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Published byVirginia Hensley Modified over 9 years ago
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Beta lactams
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INHIBITORS OF CELL WALL SYNTHESIS
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Natural: Pencillinase Resistant: (Anti staph) 1)Benzyl pencillin (G) k+ Na+1) oxcillin 2)Procaine pencillin (G) 2) Nafcillin 3)Benzathine pencillin (G)3) Cloxacillin 4)Phenoxymethyl pencillin (V)4) Dicloxacillin
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Broad spectrum : Extended spectrum: (Amino) (Antipseudomonal) 1)Ampicillin A) Carboxypenicillin: carbenicillin, Indanyl carbencillin, Ticarcillin 2) Amoxicillin 3)Bacampicillin B) Ureidopencillin: Mezlocillin Pipercillin
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- lactamase inhibitor Combination: 1) Amoxicillin + Clavulanate 2) Ticarcillin + Clavulanate 3) Ampicillin + sulbactum 4) Piperacillin + Tazobactum
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Unique - Lactams:- 1)Monobactams – Aztreonam 2)Carbapenems – imipenem & Meropenem Doripenem & Ertapenem
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Glycopeptides:- Vancomycin Dalbavancin Teicoplanin Telavancin Others:- Daptomycin Fosfomycin Bacitracin Cycloserine
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Cephalosporins:- 1 st gen: Cefadroxil (PO) Cephalexin Cephradime (PO) Cefazolin IV.
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2nd: Cefuroxime, (IV) – H influenzae Cefuroxime Axetill (PO), Cefaclor, loracarbef Cefoxitin (IV) – B fragilis Cefotetan (IV) Cefmetazole
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3 rd :- Cefotaxime Cefoperazone Cefdinir Ceftazidime Cefixime Ceftibuten Ceftriaxone Cefpodoxime Moxalactum 4th: Cefepime
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– Lactams – cell wall synthesis. Peptidoglycan matrix (Gram +ve more, – ve less). Glycan → NAG + NAM + Pentapeptide. 1,4 linkage. Final stage → cross – linking transpeptidase enzyme
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D- ala – D -ala + trans peptidase. D- ala + acylenzyme intermediate + free amino group of pentapeptide of adjacent chain ↓ transpeptidase regenerated.
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Transpeptidases – PBPs, - 5 in Gram +ve, 6 in Gram – ve -Bacterial swell & bursts - Long filamentous structure – fragment -Autolysins Resistance:- - lactamase - failure to reach target PBP - failure to bind to target PBP.
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1 unit = 0.6 micro gram of crystalline sodium salt of Pencillin G. Penicillin G & V: Kinetics -Oral - Parenteral - Distribution - Excretion
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Uses: Pneumococcal infections 1.Streptococcal infections 2.Streptococcal toxic shock & necrotizing fasciitis. 3.Strept pneumonia, arthritis, meningitis, Endocarditis 4.Other sterptococci: Viridans; Endocarditis
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6) Anaerobes 7) Streptococcal infections 8) Meningococcal infections 9) Syphilis 10) Actinomycosis 11) Diptheria 12) Gas gangrene
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13) Gingivostomatitis 14) Rat bite fever 15) L. monocytogenes 16) Lyme’s disease 17) Erysipeloid Prophylactic uses: 1) Streptococcal infections 2) Syphilis
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