind 23S rRNA of 50S |
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Macrolides Use
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URI, Pneumonias, STD (gram (+) cocci), Mycoplasma, Legionella, Chlamydia, Neisseria
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Macrolides Tox
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Prolonged QT, GI discomfort (MCC of noncompliance), Acute cholestatic hepatitis, eosinophilia, skin rashes. increases serum concentration of theophyllines, oral anticoagulants.
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Chloramphenicol MOA
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Inhibit 50S peptidyltransferase
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Chloramphenicol Use
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Meningitis (H.influenzae, Neisseria meningitidis, Streptococcus pneumoniae)
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Chloramphenicol Tox
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Anemia (dose dependent)
Aplastic Anemia (dose Independent) Gray Baby Syndrome (Premies bc lack liver UDP-glucuronyl transferase) |
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Clindamycin MOA
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Block peptide bond formation at 50S
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Clindamycin Use
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Anaerobes above the diaphragm
(Bacteroides fragilis, C. perfringens) |
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Clindamycin Tox
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Pseudomembranous colitis, fever, diarrhea
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Sulfonamides MOA
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Sulfamethoxazole, Sulfsoxazole, Sulfadiazine
PABA antimetabolites. Inhibit dihydropteroate synthetase |
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Sulfonamides Use
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Gram (+), Gram (-), Nocardia, Chlamydia.
Simple UTI's |
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Sulfonamides Tox
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Hypersensitivity reaction, Hemolysis if G6PD def., interstitial nephritis, photosensitivity, kernicterus in infants, displace other drugs from albumin
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Causes of Hemolysis in G6PD def patients
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1. fava beans
2. Sulfa drugs 3. Methotrexate 4.Primaquine 5.Anti-Tb drugs 6.Infections (generation of free radicals) |
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Trimethoprim MOA
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inhibit dihydrofolate reductase
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Trimethoprim Use
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in combo with SMX
Recurrent UTI, Shigella, Salmonella, PJP |
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Trimethoprim Tox
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Megaloblastic Anemia, leukopenia, granulocytopenia
rescue with supplemental folinic acid |
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Fluoroquinolones MOA
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Ciprofloxacin, Norfloxacin, Ofloxacin, Moxifloxacin, Gatifloxacin, Nalidixic acid (quinolone)
Inhibit DNA gyrase (topoisomerase II) Must not be taken with antacids |
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Fluoroquinolones Use
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Gram (-) rods of urinary and GI (include pseudomonas), Neisseria, Some Gram(+)
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Fluoroquinolone Tox
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GI upset, Superinfection, Skin rash, headache, dizzy.
Damage cartilage so CI in pregnancy and kids. Tendonitis and tendon rupture (adults) leg cramps and myalgia (kids) Moxifloxacin: Torsades Gatifloxacin: hypoglycemia |
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Metronidazole MOA
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Toxic metabolits in bacterial cell that damage DNA
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Metronidazole Use
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GET GAP
Giardia,Entamoeba,Trichoonas, Gardnerella vaginalis,Anaerobes, Pseudomembranous colitis, H.pylori (with amocillin/tetracycline,omeprazole) |
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Metronidazole Tox
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Disulfiram-like reaction with alchole, headache, metallic taste, drug induced pancreatitis
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Polymyxin MOA
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Bind cell membrane of bacteria and disrupt osmotic properties.
Act like detergents |
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Polymyxin Use
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Resistant Gram (-) infections
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Polymyxin Tox
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Neurotoxic, ATN
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Anti-Tb Drugs
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Rifampin, INH, Pyrazinamide, Ethambutol, Streptomycin
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Ethambutol Side Effect
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Optic neuropaty (red-green color blindness)
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Pyrazinamide Side Effects
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Hepatotoxic
Increased Uric acid SLE |
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INH MOA
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Decrease synthesis of mycolic acid
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INH Use
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M. Tb
Only agent as solo prophylaxis against Tb |
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INH Tox
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Neurotoxic, Hepatotoxic, Induces pyridoxine deficiency. Give Vit B6 to prevent neurotoxic
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Rifampin MOA
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Inhibit DNA dependent RNA polymerase
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Rifampin Use
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M. Tb
Delays resistance to dapsone when used for leprosy Meningococcal prophylaxis and chemoprophylaxis in contacts of kids with HIB |
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Rifampin Tox
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Minor hepatotoxic, Induce P-450, Orange body fluids
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Treatment of VRE
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Linezolid and streptogramins
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