SEM 2 ANTIBACTERIAL AGENTS

• Interfere with last step of cell wall synthesis (transpeptidation or cross-linking


  Penicillins
• 2 Natural Penicillins 


  Penicillin G or Benzylpenicillin and Penicillin V (Phenoxymethylpenicillin)
• Penicillin G (Benzylpenicillin)-______ (Procaine and ____) Use: ___ and ___


  PO, IV, IM-Benzocaine-RHD-Syphilis
• Interfere with last step of cell wall synthesis (____)


  transpeptidation or cross-linking
• Penicillinase-Resistant/Antistaphylococcal Penicillins/Narrow Spectrum 


  Methicillin, Nafcillin, isoxazolyl Penicillins
• ____(2,6-dimethoxyphenylpenicillin) - Prototype; off the market (interstitial nephritis)


  Methicillin
• (2-ethocy-1-phenylpenicillin) 


  Nafcillin
• Beta lactam attached to thiazolidine ring, Nucleus: 


  6-aminopenicillanic acid
• (Oxacillin, Cloxacillin, Dicloxacillin-best absorbed)


  Isoxazolyl Penicillins
• . Aminopenicillins/Broad Spectrum 


  Ampicillin, Amoxicillin
• Ampicillin (___,___) - Prodrugs: Hetacillin, ___,___


  Parenteral, poor Gl absorption- Bacampicillin, Cyclacillin
• Extended Spectrum/Anti-Pseudomonal Penicillins 


  Carboxypenicillins, Ureidopenicillins
• (Carbenicillin, Ticarcillin) 


  Carboxypenicillins
• (Piperacillin-most potent, Azlocillin, Mezlocillin)


  Ureidopenicillins
• (Clavulanic acid, sulbactam, tazobactam)


  Beta-lactamase Inhibitors
• No antibacterial activity. They inactivate beta-lactamases


  Beta-lactamase Inhibitor
• Beta-lactam ring attached to dihydrothiazine ring; Nucleus: 7- aminocephalosporanic acid


  Cephalosporins
• ____Thienamycin, Meropenem, Imipenem (cleaved by dihydropeptidase; cilastatin)


  Carbapenems
• The beta-lactam ring is not fused to another ring, no cross sensitivity with penicillin


  Monobactam
• Monobactam (___)


  Aztreonam
• MOA: inhibits mucopeptide cell wall synthesis of G (+) bacteria


  BACITRACIN (Bacillus subtilis)
• BACITRACIN (____) 


  Bacillus subtilis
• VANCOMYCIN (___)


  S. orientalis
• VANCOMYCIN (S. orientalis) - Glycopeptide • DOC for Pseudomembranous colitis caused by ___


  Clindamycin
• Redman's syndrome (diphenhydramine before administering; slow IV infusion/drip)


  VANCOMYCIN
• ___ (diphenhydramine before administering; slow IV infusion/drip)


  Redman's syndrome