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Beta Lactam Drugs
- most common
- diverse
- bactericidal
- inhibits synthesis of peptidoglycan
Penicillin- Natural
Gram positive spectrum
Penicillin- penicillinase resistant
- Gram positives
- adds side chain
- methilicillin, oxacillin
Penicillin- Extended spectrum
- Gram positive and negative
- amoxicillin, ampicillin
Penicillin Co-drugs
Combination of b-lactam with b-lactamase inhibitor
- augmentin
Cephalosporins
resemble penicillin but can withstand b-lactamase
- can be modified
Cephalosporin 4th and 5th generation
affect both Gram positive and negative
Monobactams
- gram negative
- aztreonam
Carbapenems
- similar to third gen cephalosporin
- imipenem
Cell wall targets have no
side effects because human cells lack cell walls
Cell membrane inhibitors
- create leakage
- topical use
- bacitracin or polymyxins
Glycopeptides
interfere with cross-linking in peptidoglycan chains
- G+
- Vancomycin
Fosfomycin
- stops cell wall synthesis
- UTIs
- not for children
Quinolones
- inhibit DNA gyrase
- Nalidixic acid for UTIs
- fluoroquinolones for broader spectrum
Sulfonamides
- inhibit folic aicd
- UTIs
- photosensitive and forms sulfa crystals
Nitrofurantoin
- interferes with enzyme and protein synthesis
- UTIs
- Proteus is resistant
Rifampin
- inhibits RNA polymerase
- treats TB
- causes discoloration (red orange)
Flagyl (metronidazole)
- prevents synthesis of nucleic acids
- anaerobes
- parasites (Trichomonas)
Aminoglycosides
- interfere with 30s ribosome
- oto and nephro toxic
- for serious Gram +
- inpatient drug to monitor peaks and troughs
Tetracycline
- interfere with 30s ribosome subunit
- broad spectrum
- photosensitive
- deposits in bone and teeth
- decrease normal flora= secondary infection
Macrolides
- interfere with 50s subunit
- older= G+; new= broad
- accumulate in WBCs for good for intracellular infections
- heart on liver, heart, and GI
Chloramphenicol
- interfere with 50s subunit
- only gram negative infections
- can cross blood brain barrier (meningitis)
- aplastic anemia and bone marrow aplasia (grey baby syndrome)