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72 Cards in this Set
- Front
- Back
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MOA of Penicillins
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Interact with PBPs to inhibit transpeptidation rxns
Activates autolysis enzymes |
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Mechanism of resistance for Penicillins
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Beta lactamases
Structural change in PBPs Change in porin structure |
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What penicillin can be used to treat Treponema pallidum?
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Pen G/V
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What penicillin can be used to treat Listeria monocytogenes?
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Ampicillin
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Anti-pseudomonal penicillins
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Piperacillin, Ticarcillin, Azlocillin
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Anti-staph penicillins
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Nafcillin, Oxacillin, Methicillin
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Beta lactamase inhibitors
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Clavulanic acid
Sulbactam Tazobactam |
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How are penicillins eliminated?
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Via active tubular secretion
(inhibited by probenecid) |
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What generation of cephs
-cefazolin -cephalexin and what are they used for |
1st generation
narrow spectrum - G+ cocci, E.coli, Klebsiella pneumo, Proteus None enter CNS |
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What generation cephs
-cefotetan -cefaclor -cefuroxime -cefamandole what are they used for |
2nd generation
Broad spectrum (some G-) None enter CNS except cefuroxime |
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What generation cephs
-ceftriaxone -cefotaxime -cefdinir -cefixime what are they used for |
3rd generation
very broad spectrum Most enter CNS **important in empiric management of meningitis |
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what generation ceph
-cefepime |
4th generation
wide spectrum resistant to most B-lactamases Enters CNS |
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What cephalosporins are eliminated in the bile?
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Ceftriaxone
Cefoperazone |
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orgnaisms not covered by cephalosporins are LAME
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Listeria monocytogens
-Amp + Gent Atypicals (Chlamydia, Mycoplasma) -Tets or Macs MRS -Vanco Enterococci -Ampt +/- Gent |
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What kind of spectrum to the
-penems have? Imipenem, Meropenem, Ertapenem |
Very broad
Broadest spectrum of the antibiotics Resistant to B-lactamases |
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What are the -penems used for
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Empiric use in severe life threatening infections
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What abx is always given with cilastatin?
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Impipenem
Cilastatin inhibits impipenem's metabolism to a nephrotoxic metabolite |
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Important side effect of impipenem
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Seizures
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Aztreonam
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Resistant to B-lactamases
G- rods (NO G+) NO CROSS ALLERGENICITY with pens or cephs |
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What is the MOA of Vancomycin
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binds to the D-ala-D-ala muramyl pentapeptide
-involved in elongation of peptidoglycan chain |
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Spectrum of Vancomycin
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MRSA
Enterococci C. difficile (back up to metronidazole) |
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Side effects of Vancomycin
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Red Man Syndrome
-due to histamine release -upper parts of body flush Ototoxicity (usually permanent) Nephrotoxic |
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What do aminoglycosides bind to?
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30S
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What do aminoglycosides require?
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Oxygen!!
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What are the following abx:
gentamicin tobramycin amikacin streptomycin neomycin |
Aminoglycosides
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What are the major side effects of aminoglycodes?
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Nephrotoxicity
Ototoxicity Neuromuscular blockade -may enhance effects of skeleta muscle relaxants |
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What is the MOA of tetracyclines
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Bind to 30S
Block the attachment of aminoacyl tRNA to acceptor site Bacteriostatic |
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Doxycyline, Minocycline, Demeclocyline and Tigecycline are what kind of abx?
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Tetracyclines
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What organisms are tetracyclines used for?
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Chlamydia
Mycoplasma Rickettsia Borrelia burgorferi **Tets for ticks** |
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What is a specific use for demeclocycline
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SIADH
-blocks the V2 receptors |
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Side effects of tetracyclines
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Tooth enamel dysplasia
decrease bone growth in children Phototoxicity Have caused liver dysfunction in pregnancy |
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Tetracyclines are chelators, which means..
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You must avoid taking them with antacids, milk and aluminum!!!!
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What is the MOA of Chloramphenicol?
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Binds to 50S
Inhibit the activity of peptidyltransferase bacteriostatic |
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How is chloramphenicol metabolized?
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Hepatic glucuronidation
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Side effects of Chloramphenicol
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bone marrow suppression
Gray baby syndrome -due to decrease glucuronosyl transferase |
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What is Chloramphenicol used for?
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Back up drug for infections due to:
-Salmonella typhi -B. fragilis -**Rickettsia** |
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MOA of Macrolides
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Bind to 50S
Inhibit translocation of peptidyl tRNA from acceptor to donor site bacteriostatic |
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Azithromycin
Clarithromycin Erythromycin |
Macrolides
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Macrolides are great for the treatment of what?
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Pneumonia
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Clinical uses of macrolides
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Chlamydia, Mycoplasma
Legionella pneumophila Campylobacter jejuni Mycobacterium avium (MAC) |
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Pharmacokinetics of macrolides
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Inhibit cytochrome P450
-but not azithromycin! |
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Side effects of macrolides
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Stimulate motilin receptors and stimulate GI activity
-esp with erythromycin |
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MOA of clindamycin
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Bind to 50S
Inhibit translocation of peptidyl tRNA from acceptor to donor site Bacteriostatic |
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What is the spectrum of Clindamycin
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Narrow spectrum
-G+ cocci -Anaerobes (including B. fragilis) |
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Side effects of clindamycin
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Pseudomembranous colitis
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MOA of linezolid
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Binds to 50S
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Spectrum of Linezolid
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Treatment of VRSA, VRE
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MOA of Quinupristin-Dalfopristin
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Bind to 50S
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Spectrum of Quinupristin-Dalfopristin
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Used parenterally in severe infections caused by VRSA and VRE
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What is the MOA of sulfonamides
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Inhibit dihydropteroate synthetase
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What is the MOA of Trimethoprim and pyrimethamine
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Inhibit dihydrofolate reductase
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Uses of TMP-SMX
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DOC in Nocardia
Listeria (backup) Pneumocystic jiroveci Toxoplasma gondii |
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Pharmacokinetics of sulfonamides
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High protein binding
-can lead to drug interactions and kernicterus in neonates |
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Side effects of sulfonamides
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Stevens-Johnson Syndrome
Hemolysis in G6PD deficiency Phototoxicity |
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Side effects of trimethoprim and pyrimethamine
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Bone marrow suppression
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MOA of the quinolones
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inhibit topoisomerase II (DNA gyrase) and topoisomerase IV
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Ciprofloxacin
Levofloxacin "-floxacins" |
Quinolones
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Clinical uses of "floxacins"
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UTIs
Chlamydia Drug resistant pneumococci -levofloxacine Bacillus anthracis |
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Pharmacokinetics of quinolones
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Iron and calcium limit their absoprtion
eliminated mainly by kidney -filtration and active secretion |
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Side effects of Quinolones
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Tendonitis, tendon rupture
Phototoxicity Contraindicated in children and pregnancy -inhibts chondrogenesis |
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What protozoans is metronidazole used for
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Giardia
Trichomonas Entamoeba |
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What bacteria is metronidazole used for
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Bacteroides
Clostridium -DOC in pseudomembranous colitis Garnerella |
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Side effects of metronidazole
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Disulfiram like effect
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MOA of isoniazid
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inhibits mycolic acid synethesis
-selective for mycobacterium Produrg requiring conversion by catalase |
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Side effects of Isoniazid
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Peripheral neuritis (use vitamin B6)
Sideroblastic anemia (use B6) SLE in slow acetylators |
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MOA of Rifampin
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inhibits DNA-dependent RNA polymerase
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Side effects of Rifampin
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Induction of P450
Red-orange metabolites |
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Side effects of Ethambutol
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Red-green colorblindness
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Side effects of pyrazinamide
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Hyperuricemia
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Side effects of Streptomycin
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Deafness
Nephrotoxicity |
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Prophylaxis for mycobacterium avium-intracellulare (MAC)
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azithromycin or clarithromycin
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Treaments for:
Treponema Gonorrhea Chlamydia Trichomonas Bacterial vaginosis Ticks |
Treponema: Pen G
Gonorrhea: Ceftriaxone Chlamydia: Azithromycin or Doxycycline Trichomonas: Metronidazole Bacterial vaginosis: Metro Ticks: Doxycycline |
