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USU Pharm lec 58

Antibiotics I

QuestionAnswer
Name the B-Lactams Penicillins, Cephalasporins, Carbapenems, Monobactam
B-lactam mechanism inhibits transpeptidase from cross-linking the D-ala--D-ala substrates (Dala-Dala analogue)
B-lactam mechanisms of resistance increased penicillinases. decreased affinity of PBPs (mutation & recombination). decreased cell membrane permeability. energy-dependent efflux pumps.
B-lactam adverse effects Allergic, diarrhea, CV effects, CNS, Coagulation defects
acid stable antibiotic, active against gram-positive (non-penicillinase), also Neisseria and some anaerobes Penicillin V
penicillinase-resistant penicillins methicillin (also nafcillin, oxacillin, cloxacillin, dicloxacillin)
Methicillin resistance (MRSA) related to failure to bind PBPs
1st penicillin for gram-neg. Active against E.coli, P. mirabilis, H.influenza, Salmonella, Shigella, Neisseria ampicillin (also amoxicillin)
Cephazolin (also cephalexin, cephadrine, cefadroxil) 1st Gen cephalosporin. narrow spectr. surg prophylax. most gram +, moderate against gram -.
Cefotetan 2nd Gen ceph. B. fragilis, other anaerobes. intra-abdominal surg prophylaxis
2nd Gen Cephalosporins increased activity against Gram - (E.coli, P.mirabilis).
3rd Gen cepalosporins CNS, bone, lung, urinary tract penetration. Gram -, enteric bacteria
Ceftazidime 3rd Gen ceph. for multi-drug resistant Gram - like P. aeruginosa
First drug approved for MRSA ceftaroline (3rd Gen ceph)
Cefepime 4th Gen Ceph. like ceftazidime against P. aeruginosa & other Gram -. resistance to chromosomally-encoded B-lactamases
Imipenem (also meropenem, ertapenem, doripenem) Carbapenems. IV only.
"may not always have cross-allergenicity with penicillin" vs "usually does not show cross-allergenicity" may not: imipenem. usually does not: aztreonam
Carbapenem with extremely broad spectr, B-lactamase reist, imipenem
Aztreonam Monobactam. Gram -.
Vancomycin Glycopeptide Antibiotic. binds D-ala-D-ala terminus.
no cross-resistance/allergenicity. used for serious staph/strep infection in B-lactam sensitive patients vancomycin
Daptomycin inhibit cell membrane potential lipopeptide antibiotic. For complicated skin infections, endocarditis by gram +.
clavulanate "suicide inhibitor" of B-lactamase, given with a penicillin ie Augmentin(amoxicillin + clavulanate), Timentin (ticarcillin + clavulanate)
cilastatin (in drugs to know list at cilastin) dipeptidase inhibitor (given in combo with imipenem to preven renal tubule hydrolyzation)
ticarcillin carboxylated penicillin derivative. anti-pseudomonal
Created by: dennisw2100
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