Pharm antimicrobials 2 Flashcards Preview

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Flashcards in Pharm antimicrobials 2 Deck (57)
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1

vancomycin class

glycopeptide - cell wall synthesis inhibitor

2

vancomycin mechanism

binds rapidly and irreversibly to the D-alanyl-D-alanine group on the peptide side-chain of the membrane-bound precurosr; glycan chain extension, transpeptidation inhibited

3

vancomycin spectrum - why?

gram + only - molecule is HUUUUGGGGGEEEEE!!! can't get into gram -

4

vancomycin clinical uses

serious, multidrug-resistant organisms including MRSA, s epidermidis, enterococcus, clostridium difficile

5

vancomycin adverse effects

well tolerated in general but NOT trouble free (Nephrotoxicity, Ototoxicity, Thrombophlebitis and red man syndrome)
Red man driving a van down the intestine getting c diff

6

vancomycin administration

IV only - not absorbed orally

7

what is the advantage of vancomycin not being absorbed orally?

c difficile is in gut - it doesn't need to be absorbed to treat this

8

daptomycin class

cell wall TOXIN - lipopetide

9

daptomycin mechanism

penetrates gram + cell wall forming a channel for subsequent leakage of intracellular ions
-insertion into the gram + cell membrane causing depolarization and ultimate cell death

10

daptomycin spectrum

gram + cocci only - used for VRE and VRSA (vancomycin resistant organisms)

11

what is daptomycin not used for? why?

pneumonia because it avidly binds to and is inactivated by surfactant

12

daptomycin side effects

myopathy and rabdomyolysis,
also eosinophilic pneumonia

13

what are the lipoglycopeptides (analogs of vancomycin)

-vancins
dalbavancin, telavancin, oritavancin

14

-vancins mechanism

binds to same target as vancomycin (D-alanyl-D-alanine group on peptide side-chain of the membrane-bound precursor)--> cell wall precursor and inhibits transglycosylation

15

-vancins spectrum

similar to vancomycin (gram + only) but active against VRE and more anaerobe coverage

16

-vancins side effects

metallic taste, nausea, HA, nephrotoxicity, teratogenic (don't take if preggers)
also very very expensive

17

what is the half life of the -vancins? what is the longer half life due to?

telavancin - 7.5 hr
dalbavancin and oritavancin long (100+ hrs)
-due to lipophilic side chain that prolongs half life

18

are protein synthesis inhibitors bacteriocidal or bacteriostatic?

bacteriostatic EXCEPT aminoglycosides

19

30 S ribosomal subunit protein synthesis inhibitors

ATG = DNA = small
aminoglycosides, tetracyclines, glycylcyclines

20

50S ribosomal subunti protein synthesis inhibitors

COM = bigger and better!
clindamycin, oxazolidinones, macrolides

21

what are the aminoglycosides?

gentamicin, tobramycin, amikacin, streptomycin

22

aminoglycoside mechanism

bactericidal: irreversible inhibition of initiation complex through binding of the 30S subunti - can cause misreading of mRNA - also inhibits initiation

23

aminoglycoside spectrum

extremely effective against G- rods (esp enterics)
covers pseudomonas aeruginosa!!

24

what are aminoglycosides ineffective against? why?

anaerobes!! have O2 dependent uptake mechanism!!!

25

clinical use of aminoglycosides - what is it given with? why?

synergistic with cell-wall active agents for enterococcus infections (esp penicillins because they facilitate entry), cystic fibrosis (pseudomonas common infection)

26

aminoglycosides side effects

the MEAN GUY! (bacteriocidal)
-punch to the ear (ototoxicity)
-punch to the kidney (nephortoxicity)
-punch a pregnant woman (teratogen)
-knock them out (neuromuscular blockade)

27

which aminoglycoside is toxic and is typically only used topically for skin infections?

neomycin

28

which aminoglycoside has the broadest spectrum?

amikacin

29

what are the tetracyclines?

-cycline
doxycycline, minocycline, tetracycline

30

tetracycline mechanism

inhibits 30S ribsome - blocks access of tRNA anticodon to its codon