Although 1st generation cephalosporins (cefazolin, cephalexin) treat mostly Gram(+) cocci, they also treat some Gram(-) organisms, including: Proteus mirabilis E. coli Klebsiella pneumoniae
2nd generation cephalosporins (cefoxitin, cefaclor, cefuroxime) treat Gram(+) cocci & the following Gram(-) organisms: Haemophilus influenzae Enterobacter Neisseria Proteus mirabilis E. coli Klebsiella pneumoniae Serratia marcescens
Make imipenem EVER LASTIN' with ciLASTatIN
Imipenem is a broad-spectrum, β-lactamase-resistant carbapenem and must be administered with Cilastatin (an inhibitor of renal dehydropeptidase I) to decrease inactivation of the drug in the renal tubules
Pay back 2 D-alas ("dollars") for vandalyzing
Vancomycin (a glycopeptide) resistance occurs when D-Ala D-Ala changes to D-Ala D-Lac in crosslinks, and then it cannot bind and prevent formation of cell wall precursors.
Side note: Cycloserine inhibits D-ala racemase and D-ala ligase
"Mean" GNATS canNOT kill anaerobes
The aminoglycosides require O2 for transport Gentamycin*** Neomycin Amikacin*** Tobramycin*** Streptomycin
Toxicity: Nephrotoxicity Ototoxicity Teratogen
MacroSlides ACE it
Macrolides (ACE: azithro-, clarithro, and erythro-mycin) inhibit protein synthesis by blocking translocation "sliding" (bind 23S rRNA of 50S subunit)
TMP = "Treats Marrow Poorly"
Trimethoprim (TMP) (a diaminopyrimidine; dihydrofolate analogue) has the side effects of: (1) megaloblastic anemia (2) leukopenia (3) granulocytopenia
FluoroquinoLONES hurt attachments to your BONES
FluroquinoLONES (cipro-, moxi-, and levo-floxacin), which inhibit DNA gyrase (topoisomerase IV), have the side effects of tendonitis and tendon rupture in adults
GET GAP on the Metro!
Metronidazole (an nitroimidazole) treats anaerobic infections below the diaphragm and has a disulfram-like reaction; treats: Giardia Entamoeba Trichomonas Gardnerella vaginalis Anaerobes (Bacteroides & C. dif) and with bismuth & amoxicillin/tetracycline for "triple" therapy vs. H. Pylori
RIPE for treatment of TB (mycobacteria tuberculosis)
Rifampin --> NEVER used alone Isoniazid Pyrazinamide Ethambutol
***All TB drugs are hepatotoxic!
Rifampin's 4 R's:
RNA polymerase inhibitor Revs up microsomal P450 (hepatotoxicity) Red/orange body fluids Rapid resistance if used alone
Unlike ofter penicillins, Nafcillin is Not susceptible to β-lactamases
Nafcillin is a penicillinase-resistant penicillin (along with methicillin and oxacillin)
PolymyxiNs cause Nephrotoxicity & Neurotoxicity
Colistin (a polymyxin), which destroys cell membranes) is the drug of last resort for Gram(-) bacteria because of side effects
Treats anaerobes above diaphragm? vs. Treats anaerobes below diaphragm?
Which antibiotics block protein synthesis at 30S ribosomal subunit AND which ones are bacteriCIDAL vs. bacterioSTATIC?
A site (bacteriCIDAL) (1) aminoglycosides (gentamycin, tobramycin, amikan) -->ONLY(?) protein synthesis inhibitor that is bactericidal (cause insertion of wrong amino acids) -->ineffective against anaerobes (requires O2 to absorb)
A site (bacterioSTATIC) (2) tetracyclines (tetracylines, doxycyclines, monocycline) (3) glycylcyclines (tigecycline)
BAM! Use these drugs and H. pylori is gone!
Bismuth Amoxicillin Metronidazole
CHloramphenicol is CHeap, so MPHs like to use it
Chloramphenicol is cheap, so it is used for meningitis caused by: Meningococcus Pneumococcus H. influenzae