Micro 08
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| Penicillin G mechanism | penicillin β-lactam ring binds to and competitively inhibits transpeptidase --> transpeptidase can't cross link the repeating disaccharide units and peptides that make up the peptidoglycan layer --> bactericidal. Still works on Strep pneumoniae. Suscept
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| Ampicillin mechanism | Penicillin with more G- coverage. Penicillin β-lactam ring binds to and competitively inhibits transpeptidase --> transpeptidase can't cross link the repeating disaccharide units and peptides that make up the peptidoglycan layer --> bactericidal. Can st
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| Amoxicillin mechanism | Penicillin with more G- coverage. Penicillin β-lactam ring binds to and competitively inhibits transpeptidase --> transpeptidase can't cross link the repeating disaccharide units and peptides that make up the peptidoglycan layer --> bactericidal. Can st
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| Methicillin mechanism | Penicillin that is resistant to β-lactamase. IV. Penicillin β-lactam ring binds to and competitively inhibits transpeptidase --> transpeptidase can't cross link the repeating disaccharide units and peptides that make up the peptidoglycan layer --> bacter
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| Why is methicillin not used anymore? What to use instead? | Causes interstitial nephritis. Use nafcillin and oxacillin instead.
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| Nafcillin mechanism | Penicillin that is resistant to β-lactamase. IV. Penicillin β-lactam ring binds to and competitively inhibits transpeptidase --> transpeptidase can't cross link the repeating disaccharide units and peptides that make up the peptidoglycan layer --> bacter
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| Oxacillin mechanism | Penicillin that is resistant to β-lactamase. IV. Penicillin β-lactam ring binds to and competitively inhibits transpeptidase --> transpeptidase can't cross link the repeating disaccharide units and peptides that make up the peptidoglycan layer --> bacter
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| Cloxacillin mechanism | Penicillin that is resistant to β-lactamase. Oral. Penicillin β-lactam ring binds to and competitively inhibits transpeptidase --> transpeptidase can't cross link the repeating disaccharide units and peptides that make up the peptidoglycan layer --> bact
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| Dicloxacillin mechanism | Penicillin that is resistant to β-lactamase. Oral. Penicillin β-lactam ring binds to and competitively inhibits transpeptidase --> transpeptidase can't cross link the repeating disaccharide units and peptides that make up the peptidoglycan layer --> bact
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| Ticarcillin | Anti-pseudomonal penicillin. It takes James Bond to kill Pseudomonas with his CAR his TICk and his PIPE bomb.
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| Carbenicillin | Anti-pseudomonal penicillin. It takes Joames Bone to kill Pseudomonas with his CAR his TICk and his PIPE bomb.
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| Piperacillin | Anti-pseudomonal penicillin. It takes Joames Bone to kill Pseudomonas with his CAR his TICk and his PIPE bomb.
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| Name the β-lactamase inhibitors | Clavulanic acid, sulBACTAM, tazoBACTAM. BAC TAM CLAps when you inhibit the β-lactamases.
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| Clindamycin | G+ and anaerobes above the diaphragm
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| How is ampicillin different from amoxicillin? | AmOxicillin has great Oral bioavailability
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| Ampicillin and amoxicillin used on what organisms? | ampicillin and amoxicillin HELPS (+) kill enterococci. Haemophilus influenzae, E.coli, Listeria monocytogenes, Proteus, Salmonella, enterococci.
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| Penicillin used for…. | G = IV, V = oral, G+ rods and cocci, G- cocci, spirochetes, strep pneumoniae
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| Penicillin allergies: rash, hemolytic anemia | rash is Type I, anemia is Type II
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| Methicillin, Nafcillin, Oxacillin; cloxacillin, dicloxacillin used for… | Staph aureus, except for MRSA
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| Ticarcillin, Carbenicillin, Piperacillin used for | TCP Takes Care of Pseudomonas
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| Cephalosporin mechanism | Penicillin but more resistant to β-lactamases.
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| 1st generation cephalosporins | Penicillin but more resistant to β-lactamases. Little boy playing viOLIN with an EX-bow, PEcK. CefazOLIN, cephalEXin. Proteus, Ecoli, Klebsiella
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| 2nd generation cephalosporins | Penicillin but more resistant to β-lactamases. Older sis that is wearing FAC FOX FUR. Cefaclor, Cefoxitin, Cefuroxime. HEN PEcKS. Hemophilus influenzae, Enterobacter, Niesseria, Proteus, Ecoli, Klebsiella, Serratia.
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| 3rd generation cephalosporins | Penicillin but more resistant to β-lactamases. The most NEGATIVE (serious G-) older brother (who has meningitis) TRIes to AX TAZ, the TAX guy. TAZ has Pseudomonas because he TRIes to have sex (gonorrhea). Ceftriaxone, Ceftazadime, Cefotaxime.
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| 4th generation cephalosporins | Penicillin but more resistant to β-lactamases. The POSITIVE oldest sister does ballet and PIRouettes and FlEPs. Cefpiramide, cefepime. Kills G+ and pseudomonas.
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| Name the cephalosporins that kill Pseudomonas | Taz Fep Fop: Ceftazidime (3rd), Cefepime (4th), Cefoperazone (4th)
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| What drug to give for meningitis and why? | Give 3rd generation cephalosporins because they can cross the blood brain barrier: ceftriaxone, cefTAZidime, cefoTAXime.
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| Mechanism of aztreonam | Binds to transpeptidase of G- only. Resistant to β-lactamases. Kills G- and aerobes who wear KaPS. Klebsiella, Pseudomonas, Serratia.
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| Who should be given aztreonam | Those allergic to penicillin and those who have renal failure and can't use Aminoglycosides. Those who have
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| Mechanism of Imipenem | Crosses out G+ cocci. Crosses out G- rods. Makes a noose for the anaerobes. Squeezes down in through the porins and binds to transpeptidase. Not broken down by β-lactamase, so bugs develop resistence to Imipenem by making porins smaller and by hydroly
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| Imipenem is DOC for what organism? | Enterobacter
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| Adverse effects of Imipenem | Squeezes through the porin channels so scratch up skin --> skin rash. Squeezed so much --> GI distress. Doubling over for tummy, hit head on side of porin channel --> CNS/seizures.
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| How is meropenem different from Imipenem? | 1. Not susceptible to dihydroxypeptidase so don't have to give with Cilastin, 2. less CNS/seizure effects.
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| Name the antibiotics that are protein synthesis inhibitors | buy AT 30, CELL at 50. Aminoglycosides (bactericidal -- all the others are bacteriostatic), Tetracyclines. Chloramphenicol, Erythromycin, Linezolid/Lincomycin, Clindamycin.
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| Polymyxins B/E | Antibiotics that bind to LPS in cell membranes of G- bacteria & disrupt their osmotic properties with their hydrophobic tail. Polymyxins are cationic, basic proteins that act like detergents. MYXins MIX up membranes, mix up the brain (neurotoxicity), ki
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| Toxicity of chloramphenicol | anemia (dose-dependent), aplastic anemia (irreversible), gray baby syndrome (can't conjugate the drug)
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| Mechanism of chloramphenicol | Inhibits 50S peptidyltransferase
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| Resistance against penicillins and cephalosporins | cleave β-lactamase ring
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| Resistance against aminoglycosides | ations: Modification via acetylation, adenylation, or phosphorylation
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| Resistance against vancomycin | terminal D-ala of cell wall component, which vancomycin binds to, is changed to D-lac ---> decreased vancomycin affinity for the cell wall
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| Resistance against chloramphenicol | modification by acetylation -- pour chloramphenicol is like pouring acid (acetylation) into the bone!
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| Resistance against Macrolides | Methylation of rRNA near erythromycin's ribosome-binding site
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| Resistance against Tetracycline | decrease upTake to increase Transport out of the cell
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| Resistance against sulfonamides (SMX) | altered enzyme (bacterial dihydropteroate synthetase), decreased uptake, or increased PABA synthesis
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| Resistance against Amantadine | Antiviral that blocks virus from taking off its viral coat (M2 protein). Resistance - virus makes a mutated M2 protein that Amantadine can't bind to.
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| Resistance against Acyclovir | It needs to be activated/phosphorylated by viral thymidine kinase, so viruses that don't have thymidine kinase are therefore resistant to Acyclovir.
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| Resistance against Foscarnet | Anti-viral for HERPES infection (with some anti-HIV action). Pyrophosphate analogue ---| DNA polymerase and reverse transcriptase. FOScarnet = pyroFOSphate analog. Resistance by mutating the viral DNA polymerase.
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| Resistance against ciprofloxacin | Quinolones inhibit drug synthesis, recombination, and repair by inhibiting DNA gyrase or topoisomerase 4. Genes encoding resistance are chromosomally encoded -- mutations in structural genes for DNA gyrase and topoisomerase type 4. Another chromosomal m
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| Prophylaxis against meningococcal infection | Rifampin DOC
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| Prophylaxis against gonorrhea | Ceftriaxone (3rd generation cephalosporin)
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| Prophylaxis against syphilis | Benzathine penicillin G. Avoid getting syphilis if you get a boyfriend who has a Benz and has got his G thang going on.
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| Prophylaxis against recurrent UTI's | TMP-SMX DOC -- Kit should be on this!
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| Prophylaxis against endocarditis with surgical or dental procedures | penicillins
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| Prophylaxis against Herpes infection in immunocompromised patients | Acyclovir
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