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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 |
| 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 |
| 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 |
| 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 |
| Why is methicillin not used anymore? What to use instead? |
Causes interstitial nephritis. Use nafcillin and oxacillin instead. |
| 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 |
| 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 |
| 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 |
| 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 |
| Ticarcillin |
Anti-pseudomonal penicillin. It takes James Bond to kill Pseudomonas with his CAR his TICk and his PIPE bomb. |
| Carbenicillin |
Anti-pseudomonal penicillin. It takes Joames Bone to kill Pseudomonas with his CAR his TICk and his PIPE bomb. |
| Piperacillin |
Anti-pseudomonal penicillin. It takes Joames Bone to kill Pseudomonas with his CAR his TICk and his PIPE bomb. |
| Name the β-lactamase inhibitors |
Clavulanic acid, sulBACTAM, tazoBACTAM. BAC TAM CLAps when you inhibit the β-lactamases. |
| Clindamycin |
G+ and anaerobes above the diaphragm |
| How is ampicillin different from amoxicillin? |
AmOxicillin has great Oral bioavailability |
| Ampicillin and amoxicillin used on what organisms? |
ampicillin and amoxicillin HELPS (+) kill enterococci. Haemophilus influenzae, E.coli, Listeria monocytogenes, Proteus, Salmonella, enterococci. |
| Penicillin used for…. |
G = IV, V = oral, G+ rods and cocci, G- cocci, spirochetes, strep pneumoniae |
| Penicillin allergies: rash, hemolytic anemia |
rash is Type I, anemia is Type II |
| Methicillin, Nafcillin, Oxacillin; cloxacillin, dicloxacillin used for… |
Staph aureus, except for MRSA |
| Ticarcillin, Carbenicillin, Piperacillin used for |
TCP Takes Care of Pseudomonas |
| Cephalosporin mechanism |
Penicillin but more resistant to β-lactamases. |
| 1st generation cephalosporins |
Penicillin but more resistant to β-lactamases. Little boy playing viOLIN with an EX-bow, PEcK. CefazOLIN, cephalEXin. Proteus, Ecoli, Klebsiella |
| 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. |
| 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. |
| 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. |
| Name the cephalosporins that kill Pseudomonas |
Taz Fep Fop: Ceftazidime (3rd), Cefepime (4th), Cefoperazone (4th) |
| What drug to give for meningitis and why? |
Give 3rd generation cephalosporins because they can cross the blood brain barrier: ceftriaxone, cefTAZidime, cefoTAXime. |
| Mechanism of aztreonam |
Binds to transpeptidase of G- only. Resistant to β-lactamases. Kills G- and aerobes who wear KaPS. Klebsiella, Pseudomonas, Serratia. |
| Who should be given aztreonam |
Those allergic to penicillin and those who have renal failure and can't use Aminoglycosides. Those who have |
| 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 |
| Imipenem is DOC for what organism? |
Enterobacter |
| 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. |
| How is meropenem different from Imipenem? |
1. Not susceptible to dihydroxypeptidase so don't have to give with Cilastin, 2. less CNS/seizure effects. |
| 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. |
| 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 |
| Toxicity of chloramphenicol |
anemia (dose-dependent), aplastic anemia (irreversible), gray baby syndrome (can't conjugate the drug) |
| Mechanism of chloramphenicol |
Inhibits 50S peptidyltransferase |
| Resistance against penicillins and cephalosporins |
cleave β-lactamase ring |
| Resistance against aminoglycosides |
ations: Modification via acetylation, adenylation, or phosphorylation |
| 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 |
| Resistance against chloramphenicol |
modification by acetylation -- pour chloramphenicol is like pouring acid (acetylation) into the bone! |
| Resistance against Macrolides |
Methylation of rRNA near erythromycin's ribosome-binding site |
| Resistance against Tetracycline |
decrease upTake to increase Transport out of the cell |
| Resistance against sulfonamides (SMX) |
altered enzyme (bacterial dihydropteroate synthetase), decreased uptake, or increased PABA synthesis |
| 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. |
| 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. |
| 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. |
| 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 |
| Prophylaxis against meningococcal infection |
Rifampin DOC |
| Prophylaxis against gonorrhea |
Ceftriaxone (3rd generation cephalosporin) |
| 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. |
| Prophylaxis against recurrent UTI's |
TMP-SMX DOC -- Kit should be on this! |
| Prophylaxis against endocarditis with surgical or dental procedures |
penicillins |
| Prophylaxis against Herpes infection in immunocompromised patients |
Acyclovir |
