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Pharmacology > Anti-bacterial (B lactams) > Flashcards

Anti-bacterial (B lactams) Flashcards

1
Q

What are B lactams broadly know to do in their anti-bacterial mechanism?

A

Inhibit bacterial cell wall synthesis

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2
Q

What four categories can B lactams be divided into?

A
  1. Natural
  2. B-lactamase resistant
  3. Aminopenicillins
  4. Anti-pseudomonal
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3
Q

Name two Natural B lactams.

A
  1. Penicilin G (Benzylpenicillin)

2. Penicillin V (Phenoxymethyl-penicillin)

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4
Q

Name two B-lactamase resistant B lactams.

A
  1. Cloxacillin

2. Flucloxacillin

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5
Q

Name two Aminopenicillin B lactams.

A
  1. Ampicillin

2. Amoxicillin

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6
Q

Name one Anti-pseudomonal B lactam.

A
  1. Piperacillin
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7
Q

How can Penecillin G (Bezylpenicillin) be administered?

A
  • IV

- IM

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8
Q

How can Penecillin V (Phenoxymethyl-penicillin) be administered?

A
  • Oral
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9
Q

How can Cloxacillin be administered?

A
  • Oral
  • IV
  • IM
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10
Q

How can Flucloxacillin be administered?

A
  • Oral
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11
Q

How can Ampicillin be administered?

A
  • Oral

- Parenteral

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12
Q

How can Amoxicillin be administered?

A
  • Oral
  • IV
  • IM
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13
Q

How can Piperacillin be administered?

A
  • Parentral
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14
Q

What is the MOA for Natural B lactams (Penicillin V and Penicillin V)?

A
  • Bactericidal
  • Targets growth and replication phase
  • Inhibits transpeptidase enzyme (defects and rupturing of cell membrane)
  • B-lactamase sensitive
  • Acid labile
  • Penicillin V less active
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15
Q

What is the MOA for B-lactamase resistant B lactams (Cloxacillin and Flucloxacillin)?

A
  • Bactericidal
  • B-lactamase resistance
  • Acid stable
  • Less active than Penicillin G
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16
Q

What is the MOA for Aminopenicillin B lactams (Ampicillin and Amoxicillin)?

A
  • Bactericidal
  • Absorption decreased by food
  • Broad spectrum
  • Co-amoxiclav (amoxicillin + clavulanic acid = B-lactamse resistant as clavulanic acid inhibits B-lactamse)
  • B-lactamase sensitive
  • Acid stable
  • Cloxacillin + ampicillin = extends spectrum (additive interaction)
17
Q

What is the MOA for Anti-pseudomonal B lactams (Piperacillin)?

A
  • Bactericidal
18
Q

What spectrum is Penicillin G (Benzylpenicillin)?

A
  • Gram +ve cocci
  • Anaerobes
  • Narrow spectrum
  • Enterococci (less susceptible) - add aminoglycoside
  • Prophylaxis: streptococcal infections, rheumatic fever recurrence and surgical procedures of patients with valvular heart disease
  • Penecillin G = initial therapy for serious infections and syphilis
19
Q

What spectrum is Penicillin V (Phenoxymethyl-penicillin)?

A
  • Streptococcal tonsilitis / pharyngitis
  • Less serious infections
  • Follow up treatment after serious infections
20
Q

What spectrum are B-lactamase resistant B lactams (Cloxacillin and Flucloxacillin)?

A
  • Mild B-lactamase +ve staphylococcal infections
21
Q

What spectrum are Aminopenicillin B lactams (Ampicillin and Amoxycillin)?

A
  • Gram +ve (especially enterococci and listeria)
  • Gram -ve (hydrophilic amino-side chain gives penetration)
  • Resistant organisms
  • Prophylaxis: infective endocarditis
22
Q

What spectrum are Anti-pseudomonal B lactams (Piperacillin)?

A
  • Pseudomonas aeruginosa
  • Extended spectrum
  • Gram -ve when synergistic with tazobactam (B-lactamase inhibitor) and Aminoglycosides
23
Q

What are the adverse effects of Penicillin G (Benzylpenicillin)?

A
  • Neurotoxic effects (convulsions)
  • Hypersensitivity
  • Crosshypersensitivity
  • Mild GIT disturbances
  • Neutropaenia and agranulocytosis
  • Superinfections
  • Bleeding (decreased platelet aggregation)
  • Fluid retention
24
Q

What are the contra-indications of Penicillin G (Benzylpenicillin)?

A
  • Elderly
  • Neonates
  • Allergic patients
25
Q

What are the drug interactions of Penicillin G (Benzylpenicillin)?

A
  • Probenecid, allopurinol and COCP (do NOT mix in IV)

- Probenicid, procaine and benzathine (extend half-life)

Pharmacology (12 decks)

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