Antimicrobial Drugs

Works on Cell Wall
1. Peptidoglycan cross-linking inhibition= no wall synthesis
  1. Penicillinase Resistant
    1. Naficillin
      1. Staph. Aureus; except MRSA
      2. Interstitial Nephritis
    2. Oxacillin
    3. Dicloxacillin
    4. Aztreonam
      1. Gram NEG RODS ONLY!!
    5. Vancomycin
      1. Gram POSITIVE ONLY! Multi-drug resistant organisms
        MRSA, Enterococci, & C.diff
      2. RED MAN SYNDROME (diffuse flushing) Nephrotoxicity, Ototoxiicity, Thrombophlebitis
  2. NOT resistant to B-lactamase
    1. Penicillin (B-lactam)
      1. 1.Gram + organisms w/ no B-lactamase, 2.Neisseria M. 3.Treponema Pallidum
      2. Hemolytic Anemia
    2. Ampicillin/AmOxicillin
      1. EXTENDED SPECTRUM: 1.H.influenzae 2.E.coli 3.Listeria M. 4.Proteus Mirabilis 5.Salmonella 6.Shigella
      2. Pseudomembranous Colitis
    3. +Clavulanic Acid/ Tazobactam/ Sulbactam (B-lactamase inhibitor)
    4. Ticarcillin/ Piperacillin
      1. Pseudomonas
    5. Cephalosporins
      1. First Generation
        Cefazolin/cephalexin
        Prior to surgery for Staph a.
        1. ProteusM. 2.E.coli 3.Klebsiella
      2. Vit K deficiency
      3. 2nd generation
        Ceftriaxone
        Meningitis and Gonorrhea
        Ceftiazidime
        Pseudomonas
Protein Synthesis Inhibitors
1. 30S inhibitors
  1. Aminoglycosides
    1. Gentomycin Neomycin Streptomycin
    2. Nephrotoxicity Ototoxicity NM blockage
  2. Tetracyclines
    1. Tetracycline Deoxycycline
      1. Borrelia Burgdorferi M.pneumonia Rickettsia Chlamydia
      2. Teeth discoloration Bone growth inhibition Photosensitivity
2. 50S inihibitors
  1. Chloramphenicol
    1. MENINGITIS (H.influenza, N. meningitis, Strep. pneum)
      1. Anemia Pancytopenia
  2. Erythromycin Azithromycin
    1. Atypical pneumonias (Mycoplasma & LEGIONELLA= Eryth #1) Chlamydia Strep infections in pencillin allergy
    2. Motility problems Arrythmia Cholestatic hepatits Rash Eosinophilia
  3. Clindamycin
    1. Pseudomembranous colitis; ASPIRATION PNEUMONIA (alcoholics) = works against oral anaerobes & G+ aerobes (S.pneum) ; and oral infections w/ mouth anaerobes
      1. Treats anaerobes ABOVE the diaphragm vs Metronidazole that works BELOW
Others:
1. Isoniazid (INH)
  1. Myco. TB (& prophylaxis)
    1. Neurotoxicity (due to similar structure to B6)
2. Rifampin
  1. Mycob. TB
    1. ORANGE Urine
3. TMP-SMX
  1. (Trimethoprim- Sulfamethoxazole)
    1. HIV prophylaxis Hx of recurrent UTI's
4. TB Treatment
  1. Prophylaxis
    1. Isoniazid
  2. Active infection treatment drugs
    1. Isoniazid
    2. Rifampin
    3. Ethambutol
    4. Pyrazinamide
      1. Only one that works best in LOW pH and INTRACELLULARLY
    5. I/E work on the cell wall. Rif- inhibits DNA- dependent RNA polymerase Pyra-kills intracellularly
5. '-floxacin' (Fluroquinolones)
  1. Inhibit DNA gyrase & topoisomerase IV
    1. G- rods of urinary and GI tracts; Neisseria
      1. DONT take with ANTACIDS!! GI upset; Superinfections; TENDONITIS; Tendon rupture; Myalgias
6. Metranidazole
  1. Forms free radicals in the bacteria
    1. Treats ANAEROBIC infections BELOW the diaphragm; Giardia; Entamoeba; Trichomonas; Gardnerella vaginalis; and H.pylori (+clarithromycin & PPI)
      1. Disulfiram-like rxn w/ alcohol; METALLIC TASTE

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Antimicrobial Drugs

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