Flashcards in Pharm Deck (31):
What are the beta lactams?
What is the MOA of beta-lactams?
Binds to penicillin binding proteins which are transpeptidases that catalyze the terminal reactions in the bacterial cell wall synthesis
- they bind amino acid side chains to one another to form cross linking
- inhibits cross linking
How do beta lactams cause antibiotic therapy?
Bactericidal via osmosis (because of weakend cell wall) causing cell to burst
What causes penicillin resistance and what organisms can do so?
Pinicillinases which inactivate Penicillins
- Staph strain and N gonorrhea
What are Nafcillin and Diclozacillin?
Antistaphlococcal penicillins or Penicillinase- resistant penicillins
- Fight staph Aureus because they have larger R groups which are resistant to penicillinases
What the are the beta lactam inhibitors?
Clavulanate, Sulbactam and Tazobactam
- inhibit penicillinase
What are ampicillin and amoxicillin?
More water soluble and can thus pass through porin channels and taken up by Gram - strains of bacteria that resist penicillins simply by not taking up as much of the drug.
Inactivated by Beta lactamases
What is added to amox and amp for additional beta latamase support?
What is Atreonam?
monocyclic beta lactam
- given is have allergy to penicillin
- specific to gram - rods
- but sensitive to penicillinases
What is the MOA of cephalosporin?
Bind to penicillin binding proteins and inhibit cell wall synthesis.
Sensitive to beta lactamases but not penicillinases
What are the 1st, 2, 3,4 and 5th generation cephasporins?
What are the carbapenems?
What is the MOA of carbapenems?
Beta lactam ring binds to the penicillin binding protein
What is the MOA of vancomycin?
NOT a beta lactam
- Binds to D alanyl D alanine terminus of cell wall and inhibits release from bactoprenol carrier which prevents peptidoglycan synthesis
Resistant to beta lactamases
- turns D-alanyl-D alanine into D-alanyl-D-lactate or D-serine
What are the aminoglycosides?
What is the MOA of aminoglycoside?
Bacteriocidal by binding to 30S subunit to prevent protein synthesis
What is Epitofibatide? What are some other drugs of its class?
Inhibits GpIIB/IIIA from binding to fibrinogen
Abciximab and Tirofiban
What is the MOA of Clopidogrel and what are some other drugs in its class?
They inhibit the binding of ADP to the platelet. When ADP usually binds to the platelet its cause endocytosis of the GpIIB/IIIA receptor onto the outside of the platelet where it serves to bind fibronigen and another GpIIB/IIIA on another platelet.
prasugrel and ticlopidine
What are statins?
Inhibit HMG-CoA from being converted to Mavelonate which later becomes cholesterol. The enzyme that does this is HMG-CoA reductase which is inhibited by statins
What are the bile acids resins?
What is the MOA of bile acids resins?
Prevent intestinal resorption of bile acids. In order to make more bile acids the liver must use cholesterol. Which there by decrease the bodies cholesterol.
What happens to LDL, HDL and triglycerides in bile acid resins?
Big decrease in LDL's
Slight increase in the later 2
What is Ezetimibe? Its MOA?
Prevents cholesterol absorption at small intestine brush border
Big decrease in LDL's
No affect on Tri's and HDL's
What are the fibrates and their affects on LDL, HDL, and triglycerides?
Small decrease in LDL
Small increase in HDL
Huge decrease in triglycerides
What is the MOA of fibrates?
Upregulate LPL to increase triglyceride clearance
Activate PRAR-alpha to induce HDL synthesis
What is the affect of Niacin on LDL, HDL and triglycerides?
Medium decrease in LDL
Medium increase in HDL
Small decrease in triglycerides
What is the MOA of niacin?
Inhibits lipolysis (hormone sensitive lipase) in adipose tissue
Reduced hepatic VLDL synthesis
What is the MOA of Hydralazine?
increase cGMP to increase SM relaxation
Arterioles dilate greater than veins
What are Hydralazines used for?
Severe HTN, reduced afterload
Safe for pregnancy
What are he HTN drugs safe for pregnancy?