Term
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Definition
2 Layers
-Plasma membrane
-Peptidoglycan layer: thick; 60-90%
-Lipoteicholic acid & telchic acid |
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Term
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Definition
3 Layers
-Plasma membrane
-Peptidoglycan layer: thin; 1-20% (inner-periplasmic space)
-Outer membrane |
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Term
| Inhibitors of Cell Wall Synthesis (bactericidal) |
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Definition
| Penicillins, Cephalosporins, Monobactam, Carbapenems |
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Term
| Interfere w/ Bacterial Cell Membranes |
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Definition
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Term
| Bactericidal inhibitors of protein synthesis |
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Definition
| Aminoglycosides, Quinupristin/dalfopristin |
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Term
| Bacteriostatic inhibitors of protein synthesis |
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Definition
| Clindamycin, Linezolid, Macrolides, Tetracyclines, Tigecycline |
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Term
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Definition
-Enzyme which degrades drug (beta lactamases-Penicllins)
-Change target proteins
-Reduce drug uptake (i.e. efflux pumps)
-Synthesis of compounds to antagonize drug action (Sulfonamides) |
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Term
| Mechanisms by which resistance is acquired |
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Definition
Spontaneous mutation: Generally confers resistance to 1 org.
Conjugation: Most w/ Gram- bac, frequently results in multiple drug resistance; not org specific. |
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Term
| Causes of antibiotic resistance |
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Definition
| -Over prescribing, inappropriate drug used, too little of a drug or probiotics in animal feed |
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Term
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Definition
| New infection that occurs during course of treatment for a primary infection; more common w/ broad spectrum drugs |
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Term
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Definition
-Match the drug w/ the bug; do a culture to identify G+/-.
-Drug susceptibilites: minimum inhibitory conc. (sensitive, intermediate, resistant)
-Host factors: Immune system, site of infection (antibiotic must be present at 4-8X the MIC to be effective)
-Age, pregnancy & lactation,allergies, AE's, genetic factors (G6PD deficiency) |
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Term
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Definition
Duration dept on host defense, site of infection, identity of infecting org.
- Dose should provide conc > or = to MIC |
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Term
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Definition
Synergism: beta-lactam+aminoglycoside + sulfonamide+trimethoprim
Additive: aminoglycoside+fluroquinolone
Antagonsim: bacteriostatic+bactericidal |
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Term
| Indications for Combination Therapy |
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Definition
-Initial therapy of severe infection (etiology unknown)
-Mixed infections
-Prevention of resistance (TB, 4drugs)
-Decreased toxicity (syn effect)
-Enhanced antibacterial action |
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Term
| Disadvantages of Combination Therapy |
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Definition
-Increased risk of toxic/allergic reaction
-Possible antagonism
-Increased risk of superinfection
-Selection of drug-resistant org's
-Increased cost |
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Term
| Misuse of antimicrobial drugs |
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Definition
-Attempted treatment of untreatable infection (cold/virus)
-Treatment of fever of unknown origin
-Improper dosage
-Tx in the absence of aqeduate bacteriologic info
-Omission of surgical drainage (abcess) |
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Term
Penicillins (PCNs): IV PO
Cell Wall Active |
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Definition
-MOA: binds to penicillin-binding proteins (PBPs) leading to bactericidal inhibition of transpeptidases.
-Resistance: beta-lac, altered PBPs
-Interactions: probenecid, bacteriostatics
-A.E: Anaphylaxis, rash/hives, seizures w/high dose, GI intolerance, blood dyscrasias, interstitial nephritis, elevated liver enzymes, hypo/hyperkalemia |
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Term
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Definition
Spectrum: Gram+, anaerobes, spirochetes (Treponema pallidum)
-Pen V: oral
-Pen G: IM/IV
DOC for strep throat (s. pyogenes), syphillis, dental work |
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Term
Antistaphylococcal PCNs
(Penicllinase-resistant PCNs) (N) |
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Definition
Spec: staph & strep
DOC for staphylococcal infections
(Nafcillin,Dicloxacillin) |
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Term
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Definition
-Same as PCNs w/ some Gram- coverage
-Inactivated by betalactamases
(Ampicillin, amoxicillin)
-UTI: proteus, e. coli |
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Term
Antipseudomonal PCNs (extended-spectrum)
(B) |
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Definition
Spectrum: same as aminopenicllins + p. aeruginosa & enterobacteriacea
-Inactivated by beta-lac.
-DOC for pseudomonal infections.
(Piperacillin, Ticarcillin) |
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Term
| PCNs + beta-lactamase inhibitor (B) |
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Definition
-When you need to use a specific drug.
-Spectrum: Gram+/-, anaerobes
-Amoxicillin/clavulanate (PO)
-Ampicillin/sulbactam, pipercillin/tazobactam, ticarcillin/clavulanate (IV) |
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Term
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Definition
MOA: same as PCNs, bactericidal
Resistance: enzymes(1-3 gen)
Interactions: alcohol, warfarin (nMTT side chain), probenacid
-A.E: allergic reactions, bleeding, biliary sludging. |
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Term
| Cephalosporins: Generations |
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Definition
1st: (N) Gram +; indicated for strep/staph infections, surgical prophylaxis, UTI
2nd:(B) Gram+, some g-, some anaerobes; indicated for upper respiratory tract infections, intraabdominal, surgical prophylaxis
3rd: (B) G->G+, good CNS penetration; indicated for pneumonia & meningitis
4th: (B) G+ & G-, good CNS penetration |
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Term
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Definition
MOA:similar to PCN, bactericidal
A.E: GI, seizures, allerigic reaction/rash
Indications: mixed or complicated infections, resistant pathogens
(not MRSA) |
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Term
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Definition
MOA: Similar to PCN, bactericidal
Spectrum: ONLY G-
-No cross reactivity w/ PCNs (for those w/ anaphylaxis to PCN) |
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Term
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Definition
MOA: inhibits cell wall formation, bactericidal. IV/PO
A.E: Infusion-related reactions due to histamine release (red man syn)
Nephrotoxicity (trough conc) & ototoxicity (peak conc)--therapeutic drug monitoring
-Spectrum: MRSA, serious G+ infections in pts w/ PCN allergy, PO for c. dif infections |
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Term
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Definition
MOA: disrupts cell plasma membrate & results in cell death
-IV
-A.E: muscle toxicity, GI
Spectrum: MRSA, G+ skin infections, endocarditis, pts w/ PCN allergy |
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Term
Aminogylcosides
Protein synthesis inhibitors |
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Definition
MOA: bactericidal
-nephrotoxicity, ototoxicity, NM blockade (tx drug monitoring essential!)
-Increased risk of nephrotoxicity assoc w/ elderly, preexisting kidney disease, concurrent nephrotoxic drugs, duration >10 days. Toxicity assoc w/ total accum dose.
Mechanism of resistance: bac enzymes.
Spectrum: all G-, G+ synergy w/ gemtamicin.
Interactions: nephro/ototoxic drugs, neuromuscular drugs. |
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Term
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Definition
MOA: bacteriostatic; inhibit protein syn.
Resistance: decrease drug uptake, increase drug inactivation.
Spectrum: Staph, Strep, some G- & anaerobes, atypicals, MRSA, spirochetes, Borrelia burgdorferi, Rickettsia
A.E: teeth staining (not for children <8 or pregnancy), photosensitivity, dizziness, tinnitus (minocycline)
Interactions: Calcium, iron, mag, aluminum, zinc.
Indications: Rocky Mt syn, Chlamydia trachomatis, atypical pneumonia, Lyme disease, anthrax, acne, periodontal disease |
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Term
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Definition
MOA: inhibit protein syn-bacteriostatic
Spec: Staph, strep, MRSA, VRE, G- (not s. aeruginosa) anaerobes
-N/V, tooth discoloration; not for those <8 or pregnancy.
Interactions: warfarin
-Indications: complicated skin infections, intraabdominal infections. |
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Term
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Definition
MOA: inhibit protein syn-bacteriostatic
Resistance: efflux pump, modifaction of target ribosomes.
Spec: Stap, strep,some G- & anerobes, atypicals, Chlamydia trachomatis
A.E: GI UPSET, OTc prolongation, superinfection of bowel
Interactions: CYP drugs w/ eryth&clarith (warfarin, carbamez, statins, theophylline)
Indications: bronchitis, sinusitus, CAP, dental, Chalm. trach, B pertussis, H. pylori |
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