-
Drugs that block cell wall synthesis by inhibiting peptidoglycan cross-linking
PCN, methicillin, amp, pip, cephalosporins, aztreoam, imipenem
-
Drugs that block peptidoglycan synthesis
Bacitracin and vanc
-
Drugs that block nucleotide synthesis
Sulfonamides and trimethoprim
-
Drugs that block DNA topoisomerases
fluoroquinolones
-
Drugs that block mRNA synthesis
Rifampin
-
Drugs that damage DNA
metronidazole
-
Drugs that block 50s (block protein synthesis)
Chloramphenicol, macrolides, clindamycin, streptogramis (quinupristin and dalfopristin)
-
Drugs that block 30s (block protein synthesis)
Aminoglycosides, tetracyclines
-
PCN
- Mechanism: bind penicillin binding proteins and blocks transpeptidase cross-linking of peptidoglycan
- Use: Group A strep, clostridium perfringes, actinomyces, and syphilis, and anaerobes
- SE: Hemolytic anemia
-
Amp
- Mechanism: Binds PCN-binding proteins and blocks transpeptidase cross-linking of peptidoglycan
- Use: G+, G-, Anaerobes-> HIB, E coli, Listeria, enterococcus, proteus, shigella, salmonella
- SE: Rash and pseudomembranous colitis
-
Naf
- Mechanism: Blocks transpeptidase cross-linking of peptidoglycan -> no cell wall
- Use: G+, anaerobs, MSSA
- SE: Interstitial nephritis (methicillin)
-
Amp-sulbactam or Amoxicillin/clauvulanic acid(Augmentin)
- Mechanism: Blocks transpeptidase crosslinking of peptidoglycan and has clavulanic acid to block beta-lactamase
- Use: GP, GN, and anaerobes-> MSSA, HIB, E coli
- SE: Rash, colitis
-
Pip-tazo
- Mechanism: Blocks transpeptidase crosslinking of peptidoglycan and has protection against beta-lactamase
- Use: GP, GN, anaerobes, pseudomonas -> MSSA, HIB, Ecoli, Pseudomonas
- SE: Colitis
-
Cefazolin (Keflex)
- 1st gen cephalosporin; also cephalexin
- Mechanism: Inhibits cell wall synthesis
- Use: GP and GN -> SSTI, osteomyelitis, septicemia, Klebsiella, E. coli, HIB
- SE: Vit K def, nephrotox with aminoglycosides, disulfram-like rxn with EtOH
-
Cefoxitin, cefaclor, cefuroxime
- 2nd gen cephalosporin
- Mechanism: Blocks cell wall synthesis
- Use: Hib, Enterobacter aerogenes, Neisseria, Proteus mirabilis, E. coli, Klebsiela, Serratia
- SE: Vit K def, nephrotox with aminoglycosides, disulfram-like rxn with EtOH
-
Ceftriaxone, cefotaxime, ceftazidime
- 3rd gen cephalosporin
- Mechanism: Inhibit cell wall synthesis
- Use: GP, GN-> Has 2nd gen coverage + strep pneumo
- CTX: meningitis and gonorrhea
- Ceftazidime: pseudomonas
- SE: Vit k def, nephrotox with aminoglycosides, disulfram-like rxn with EtOh
-
Cefepime
- 4th gen cephalosporin
- Mech: inhibits cell wall synthesis
- Use: GP, GN, pseudomonas (UTIs!)
- SE: Vit k def, nephrotox with aminoglycosides, disulfram-like rxn with EtOH
-
Cefteroline
- 5th gen cephalosporine
- Mech: inhibits cell wall synthesis
- Use: GP, GN, MRSA
-
Aztreonam
- Monobactam
- Mech: inhibits cell wall synthesis by binding PBP3; synergistic w/ aminoglycosides
- Use: GN rods and pseudomonas
- SE: GI upset
-
Imipenem/cilastatin, meopenem
- Carbapenams are very broad spectrum
- Use: GP, GN, anaerobes, and pseudomonas
- SE: Seizures, rash
-
Ciprofloxacin (-oxacin)
- Fluoroquinolone
- Mech: Inhibit DNA gyrase (topoisomerase II)
- Use: Gp, GN, and pseudomonas
- SE: Superinfection, rash, tendonitis and tendon rupture
-
Gentamicin, neomycin, amikacin, tobramycin, streptomycin
- Aminoglycosides
- Mech: Inhibit formation of initiation complex via 30s -> bactericidal
- Use: GN and pseudomonas; synergistic with Amp for enterococcus infection
- SE: Nephrotox, ototox, teratogen
-
Metronidazole
- Mech: Free toxic metabolites -> DNA damage
- Use: Anaerobes below diaphragm (Gardnerella, bacteroides, C. diff, H. pylori)
- SE: Disulfram-rxn with EtOH, metallic taste
-
Clindamycin
- Mech: Blocks peptide formation at 50s subunit
- Use: GP, Anaerobes, MRSA-> bacteroides fragilis, clostridium perfringes (anaerobes above the diaphragm)
- SE: Colitis
-
TMP/SMX
- Mech: Inhibit dihyropteroate synthesis (no nucleotide synthesis)
- Use: GP, GN, MRSA -> nocardia, chlamydia, UTI
- SE: Nephrotox, photosensitivity, hemolysis in G6PD
-
Doxy
- A tetracycline
- Mech: Prevent aminoacyl-tRNA from attaching by binding 30s
- Use: GP, GN, MRSA -> borrelia burgdorferi, mycoplasma pneumoniae, rickettsia, and chlamydia; good for pt with renal failure
- SE: Teeth discoloration, inhibition of bone growth in kids, photosensitivity
-
Vanc
- Mech: Inhibits cell wall mucopeptide formation by binding D-ala D-ala (bactericidal)
- Use: GP only -> MRSA, enterococcus, C. diff
- SE: Nephrotox, ototox, thrombophlebitis, red man syndrome
-
Tetracycline, demeclocycline, minocycline, doxy
- Tetracyclines that bind 30S and prevent tRNA attachment
- Use: Borrelia burgdorferi, mycoplasma pneumoniae, rickettsia, chlamydia
- SE: Teeth discoloration, bone growth inhibition in kids
-
Erythromycin, azithromycin, and clarithromycin
- Macrolides that bind 50s and prevent ribosomal translocation (macroSLIDES)
- Use: Atypical pneumonias (Mycoplasma, Chlamydia, Legionella); pt with strep allergic to PCN, neisseria
- SE: prolong QT, GI discomfort, acute cholestatic hepatitis
-
Chloramphenicol
- Blocks peptide bond formation at 50s
- Use: Meningitis (HIB, Neisseria, streptococcus pneumoniae)
- SE: Aplastic anemia, grey bby syndrome
|
|
