(精选)BETA LACTAM ANTIBIOTICS AND OTHER CELL ... - Caangay.com教学课件.ppt

BETA LACTAM ANTIBIOTICS AND OTHER CELL WALL SYNTHESIS INHIBITORSMa. Shiela Cano-Guiking, M.D.;;PENICILLINS I. CLASSIFICATION A. Penicillinase Resistant ( Antistaphylococcal Penicillins) 1. Methicillin ( Staphcillin)2. Nafcillin (Unipen, Nafcil, Nallpen)3. Isoxazolyl penicillins a. Oxacillin  b. Cloxacillin c. Dicloxacillin d. Flucloxacillin  ;B. Penicillinase-Susceptible 1. Narrow-Spectrum a. Benzylpenicillin – Penicillin G b. Phenoxymethyl penicillin – Penicillin V 2. Extended Spectrum A. Aminopenicillins a.1 Ampicillin a.2 Esters a.2.1. Bacampicillin a.2.2. Pivampicillin a.2.3. Talampicillin a.3. Amoxicillin ;B. Carboxypenicillins a.1 Carbenicillin a.1.1. Indanyl carbenicillin e.g Geopen a.1.2. Disodium carbenicillin e.g. Pyopen a.2. Ticarcillin a.3. Temocillin C. Ureido-penicillins c.1. Mezlocillin c.2. Azlocillin c.3. Piperacillin c.4. Apalcillin  ;II. GENERAL PROPERTIES A. Chemical Properties Penicillins are derivatives of benzylpenicillin, from which the methyl benzene radical is split off by amidase producing 6-aminopenicillanic acid, the parent compound of all semisynthetic penicillins ;The compound consists of 2 basic structures: 1 Thiazolidine Ring (A) 2.Beta-Lactam Ring (B) - Site of action of Beta-lactamase - Site of action of Amidase - Site of attachment of side chain ?, which determines many of the antibacterial and pharmacologic characteristics of a derivative ( spectrum and penicillin-resistance) ;;;;;;- cannot penetrate the blood-brain barrier; but 50% of the plasma concentration can pass through in the presence of inflammation:  Probenecid and certain organic acids can inhibit transfer from cerebrospinal fluid (CSF) to blood stream; may lead to increase CSF level. - Metabolized by the liver to penicillanic/penicillenic a