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Antibiotics MOA

Terms

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Penicillin
Inactivate bacterial transpeptidases and prevent cross-linking of peptidoglycan polymers to interrupt cell-wall integrity; Gram pos bacteria with thick external cell walls are more susceptible
Vancomycin
inhibits cell wall synthesis. Tricyclic glycopeptide that binds to terminal end of growing peptidoglycan, preventing further elongation adn cross-linking.; Gram + organisms; penetrates CSF only during inflammation
2nd generation cephalosporins
cefuroxime, cefoxitin, cefaclor; Spectrum extended to include H. flu and indole-positive Proteus. Less active against gram + than 1st geneartions
Primaxin
Imipenem/Cilastin; cell wall inhibitor/inhibitor of renal dehydropeptidase I (that inactivates imipenem); Broad spectrum, including S. aureus, E. coli, Klebsiella, Enterobacter and H.flu.
Nafcillin
Also disrupts cell wall formation, but is resistant to beta-lactamase; gram pos cocci, better for beta-lactamase producing staph infx.
3rd generation cephalosporins
cefotaxime, ceftazidime, cefotetan, ceftriaxone; reduced activity against gram+ organisms, but enhanced activity against H.flu, N.gonorrhea, enterobacter, salmonella, serratia, indole-pos proteus; also, improved CSF penetration
Augmentin
amoxicillin + clavulanic acid; Clav. acid irreversibly inhibits beta lactamase
Erythromycin
Macrolide inhibits protein synthesis by binding irreversibly to the bacterial 50S ribosomal subunit to terminate protein synthesis. Gram pos. , Legionella, Mycpolasmaaa, pertussis
Aminoglycosides
Inhibit bacterial protein synthesis. Interact with receptor proteins on the 30S ribosomal subunit. Are polycations that require active uptake, so gram neg aerobes only...enterobacter, Pseudomonas, Klebsiella, Serratia, Proteus
Tetracyclines
Bind to the 30S subunit and prevent binding of tRNA to the acceptor site on the mRNA-ribosome complex, inibitins bacterial protein synthesis. Active against gram neg and pos organisms, but use is declining. Mostly for Rickettsial infx
Sulfonamides
Prevent the synthesis of dihydrofolic acid. Competes with PABA for dihydropteroate synthetase. Inhibit both gram neg and gram pos organisms.
Trimethoprim
Inhibits dihydrofolate reductase. Used in combination with sulfamethoxazole
Rifmapin
Inhibits bacterial DNA-dependent RNA polymerase by binding to the beta subunit of the polymerase. Most gram pos organisms
Aztreonam
naturally occuring monobactam, also transpeptidase inhibitor. Activity against gram neg but none for gram positive or anaerobes.
Nitrofurantoin
Causes bacterial DNA damage by unknown mechanism. Bacteriostatic. Used soley as a urinary tract antiseptic against E.coli
Quinolones
Inhibit the nicking and closing action of bacterial DNA gyrase during bacterial DNA replication and growth. Concentrated in urine, therefore used as urinary tract antiseptics
4-Quinolone derivatives
flourinated derivatives of nalidixic acid. Inhibit bacterial DNA gyrase (topoisomerase II) Gram neg are more sensitive than gram pos.
Isoniazid
Inhibits cell wall synthesis in mycobacteria. Most active drug against M. tuberculosis and M. kansasii
1st Generation Cephalosporins
cephalothin, cephalexin, cefazolin; as with pcn, disrupts cell wall; good activity agains most gram pos and some gram neg (E. coli and klebsiella)

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