Flashcards in Pharm antimicrobials 2 Deck (57)
Loading flashcards...
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