Antimicrobial drugs (bacteria, fungal, and malaria)

penicillin

inhibits cell wall synthesis leading to cell death

penicillin

used for infection by gram + bacteria

penicillin adverse effects

allergic reactions

penicillin resistance

Genes that code for beta-lactamases can be
transferred from one bacterium to another; Beta-lactamases that specifically inhibit penicillin molecules are called penicillinases

drugs used to treat penicillin resistance

zosyn, cephalosporins, primaxin, vancomycin

zosyn moa

Tazobactam protects piperacillin from degradation
by beta-lactamases

zosyn adverse effects

allergic reactions

cephalosporins

cefazolin, cefepime, and ceftaroline

cefazolin indication

surgical prophylaxis

cefepime indication

resistant organisms

ceftaroline indications

skin infections and HCAP

adverse effects of cephalosporins

allergic reactions, bleeding tendencies, toxic with alcohol

primaxin moa

binds specifically to penicillin-Binding Protein (found in bacterial cell
membrane) to weaken cell wall and can resist beta-lactamases

primaxin combined with cilastatin to

inhibit renal degradation

adverse effects primaxin

GI effects NVD, seizures w/ renal impairment, superinfections

vancomycin moa

inhibits cell wall synthesis by binding to
molecules that serve as precursors for cell wall
biosynthesis

adverse effects vancomycin

nephrotoxicity, ototoxicity, red man syndrome, VRE

doxycycline moa

inhibit binding of transfer RNA to mRNA to inhibit protein synthesis

indications doxycycline

broad spectrum against gram + and - organisms

doxycycline advers effects

GI effects NVD, bone growth supression, teeth discoloration, fatty liver, renal impairment, superinfections, photosensitivity

erythromycin moa

block addition of new amino acids to growing
peptide chain

erythromycin indications

most gram + and some gram -

adverse effects erythromycin

GI NVD, QT prolongation, hepatotoxicity, ototoxicity

clindamycin moa

block addition of new amino acids to
growing peptide chain

clindamycin indications

gram + and gram -

adverse effects clindamycin

severe to fatal c. diff

linezolid moa

block formation of initiation
complex

adverse effects linezolid

headache, NVD, myelosupression, optic and peripheral neuropathy

gentamicin moa

inhibition protein
synthesis, premature termination of protein
synthesis, and production of abnormal proteins

adverse effects gentamicin

nephrotoxicity, ototoxicity

ciprofloxacin

inhibits two enzymes needed for DNA replication and cell division

adverse effects ciprofloxacin

CNS effects, tendon rupture (achilles), QT prolongation, phototoxicity, NVD

metronidazole moa

breakage and loss of helical structure that
result in inhibition of nucleic acid synthesis and cell death

adverse effects metronidazole

GI NVD, dry mouth & fatigue, neutropenia, thrombocytopenia, med interactions cause toxicity

daptomycin moa

efflux of intracellular potassium to

depolarize the cell

inhibit synthesis of DNA, RNA, and protein to

cause cell death

adverse effects of daptomycin

GI NVD, myopathy, hypo & hypertension

bactrim moa

inhibit tetrahydrofolate synthesis that is
needed to make DNA, RNA, & proteins

adverse effects bactrim

Sulfonamide AE

■ Photo- & hypersensitivity reactions, including

SJS/TENS

■ Hemolytic anemia

■ Kernicterus in newborns

■ Renal damage from crystalline aggregates

○ Trimethoprim AE

■ Megaloblastic anemia

■ Hyperkalemia

nitrofurantoin moa

inhibition of protein, DNA, RNA, &
protein synthesis, as well as energy metabolism

adverse effects nitrofurantoin

NVD, dyspnea, cough, malaise, agranulocytosis, leukopenia, thrombocytopenia, megaloblastic anemia

anti fungals

amphotericin, itraconazole, nystatin

anti fungal moa

Bind to components of fungal cell membrane to

increase permeability, with resultant leakage leading to

reduced viability

amphotericin adverse effects

infusion reactions, dysrhythmias, nephrotoxicity/hyperkalemia

itraconazole adverse effects

NVD, cardiac suppression, liver injury

nystatin adverse effects

NVD, urticaria & rash

malaria drugs

chloroquine & artesunate

chloroquine moa

Prevents conversion of heme to nontoxic

metabolites

○ Concentrates heme in parasitized

erythrocytes to produce lethal effect

adverse effects chloroquine

GI NV, visual disturbances, pruritis

artesunate moa

reactive oxygen species

○ Damages Parasite Proteins and Membranes

○ Leads to rapid clearance of parasitized erythrocytes

artesunate adverse effects

delayed hemolytic anemia, elevated liver enzymes, hypotension, bradycardia, allergic reaction