Adv Pharm exam 3
Antimicrobial resistance risk factors - ANS •Recent use of antibiotics
•Day care attendance
•Age <2 or >65 years
•Multiple medical comorbidities
•Recent hospitalization
•Immunosuppression
antibiotics beta lactams - ANS -Penicillins
-Cephalosporins
-Monobactams
-Carbapenems
all antibiotics - ANS •Beta Lactams
-Penicillins
-Cephalosporins
-Monobactams
-Carbapenems
-
§Fluoroquinolones
§Lincosamides
§Macrolides, azalides, ketolides
§Oxalodinones
§Sulfonamides, trimethoprim, nitrofurantoin and Fosomycin
,§Tetracyclines
§Vancomycin
§Aminoglycosides
§Antimycobacterials
§Antivirals
§Nucleoside analogues
§Antivirals for influenza
§Systemic azoles and other antifungals
§Anthelminthics
§Metronidazole and nitazoxanide
MOA of antibiotics - ANS •Inhibition of cell wall synthesis
•Inhibition of protein synthesis
•Inhibition of DNA synthesis
inhibit cell wall synthesis - ANS Beta-lactams
·Penicillins (+/- Beta-lactamase inhibitors)
·Cephalosporins (3 generations)
·Monobactams
·Carbapenems
Glycopeptides
Fosfomycin
inhibit protein synthesis - ANS Aminoglycosides Ansamycins
,Tetracyclines Glycylcyclines
Macrolides & Ketolides Oxazolidinones
Lincosamides Phenicols
Streptogramins
inhibit membrane functions - ANS Leptopeptides
Polymyxin
antimicrobial selection - ANS •1. Clinical diagnosis
•2. Obtain cultures/specimens
•3. Microbial diagnosis based on most likely organism or culture/test result
•4. Select appropriate medication
•5. May need to change drug based on culture/sensitivity test results
empiric therapy - ANS treatment of an infection before specific culture information has been reported
or obtained
definitive therapy - ANS antibiotic therapy tailored to treat organism identified with cultures
prophylactic therapy - ANS •treatment with antibiotics to prevent an infection, as in intraabdominal
surgery or after trauma
Beta-lactam antibiotics - ANS •Penicillins
•Cephalosporins
·Monobactams
·Carbapenems
, Beta-lactamase inhibitors- Beta-lactamase inhibitor blocks the activity of beta-lactamase enzymes
preventing the degradation of beta lactam antibiotics
Antibiotics in this category (penicillins, cephalosporins & certain miscellaneous compounds) contain a
beta lactam ring that is essential for activity but is also susceptible to hydrolysis by beta-lactamases,
destroying the antimicrobial action of the compound. (Some agents are resistant to destruction by the
beta lactamases). Beta-lactamase-producing staphylococci cause about 80% of community-acquired
staph infections.
Beta Lactam ABX are bactericidal when concentrations exceed the minimum inhibitory concentration
(MIC) for the pathogen for 50% of the dosing interval.
Monobactams & carbopenems are used for treating serious infections and are administered to
inpatients.
natural penicillin ` - ANS PCN V -PO, Prociane & Benzathine PCN -IM, PCN G- IV
aminopenicillins - ANS Ampicillin & Amoxicillin
Penicillinase-resistant penicillins - ANS Nafcillin, Oxacillin, Cloxacillin, Dicloxacillin
anti-pseudomonal penicillins - ANS Piperacillin, Ticarcillin
beta lactum penicillin pharmacodynamics - ANS §Inhibit the biosynthesis of peptidoglycan bacterial cell
wall
§Sensitivity
§Natural penicillins: Streptococcus, some Enterococcus strains, some non-penicillinase-producing
Staphlococcus
§Aminopenicillins greater activity against gram-negative bacteria due to enhanced ability to penetrate
the outer membrane organisms
Antimicrobial resistance risk factors - ANS •Recent use of antibiotics
•Day care attendance
•Age <2 or >65 years
•Multiple medical comorbidities
•Recent hospitalization
•Immunosuppression
antibiotics beta lactams - ANS -Penicillins
-Cephalosporins
-Monobactams
-Carbapenems
all antibiotics - ANS •Beta Lactams
-Penicillins
-Cephalosporins
-Monobactams
-Carbapenems
-
§Fluoroquinolones
§Lincosamides
§Macrolides, azalides, ketolides
§Oxalodinones
§Sulfonamides, trimethoprim, nitrofurantoin and Fosomycin
,§Tetracyclines
§Vancomycin
§Aminoglycosides
§Antimycobacterials
§Antivirals
§Nucleoside analogues
§Antivirals for influenza
§Systemic azoles and other antifungals
§Anthelminthics
§Metronidazole and nitazoxanide
MOA of antibiotics - ANS •Inhibition of cell wall synthesis
•Inhibition of protein synthesis
•Inhibition of DNA synthesis
inhibit cell wall synthesis - ANS Beta-lactams
·Penicillins (+/- Beta-lactamase inhibitors)
·Cephalosporins (3 generations)
·Monobactams
·Carbapenems
Glycopeptides
Fosfomycin
inhibit protein synthesis - ANS Aminoglycosides Ansamycins
,Tetracyclines Glycylcyclines
Macrolides & Ketolides Oxazolidinones
Lincosamides Phenicols
Streptogramins
inhibit membrane functions - ANS Leptopeptides
Polymyxin
antimicrobial selection - ANS •1. Clinical diagnosis
•2. Obtain cultures/specimens
•3. Microbial diagnosis based on most likely organism or culture/test result
•4. Select appropriate medication
•5. May need to change drug based on culture/sensitivity test results
empiric therapy - ANS treatment of an infection before specific culture information has been reported
or obtained
definitive therapy - ANS antibiotic therapy tailored to treat organism identified with cultures
prophylactic therapy - ANS •treatment with antibiotics to prevent an infection, as in intraabdominal
surgery or after trauma
Beta-lactam antibiotics - ANS •Penicillins
•Cephalosporins
·Monobactams
·Carbapenems
, Beta-lactamase inhibitors- Beta-lactamase inhibitor blocks the activity of beta-lactamase enzymes
preventing the degradation of beta lactam antibiotics
Antibiotics in this category (penicillins, cephalosporins & certain miscellaneous compounds) contain a
beta lactam ring that is essential for activity but is also susceptible to hydrolysis by beta-lactamases,
destroying the antimicrobial action of the compound. (Some agents are resistant to destruction by the
beta lactamases). Beta-lactamase-producing staphylococci cause about 80% of community-acquired
staph infections.
Beta Lactam ABX are bactericidal when concentrations exceed the minimum inhibitory concentration
(MIC) for the pathogen for 50% of the dosing interval.
Monobactams & carbopenems are used for treating serious infections and are administered to
inpatients.
natural penicillin ` - ANS PCN V -PO, Prociane & Benzathine PCN -IM, PCN G- IV
aminopenicillins - ANS Ampicillin & Amoxicillin
Penicillinase-resistant penicillins - ANS Nafcillin, Oxacillin, Cloxacillin, Dicloxacillin
anti-pseudomonal penicillins - ANS Piperacillin, Ticarcillin
beta lactum penicillin pharmacodynamics - ANS §Inhibit the biosynthesis of peptidoglycan bacterial cell
wall
§Sensitivity
§Natural penicillins: Streptococcus, some Enterococcus strains, some non-penicillinase-producing
Staphlococcus
§Aminopenicillins greater activity against gram-negative bacteria due to enhanced ability to penetrate
the outer membrane organisms
