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Host Defense Unit 1 - Abx
Penicillin
Gram Positive
Spirochetes
Bind PBPs
Block Transpeptidase Cross-linking of Cell Wall
Activate Autolytic Enzymes
Bactericidal
Hypersensitivity Reactions
Hemolytic Anemia
Beta-lactamase Sensitive
2 mins
Cephalosporins Overview
Mechanism of Action
Beta lactam drug
Inhibits cell wall synthesis
Bactericidal
Side Effects
Hypersensitivity reactions
Vitamin K Deficiency
Disulfiram like reaction with Alcohol
Increased Nephrotoxicity of Aminoglycosides
1 min
Beta-Lactamase Inhibitors
Considerations
Often Combined with Penicillin Antibiotics
Drug Names
Clavulanic Acid
Sulbactam
Tazobactam
51 secs
Imipenem
Mechanism
Resistant to Beta-Lactamases
Broad Spectrum
Indications
Anaerobes
Gram-Negative Rods
Gram-Positive Cocci
Must Administer with Cilastatin
Cilastatin is Inhibitor of Renal Dehydropeptidase I
Side Effects
Diarrhea
Skin Rash
Seizures
Considerations
Meropenem
Stable to Dehydropeptidase I
Reduced Risk of Seizures (Non-Seizure Causing)
2 mins
Aztreonam
Monobactam
Resistant to beta lactamases
Binds to penicillin binding protein (PBP)
Inhibit cell wall synthesis
No Activity on Gram-Positives or Anaerobes
Gram-Negative Rods
Non allergenic to penicillin
Synergistic with aminoglycosides
2 mins
Vancomycin Mechanism
Bacteriostatic and Bactericidal
Gram-Positive
Inhibits Cell Wall Mucopeptide
Binds to D-ala D-ala
Resistance with Change to D-ala D-lac
Staphylococcus aureus
Orally for Clostridium difficile
Enterococci
2 mins
Vancomycin Side Effects & Toxicity
Side Effects
Thrombophlebitis
Nephrotoxicity
Ototoxicity
Diffuse Flushing Called Red Man Syndrome
Prevent with Antihistamine
Prevent with Slow Infusion
2 mins
Isoniazid
Indications
Tuberculosis (TB)
Mechanism of Action
Requires Catalase Peroxidase
Decreases Mycolic Acid Synthesis
Fast vs Slow Acetylators
Side Effects
B6 Deficiency
Neurotoxicity
Hepatotoxicity
Drug-induced Lupus
1 min
Ethambutol
Mechanism of Action
Bacteriostatic
Blocks Arabinosyltransferase
Arabinosyltransferase Polymerizes Carbohydrates
Carbohydrate Polymers Make Mycobacterium TB Cell Wall
Side Effects
Red/Green Color Blindness
Reversible with Drug Discontinuation
40 secs
Protein Synthesis Inhibitors
Drug Names
30S inhibitors
Aminoglycosides
Tetracyclines
50S inhibitors
Chloramphenicol
Clindamycin
Erythromycin
Lincomycin
Linezolid
3 mins
Aminoglycosides
Drug Names
Gentamicin
Neomycin for Bowel Surgery Prep
Amikacin
Tobramycin
Streptomycin
Mechanism of Action
Bactericidal
Inhibit Formation of Initiation Complex
Cause Misreading of mRNA
Require O2 for Uptake
Resistance
Resistance by Transferase Enzymes
Acetylation
Phosphorylation
Adenylation
Indications
Gram-Negative Rod Infections
Synergistic with B-Lactam Antibiotics
Side Effects
Nephrotoxicity Especially When Used with Cephalosporins
Ototoxicity Especially When Used with Loop Diuretics
Teratogen
5 mins
Tetracycline Drug Names and Indications
Drug Names
Demeclocycline
Minocycline
Doxycycline
Fecally Eliminated
Can be Used in Renal Failure
Indications
Antidiuretic Hormone Antagonist
Chlamydia
Rickettsia
Borrelia burgdorferi
Helicobacter Pylori
Mycoplasma Pneumonia
3 mins
Tetracycline Mechanism
Binds to 30 S to Prevent Attachment of Aminoacyl tRNA
Limited CNS Penetration
Divalent Cations Inhibit Absorption
Must Not Take with Milk, Antacids, Iron
1 min
Tetracycline Toxicities
Inhibition of Bone Growth in Children
Teratogen
Discoloration of Teeth
Photosensitivity
GI Distress
2 mins
Chloramphenicol
Mechanism
Bacteriostatic
Inhibits 50S Peptidyltransferase Activity
Indications
Meningitis
Rocky Mountain Spotted Fever in Pregnant Women
Side Effects
Anemia
Aplastic Anemia
Gray Baby Syndrome due to Decreased UDP-Glucuronyl Transferase
Resistance Caused by Plasmid Encoded Acetyltransferase
2 mins
Macrolides
Mechanism of Action
Bacteriostatic
Bind to 23S rRNA of 50S Subunit
Inhibit Protein Synthesis by Blocking Translocation
Macrolides
Erythromycin
Azithromycin
Clarithromycin
Indications
Gram-Positive Cocci
Atypical Pneumonia
Chlamydia
Considerations
Resistance by Methylation of 23S rRNA Binding
2 mins
Macrolides Side Effects
Side Effects
Diarrhea
Prolonged QT Interval
P450 Inhibitor
Cholestatic Hepatitis
Skin Rash
Eosinophilia
3 mins
Clindamycin
Mechanism of Action
Bacteriostatic
Binds 50S Ribosomal Subunit
Blocks Translocation
Indications
Anaerobic Infections above the Diaphragm
Aspiration Pneumonia
Lung Abscess
Side Effects
Can Cause Pseudomembranous Colitis
1 min
Sulfonamides Mechanisms
Bacteriostatic
Gram-Positive
Gram-Negative
Nocardia
Chlamydia
PABA antimetabolites
Inhibit dihydropteroate synthase
Sulfamethoxazole
Sulfisoxazole
Sulfadiazine
1 min
Sulfonamides Side Effects
Side Effects
Hypersensitivity
Nephrotoxicity
Photosensitivity
Kernicterus in Infants
Displaces Warfarin from Albumin
Considerations
Hemolysis with G6PD Deficiency
3 mins
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