antimicrobials sheet | Schemes and Mind Maps Pharmacology

Class Example Drugs Mechanism of Action Common Uses Notes

Penicillins

Penicillin, Amoxicillin, Ampicillin,

Methicillin, Nafcillin, Oxacillin,

Piperacillin, Ticarcillin

Inhibit cell wall synthesis

by binding to PBPs

Streptococcal

infections, syphilis Broad-spectrum, resistance can occur

Cephalosporins

Cephalexin, Cefazolin, Cefuroxime,

Cefoxitin, Ceftriaxone, Cefotaxime,

Ceftazidime, Cefepime, Ceftaroline,

Ceftobiprole

Inhibit cell wall synthesis

by binding to PBPs

Pneumonia, UTIs,

skin infections

Divided into generations (1st to 5th)

with varying spectrums

Macrolides Azithromycin, Erythromycin,

Clarithromycin

Inhibit protein synthesis by

binding to the 50S

ribosomal subunit

Respiratory

infections, STIs

Good alternative for penicillin-allergic

patients

Tetracyclines Doxycycline, Tetracycline,

Minocycline

Inhibit protein synthesis by

binding to the 30S

ribosomal subunit

Acne, Lyme

disease, respiratory

infections

Avoid in children and pregnant women

due to teeth discoloration

Aminoglycosides Gentamicin, Amikacin, Tobramycin,

Streptomycin

Inhibit protein synthesis by

binding to the 30S

ribosomal subunit

Severe Gram-

negative infections

Monitor for nephrotoxicity and

ototoxicity

Fluoroquinolones Ciprofloxacin, Levofloxacin,

Moxifloxacin, Ofloxacin

Inhibit DNA gyrase and

topoisomerase IV,

preventing DNA

replication

UTIs, respiratory

infections, GI

infections

Risk of tendonitis and tendon rupture

Sulfonamides Sulfamethoxazole, Trimethoprim

Inhibit folic acid synthesis

by blocking

dihydropteroate synthase

and dihydrofolate

reductase

UTIs,

Pneumocystis

jirovecii pneumonia

Watch for allergic reactions and

Stevens-Johnson syndrome

Glycopeptides Vancomycin, Teicoplanin

Inhibit cell wall synthesis

by binding to D-alanyl-D-

alanine portion of cell wall

precursors

MRSA, C. difficile

colitis

Monitor for nephrotoxicity and "red

man syndrome"

Oxazolidinones Linezolid, Tedizolid

Inhibit protein synthesis by

binding to the 50S

ribosomal subunit

MRSA, VRE

infections Risk of serotonin syndrome with SSRIs

Carbapenems Meropenem, Imipenem, Ertapenem,

Doripenem

Inhibit cell wall synthesis

by binding to PBPs

Severe or resistant

bacterial infections

Broad-spectrum, reserved for multi-

drug resistant infections

Polymyxins Colistin (Polymyxin E), Polymyxin

Disrupt cell membrane

integrity by interacting

with phospholipids

Multi-drug resistant

Gram-negative

infections

Monitor for nephrotoxicity and

neurotoxicity

Antifungals

Fluconazole, Itraconazole,

Voriconazole, Amphotericin B,

Nystatin, Caspofungin, Micafungin,

Anidulafungin, Terbinafine

Inhibit ergosterol synthesis

or bind to ergosterol,

disrupting fungal cell

membrane

Candidiasis,

aspergillosis,

cryptococcosis

Amphotericin B has significant

nephrotoxicity

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Class Example Drugs Mechanism of Action Common Uses Notes Penicillins Penicillin, Amoxicillin, Ampicillin, Methicillin, Nafcillin, Oxacillin, Piperacillin, Ticarcillin Inhibit cell wall synthesis by binding to PBPs Streptococcal infections, syphilis Broad-spectrum, resistance can occur Cephalosporins Cephalexin, Cefazolin, Cefuroxime, Cefoxitin, Ceftriaxone, Cefotaxime, Ceftazidime, Cefepime, Ceftaroline, Ceftobiprole Inhibit cell wall synthesis by binding to PBPs Pneumonia, UTIs, skin infections Divided into generations (1st to 5th) with varying spectrums Macrolides Azithromycin, Erythromycin, Clarithromycin Inhibit protein synthesis by binding to the 50S ribosomal subunit Respiratory infections, STIs Good alternative for penicillin-allergic patients Tetracyclines Doxycycline, Tetracycline, Minocycline Inhibit protein synthesis by binding to the 30S ribosomal subunit Acne, Lyme disease, respiratory infections Avoid in children and pregnant women due to teeth discoloration Aminoglycosides Gentamicin, Amikacin, Tobramycin, Streptomycin Inhibit protein synthesis by binding to the 30S ribosomal subunit Severe Gram- negative infections Monitor for nephrotoxicity and ototoxicity Fluoroquinolones Ciprofloxacin, Levofloxacin, Moxifloxacin, Ofloxacin Inhibit DNA gyrase and topoisomerase IV, preventing DNA replication UTIs, respiratory infections, GI infections Risk of tendonitis and tendon rupture Sulfonamides Sulfamethoxazole, Trimethoprim Inhibit folic acid synthesis by blocking dihydropteroate synthase and dihydrofolate reductase UTIs, Pneumocystis jirovecii pneumonia Watch for allergic reactions and Stevens-Johnson syndrome Glycopeptides Vancomycin, Teicoplanin Inhibit cell wall synthesis by binding to D-alanyl-D- alanine portion of cell wall precursors MRSA, C. difficile colitis Monitor for nephrotoxicity and "red man syndrome" Oxazolidinones Linezolid, Tedizolid Inhibit protein synthesis by binding to the 50S ribosomal subunit

MRSA, VRE

infections Risk of serotonin syndrome with SSRIs Carbapenems Meropenem, Imipenem, Ertapenem, Doripenem Inhibit cell wall synthesis by binding to PBPs Severe or resistant bacterial infections Broad-spectrum, reserved for multi- drug resistant infections Polymyxins Colistin (Polymyxin E), Polymyxin B Disrupt cell membrane integrity by interacting with phospholipids Multi-drug resistant Gram-negative infections Monitor for nephrotoxicity and neurotoxicity Antifungals Fluconazole, Itraconazole, Voriconazole, Amphotericin B, Nystatin, Caspofungin, Micafungin, Anidulafungin, Terbinafine Inhibit ergosterol synthesis or bind to ergosterol, disrupting fungal cell membrane Candidiasis, aspergillosis, cryptococcosis Amphotericin B has significant nephrotoxicity

Class Example Drugs Mechanism of Action Common Uses Notes Antivirals Acyclovir, Valacyclovir, Famciclovir, Oseltamivir, Zanamivir, Zidovudine, Lamivudine, Efavirenz, Ritonavir, Sofosbuvir, Ledipasvir, Ribavirin Inhibit viral DNA polymerase or neuraminidase, preventing viral replication Herpes infections, influenza, HIV, Hepatitis C

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