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25 Cards in this Set
- Front
- Back
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Name glycopeptide antibiotics |
Vancomycin, teicoplanin |
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Mechanism of action of glycopeptide antibiotics? |
They bind to the D-ala-D-ala residue of the substare for transpeptidation, inhibiting cell wall synthesis. |
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Which bacteria are glycopeptide antibiotics effective against? |
Gram positives. |
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Why is it beneficial that Vancomycin has poor oral absorption? |
The drug will remain in the GI-tract, making it good for treatment of resistant C. difficile |
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Adverse effects of vancomycin and teicoplanin? |
- Red man syndrome, where there is red flushing of the skin, dyspnea and hypotension due to mast cell degranulation and histamine release. This happens if the drug is given too fast. - Can increase nephrotoxicity of other nephrotoxic drugs like aminoglycosides or NSAIDs. |
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Clinical use of Vancomycin? |
- First-line treatment of MRSA - Second-line treatment of C.difficile colitis. |
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Name a lipopeptide antibiotic |
Daptomycin |
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What is the mechanism of action of daptomycin? |
It integrates into the cell membrane and increases the permeability. The bacterial cell will become depolarized due to ion efflux and die. |
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Why cant we treat pneumonia with Daptomycin? |
It gets inactivated by surfactant in the lungs |
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What is the clinical use of Daptomycin? |
Treatment of multiressistant bacteria like MRSA, VRE and VRSA. |
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What is the clinical use of Fosfomycin? |
It has wide spectrum. Used to treat MRSA, ESBL, VRE and uncomplicated UVIs where there is resistance against first-choice antibiotics. |
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How do we dose Fosfomycin? |
Often with a single dose of 3 g. |
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Clinical use of Bacitracin? |
Mostly used topically for skin infections. Never given systemically since its highly nephrotoxic. |
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Name some Polymixins |
Polymyxin B and Polymixin E/colistin |
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Mechanism of action of Polymixins? |
They kill bacteria by distrupting the structure of the outer cell membrane of gram negatives. |
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Clinical use of Polymixins? |
- Used topically - Systemically for severe gram-negative infections like pseudomonas |
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Why do we not use polymixins more often for treating pseudomonas? |
They can cause severe nephrotoxicity and neurotoxicity. |
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Mechanism of action of Gramicidins? |
Kill bacteria by forming ion channels in the membrane which destroys the ion gradient |
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Clinical use and adverse effects of Gramicidin? |
Used topically in eyes or as ear drops. It causes hemolysis of RBCs. |
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Name the important Nitroimidazoles |
Metronidazole, Tinidazole |
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Mechanism of action of Nitroimidazoles? |
They get reduced into reactive metabolites which bind to and damage DNA and proteins. The bacterial cell dies. |
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Which enzymes are inhibited by Nitroimidazoles? |
- CYP2CP - CYP3A4 - Aldehyde dehydrogenase (disulfiram-like effect when drinking alcohol) |
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Clinical use of Nitroimidazoles? |
- Metronidazole is first-line treatment in C. difficile colitis. - Trichomoniasis - Entamoeba histolytica infection - Giardia infection - Combined with clarithromycin and PPI against H. Pylori |
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Name Nitrofurans |
Nitrofuratoin |
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Clinical use of Nitrofuratoin? |
Treatment of uncomplicated cystitis and prophylaxis. |
