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ANTIBIOTICS Terms: Def: Names: Chemical, Generic, Trade Bactericidal vs. Bacteriostatic (Kill vs.

Inhibit Growth) Natural/Synthetic/Semi-synthetic Spectrum of Activity: Broad vs. Narrow, G+ vs. GMechanism of Action (MOA)- How does it work? Adverse (side) Effects Families: Sulfa Chemistry- similar to PABA MOA- competitive inhibition Resistance Synergism- increase efficacy when combined c Trimethoprim (Key terms: potentiation, additive effect, antagonism) Kinetics- how often is it dosed? Oral/parenteral? Uses- UTI, otitis media Adverse Effects- photosensitivity, allergies, resistance Penicillins Chemistry Acid stability- can (now) be taken orally Units- cf mgs

MOA- destroys cell wall cross-linkage Resistance Beta lactamase (penicillinase) Synergism- often used with other antibiotics KineticsUses- Gram + bacteria Adverse Effects- Allergies, effect on OC, resistance Cephalosporins- cf PCN Chemistry MOA Generations: change in spectrum of activity 1st- almost all G+, few G2nd- most G+, some G3rd- some G+, most G4th- few G+, almost all GUses- Staph aureus Kinetics Adverse Effects- cross-sensitivity c PCN, No Alcohol !!, pseudomembranous colitis (Clostridium difficile) Macrolides- Safest (?) Chemistry MOA- inhibits tRNA binding to ribosome Resistance

Kinetics Uses- for PCN-allergic Adverse Effects- GI upset (queasy stomach) Tetracyclines- Broad-spectrum (G+ and G-) Chemistry Chelation- irreversible binding to Ca++ MOA- inhibits protein synthesis (attachment of mRNA to tRNA) Resistance Kinetics Uses- zits, UTI (nonspecific urethritis) Adverse Effects- bones, teeth Clindamycin Chemistry MOA Resistance Kinetics Uses- polymicrobial (multi-flora) infections, esp. c diabetics Adverse Effects- STINKS! Derived from sewage Chloramphenicol Chemistry MOA- blocks attachment of mRNA to ribosome

Resistance Kinetics Uses- originally developed to treat neonatal Haemophilus influenzae infections. Today-- Typhus or Typhoid Adverse Effects- Bone marrow suppression, aplastic anemia, Gray Baby Syndrome

Aminoglycosides- The Bad Drugs for the Bad Bugs! Chemistry MOA- leads to misreading of RNA Resistance Kinetics- given parenterally (IV or IM) Uses- serious Gram infections (sepsis) Adverse Effects- kidney damage (nephrotoxicity), deafness Quinolones Chemistry MOA- blocks DNA gyrase Resistance Kinetics- oral administration equivalent to IV Uses- prostatitis, ??? Adverse Effects- drug-induced psychosis (c caffeine), possible tendon rupture, resistance Vancomycin- The LAST Resort Chemistry

MOA ResistanceMRSA VISA VRSA Kinetics Uses- MRSA, pseudomembranous colitis Adverse Effects

Primary Isoniazid (INH) Secondary Rifampin Ethambutol Tertiary Pyrazinamide Streptomycin PAS (Para-aminosalicylic acid) Amikacin Ciprofloxacin Ethionamide Cycloserine

Dapsone (sulfones) Rifampin Clofazimine