Antibacterials

1. Antibacterials Summarizes FA 2007 pg 168-175 Sorry for spelling or inaccuracies.

2. Antimicrobials to avoid in pregnancy

3. SAFE Moms Take Really Good Care • Sulfonamides- kernicterus • Aminoglycosides- otoxicity • Floroquinolones-cartilage damage • Ertyhromycin-acute cholecstatichep in mom • Clarithro- embyrotoxic • Metronidazole-mutagensis • Tetracylines- discolored teeth, bone growth • Ribavirin (antiviral) • Griseofulvin • Chloramphenicol-gray baby

4. Mechanisms of Resistance • To PCN and cephalosporins

5. 1. production of beta lactamases (staph) • 2. change in PBP (MRSA) • 3. change in porins (pseudomonas)

6. To aminoglycosides

7. Conjugation rxn that transfer acetyl, phosphoryl or adenylyl

8. To macrolides

9. 1. active transport out of cells • 2. formation of methyltransferases that alter drug binding sites on 50S

10. To tetracyclins

11. Pump drugs out

12. To sulfonamides

13. Increase formation of PABA; • use of exogenous folic acid

14. To floroquinolones

15. Change in sensitivity • Drug efflux

16. To chloramphenicol

17. Inactivating actelytransferases

18. Penicillins • Mechanism of Action

19. Interact with PBP to inhibit transpeptidation reactions involved in cross-linking, the final steps in cell wall synthesis

20. Clinical USEs PCN G and V

21. APLANTS • Actinomyces Israelis • PasturellaMultocida • ListeriaMonocytogenes • Grp A • Nesseria Meningitis • TreponemaPallidum • Strep Pneumoniae

22. Clinical use of nafcillin, methicilin, oxacillin • Use of dicloxacillin

23. Staph not MRSA • Dox: penicillinase producing S aureus

24. Use of beta lactamase sensitive broad spectrum ampicillin and amoxicillin

25. Gram + and HELPS kill enterococci • Given w/ beta lactamse inhibitors clavulanic acid and sulbactam • Syngery w/ aminoglycosides against enterococcal • H flu, E Coli, Listeria, Proteus, Salmonella, Enterococci • Borrelia and H Pylori- amoxicillin • amOxicillin has greater Oral bioavailability

26. Use of extended spectrum, beta lactamase sensitive ticarcillin, piperacilin, carbenicillin

27. TCP Takes Care of Pseudomonas • Pseudomonas! • Synergy w/ aminoglycosides

28. Elimination of most • Special thing about ampicillin • Special thing about nafcillin and oxacillin

29. Renal • Undergoes enterohepatic circulation • Eliminated by bile

30. SE of PCN • Specifically methicillin • Specifically ampicillin • w/ treatment of syphillis

31. Hypersensitivity 1-4 • Methicillin-interstitial nephritis • Ampicillin- pseudomembranous colitis • Jarisch-herxheimer

32. Cephalosporins Mechanism

33. Interact w/ PBPs to inhibit transpeptidation reactions involved in cross-linking of cell wall

34. 1st generation • names

35. Ph & faz • Cephalexin, Cafazolin

36. 1st generation use

37. Gram + and PEcK • Proteus • E Coli • Klebsiella • Pre-surgery • Don’t enter CNS

38. 2nd generation • Names

39. The Fam is gathered wearing Fur Coats looking Foxy and drinking TEa • Ex cefotetan, cefaclor, cefuroxime

40. 2nd gen use

41. HEN PEcKS • H flu • Enterobacter • Neisseria • Proteus • E coli • Klebsiella • Serratia • KEY in sinusitis, otitis, pneumonia • Only cefuroxime enters CNS

42. 3 generation • Name

43. T in it • “T” in it • ie. Ceftriaxone (IM) • Cefotaxime (IV) • Cefdinir and cefixime (oral)

44. use

45. Gram – • Ceftriaxone- meningitis, gonorrhea • Community acquried pneumonia not atypicals

46. 4 generation • name

47. Only 1 • cefepime

48. use

49. Gram +, Gram -, Pseudomonas • Enter CNS

50. Pharmaco of Ceph • Most eliminated by • Cefoperazone and ceftriaxone eliminated by