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How do antibiotics work (four mechanisms)?
Inhibit bacterial cell wall synthesis; disrupt or alter bacterial cell membrance permeability; inhibit baterial protein synthesis (interrupt protein synthesis or form defective proteins); inhibit ability of bacteria to synthesize essential metabolites
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Bacteriostatic
Stops bacterial growth but does not kill the bacteria - ex. Sulfanomides
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Bacteriocidal
Kills bacteria by disrupting the bacterial cell wall - ex. penicillin
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Common side effects to antibiotics
Rash, fever, itchy hives (urticuria with pruritis), chill, redness (general erythema), anaphylaxis (circulatory collapse, airway narrowing)
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Four types of penicillin
Basic (natural), penicillinase-resistant, broad spectrum, extended spectrum
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Beta-lactam ring is common for both...
- penicillins and cephalosporins
- breakage causes loss of effectiveness for both
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Beta-lactamase inhibitors prevents.....
loss of antibiotic activity
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Hypersensitivity (anaphylaxis) is an adverse effect....
shared by penicillins and cephalosporins
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Four generations of cephalosporins
- First generation - effective against gram-positive bacteria; least resistant to beta-lactamase
- Second generation - more resistant to beta-lactamase; greater gram-negative activity than gram-positive
- Third generation - more active against gram-negative; resistant to beta-lactamase producing bacteria
- Fourth generation - similar to third generation but more resistant to beta-lactamase bacteria; many can cross brain-blood barrier; effective in malaria
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When are lincosamides bacteriostatic and bacteriocidal
Bacteriostatic at normal dose and bacteriocidal at large doses
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So, tell me about vancomycin...
It's a glycopeptide, it's bacteriocidal, it was once considered the antibiotic of last resort and adverse effects include ototoxicity and nephrotoxicity
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Aminoglycosides are...
bacteriocidal; used in combination with penicillins, cephalosporins or vancomycins; side effects include nephrotoxicity, neurotoxicity, hypersensitivity, ototoxicity and neuromuscular weakness
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Tetracyclines are...
the first broad-spectrum antibiotic; bacteriostatic by inhibiting protein synthesis; contraindicated in pregnant women, breast-feeding women and children under 8 (leads to permanently mottled and discolored teeth and impaired bone development); useful for treating Lyme Disease
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Chloramphenicol is...
broad-spectrum antibiotic; inhibits protein synthesis; bacteriostatic at normal dose and bacteriocidal at larger doses; contraindictated in pregnant women and breast-feeding women (neonates may develop gray syndrome)
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Fluoroquinolones are...
synthetic, broad-spectrum antibiotics; affect bacterial growth by inhibiting DNA replication
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Sulfanomides are...
synthetic, broad-spectrum antibiotics; affect bacterial growth by inhibiting DNA replication
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Tuberculosis
Mycobacterium tuberculosis; kills more people than any other infectious disease; 1 in 3 people infected with dormant TB worldwide; bacteria become active as a result of anything that reduces a person's immunity (HIV, advancing age, medical condition); there is a multi-drug resistant TB
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What are the first-line drugs for TB?
Isoniazid, Ethambutol, Pyrazinamide, Rifampin, Streptomycin
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What are the second-line drugs for TB?
Aminosalicylate sodium, Capreomycin, Cycloserine, Ethionamide, Rifabutin
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