Drawing Pharmacology Video 4 Antibiotics I

Antibiotics

Cell Wall synthesis inhibitors

1. B lactams
   • Penicillin -- IV vs Oral
     1. G
     2. VK
   • Aminopenicillins -- both start with 'A'
     1. Amoxicillin
     2. Ampicillin
   • Penicillinase resistant -- MSSA
     1. Methicillin
     2. Nafcillin
     3. Oxacillin
2. Cephalosporins -- gram + vs -, 1st gen "-in"
   • Gen 1
   • Gen 2
   • Gen 3
   • Gen 4
   • Gen 5
3. Carbapenems -- ESBL (extended spectrum beta lactamase) producers, very BS, not used often
   • Doripenem
   • Imipenem
   • Meropenem
   • Ertapenem
4. Monobactam
   • aztreonam
5. Glycopeptides
   • Vancomycin
6. Lipoglycopeptides
   • Dalbavancin
   • Oritavancin
   • Telavancin

For the rest of this video series, I have my 4th professional year Advanced Pharmacy Practice Experience Jaclyn Aremka take her turn as instructor for antibiotics and antivirals. Academic Pharmacy Practice experiences provide pharmacy students with opportunities to teach in the classroom before they go on to residencies or future positions in teaching.

She goes over the 3-video series of antibiotic pharmacology as well as HIV medicines in video 7.The pharmacology of antibiotics is a complex topic to say the least. It's a broad topic with hundreds of medications, but there are clear patterns in their use. Trying to decide which antibiotic to use in each patient sometimes often comes down to professional judgment taking into account the practice setting, patient condition, and other factors.
The medications themselves are also complex. Some can treat a broad spectrum of bacterial infections, while others are more specific for a few types of bacteria and completely ineffective against others.

Perhaps one of the most challenging aspects is the concept of antibiotic resistance. 'Superbugs' that are resistant to even our strongest antibiotics are becoming more common. This is why the proper use of these medications - antibiotic stewardship - is a critical healthcare skill. Proper antibiotic stewardship can reduce the likelihood of resistance.
With that in mind, we focus on 3 different types of antibiotics in video 4: beta lactams, glycopeptides, and lipoglycopeptides. What these antibiotic classes have in common is that they all target the bacteria's cell wall.

Beta lactams:

A Beta lactam is a part of the molecule. If you haven't had organic chemistry, it may be good to check out a picture. We break down this class of antibiotics into 6 sub-classes: penicillins, aminopenicillins, penicillinase resistant penicillins, cephalosporins, carbapenems, and monobactams. They all have a beta-lactam ring within their molecular structure (hence the name "beta lactams") and kill bacteria in much the same way. Even though they work in similar ways, the medications within these 6 sub-classes are used for varying bacterial infections.

Glycopeptides:

The one drug we'll go over is vancomycin, or vanc for short. This one can be confusing because as we'll see in later videos, there are many antibiotics that end in -mycin, but it's not an official stem.

Lipoglycopeptides: Lipoglycopeptides are similar to vancomycin, a glycopeptide. The medications in both of these classes work in much the same way and they share the risk of nephrotoxicity. One major difference is that the lipoglycopeptides medications include a recognized stem, -vancin.