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Pharm > ABx II > Flashcards

ABx II Flashcards

1
Q

What are the abx that are cell wall synthesis inhibitors?

A 
PCN
Cephalosporins
Monobactam
Glycopeptides
Polypeptides
Carbapenems
Phosphoenolpyruvate
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2
Q

What are the three general classes of protein synthesis inhibitors?

A

Tetracyclines
Aminoglycosides
Macrolides

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3
Q

What are the four abx that cause DNA damage, inhibit gyrase, or inhibit folate?

A

Sulfonamides
Trimethoprim
Fluoroquinolones
Metronidazole

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4
Q

What are the two components of the cell wall?

A

NAM and NAGs

N-acetylmuramic acid, N-acetylglucosamine

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5
Q

True or false: peptidoglycan is only found in gram positive bacteria?

A

False-both

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6
Q

What are the molecules that attach NAMs and NAGs together?

A

5 amino acids in a species-specific sequence

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7
Q

What is the enzyme that joins monomers to form NAM-NAG chains?

A

Transglycosylases

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8
Q

What are the enzymes that bind NAMs and NAGs to AAs?

A

Transpeptidases

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9
Q

What is the role of penicillin binding proteins?

A

play a role in the synthesis and maintenance of bacterial cell wall peptidoglycan

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10
Q

What is the MOA of beta-lactam abx?

A

Binds to and inhibits the PBP enzymes, which play a role in the synthesis and maintenance of bacterial cell wall peptidoglycan

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11
Q

What are the four types of beta-lactams?

A

PCN
Cephalosporins
Monobactam
Carbapenem

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12
Q

Are beta-lactams bactericidal or bacteriostatic?

A

Bactericidal

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13
Q

What is the enzyme that causes resistance to beta lactams?

A

Beta lactamases

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14
Q

What are the four major PCN compounds?

A

PCN G
PCN V
Amoxicillin
Methicillin

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15
Q

What is the most common adverse effect of beta-lactam abx?

A

Hypersensitivity

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16
Q

What are the CNS adverse effects of beta lactams?

A

Confusion

Hallucinations

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17
Q

What are the blood adverse effects of beta lactams?

A

Hemolytic anemia

Thrombocytopenia

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18
Q

What secondary infections are pts more susceptible to following beta lactam use?

A

Vaginal candidiasis

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19
Q

If there is a mild reaction to a beta lactam, should you consider another beta lactam?

A

Yes, but only for a MILD reaction.

If severe, then no

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20
Q

Are PCN G/V broad or narrow spectrum? Beta lactamase sensitive?

A

Narrow

Beta lactamase sensitive

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21
Q

Are methicillin, Nafcillin, oxacillin broad or narrow spectrum? Beta lactamase sensitive?

A

Very narrow

Resistant

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22
Q

Are ampicillin/amoxicillin broad or narrow spectrum? Beta lactamase sensitive?

A

Broad

Sensitive

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23
Q

Are piperacillin, ticarcillin, azlocillin, broad or narrow spectrum? Beta lactamase sensitive?

A

Extended spectrum

Sensitive

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24
Q

What is the drug that is coadministered with PCN abx to inhibit beta lactamase?

A

Clavulanic acid

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25
Q

What is the MOA of clavulanic acid?

A

Beta lactamase inhibitor

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26
Q

What are the key adverse effects of beta lactamase inhibitors?

A

Similar to PCN

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27
Q

What agents are used if there is a sensitivity to PCNs?

A

Cephalosporins

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28
Q

What is the MOA of cephalosporins?

A

Bind to PBPs

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29
Q

What is the key adverse effect of cephalosporins?

A

Hypersensitivity

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30
Q

What are first generation cephalosporins good to treat? Second? Third? 4th?

A
  1. Gram positive cocci
  2. above plus some gram -
  3. above and many gram neg rods
  4. broad
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31
Q

What are the two 1st generation cephalosporins?

A

Cefazolin

Cephalexin

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32
Q

What are the three second generation cephalosporins?

A

Cefotetan
Cefaclor
Cefuroxime

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33
Q

What are the four third generation cephalosporins?

A

Ceftriaxone
Cefotaxime
Cefdinir
Cefixime

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34
Q

Which generation of cephalosporins are effective in CNS treatment?

A

3 and 4

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35
Q

What is the one 4th generation cephalosporin?

A

Cefepime

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36
Q

Are any of the cephalosporin generations beta lactamase resistant? If so, which one(s)?

A

4th generation resistant

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37
Q

What is the only monobactam drug?

A

Aztreonam

38
Q

What is the MOA of monobactams? Is it beta lactamase resistant?

A

Inhibit PBPs

Beta lactamase resistant

39
Q

Can Monobactams penetrate the CNS?

A

Yes

40
Q

What is the major adverse effect with monobactam?

A

Hypersensitivity

41
Q

What are the four carbapenems?

A

Doripenem
Imipenem
Ertapenem
Meropenem

42
Q

Imipenem needs to be administered with what? Why?

A

Cilastatin

imipenem is inactivated in the kidney. Cilastatin prevents this

43
Q

Are most carbapenems beta lactamase resistant or sensitive? Which are outside this rule?

A

All Resistant

44
Q

What is the MOA of carbapenems?

A

PBP

45
Q

What are the adverse effects of carbapenems?

A

N/v

46
Q

What are carbapenems used for?

A

Severe infections

47
Q

What is the one glycopeptide abx?

A

Vanco

48
Q

Does vanco penetrate the CNS?

A

Not really

49
Q

What is the MOA of vanco?

A

Prevents the elongation of the peptidoglycan cell wall structure by binding to the D-ala-D-ala

50
Q

MRSA should be treated with what?

A

Vanco + metronidazole(?)

51
Q

What are the key adverse effects of vanco?

A
  • Flushing (red man syndrome)

- Ototoxic and nephrotoxic

52
Q

Vanco does not penetrate the CNS very well. Why is it so good for meningitis?

A

Getting some of it there via high doses is very effective

53
Q

Is vanco a beta-lactam abx? MOA?

A

Yep

Prevents the elongation of the peptidoglycan cell wall structure by binding to the D-ala-D-ala

54
Q

Red man syndrome = which abx side effect?

A

Vanco

55
Q

What is vanco good to treat?

A

Gram positive +
MRSA
Enterococci
C.diff

56
Q

What is the MOA of bacitracin?

A

Blocks incorporation of amino acids and nucleic acids into the cell wall

57
Q

What is bacitracin good for treating?

A

Broad spectrum for both gram positive and negative

58
Q

What is the key adverse effect with bacitracin?

A

Hypersensitivity

59
Q

Which Abx prevents the elongation of the peptidoglycan cell wall structure by binding to D-ala-D-ala pentapeptide?

A

Vanco

60
Q

Which abx blocks the incorporation of amino acids and nucleic acids into the cell wall?

A

Bacitracin

61
Q

What is the MOA of fosfomycin?

A

Blocks an early step in cell wall synthesis by preventing synthesis of UDP-N-acetylmuramic acid

62
Q

Which abx Blocks an early step in cell wall synthesis by preventing synthesis of UDP-N-acetylmuramic acid?

A

Fosfomycin

63
Q

What disease is fosfomycin usually used to treat?

A

UTIs

64
Q

What type of bacteria can fosfomycin kill well?

A

Both gram + and gram -

65
Q

What are the three major protein synthesis inhibitor abxs?

A

Aminoglycosides
Macrolides
Tetracyclines

66
Q

Cell wall inhibition is generally bacteriostatic or bactericidal?

A

Bactericidal

67
Q

Protein synthesis inhibition is generally bacteriostatic or bactericidal?

A

Bacteriostatic

68
Q

What is the target of protein synthesis inhibiting abx?

A

50s and 30s subunit of prokaryotes

69
Q

What are the ribosomes that are in prokaryotes?

A

50s and 30s, which form 70s

70
Q

What is the first step of prokaryotic protein synthesis?

A

charged tRNA binds to A site

71
Q

What is the second step of prokaryotic protein synthesis?

A

Peptidyl tRNA peptide bond formed between growing chain and A site

72
Q

What is the third step of prokaryotic protein synthesis?

A

newly uncharged tRNA exits

73
Q

What is the fourth step of prokaryotic protein synthesis?

A

The now longer amino acid chain translocates to the P site

74
Q

What are the 6 aminoglycosides?

A
  1. streptomycin
  2. gentamicin
  3. kanamycin
  4. amikacin
  5. tobramycin
  6. Neomycin
75
Q

-mycin suffix indicate what abx type? What are the three exceptions?

A

Aminoglycosides

Erythromycin
Clarithromycin
Azithromycin
=macrolides

76
Q

Are aminoglycosides bacteriostatic or bactericidal?

A

Bactericidal

77
Q

What is the MOA of aminoglycosides?

A

binds to 30s and blocks formation of initiation complex

78
Q

What are the two key adverse effects of aminoglycosides?

A

Nephrotoxic

Ototoxic

79
Q

What are aminoglycosides used to treat?

A

Used in combination with Beta lactams to treat serious gram -

80
Q

What are the three macrolides?

A

erythromycin
Clarithromycin
Azithromycin

81
Q

What is the MOA of macrolides?

A

Binds to 50s subunits and impairs the translocation to the P site

82
Q

What abx binds to the 30s site? 50s?

A 
30s = aminoglycoside
50s = macrolides and tetracyclines
83
Q

What are the key adverse effects of macrolides?

A

GI: n/v

84
Q

What are macrolides used to treat? Bacteriostatic or bactericidal?

A

most gram +

Bacteriostatic

85
Q

What are macrolides effects on the GI?

A

stimulate the GI Tract motility

86
Q

What are the four tetracyclines?

A
  1. Tetracycline
  2. Minocycline
  3. Tigecycline
  4. doxycycline
87
Q

What is the MOA of tetracycline?

A

Binds to 30 s subunit and prevent binding of a new aminoacyl to A site

88
Q

What are tetracyclines used to treat?

A

Broad spectrum

89
Q

What are the three key adverse effects of tetracyclines?

A
  1. Binds Ca (reduced growth of bone)
  2. Disrupts normal flora
  3. Skin photosensitivity
90
Q

What is the difference in MOA of tetracyclines and macrolides?

A

both bind to 50s subunit, but tetracyclines prevent new aminoacyl T site binding, whilst macrolides prevent translocation to the P site

Pharm (73 decks)

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