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Flashcards in Cell Wall Inhibitors Deck (24)
1

penicillin G

penicillins:

Acid-labile

parenteral admin (IM usually)
IV for serious

Procaine and benzathine added in IM injection

Water-insoluble, slow release

Adverse Effect:
- Allergy
- Dose dep. neurotoxicity and seizures
- STEVEN JOHNSON syndrome
- rashes, swelling

2

penicillin V

penicillins:

Acid stable

Oral Admin

Absorption 65%

3

oxacillin

beta–lactamase resistant

Hepatitis at high levels

Use to treat penicillinase containing staph and strep

4

amoxicillin

extended spectrum

Aminopenicilin

Better absorption
- not affected by food

Prophylaxis against bac endocarditis

5

ampicillin

extended spectrum

Aminopenicillin

6

piperacillin

extended spectrum

Ureidopenicillin

Parenteral

Anti-pseudomonal

Reserved for severe infections caused by Klebs. and Pseudomonas
- Combo with aminoglycoside to resist resistance

7

carbenicillin

extended spectrum

carboxypenicillin

Parenteral administration

Anti-pseudomonas

8

clavulanic acid

beta lactamase inhibitors

9

sulbactam

beta lactamase inhibitors

10

tazobactam

beta lactamase inhibitors

11

cefazolin

cephalosporins:
1st generation:

Broadest spectrum against gram + cocci

Effective against gram - bacilli

12

cefuroxime

cephalosporins:
2nd generation:

Only group to kill ANAEROBES

13

cefotaxime

cephalosporins:
3rd generation:

Anti-pseudomonal/pneumococcal

Serious gram - infections
Meningitis, pneumonia, gonorrhea

MOST widely used in treatment of children/infants with moderate to severe infections

14

cefepime

cephalosporins:
4th generation:

Anti-pseudomonal

High resistance to B lactamase for treating ENTEROBACTER and PENICILLIN-RESISTANT streptococci

15

imipenem

carbapenems:

Broadest activity

B lactam ring that binds more efficiently than pens/cephs

Resistant to B lactamases
- However, induce expression of those that affect cephalosporins and B lactams

Parenteral

Renal metabolism and inactivation

ADMINISTER WITH CILASTATIN to prevent metabolism

16

meropenem

carbapenems

17

cilastatin

carbapenems
peptidase inh

18

aztreonam

monobactams:

Anti pseudomonas

Resistant to B lactamase

Gram - UTI
Lower RTIs
Systemic infection

19

bacitracin

other:

Cell wall synth inhibitor

Depletes lipid carrier for PDG synth

TOPICAL only, poorly absorbed

NARROW (g+, Neisseria. T pallidum)

Toxicity:
- Severe nephrotoxicity

USE:
- Skin
- Opthalmologic infections

Good in combination with polymyxin B

20

cycloserine

other

Cell wall synth inhibitor

Blocks step 2 in PDG synth
- Analog of D-ala

Oral
Good CNS penetration

Active form in URINE

Toxicity:
SERIOUS CNS
Reversible

Broad spectrum

Restricted second-line therapy for M. tuberculosis

21

daptomycin

other

Cell membrane agent

Membrane depolarization

Bactericidal

IV administration
RENAL elimination

Vanc spectrum

Adverse effects:
- MYOPATHY

22

fosfomycin

other

Cell wall synth inh.

Block Step 1 PDG synth
- analog PEP

Broad Spectrum (G- also)

Toxicity:
- diarrhea, vaginitis

Use:
- Oral treatment of uncomplicated UTIs (E. faecalis and E. coli)

Excreted unchanged in URINE

23

vancomycin

other

Non-beta lactam

Mechanism:
- Binds D-ala-D-ala terminus

Blocks X linking of PDG by binding substrate

Rapidly bactericidal for dividing bacteria

Exception (static in enterococcus)

IV administration

Rarely, oral: poor absorption

Distribution excellent (bone, CNS if meninges inflamed)

Renal excretion

Narrow spectrum
Gram + mainly MRSA

Resistance:
- 2 mech:
- VRE: enterococcus vanA, vanB, van C genes make different wall subunits

- VRSA: Overexpression of D-ala-D-ala

Toxicity:
- Red man
- Ototoxicity and nephrotoxicity

Synergistic with aminoglycosides but ototoxic also

24

nafcillin

beta-lactamase inhibitor