Antibacterial drugs

Beta-Lactam MOA

Beta lactams inhibits transpeptidase (its a PBP) (mimics D-ala-D-ala side chain) and prevents crossliking of the peptidoglycans and inhibit cell wall synthesis

Beta lactam post-antibiotic effect

can continue suppression fo antibacterial growth after aministration of antibiotic has stopped

Penicillan G (oral) and V (IV) MOA

Beta lactams

Penicillan G (oral) and V (IV) clinical use

broad spectrum Gram +, Strep pneumo, Strep pyogenes, limited Gram -: Nisseria Menigitis, Spirochete Treponema pallidum

Amoxicillan/Ampicillin MOA

Beta lactams

Amoxicillan/Ampicillin Clinical Use

Broad spectrum Gram + and -:

-H. Flu, E.Coli, Salmonella, Listeria, Proteus, Enterococci

What Beta-lactamase inhibitor do you add to amoxixillin/ampicillin to combact resistance

CLAVULANIC ACID

Nafcillin has what MOA

Beta lactams

Nafcillin clinical Use

Narrow spectrum. MSSA

Piperacillin MOA

Beta lactams

Piperacillin Clinical Use

Broad spectrum. For Pseudonomas

What B-lactamase inhibitor do you pair with Piperacillin

Tazobactam. It protects against degradation

AE of Penicillin

Allergic reaction, contraindicated to anyone allergic to any b-lactam antibiotic.

AE of Naficillin

allergic nephritis

AE of amoxilicillin and ampicillin

GI: diarrhea, vomiting, nausea

Colitis

Imipenem-Carbapenems MOA

beta lactams with broader spectrum d/t sterochemistry and R group position

What generation Cephalosporin is Cefazolin and Cephalexin?

first generation

What generation Cephalosporin is CEFOTAXIME,CEFTAZIDIME, CEFTRIAXONE

3rd gen

Which generation cephalosporin has a wider sprectrum of activity

3rd

What is the MOA of the cephalosporins

Beta-lactams

Imipenem-Carbapenems clinical use

broad spectrum covers most G+ and G- and anaerobes, HELD AS RESERVE TX

1st gen cephalosporins clinical use (cefazolin/cephalexin)

G+ cocci (e.g. Staph and Strep)• G- (E. coli, Proteus mirabilis)

3rd gen cephalosporins clinical use CEFOTAXIME, CEFTAZIDIME, CEFTRIAXONE

-G- (Enterobacter, Serratia, Neisseria gonorrhoeae)

-Pseudomonas

-Meningitis

Aztreonam MOA

its a Monobactam Beta lactam: single ring thats specific for only Gram - aerobes

Aztreonam clinical use

G- aerobes only (aerobic forms of Enterobacter, Pseudomonas)OK for patients with penicillin allergy

AEs of ceftriaxone

billiary sludging

What drugs are Fluoroquinolones (2)

Ciprofolxacin and Levofloxacin

What is a Quniolone's MOA

They are bacterialcidal! they target/inhibit bacterial topoismoerases (gram+ topo IV/Gram - topo II)which increases supercoiling: disrupting DNA/RNA replication/repair/transcription

Clinical use of fluoroquinolones

-UTIs and GI tract infections caused by G- rods (Pseudomonas/ETEC)

-Chlamydial cervicitis/urethritis

-Bacillus anthracis (G+) infections

-streptococcus pneumoniae (G+) with high-level penicillin resistance

fluoroquinolones AEs

-Metals chelate quinolones and blocks their absorption (mg+, iron)

-GI: vomit, nausea, anorexia

CNS: peripheral neuropathy

Heart: prolongs QTc interval

-Tendonitis

Contraindication for Quinolones

avoid in childres/ preg women because they disrupt growing cartilage

What are all the drugs for UTIs (4)

-fluoroquinoloes

-Nitrofuratoin

-Sulfonamides

- TMP/SMX (trimethoprim/sulfamethaozaole)

Nitrofuratoin MOA

produces lots of free radicals in bacteria to kill them ->Bacterialcidal

Nitrofuratoin AE

pulmonary toxicity

TMP/SMX MOA

Bactericidal. Inhibits folic acid synthesis and inhibits bacterial synthesis of dihydrofolic acid. Stops purine synth-Bacteria cannot make DNA/RNA

TMP/SMX AEs and contraindications

Contra: avoid in preg women as there is risk of bilirubin displacement

AE: allergic rxns in ppl with G6PD deficiency

-megaloblastic anemia

TMP/SMX clinical use

recurrent UTIs and acute chronic broncitis

Protein Synthesis Inhibitors- Macrolide Antibiotics Drugs (3)

Azithromycin

Clarithromycin

Erythromycin

Macrolide Antibiotics Drugs MOA

Bacteriostatic.

-Inhibit translation of RNA to protein

-Bond to 50s to inhibit trnaslocation

Macrolide clinical use

-accumulate in Gram + and human macrophage (Listeria)

-azithromycin is used for gram -

-legionella, H.flu, Chlamydia, bronchitis, otisis media, mycobacterium avium complex, mycoplasma pneumonia, C.diffe

Macrolide contraindications/AEs

-hepatic impairement

-POTENT INHIBITOR OF CYTOCHROME P450

-GI: nuasea, vom, diarrhea

-cardio: caution w/ pts. prolongs QT

Protein Synthesis Inhibitors- Tetracyclines drugs (1)

doxyclycline

Tetracycline MOA

-Bacteriostatic

-Binds to 30s, blocks binding of aminoacyl tRNA

-Inhibits translation of RNA to protein

Tetracycline(doxy) drug interactions

Antacids: Al, Ca+, Mg+

Iron salts: Fe+

Tetracycline(doxy) AEs/Contrindications

Photosensitivity, GI-GERD

-Contraindication: Preg/Kids bc it binds to bones and teeth

Tetracycline(doxy) Clinical Use

-Brain abscesses (Fragilis/Strep)

- Meningitis (h.flu, N.Men)

-Ricketssia

-Bacterial conjunct

Protein Synthesis Inhibitors- Others (2)

-Chrolramphenicol

-Clindamycin

Chrolramphenicol MOA

Bacteriostatic. its a protein sytnhesis inhibitor (other), it stops the translation of RNA to protein. Esp. mitochondrial protein synthesis

Clindamycin MOA

Bacteriostatic. its a protein sytnhesis inhibitor (other), it stops the translation of RNA to protein. Inhibits 50s ribosome

Chrolramphenicol AEs

-Bone marrow supression

-Grey baby Syndrome (baby will OD=grey bc they cant metabolize drug)

-Drug interactions with Cyt p450

-Ihibits Clindamycin and Erythromycin

Clindamycin clinical use

-Anaerboic Gram - bacilli

-Aerobic Gram + cocci

-Acne

Clindamycin AEs/Contraindications

-GI: diarrhea

-Inhibits Chloramphenicol and macrolides (same 50s)

-inhibits drugs for c.diff like metronidazole

Aminoglycosides (4)

-Gentamycin

-Streptomycin

-Neomycin

-Tobramycin

Aminoglycosides MOA

Bactericidal. Bind to the rRNA of 30s unit; blocks translation initiation anad causes mis coded proteins, also blocks translocation

Aminoglycosides Clinical Use

-Only for Aerobic bacteria

-Gram - aerobics: Enterobacter, Proteus, Klebsiella

-Gram + Aerobics: Strep Viridins, Strep. agalact, Enterococcus

-Mycobacterium, N.Gonorrhoeae

Aminoglycosides AEs

-Nephrotox

-Ototox

Neuromuscular blockade-MG