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Pharm Block 3 > Anti Cell Wall > Flashcards

Anti Cell Wall Flashcards

1
Q

target unique aspects of pathogen

A

ideal goal

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2
Q

unique target - composed of peptidoglycan layer

A

bacterial cell wall

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3
Q

penicillin binding protein

responsible fro cross linking peptidoglycan to create strong cell wall

A

transpeptidase

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4
Q

last 2 D alanine molecules enzymatically reduced from L alanine by?

A

alanine racemase

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5
Q

NAM penta peptide is attached to

A

bactoprenol carrier

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6
Q

bactoprenol -p-p has to dephosphorylates to?

A

bactoprenol -p

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7
Q

NAG attaches to

A

NAM penta peptide on bactoprenol -p

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8
Q

moves NAM-NAG out of cell

A

bactoprenol

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9
Q

catalyzes binds between NAM and NAG

A

transglycosylase

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10
Q

enzymes reform peptide cross links between rows and layers of peptidoglycan to make strong wall

A

transpeptidase (PBP)

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11
Q

inhibits bactoprenol phosphate

used topically only and causes nephrotoxicity

A

bacitracin

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12
Q

inhibits alanine racemase, which converts L alanine to D alanine
Anti tubular

A

cycloserine

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13
Q

inhibits enol pyruvate transferase and blocks the addition of phosphoenol pyruvate to UDP-NAG
For UTI

A

fosfomycin

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14
Q

destabilizes gram neg bacteria outer cell wall through ionic interaction
topical use

A

polymyxin B

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15
Q

allows uncontrolled ion transport (K/Na) across plasma membrane
destroys ionic gradient

A

gramicidin

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16
Q

5 glycine bridge chain

A

gram postive

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17
Q

1) B lactam ring interferes with transpeptidation rxn of bacterial cell wall syndrome.
2) B lactam ring can be hydrolyzed by B lactamases - leads to antibiotic inactivation
3) activity against gram +

A

pencillin

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18
Q

MOA:

1) bactericidal
2) peptidoglycan cell wall with repeating D alanyl - D alanine oligopeptides

A

penicillin

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19
Q

treats strep pharyngitis, rheumatic fever

A

Penicillin V

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20
Q

treats rheumatic fever, group B strep (given intrapartum for GBS prophylaxis), actinomycetes Israeli, clostridium perfringens (gas gangrene), pastuerella inf, neisseria meningitides

A

penicillin G

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21
Q

single dose benzathine pen G treats

A

syphilis

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22
Q

1st choice for

1) syphilis
2) gas gangrene
3) rheumatic fever
4) listeria

A

penicillin

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23
Q

ADR

1) type 1-4 hypersensitivity rxn
2) drug induced autoimmune hemolytic anemia (+ Coombs)
3) drug induced interstitial nephritis
4) GIT distress
5) superinfection: cause C Dif
6) jarisch herxheimer rxn in treatment of syphilis
7) MC - rash
8) most severe- anaphylaxis

A

pencillin

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24
Q

mech of resistance

1) inactivation by B lactamase (MSSA produces lactamase)
- combo with lactamase inhibitor
- tx with B lactamase resistant - nafcillin
2) modification if transpeptidase
- MRSA tx with non B lactam antibiotics
3) impaired penetration (G -, porin)
4) efflux pump: bacterially expressed transporter to expel drug

A

penicilin

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25
Q

penicillin skin test +

A

change to cephalosporins or macrolide

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26
Q

what two conditions do you still use penicillin when skin test is +?

A

neurosyphilis

syphilis in pregnancy

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27
Q

if penicillin test +, in syphilis without the other two conditions can be treated with

A

doxycycline or macrolide

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28
Q

lactamase resistant penicillin

A 
nafcillin
oxacillin
dicloxacillin
cloxacillin
methicillin
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29
Q

B lactam ring is not hydrolyzed by B lactamase

A

lactamase resistant pencillins

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30
Q

are eliminated in bile, so can use in bile duct infection

A

nafcillin

oxacillin

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31
Q

used in lab

not used anymore bc it causes interstitial nephritis

A

methicillin

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32
Q

1st choice for MSSA

A

lactamase resistant pencillin

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33
Q

destroyed by lactamase
activity against gram + and -
augmenting (amoxicillin + clavulanate) - against staph aureus

A

extended spectrum penicillin

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34
Q

extended spectrum penicillin

A 
amoxicillin 
ampicillin
clavulanate 
tazobactam 
sulbactam
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35
Q

treats otitis media, sinusitis cause by strep pneumonia

A

amoxicillin

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36
Q

undergoes enterohepatic cycling but excreted by kidney

treats meningitis caused by listeria monocytes

A

ampicillin

37
Q

no antibacterial effect

Irreversible inhibition of B lactamase

A

clavulanate
tazobactam
sulbactam

38
Q

effective only against plasmid encoded b lactamase

not effective in inhibiting the inducible chromosomal B lactamases

A

B lactamase inhibitors

39
Q

anti pseudo monal penicillins

A

piperacillin
ticarcium
mezlocillin
azlocillin

40
Q

increase activity against gram - rods including pseudo aeruginosa
lactamase sensitive
tx both gram + and -

A

anti pseudo monal penicillins

41
Q

synergy with ahminoglycosides against pseudomonas and enterococcal species
most eliminated by active PCT secretion (inhibited by probenecid)

A

penicillins

42
Q

active against aerobic gram - rods
resistant to lactamase
no cross allergy with penicillin

A

aztreonam - monobactam

43
Q

cystic fibrosis px - use for pseudomonas inf., inhalation route available

A

aztreonam - monobactam

44
Q

carbapenems

A

imipenem
ertapenem
meropenem
doripenem

45
Q

MOA: same as penicillin, resistant to lactamase, renal elimination

A

carbapenems

46
Q

treat pseudomonas inf., activity on both gram + and -; anaerobic infections

A

carbapenems

47
Q

GI, fever and skin rash

A

carbapenems SE

48
Q

inactivated by dehydropeptidase in renal tubule

A

imipenem

49
Q

inhibits dehydropeptidase in renal tubule preventing degradation of imipenem

A

cilastatin

50
Q

causes seizure in 33% px

A

imipenem

51
Q

less seizure potential then imipenem

A

meropenem

52
Q

activity against gram + and MRSA

A

vancomycin

53
Q

inhibition of cell wall syn. by directly binding D ala - D ala oligopeptides (inhibits transglycosylase and transpeptidase)

A

vancomycin

54
Q

resistant to B lactams and ineffective against vancomycin

A

altered PBPs

55
Q

resistance: conversion of D ala in the proteoglycan chain to D lactate by plasmid expressing converting enzyme

A

vancomycin

56
Q

poorly absorbed in GIT, requires IV route

A

vancomycin

57
Q

oral med treats clostridium difficile colitis

A

vancomycin

58
Q

SE: ototoxicity, nephrotoxicity, Red mans syndrome

A

vancomycin

59
Q

uncontrolled histamine release - fever, flushing, pain [can be prevented by diphenhydramine]

A

red mans syndrome

60
Q

antibiotics for C Dif. colitis

A

Co amoxicillin and clavulanic acid
clindamycin
cephalosporin
ciprofloxacin

61
Q

loose stool with or without mucus or blood

Dx: detect cytotoxin of C Dif in blood

A

C Dif colitis

62
Q

1) metronidazone
2) oral vancomycin
3) fidaxomicin: inhibits RNA poly
4) only gram + aerobic and anaerobic bacteria - reduces recurrence

A

treatments for C Dif colitis

63
Q

1) activity against gram + cell wall
2) lipid tail into membrane to depolarize cell - K+ efflux - cell death
3) eliminated by kidney
4) activity against MRSA
5) ineffective against pneumonia

A

daptomycin

64
Q

inhibits daptomycin

A

surfactant

65
Q

not destroyed by penicillinase

A

Cephalosporins

66
Q

Pharmacokinetics

1) eliminated by active secretion in PCT
2) probenecid inhibits secretion
3) ceftoperazone and ceftriaxone are eliminated by bile
4) dose adjusted in renal failure

A

Cephalosporins

67
Q

Resistance

1) inactivation by Cephalosporinases - 4th gen is insensitive
2) alterations to PBP (different from those affecting penicillins)
3) inability to reach site of action - loss permeability

A

Cephalosporins

68
Q

1st gen Cephalosporins

A

cephalexin

cefazolin

69
Q

none enter CNS
activity against gram +

tx: cellulitis, strep pyogenes

activity against gram - UTI bugs [proteus, e coli, klebsiella]

A

1 st gen Cephalosporins

70
Q

2nd gen Cephalosporins

A

cefuroxime
cefotetan
cefoxitin
cefamandole

71
Q

only 2nd gen with CNS entry

A

cefuroxime

72
Q

2nd gens that treat anaerobes

A

cefotetan

cefoxitin

73
Q

treat gram + and -

activity against H flu, neisseria, serratia, enterobacter, proteus, e coli, klebsiella,

A

2nd gen Cephalosporins

74
Q

contain MTT group and inhibit Vit K epoxide reductase like warfarin

A

cefamandole
cefotetan
cefoperazone

75
Q

causes disulfiram like rxn with ethanol

A

MTT

76
Q

bleeding disorder because free MTT inhibits vit k epoxide reductase

A

hypo prothrombinemia

77
Q

3rd gen Cephalosporins

A

ceftriaxone
cefotaxime
ceftazidime
cefoperazone

78
Q

all enter CNS except cefoperazone
work on gram - mostly and some gram +
no activity against listeria, MRSA and enterococci

A

3rd gen Cephalosporins

79
Q

used to treat meningitis

A

ceftriaxone

cefotaxime

80
Q

treat pseudomonas infection

A

ceftazidime

cefoperazone

81
Q

binds to albumin competing with bilirubin, increase free bilirubin; in neonate (kernicterus), so not used in neonates

binds to Ca2+, biliary sludge

A

ceftriaxone SE

82
Q

gonorrhea treatment

A

ceftriaxone, IM - one dose

83
Q

chlamydia treatment

A

azithromycin, oral - one dose

84
Q

STD treatment:
treat co infection
treat sex partners for last 60 days treat if positive test
avoid sexual intercourse for 7 days

A

3rd gen Cephalosporins

85
Q

cover staph and pseudomonas
resistance to most lactamases
enter CNS

A

4th gen - cefepime

86
Q

FDA tx of common acquired bacterial pneumonia
Treats MRSA
has high affinity for PBP2A = better activity

A

5th gen - ceftaroline

87
Q

has PBP2A

most B lactams have low affinity fo this

A

MRSA

88
Q

ADR: same ad penicillin, nephritis, hemolytic anemia, hypersensitivity rxn, cross rxn with penicillin 5%-10%

A

5th gen - ceftaroline

Pharm Block 3 (11 decks)

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