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Abx LSI

Antibiotic Drugs

QuestionAnswer
Penicillin IV - peni G oral - peni V Mech: Bind PBPs (penicillin binding proteins); block transpeptidase cross-linking of cell wall; activate autolytic enzymes. Use: gram+ & syphilis. Bactericidal for gram+ cocci/rods, gram-neg cocci, spirochetes.
Bacteriostatic Abx "We're ECSTaTiC" Erythromycin Clindamycin Sulfamethoxazole Trimethoprim Tetracyclines Chloramphenicol
Bactericidal Abx "Very Finely Proficient At Cell Murder" Vancomycin Fluoroquinolones Penicillin Aminoglycosides Cephalosporins Metronidazole
Block cell wall synthesis by inhibition of peptidoglycan cross-linking Penicillin Ampicillin Ticarcillin Piperacillin Imipenem Aztreonam Cephalosporins
Block peptidoglycan synthesis Bacitracin Vancomycin
Disrupt bacterial cell membranes Polymixins
Block nucleotide synthesis Sulfonamides, trimethoprim
Block DNA topoisomerases Fluorquinolones
Block mRNA synthesis Rifampin
Block protein synthesis at 50S ribosomal subunit Chloramphenicol Macrolides Clindamycin Streptogramins Linezolid
Block protein synthesis at 30S ribosomal subunit Aminoglycosdides Tetracyclines
Antipseudomonals TCP: Take Care of Pseudomonas Ticarcillin Carbenicillin Piperacillin
Beta-lactamase inhibitors Clavulanic acid Sulbactam Tazobactam
Cephalosporins Bactericidal 1st gen: for Proteus, E. coli, Klebsiella H. influenzae, Enterobacter, Neisseria, Serratia (plus all above) 3rd gen: gram-neg meningitis 4th gen: Pseudomonas, gram+
Imipenem Gram+ cocci, gram-neg rods, anaerobes ALWAYS give with cilastin "the kill is lastin' with CILASTIN" Tox: GI upset, skin rash, CNS tox (seizures!)
Vancomycin Gram+ only Binds D-ala-D-ala in cell wall precursor. Bactericidal. Tox: Nephrotox, Ototox, Thrombophlebitis. Does NOT have many problems. Res: D-ala-D-ala change to D-ala-D-lac
Aminoglycosides Gentamicin, Neomycin, Amikacin, Tobramycin, Streptomycin Inhibit initiation complex, mRNA misread. Bactericidal - gram-neg aerobes only. Tox: Nephro, Oto, Teratogen. Res: Inactivated by transferase --> acetylation, phosphorylation, or adenylation
Tetracyclines (Mech & Uses) Binds & blocks 30S. Bacteriostatic. Gut uptake inhibited by divalent cations, little CNS fx. Borrelia, H. pyloria, M. pneumoniae. Intracellulars. Tox: GI, teeth discolor, bone growth inhibitor, photosen. Teratogen
Tetracyclines (drugs) Tetracycline Doxycycline Demeclocycline (ADH antagonist, diuretic) Minocycline
Macrolides Erythromycin, Azithromycin, Clarithromycin Bind 50S, block translocation. Bacteriostatic. Atypical pneumn - Mycoplasma, Chlamydia, Legionella. URI, STD, gram+ cocci Tox: long QT, cholestasis
Chloramphenicol Inhibit 50S peptidyltransferase. Static. Meningitis of H. influenzae, Neisseria, Strep pneum. Tox: anemia, aplastic anemia, gray baby syndrome
Clindamycin Block peptide bond at 50S. Static. Aerobes - Bacteroides, Clostridium Tox: C. diff overgrowth (pseudomembraneous colitis)
Sulfonamides SMX, sulfisoxazole, sulfadiazine Inhibit dihydropteroate synth -> block DNA/RNA/protein synth. Nocardia, Chlamydia, UTI. Tox: ALLERGY. Hypersen, hemolysis in G6PDH, nephrotox, kernicterus in babies, bind albumin & inc. other Rx
Trimethoprim Inhibit dihydrofolate reductase; use w/sulfonamides (TMP-SMX) UTIs, Shigella, Salmonella, Pneumocystis Tox: megaloblastic anemia, leukopenia, granulocytopenia
Fluoroquinolones (Mech/Uses) Inhibit DNA gyrase. Cidal. Avoid antacids. Gram-neg UTIs/GITIs, Neisseria Tox: superinfection; cartilage damage, leg cramps, myalgia in kids; tendonitis/rupture in adults.
Metronidazole Makes free radical metabolites to damage DNA. Bactericidal, antiprotazoal. GIardia, Entamoeba, Trichomonas, Anaerobes. Triple therapy for H. pylori. Disulfram-like rxn with alcohol
Polymixins Bind bacterial membranes, disrupt osmosis. Cationic & basic, act as detergents. For resistant gram-negs. Tox: neuro, acute renal tubular necrosis.
TB drugs RIPE for Tx TB: Streptomycin, Pyrazinamide [fx in M0s], Isoniazid (INH), Rifampin, Ethambutol [optic neuropathy]. INH-SPIRE. 2nd line - Cycloserine All hepatotoxic
Isoniazid (INH) dec. mycolic acid synth. Use bacterial catalase-peroxidase to make active metabolite. Tox: Neurotoxicity & lupus, prevented by VitB6. Fast & slow acetylators determine 1/2-life
M. leprae Ask DR. C Dapson Rifampin Clofazimine
M. avium-intracellulare Azithromycin, rifampin, ethambutol, streptomycin
Created by: 6813760