Pathopharm 2, Exam 1

Sulfonamides

One of the earliest classes of antibacterial agents

Beta-lactams

Penicillins

Cephalosporins

Carbapenems

Monobactams

penicillins

Group of antibiotics that are often used to treat infections by gram-positive bacteria.

Cephalosporins

• Semisynthetic antibiotics

• Structurally and

pharmacologically related

to penicillins

• Bactericidal action

• Broad spectrum

• Divided into groups according to

their antimicrobial activity

Cephalosporins 1st Generations

• Strong gram‑positive coverage

• Limited gram‑negative coverage

• Oral (PO) and parenteral forms

Common use: surgical prophylaxis, susceptible staphylococcal infections

Cephalosporins 1st Generation Drug Examples

Examples: cefazolin (IV/IM), cephalexin (PO)

Cephalosporins Second Generation

• Improved gram‑negative coverage compared to first generation

• Oral (PO) and parenteral forms

Common use: abdominal or colorectal surgical prophylaxis

Cefoxitin provides anaerobic coverage

Cephalosporins Second Generation Examples

Examples: cefaclor (PO), cefuroxime (IV/PO), cefoxitin (IV/IM)

Cephalosporins Third Generation

Broad gram‑negative coverage

• Less potent against gram‑positive organisms than earlier generations

• Commonly used for serious infections

• Ceftazidime → strong activity against Pseudomonas (though resistance is

increasing)

Cephalosporins Third Generation Examples

Examples: cefotaxime, ceftazidime, cefdinir, ceftriaxone

Cephalosporins Fourth Generation

- Very broad spectrum

• Strong gram‑positive and gram‑negative coverage

• Used for severe or resistant infections

• Common use: complicated UTIs and serious hospital‑acquired infections

Cephalosporins Fourth Generation examples

Example: cefepime (Maxipime)

Cephalosporins Fifth Generation

• Broad spectrum activity

• Strong gram‑positive coverage, including MRSA

• Retains gram‑negative coverage (but not Pseudomonas with all agents)

Cephalosporins Fifth Generation examples

* Ceftaroline (Teflaro)

• Effective against MRSA

Carbapenems

Broadest spectrum of antibacterial activity

Beta‑lactam antibiotics

Reserved for severe or resistant infections

Primarily used in hospitalized or critically ill patients

Carbapenems examples

• Imipenem/cilastatin (Primaxin)

• Meropenem (Merrem)

• Ertapenem (Invanz)

• Doripenem (Doribax)

• Imipenem/relebactam (Recarbrio)

Carbapenems adverse effects

Diarrhea, nausea, rashes, thrombophlebitis at injection sites, seizures, administer over 60 minutes

Monobactams

Aztreonam - narrow-spectrum drug for infections by gram-negative aerobic bacilli; may be used by people allergic to penicillin

Monobactams route

IV, IM

Macrolides

prevent protein synthesis within bacterial cells,

Macrolides examples

• erythromycin (E-mycin, E.E.S,

others)

• azithromycin (Zithromax)

• clarithromycin (Biaxin)

• fidaxomicin (Dificid, Dificlir)

Macrolides Indications

-Strep infections

-Mild to moderate upper and lower respiratory tract infections

-Spirochetal infections

-Gonorrhea, Chlamydia, Mycoplasma

Tetracyclines

Bacteriostatic - Inhibit protein synthesis and bacterial growth

Stop many essential functions of the bacteria

Tetracycline examples

• demeclocycline

• oxytetracycline

• tetracycline

• doxycycline

• minocycline

• tigecycline

Multidrug-resistant organisms

• Methicillin-resistant Staphylococcus aureus (MRSA)

• Vancomycin-resistant Enterococcus (VRE)

• Organisms producing extended-spectrum beta-lactamases (ESBLs)

• Carbapenem-resistant Enterobacteriaceae

(CRE)

Aminoglycosides

Poor oral absorption; no oral forms

(exception: neomycin)

Very potent antibiotics with serious

toxicities

Bactericidal; prevent protein

synthesis

Aminoglycosides indications

Used to kill gram-negative bacteria and certain resistant gram-positive

bacteria

Often used in combination with other antibiotics for synergistic effects

(i.e., vancomycin)

Used for certain gram-positive infections that are resistant to other

antibiotics

neomycin

• Given orally to decontaminate the GI tract before surgical procedures

• Also used as an enema for this purpose

• Used to treat hepatic encephalopathy

Aminoglycosides adverse effects

• Nephrotoxicity (i.e., renal damage)

• Ototoxicity (i.e., auditory impairment

and vestibular impairment)

Quinolones and fluoroquinolones (floxacin)

• Ciprofloxacin (i.e., Cipro)

• Norfloxacin (i.e., Noroxin)

• Levofloxacin (i.e., Levaquin)

• Moxifloxacin (i.e., Avelox)

• Gemifloxacin (i.e., Factive)

• Delafloxacin (i.e., Baxdela

cillin

Penicillins Beta lactam antibiotics

-cef or ceph

Cephalosporins Beta lactam antibiotics

-penem

Carbapenems Broad spectrum beta lactams

-mycin

Macrolides such as azithromycin and erythromycin

-cycline

Tetracyclines such as doxycycline and minocycline

-floxacin

Fluoroquinolones such as ciprofloxacin and levofloxacin

-azole

Azole antifungals such as fluconazole and ketoconazole

-navir

Protease inhibitors for HIV treatment

-vir

General antivirals such as acyclovir and oseltamivir

-tidine

H2 receptor blockers used for stomach acid conditions

-prazole

Proton pump inhibitors used for acid suppression

-sulfa

Sulfonamide antibiotics like TMP SMX

-azole

antiparasitic Imidazole type antiparasitics like metronidazole

-ectin

Antiparasitics like ivermectin

-bactam

Beta lactamase inhibitors

-mivir

Neuraminidase inhibitors for influenza like oseltamivir

Amoxicillin

Penicillin antibiotic used for bacterial infections

Ceftriaxone

Cephalosporin antibiotic given by injection

Azithromycin

Macrolide antibiotic used for respiratory infections

Doxycycline

Tetracycline antibiotic used for acne and tick borne illness

Vancomycin

Glycopeptide antibiotic used for MRSA and C difficile

Metronidazole

Antibiotic and antiparasitic that treats anaerobes and causes reaction with alcohol

Rifampin

Rifamycin TB drug that turns body fluids orange

Isoniazid

TB drug that may cause nerve damage if not taken with vitamin B6

Oseltamivir

Antiviral for flu that must be started early

Acyclovir

Antiviral for herpes and shingles that can affect kidneys

Fluconazole

Azole antifungal used for thrush and yeast infections

Amphotericin B

Potent antifungal that damages kidneys and causes electrolyte loss

Nitrofurantoin

Urinary antibiotic used for bladder infections

TMP SMX

Bactrim Sulfonamide antibiotic used for UTIs and skin infections

Albendazole

Antiparasitic that kills worms by blocking energy

Praziquantel

Antiparasitic that paralyzes tapeworms and flukes

Ganciclovir

Antiviral for CMV that may suppress bone marrow

Penicillins

Inhibit bacterial cell wall and cause bacterial death

Cephalosporins

Block bacterial cell wall formation like penicillins

Macrolides

Stop bacterial protein production by binding to ribosomes

Tetracyclines

Block protein synthesis by interfering with tRNA

Sulfonamides

Block folic acid synthesis in bacteria

Aminoglycosides

Disrupt bacterial protein synthesis and are toxic to kidneys and ears

Fluoroquinolones

Inhibit DNA replication in bacteria

Glycopeptides

Inhibit cell wall formation by binding to building blocks

Nitroimidazoles

Disrupt DNA in bacteria and parasites like metronidazole

Azole antifungals

Block ergosterol synthesis in fungal cell membranes

Polyenes

Bind to ergosterol and cause fungal cell death

Anthelmintics

Paralyze or starve worms by disrupting their metabolism

Neuraminidase inhibitors

Block flu virus from leaving infected cells

Nucleoside analog antivirals

Mimic DNA pieces to stop virus from copying itself

Rifamycins

Block bacterial RNA synthesis and protein production

Direct acting antivirals for Hep C

Block enzymes that allow hepatitis C to multiply

Which medication can cause orange or red body fluids

Rifampin (Antituberculosis)

Which medication must be taken with Vitamin B6 to prevent nerve damage

Isoniazid (Antituberculosis)

Which antibiotic can cause kidney damage and hearing loss if not monitored

Vancomycin (Glycopeptide antibiotic)

Which medication should not be taken with alcohol due to risk of vomiting and flushing

Metronidazole (Antibiotic and antiparasitic)

Which antifungal requires kidney monitoring due to high toxicity

Amphotericin B (Polyene antifungal)

Which antiviral can cause kidney damage if not taken with enough water

Acyclovir (Antiviral for herpes and shingles)

Which antibiotic is dangerous in patients with sulfa allergy

TMP SMX Bactrim (Sulfonamide antibiotic)

Which antifungal can damage the liver and requires liver function tests

Fluconazole (Azole antifungal)

Which medication used for bladder infections may turn urine dark brown

Nitrofurantoin (Urinary antibiotic)

Which TB drug can cause liver damage and should be monitored with LFTs

Isoniazid (Antituberculosis)

Which antiparasitic is used for tapeworms and may cause dizziness and GI upset

Praziquantel (Anthelmintic)

Which flu medication works best within 48 hours and may cause nausea

Oseltamivir (Antiviral for influenza)

Amoxicillin (uh-MOX-ih-sill-in)

Penicillin antibiotic

Ceftriaxone (sef-try-AX-own)

Cephalosporin antibiotic

Azithromycin (ay-zith-ROW-my-sin)

Macrolide antibiotic

Doxycycline (dox-ee-SIGH-kleen)

Tetracycline antibiotic

Vancomycin (van-koe-MY-sin)

Glycopeptide antibiotic

Metronidazole (met-troh-NID-uh-zole)

Nitroimidazole antibiotic and antiparasitic

Rifampin (RIF-am-pin)

Rifamycin class tuberculosis drug

Isoniazid (eye-so-NYE-uh-zid)

Antituberculosis medication

Oseltamivir (oh-sell-TAM-ih-veer)

Neuraminidase inhibitor antiviral