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Intro to Antibacterial Drugs
Notes
31
Pharmacology
Graduate
08/21/2010

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Term
Bacteristatic Drugs
Definition
macrolids and clindamycin inhibit the multiplication of bacteria
Term
Bactericidial Drugs
Definition
e.g. B-lactams, fluoroquinolones and aminoglycosides kill bacteria
Term
the names of the fluoroquinolones end in
Definition
-floxacin
Term
Time Dependent Killing
Definition
Depends on maintaining the plasma drug concentration above the MIC. Increasing the Cp above the MIC does NOT enhance killing. Examples B-lactams and vancomycin
Term
Concentration Dependent Killing
Definition
rate and efficiency of killing increases as the Cp Increases. Eg. fluoroquinolones and aminoglycosides, e.g. gentamicin amikacin, and tobramycin
Term
pos-antibiotic effect
Definition
drug continues to be bacteriostatic or cidal after Cp has fallen below MIC. e.g. fluoroqiolones and aminoglycosides
Term
antibiotic synergism
Definition
inhibition of seqential enzymatic steps or killing bacteria by two diff mechanisms
Term
antibiotic antagonism
Definition
one drug decre the antibiotic effect of another drug. static drugs antagonize killing action of any bactericidal drug.
Term
antibiogram
Definition
more than 80% need to be sensitive for an ab drug to be considered effective
Term
antimetabolites
Definition
e.g. trimethoprim + sulfamethoxazole given singly they are static, given together they are bacteriostatic sometimes cida.
Term
inhibitors of protein synthesis
Definition
static drugs - chloramphenicol, tetracyclines, macrolides e.g. erythromycin, clindamycin, aminoglcosides e.g. gentamicin (cidal), linezolid (cicdal against certain bugs but not MRSA)
Term
Inhibitors of cell wall synthesis
Definition
penicillins
carbapenems e.g. imipenem meropenem
monobactams e.g. aztreonam
cephalosporins
vancomycin
isoniazid
ethambutol is only bacterostatic
bactracin
Term
inhibitors of DNA/RNA synthesis
Definition
bactericidal drugs
fluroquinolones e.g. levofloxacin
rifampin
nitrofurantoin (bladder only)
Term
Increase bacterial membrane permeability
Definition
bactericidal drugs
polymixin B
colistin ( polymixin E)
Term
Staph aureus MOR
Definition
B-lactamase destroy B-lactam ring.
Oxacillin and Nafcillin are not degraded by this penicillinase
Term
MRSA, ORSA MOR
Definition
express an additional B-lactam binding site which is coded by a mutated bacterial gene
Term
Strep pneumo MOR
Definition
high molecular weight PBP's with decreased affinity for B-lactams
Term
Vancomycin resistant Enterococcus MOR
Definition
VRE's mutated to D-ala-D-lactate so vanc can't bind, gene is plasmid which can be transferred to tother enterococci such as staph = VRSA
Term
bacteria with efflux pumps
Definition
Gram (-) bugs suchs as Pseudomonas and Acinetobacter. Pseudomonas spp. have 20 pumps and 3-4 B-lactamases
Strep pneumo an dStaph aureus may pump out the macrolides
Term
bacterial mutation prevents drug entry
Definition
a mutation i9n Pseudomonas decreases the number of porins which are the sit eof entr of the carbapenems
Term
Usual Gram + MOR
Definition
change in the binding site of the drug creates high lievels of resistance = MRSA, VRE, PCN resistant strep
Term
Usual Gram (-) MOR
Definition
efflux pumps and B-lactamases, can create high concentration of B-lactamase between the cell wall and the cell membrane
Term
Exception: 95% of Staph aureus produce a
Definition
B-lactamase, instead of changing the binding site.
Term
How is resistance acquired
Definition
mutation of bacterial genes which occur at random
sex = conjugation swaps of DMA and plasmisd
cannibalism - bacterial eat free bacterial DNA
transduction via plasmids carried by viruses
plasmids can swap DNA via transposons
Term
CAP typical bugs
Definition
strep pneumo, Hem influ, moraxella spp
Term
CAP atypical bugs
Definition
Mycoplasma, Chlamydia, and Legionella
Term
"Knife and gun club" bacteria = gut anaerobes
Definition
Bacteroides spp., Clostridium spp. and Peptostreptococcus, also entero coccus
Term
Top 3 UTI bugs
Definition
1 - E. cole - Gm(-) aerobe
2 - Klebsiella pneumo - Gm(-) aerobe
3 - Enterococcus faecalis - G+ aerobe,ICU
Term
Gram + resistant bugs
Definition
MRSA
VRE
VREF
PRSP - pen R srep pneumo
Term
Gram (-) R bugs
Definition
MDR Pseudomonas aeruginosa
MDR Entero, Acinetobacter, Klebsiella, E. coli
Term
aminoglycoside and B-lactam combo therapy
Definition
B-lactam enhances the penetration of the aminoglycoside into the cell
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