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blocks cell wall synthesis by inhibition of peptidoglycan cross-linking
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penicillin
ampicillin
tiracillin
piperacillin
imipenem
aztrenam
cephalosporins
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block peptidoglycan synthesis
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bacitracin, vancomycin, cycloserine
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disrupt bacterial/fungal cell membranes
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polymyxins
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block nucleotide synthesis
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sulfonamides, trimethoprim
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block fungal cell memebranes
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amphotericin B
nystatin
fluconazole/azoles
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block nuecliotide synthesis
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sulfonamides, trimethoprim
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block DNA topoisomerases
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quinolones
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red orange body fluids
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Rifampin
|
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Block Protein synthesis at 50S ribosomal subunit
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chlorophenicol, erythromycin/macrolides, lincomycin, clindamycin, streptogramins (quinupristin, dalfopristin), linezolid
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block protein synthesis at 30S ribosomal subunit
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Aminoglycosides , tetracylins
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bactericidal antibiotics
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penicillin, cephalosporins, vancomycin, aminoglycosides, floroquines, metronidazole
|
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penicillin G
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IV form of penicillin
|
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penicillin V
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oral form of penicillin
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MOA of penicillin
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1. bind penicillin binding protein (aka tranpepsidase)
2. block transpepsidase cross-lining of cell wall
3. activate autolytic enzymes
(works on dividing bacteria)
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clinical use of penicillin?
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bactericidal
for gram-positive cocci/rods
gram-negative cocci
spirochetes
|
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is penicillin penicillinase resistant?
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no
|
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toxisity of penicillin
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hypersensitivity reactions, drug-induced coombs positive-hemolytic anemia
|
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how do gram negative bacteria protect themselves from penicillin?
|
1.prvent peniciiln from penetrating cell layers by altering porins
2. beta-lactase enzyme
3.alter molecular structure of transpepsidase so beta-lactam antibiotic (penicillin) no bind to it
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example of a bacteria that uses: altered molecular structure of transpepsidase so beta-lactam antibiotic (penicillin) no bind to it
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MRSA
|
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how do gram positive bacteria protect themselves from penicillin?
|
1. secrete beta-lactamase = penicillinase(S aureus) and try to intercept antibiotic outside the cell wall
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name the penicillinase resistant penicillin?
|
methicillin, nafcillin,dicloxacillin
|
|
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clinical use of penicillinase resistant penicillin?why such narrow spectrum?
|
s. Aureus - but not MRSA
B/C HAVE BULKIER r GROUP
|
|
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TOXICITY of penicillinase resistant penicillin
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HYPERSENSITIVITY reactions
|
|
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which penicillinase resistant penicillin causes intersitial nephritis?
|
methicillin
|
|
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aminopenicillins - names?
|
ampicillin, amoxicillin
|
|
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MOA of aminopenicillins diff than penicillins?
|
wider specturm b/c better penitration through gram negative outer membrane and better binding to transpepsidase
|
|
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are aminopenicillins penicillinase sensitive?
|
yes
|
|
|
clinical use of aminopenicillins?
|
extended-spectrum penicillin
gram-poitive and gram neg rods(H.influenza,E coli,listeria monocytes, proteus mirabilis, salmoella, enterococci
note: they are one of few drugs against gram-positive enterococcus
|
|
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toxicity of aminopenicillins?
|
hypersensitivity reactions
ampicillin rash
psuedomembranous colitis
|
|
|
anti-pseudomonals?
|
ticarcillin, carbeicillin, pipercillin
|
|
|
diff in MOA of anti-pseudomonals and penicillin?
|
nothing but extensed spectrum
|
|
|
clinical use of anti-pseudomonals?
|
psudomonas spp. and gram negative rods
anerobes (bacteroides fragalis)
|
|
|
are anti-pseudomonals susceptible to penillinase? what can use to help with?
|
yes
give wiht clavulanic acid - which is a beta-lactamase inhibitor
|
|
|
toxicity of anti-pseudomonals?
|
hypersensitivity reactions
|
|
|
B lactamdrugs that inhibit cel wall synthesis but are less susceptible to penicilinase. and a bactericidal
|
cephalosprins
|
|
|
what are the first generation cephalosporins?
|
cefazolin, cephalexin
cef with lin xin
|
|
|
clinical use of 1st generation cephalosporins?
|
gram positive cocci, proteus mirabilis, ecoil, klebsiella pneumoniae
pek
|
|
|
what are the 2nd generation cephalosporins?
|
cefoxitin, cefaclor,cefuroxime
furry fox is fat
|
|
|
clinical use of 2nd generation cephalosporins?
|
gram positive cocci
h. influenza, enterobacter aerogenes, neiseseria spp,
proteus mirabilis, ecoil, klebsiella pneumoniae
hen peks
|
|
|
what are the 3rd generation cephalosporins?
|
cetriaxone, cefotaxime, ceftazidime
|
|
|
clinical use of 3rd generation cephalosporins?
|
serious gram negative infections resistant to oteher B lactams
meningitis (most penetrate BBB)
|
|
|
ceftazidime used for what?
|
pseudomonas
|
|
|
ceftriaxone used for what?
|
gonorrhea
|
|
|
what are 4th generation cephs?
|
cefepime and cefpiramide
pime mide
|
|
|
clinical use of 4th generation cephalosporins?
|
increased activity against pseudomonas and gram positive organisms
|
|
|
toxicities of all cephs?
|
hypersensitivity reactions
cross hypersensitivity wiht penicillins
increased nephro tox of aminoglycosides
disuliram like reaciton w/ ethanol
|
|
|
what is aztreonam?
|
a monobactam resistan to Beta lactamase
|
|
|
what is the mOA of aztreonam?
|
inhibits cell wall synthesis ( binds to PBP3) synergistic with aminoglycosides
no cross-allergy with penicillin
|
|
|
what is the clinical use of aztreonam?
|
gram negative rods
klebiella spp,pseudomonas spp, serratia spp
NO activity against gram positive gram positives or anerobes
|
|
|
toxicity of aztreonam?
|
usually nontoxic, occasional GI upset
|
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