pharm 5 set 3

• disrupt cell wall (mammals have no cell wall)
• inhibit of unique microbial enzymes
• disrupt bacterial protein synthesis

static= slow microbial growth but do not cause cell death

cidal= directly lethal to bacteria at clinically achievable concentrations

• dec [ ] of drug at the site (dec intake, inc export)
• Inactivate drug (enzyme- beta lactamase)
• Alter drug target receptor (change own structure)
• Produce antagonist (block receptors)

• untreatable infections - virus
• incomplete Tx
• idiopathic fever
• improper dosage
• lack of id of microbe
• omission of surgical drainage

show up during treatment for of primary infection

• penicillins
• cephalosporins
• carbapenems
• monobactums

• weaken cell wall, causing fluid intake and rupture
• bactericidal
• bacterial resistance
•  - Gram neg wall is impervious to peni
•  - beta-lactamase inactivates peni

• narrow spectrum penicillinase sensitive
• narrow spectrum penicillinase resistant
• broad spectrum
• extended release

• Not given alone
• Must be prepared in combo with peni's
• Boost peni action

methicillin resistant staph aureus

• type 1 hypersens
• mild to life threating

Use Cephalosporin for pt. with allergy

Epi and resp. support

• weaken cell wall
• most widely used group
• Beta-lactamase resistant
• similar to peni in structure
• bactericidal like peni
• eliminated by kidney

se= allergy, bleeding (interfre with Vit. K), thrombophlebitis, ETOH

• next gen cephlo's attempt to be more:
• -beta-lactamase resistant
• -effective against gram negs
• -able to reach CSF

• cell wall weakener
• not effective against MRSA

• cell wall weakener
• narrow spectrum gram neg

inhibits cell wall synthesis

• used for severe infections 
•  - MRSA, C-Diff

• SE= ototoxicity
•  = thrombophlebitis
•  = allergy
•  = RED-MAN SYNDROME

best to give slow in central line if possible

• tetracyclines
• macrolides
• clindamyacin
• Chloramphenicol
• Newer drugs

• inhibit protein synthesis
• Broad-spectrum antibiotic
• bacterial entry system w/o getting into mammal cells

absorption - cut out dairy while using

SE= GI, discolored teeth, superinfect, photosensitivity, hepatotoxicity, renal toxic

• protein synth inhib
• broad spectrum antibiotic
• Use these and cephalo's if allergic to peni

SE= sudden cardiac death, GI, cholestatic hepatitis, superinfect

protein synth inhib

can cause super infect w/ C-Diff and bloody mucous stool

Indicated only for certain anaerobic infections located outside the CNS

• new protein synth inhib
• Oxazolidinone classification

• acts against mutli-drug resistant microbes
•  - VRE and MRSA

• new protein synth inhib
• Glycylycline classification

acts against broad spectrum of resistant microbes

• narrow spectrum antibiotic
• create abnormal cell wall protein

resistance is growing

watch peak and trough very closely with this drug

• nephrotoxicity
• otoxicity
• hypersens rxns
• nueromuscular blockade (Ca+ salts)
• drug interactions (w/ penicillin in particular)

Aminoglycoside

used for serious infections caused by aerobic gram-neg bacilli

Has toxic SE's

• 1st antibiotic
• Inhib bacterial folic acid production

used for UTI's

• se= hypersense rxns
•  = hematologic effects
•  = kernicterus (bilirubin deposits in fetal brain
•   --> Prego category X drug
•  = Crystalluria

2nd gen sulfonamide

UTI only

still has Hematalogic effects

combo to dec dose and SE's

Bactrim or Septra

for uncomplicated UTI's

two or more drug types are recommended for simultaneous use for TB b/c of resistance

• induction phase - 2 months
• Continuation phase

• I= eliminate active TB
•  = Isoniazid (INH)

• C= eliminate intracellular "persisters"
•  = still using INH

• Direct Observation Therapy
• can dose 2-3 times a week

TB drugs will interact with HIV drugs

• breaks down cell wall
• introduce with other, continue by it self

• se= peripheral neuropathy
•  = vit B deficiency
•  = Hepatotaoxicity
•  = anemia

• broad spectrum antibiotic
•  -TB, leprosy, H Flu, staph, legionella

P450 enzymes increase, decreasing level of other drugs

se= hepatits, discolor of body fluids

• unknown mech of bacterial kill
• will replace INH for TB

se= hepatotoxicity, hyperuricemia, arthralgia

• bacteriostatic --> prevents reproduction
• Stops cell wall formation
• used for TB multi drug regimens

se= optic neurtits, allergy, hyperuricemia

Active against all strands of MT

Leprosy

skin lesions, neuropathy, resp tract

used together for leprosy

seen in chicken farmers

resp lesions that can spread to any organ

preventative drugs used for myobac avium

Ethambutol

• "floxin"
• broad spectrum antibiotic
• inhibits bacterial DNA

DOC for Anthrax and GI infections

SE= GI, HA, Candida of pharynx and vagina

bactericidal

• used for many GI infectious agents
• DOC for protozoa infections

SE= neurotoxicity, allergy, superinfections