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27 Cards in this Set
- Front
- Back
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Ciprofloxacin
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quinolone
gram (-) high PO bioavail variety infections: UTI; pneumonia; bronchitis; gonorrhea; infections caused by pseudomonas |
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Levofloxacin
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quinolone
RTI (pseudomonas more susceptible to levo) -- tx: UTI; pneumonia; bronchitis; |
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Drugs tx:
1. UTI 2. Gonorrhea |
1. Cipro; levo; lomefloxacin; ofloxacin
2. cipro; gatifloxacin; ofloxacin |
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quinolones MoA?
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inhibits DNA gyrase
- impt in bacteria DNA/ RNA replication; |
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Tetracyclines
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prototypical -- inhibit protein synthesis
gram + - bacteria due to resistance --> second line agent |
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Sulfonamides
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bacteriostatic
inhibit folate synthesis by: inhibiting dihydropteroate synthase |
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Trimethoprim
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bacteriostatic
inhibits folate synthesis by: inhibiting dihydrofolate reductase synergistic effects with sulfamethoxazole (not a sulfonamide) |
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macrolides overall
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contains large lactone ring
binds to 30S ribosome - inhibits protein synthesis used in tx Upper & Lower RTI caused by gram positive |
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Erythromycin
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macrolide
unstable under acid environmnet need to be given enteric coat |
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Clarithromycin
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macrolide
replace OH at C-6 w/ CH3OH better tolerability in acid condition |
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Azithromycin
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macrolide
greatest stability & long t1/2 strong gram - AND + activity (unlike eryth & clarith) |
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Carbenicillin (Geocillin)
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carboxypenicillins
- broad spectrum penicillins - incr hydrophilicity with add't of alpha carboxyl group - acid labile; readily decarboxylate -- hence given as prodrug |
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ticarcillin
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slight higher DoA than carbenicillin
has b-lactamase inhibitor attached |
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ureidopenicillilns
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active against klebsiella species
not stable in stomach acid = do not give PO ie: zosyn (piperacillin); used to tx serious pneumonia, peritonitis, diabetic foot infections |
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amoxicillin
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acid stable aminopenicillins
similar structure to ampicillin most common - tx UTI; ear/strep infections Oral BIO incr w/ OH group |
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methicillin & nafcillin
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used in staph infections that are resistant to pen G
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oxacillins
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used in infections caused by staph resistnat to penG
steric hindrance prevents lactamase action NOT taken w/ food - decr absorption |
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cephalosporin
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bicyclic - b-lactam & 6membered dihydrothiazine ring
problem: acid hydrolysis of OAc group -- prevents PO admin High resistance against Gram+ lactamases --> OCH3 sub at C7 --> cephamycin class |
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cephalexins
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mod spectrum
alpha amino group = acid stability similar to aminopenicilins (amoxil) Tx: UTIs due to minimal protein binding/renal excretion |
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Ceflaclor & loracarbef
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both have Cl at C-3
reduces acid sensitivity = can give PO used against flu infections |
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cephamycins: cefoxitin & cefotetan
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OCH3 at C7 - prx b-lactamase degradation
good against gram neg bacteria that are reistant to other cephalosporins |
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oxime cephalosporins --> add oxime group --> syn = more potent against b-lactamases
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Ex: cefotaxime; cefuroxime; ceftiraxone;
Cefuroxime: PO drug - UTIs Ceftriaxone: Respiratory infections; used w/ zpack for community pneumonia |
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Oxime / ammonium cephalos
ex: ceftazidime; cefepime; cefpirome |
oxime = incr potency
pyridinium group = better penetration into gram neg bacteria |
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AE of cephalosporins
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hypoprothrombinemia & severe bleeding prob
hypoprothrom = deficiency of prothrombin --> impaired clotting should be coadmin w/ vit K inhibits vit K req'd enzymes |
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monobactams
ex: axtreonam |
monocyclic beta lactam antibiotics
weak antibaterial but highly beta lactamase resistant due to 3OCH3 Axtreonam: broad G- bacteria; no activity against G+ or anaerobes; highly resistant to gram - lactamases |
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Carbapenems
Ex: theinamycin & meropenem |
similar to penicillin structure
broad spectrum: + and - Thienamycin --> very unstable Meropenem --> stable; ultra broad spec; given IV for serious infections |
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Imipenem
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another carbapenems
more potent in gram + than meropenem; must be given w/ cilatatin (dehydropeptidase inhibitor) |
