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Pharm part 2 > 16. Bactericidal Antibiotics > Flashcards

16. Bactericidal Antibiotics Flashcards

1
Q

Which are the bactericide antibiotics? (4)

A
  1. BETALACTAMS
  2. AMINOGLYCOSIDES
  3. QUINOLONES
  4. GLYCOPEPTIDES
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2
Q

What defines betalactams?

A

beta lactam ring

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3
Q

What is the therapuetic index of beta lactams?

A

wide: very safe

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4
Q

What is the toxicity of beta lactams?

A

low

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5
Q

What are the side effects of beta lactams? (4)

A

digestive system (most common orally):

  • nausea
  • vomiting
  • ab pain
  • dyspepsia
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6
Q

Teratogenicity with beta lactams?

A

none

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7
Q

MOA of beta lactams? (2)

A

inhibit bacterial cell wall synthesis:

-inhibit transpeptidase activity of penicilin binding protiends (PBP)

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8
Q

What drugs are betalactams?

A
  • penicillins
  • cephalosporins
  • monobactams
  • carbapenems
  • clavulanic acid
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9
Q

What is PBP? (2)

A

penicilin binding protein

-enz involved in synthesis of bacterial wall

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10
Q

What is the mechanism of action for resistence for bacteria against betalactams? (3)

A
  1. INACTIVATION of the ANTIBIOTIC: producing BETA-LACTAMASES to bind to beta- lactams
  2. REDUCE UPTAKE INTO THE CELL: loss/modification of porins and pumps of influx or active efflux from the cells
  3. ALTERATION OF THE TARGET ENZYME: they produce enzymes (mutated PBP) with less affinity for beta-lactams
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11
Q

What can you do to a bacteria that starts producing beta lactamase inhibitors?

A

Prescribe beta lactamase inhibitors so that the antibiotic will work again
ex. clavulanic acid

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12
Q

How are betalactams administered? (2)

A

orally

parenterally

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13
Q

Do betalactams cross BBB?

A

yes

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14
Q

Distribution of betalactams?

A

good/wide distribution

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15
Q

Betalactams cross placenta?

A

yes but still safe

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16
Q

Betalactam metabolism?

A

remain active until eliminated

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17
Q

Beta lactam elimination?

A

renal

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18
Q

Betalactam short term adverse effects?

A
  • hypersensitivity reactions (urticaria, angioedema)
  • anaphylactic shock: bronchospasm, severe dyspneoa
  • GI intolerance: oral candida, diarrhea, nausea, vomit
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19
Q

Betalactam long term adverse effects?

A

Less frequent

  • Hematologic: fever, eosinophilia, haemolytic anaemia
  • Renal toxicity: Renal failure
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20
Q

What is angioedema?

A

swelling (usually localized) of the subcutaneous tissues due to increased vascular permeability and extravasation of intravascular fluid.

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21
Q

What mediates angioedema? (2)

A

Mast cell derived mediators (eg, histamine, leukotrienes, prostaglandins)
Bradykinin and complement-derived mediators

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22
Q

Who discovered pencilin?

A

Alexander fleming

23
Q

The most commonly used betalactam antibiotics?

A

penicillins

24
Q

What did alexander fleming find?

A
  • penicilin

- substance released by Penicillum fungi inhibits S.aureus

25
Q

How do bacteria defend themselves against penicillin?

A

penicillinase production (betalactamase)

26
Q

What are the types of penicillins? (5)

A
  1. natural penicillins
  2. resistant to penicilinases
  3. aminopenicillins
  4. antipseduomonas (broad spectrum parenteral )
  5. betalactamase inhibitors
27
Q

What are the natural penicillins? (4)

A 
PENICILLIN G (IM, IV)
PENICILLIN G PROCAINE (IM) ---long effect 4-5 days. PENICILLIN G BENZATHINE (IM)---long effect 26 days. PENICILLIN V (ORAL)---Resistant to acid degradation.
28
Q

Natural penicillins work against which bacteria? (3)

A
  • gram + cocci (EXCEPT S. aureus)

- gram + bacillus

29
Q

What are the penicillinase resistant drugs? (2)

A
  • CLOXACILLIN (ORAL, PARENTERAL)

- METHICILLIN

30
Q

Penicillinase resistant drugs work against which bacteria?

A

staphylococcus

31
Q

What are the aminopenicillins drugs?

A
  • amoxicillin

- ampicillin

32
Q

aminopenicillins drugs work against which bacteria? (@)

A
  • GRAM + COCCI ( EXCEPT S. aureus)

- GRAM BACILLUS (EXCEPT Pseudomona)

33
Q

What are the antipseudomonas drugs also called?

A

Broad spectrum penicillins

34
Q

What are the antipseudomonas drugs? (2)

A
  • piperacillin

- ticarillin

35
Q

Antipseudomonal drugs work again which types of bacteria?

A

Gram negative bacillus

36
Q

What are the betalactamase inhibitor drugs? (3)

A
  • Clavulanic aicd
  • Sulbactam
  • tazobactam
37
Q

Indications of penicillin? (8)

A

Respiratory infections:

  • pharyngitis
  • otitis
  • bronchitis in COPD

Skin and Soft tissue infections:

  • cellulitis
  • erysipelas

Bone and joint infections
STDs
Endocarditis

38
Q

What bacteria causes pharyngitis?

A

Streptococcus pyogenes

39
Q

How do you treat pharyngitis? (2)

A

Penicillin G or amoxicillin

40
Q

What bacteria causes otitis?

A
  • Streptococcus pneumoniae
  • H. influenzae
  • produce betalactamases
41
Q

How do you treat otitis?

A

amoxicillin-clavulanic acid

42
Q

What bacteria causes bronchitis in COPD? (2)

A
  • Streptococcus pneumoniae
  • H. influenzae
  • produce betalactamases
43
Q

How do you treat bronchitis in COPD?

A

amoxicillin-clavulanic acid

44
Q

What bacteria causes cellulitis?

A

Streptococcus pyogenes

45
Q

What bacterial causes erysipelas?

A

S. aureus

46
Q

How do you treat cellulitis?

A

amoxicillin

47
Q

How do you treat erysipelas? (2)

A
  • amoxicillin-clavulanic

- cloxacillin

48
Q

What bacteria causes bone and joint inflammation?

A

S. aureus

49
Q

What bacteria causes STDs? (2)

A

gonorrhea and syphilis

50
Q

What bacteria causes causes endocarditis? (3)

A

-Streptococcus viridans
-Staphylococcus
aureus
-Enterococcus

51
Q

How do you treat bone and joint infections? (2)

A

Cloxacillin+ Gentamicin

52
Q

How do you treat STDs?

A

penicillin G

53
Q

How do you treat endocarditis? (4)

A

-Streptococcus viridans = amoxicillin
-Staphylococcus
aureus = cloxacillin
-Enterococcus = Ampicillin+Gentamicin

54
Q

Which specific bacteria is rsponsible for more than 50% of endocarditis?

A

streptococcus viridans

Pharm part 2 (7 decks)

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