PBP Inhibitor (4)
1) Penicillins
2) Cephalosporins
3) Carbapenems
4) Aztreonam
MOA for Vancomycin
D-ala-D-ala pentapeptide inhibitor
MOA for Bacitracin
Blocks incorporation of amino acids and nucleic acids into cell wall
MOA for fosfomycin
Disrupts disaccharide building block
Adverse effects for Penicillins and Cephalosporins
hypersensitiviy - anaphylactic
Adverse effects for Carbapenems
GI discomfort
Adverse effects for Vancomycin
Flushing - Red man syndrome
Adverse effects for Bacitracin
Rare (used as topical)
Adverse effects for Fosfomycin
well tolearted
Adverse effects for Azetreonam
Rash
Itching
Which protein synthesis inhibitors bind 30s? (2)
aminoglycosides
tetracycline
Which protein synthesis inhibitors bind 50s (3)?
1) macrolide
2) clindamycin
3) cholramphenicol
MOA for aminoglycosides
Binds 30s
Blocks tRNA from binding (step 1)
MOA for macrolides
binds 50s
Disrupts translocation to P site (Step 4)
MOA for tetracyclines
binds 30s
blocks tRNA from binding
(same as aminoglycosides)
MOA for clindamycin
binds 50s
prevents tRNA from binding and prevents translocation to P site
MOA for chloraphemnicol
binds 50s
prevents peptide bond formation
MOA for linezolid
*unique
prevents the very first step of protein synthesis
Adverse effects for aminoglycosides
nephrotoxicity
ototoxicity
Adverse effects for macrolides
GI - diarrhea
Adverse effects for tetracycline
photosensitivity
nutrient interaction
disrupts normal flora
Adverse effects for clindamycin
GI
Highly associated with C diff.
Adverse effects for chloramphenicol
Blood - anemia
Gray baby syndrome (infants lack glucoronic acid for conjugation)
Adverse effects for linezolid
myelosuppression
Which protein synthesis inhibitor has narrow spectrum while the others have broad?
clindamycin
1) structurally similar to PABA
2) prevents PABA from binding
3) inhibits DNA synthesis
Sulfonamides (similar to dapsone in antimycobacterial)
inhibits dihydrofolate reductase
blocks purine synthesis
Trimethoprim
MOA for fluoroquinones
DNA gyrase inhibitor
disrupts winding and unwinding of DNA
Adverse effects of sulfonamides
skin - hypersensitivity, photosensitivity
Stevens-Johnson
Adverse effects of trimethoprim
Blood and bone
Adverse effects of fluoroquinonones (3)
GI
nutrient interactions
Cardio - QT prolongation
Which two drugs have nutrient interactions?
Tetracycline
Fluoroquinonones
MOA for metronidazole
prodrug that is activated by bacteria and releases ROS
Adverse effects for metronidazole
GI
inhibits/disrupts proper elimination of alcohol –> disulfiram effect
Metronidazole is only effective against which type of bacteria?
anaerobic
Metronidazole is used to treat what type of infection?
mild to moderate C. diff
MOA of Daptomycin
depolarization of membrane –> cell death
MOA of polymyxin B
sticks to LPS and punches holes
Polymyxin B is only effective against which type of bacteria?
Gram neg (LPS present)
Adverse effects of Daptomycin
toxic to muscles
Adverse effects of polymyxin B
rare (used as topical, often mixed with bacitracin)