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Which antimicrobials inhibit cell wall synthesis?
- penicillins
- cephalosporins
- carbapenems
- monobactams (aztreonam)
- vancomycin
Which antimicrobials alter nucleic acid metabolism?
- rifamycins
- quinolones
Which antimicrobials inhibit folate metabolism?
- trimethoprim
- sulfonamides
Which antimicrobials inhibit protein synthesis?
- chloramphenicol
- tetracyclines
- glycylcycline (tigecycline)
- macrolides
- clindamycin
- streptogramins (quinupristin/dalfopristin)
- oxazolidinones (linezolid)
- aminoglycosides
What are the miscellaneous antimicrobials?
- metronidazole
- daptomycin
- polymyxins
What is the magic bullet against gram NEGATIVE bugs?
Aztreonam = a monobactam that can be used in penicillin allergic pts

- often used in combo w/vancomycin or clindamycin to cover gram postivies
What is the magic bullet against gram POSITIVE bugs?

-IV admin
- used in penicillin-allegic pts
- causes red man syndrome (nonimmunologic release of histamine giving red rash over torso and itching skin)
- complexes with D-alanine D-alanine to inhibit transpeptidation
- acts synergistically with the aminoglycosides
- not readily absorbed, useful for Clostridium dificile
What are the types of protein inhibitors? (7)
blocks initiation of translation and causes the misreading of mRNA

blocks the attachment of tRNA to the ribosome

interfere with a distinct step of protein synthesis

prevents the continuation of protein synthesis

prevents peptide bonds from being formed

prevents the continuation of protein synthesis

thought to interfere with the initiation of protein synthesis
How do rifamycins work?
Inhibit the beta subunit of DNA-dependent RNA polymerase (binding does not allow initiation of chain formation in RNA synthesis)
How do quinolones work?
inhibit the activity of topoisomerases, which are responsible for supercoiling DNA (DNA gyrase) and relaxing the supercoilded DNA (topoisomerase IV)
Which steps of folate metabolism are inhibited by sulfonamides?
dihydropteroate diphosphate + PABA --> dihydropteroic acid [dihydropteroic acid]

- sulfonamides interfere with this initial step by inhibiting dihydropteroic aci
Which steps of folate metabolism are inhibited by trimethoprim?
dihydrofolic acid --> tetrahydrofolic acid [dihydrofolate reductase]

- trimethoprim interferes with this late step by inhibiting dihydrofolate reductase
How does daptomycin work?
- calcium dependent binding and insertion of the lipophilic tail into GRAM POSITIVE cytoplasmic membrane

- oligomerization and channel formation occur

- ion leakage and collapse of organism leads to cell death
How does metronidazole work?
- enters a bacterium where, via the electron transport protein ferrodoxin, it is reduced

- then binds to DNA and causes DNA breakage
Name 5 agents that inhibit synthesis of bacterial cell walls
- penicillins

- cephalosporins

- carbapenems

- monobactams (aztreonam)

- vancomycin
Name 7 agents that affect the function of 30S and 50S ribosomal subunits to cause reversible inhibition of protein synthesis
- chloramphenicol

- tetracyclines

- glycylcyclines (tigecycline)

- macrolides

- clindamycin

- streptogramins (quinupristin/dalfopristin)

- oxazolidinones (linezolid) - binds to the 23S ribosomal subunit of the 50S ribosome
Name an agent that binds to the 30S ribosomal subunit and alters protein synthesis
Name two agents that affect bacterial nucleic acid metabolism
- rifamycins (inhibit RNA polymerase)

- quinolones (inhibit topoisomerase IV and DNA gyrase)
Name two agents that block essential enzymes of folate metabolism
- trimethoprim

- sulfonamides
Name the three miscellaneous agents


- polymyxins

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