all aboard the antibiotic express
TRANSCRIPT
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All Aboard the Antibiotic Express
With Shraya Pandya
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Learning Objectives/Outcomes 1. To be able to list sites of antibiotics with examples
2. To recognize specific groups of antibiotics including:Beta LactamsGlycopeptides
AminoglycosidesMacrolides
Fluoroquinolones3. To give examples of antibiotic side - effects and interactions
Pharmacology: Antibiotics
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Contents
Key Terms Sites of Action Specific Groups In Practice
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Key TermsBactericidal:
Kill the bacteria.
Bacteriostatic:
Prevent bacteria from multiplying.
Key Terms
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Sites of Action
Sites of Antibiotic
Action
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Sites of Antibiotic Action• Cell Wall Synthesis• Cell Membrane• 30s Protein Synthesis• 50s Protein Synthesis• DNA• DNA Gyrase• Folic Acid Synthesis
Sites of Action
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Sites of Antibiotic ActionSites of Action
Cell MembranePolymixins
Cell Wall SynthesisPenicillinsVancomycinCepahlosporinsCarbapenems
30s Protein SynthesisTetracyclinesStreptomycin (Aminoglycosides)Gentamicin (Aminoglycosides)
50s Protein SynthesisErythromycin (Macrolides)Clindamycin (Lincosamides)
DNANitrofurantoin (Macrobids)Metronidazole
DNA GyraseCiprofloxacin, Levofloxacin
Folic Acid SynthesisTrimethoprimSulfamethoxazole
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Specific Groups
Specific GroupsLet’s Go Over…
Beta LactamsGlycopeptides
AminoglycosidesMacrolides
Fluoroquinolones
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Inhibiting Cell Wall SynthesisBETA LACTAMS: PENICILLINS
Action: Bactericidal
Examples: Amoxicillin, Flucloxacillin, Piperacillin, Benzyl Penicillin
Uses: Broad - SpectrumBecomes more efficacious with Beta - Lactamase Inhibitors (Clavulanic Acid, Tazobactam) which will inhibit the bacterial breakdown of penicillin
Side Effects: Allergic Reactions - Immediate IgE mediated Anaphylaxis, Cholestasis (Flucloxacillin + Co-Amox), Rash with mononucleosis (Amoxicillin), Thrombocytopaenia
Interactions: Allopurinol + Methotrexate
Specific Groups
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Inhibiting Cell Wall SynthesisBETA LACTAMS: CEPHALOSPORINS
Action: Bactericidal
Examples: Cefuroxime, Cefotaxime, Ceftriaxone
Uses: Cover Gram + and -, Pneumonia, Serious Intra abdominal infections and UTIs
Side Effects: Nephrotoxicity, Diarrhoea, Risk of C. difficile infection, Pseudocholelithiasis(ceftriaxone)
Specific Groups
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Inhibiting Cell Wall SynthesisBETA LACTAMS: CARBAPENEMS
Action: Bactericidal
Examples: Meropenem, Imipenem
Uses: Gram + and - + Anti-Pseudomonal/Anaerobes
Side Effects: Nephrotoxicity at high concentrations, Rash, Seizures
Specific Groups
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Inhibiting Cell Wall SynthesisGLYCOPEPTIDES
Action: Bactericidal
Examples: Vancomycin, Teicoplanin
Uses: Against MRSA, C. difficile (hospital acquired)
Side Effects: Nephrotoxicity, Skin rashes, Red Man Syndrome (Vancomycin)
Specific Groups
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Inhibiting Protein Synthesis: 30sAMINOGLYCOSIDES
Action: Bactericidal
Examples: Gentamicin, Streptomycin, Amikacin
Uses: Gram +, Systemic Sepsis
Side Effects: Ototoxicity (Gentamicin), Nephrotoxicity
Interactions: Increased nephrotoxicity with vancomycin, CI in Myasthenia Gravis (Gentamicin)
Specific Groups
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Inhibiting Protein Synthesis: 30sTETRACYCLINES
Action: Bacteriostatic
Examples: Tetracycline, Doxycycline
Uses: Gram +, Renal Impairments as an alternative to B-lactams
Side Effects: Loss of appetite, GI Upset/ AAD, Sore throat, Photosensitivity
Specific Groups
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Inhibiting Protein Synthesis: 50sMACROLIDES
Action: Bacteriostatic + Bactericidal
Examples: Clarithromycin, Azithromycin, Erythromycin
Uses: Gram + , STIs, RTI, Otitis Media
Side Effects: QT prolongation, GI disturbance, Hypersensitivity, Skin rashes, Cholestatic Jaundice, Tinnitus (Azithromycin)
Interactions: StatinsSpecific Groups
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Inhibiting Protein Synthesis: 50sLINCOSAMIDES
Action: Bacteriostatic + Bactericidal
Examples: Clindamycin, Lincomycin
Uses: Prophylaxis for Infective Endocarditis in Penicillin Allergy, Osteomyelitis
Side Effects: Skin rash, Diarrhoea,
Specific Groups
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DNA GyraseFLUOROQUINOLONES
Action: Bactericidal
Inhibit Topoisomerase II (DNA Gyrase) and IVExamples: Ciprofloxacin, Levofloxacin
Uses: Gram - (GI/UTI), Anti-Pseudonomal, Opthalmic uses, TB
Side Effects: Tendonitis / rupture , AAD, Prolonged QT, Lowers seizure threshold, Photosensitivity (Ciprofloxacin)
Interactions: Avoid in pregnancy + G6PD
Specific Groups
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Folic Acid SynthesisSULPHONAMIDES
Action: Bacteriostatic
PABA to DHFA blocked
Side Effects: Hypersensitivity, Skin rash, Headaches, PhotosensitivityThrombocytopaenia
Usually used in combination with trimethoprim
Specific Groups
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Folic Acid SynthesisTRIMETHOPRIM
Action: Bacteriostatic
DHFA to THFA Blocked
Uses: In combination with sulphonamide (co-trimoxazole), RTI (Pneumonia), UTI
Side Effects: CI in patients with Megaloblastic Anaemia (Folate Deficiency), Pruritus, Suppression of hematopoiesis, Photosensitivity
Specific Groups
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DNA MACROBIDS
Action: Bactericidal
Examples: Nitrofurantoin
Uses: Often used for UTIs, Against G -
Side Effects: Peripheral Neuropathy, GI Upset, Lung Fibrosis (Long term use)
Specific Groups
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DNA SynthesisMETRONIDAZOLE
Action: Bactericidal
Reduction of metronidazole into active form in anaerobes only.
Uses: Treat C- Difficile
Side Effects: Metallic Taste, Intolerance to Alcohol
Specific Groups
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In Practice:Tips + Tricks
In Practice
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Antibiotic Coverage
So here’s one way to learn them…Many charts like this are available.Here’s one from Zero to Finals
But if this seems overwhelming to you… check out the next slide
Antibiotics in Practice
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Wheel of Common Antibiotics in Practice
Antibiotics in Practice
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Antibiotics in Practice
Wheel of Abx
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Antibiotics in Practice
Wheel of Abx
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Antibiotics in Practice
Wheel of Abx
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Antibiotics in Practice
Wheel of Abx
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Antibiotics in Practice
Wheel of Abx
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Antibiotics in Practice
Wheel of Abx
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Antibiotics in Practice
Wheel of Abx
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There’s no perfect way…Find what works for you!
• Make your own mnemonics• Draw and Write• YouTube!• See it in practice!
Antibiotics in Practice
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Summary1 2 3
Lesson Recap 1Various sites of action to
inhibit bacteria:
• Cell Wall Synthesis
• 30s/ 50s Protein
Synthesis
• DNA
Lesson Recap 2Remember the main uses + side effects as its high yield
information for your exams!
Lesson Recap 3Think about what you see
at your local trusts and put your knowledge into
practice!
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Additional Resources
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