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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
penicillin skin test +
change to cephalosporins or macrolide
26
what two conditions do you still use penicillin when skin test is +?
neurosyphilis | syphilis in pregnancy
27
if penicillin test +, in syphilis without the other two conditions can be treated with
doxycycline or macrolide
28
lactamase resistant penicillin
``` nafcillin oxacillin dicloxacillin cloxacillin methicillin ```
29
B lactam ring is not hydrolyzed by B lactamase
lactamase resistant pencillins
30
are eliminated in bile, so can use in bile duct infection
nafcillin | oxacillin
31
used in lab | not used anymore bc it causes interstitial nephritis
methicillin
32
1st choice for MSSA
lactamase resistant pencillin
33
destroyed by lactamase activity against gram + and - augmenting (amoxicillin + clavulanate) - against staph aureus
extended spectrum penicillin
34
extended spectrum penicillin
``` amoxicillin ampicillin clavulanate tazobactam sulbactam ```
35
treats otitis media, sinusitis cause by strep pneumonia
amoxicillin
36
undergoes enterohepatic cycling but excreted by kidney | treats meningitis caused by listeria monocytes
ampicillin
37
no antibacterial effect | Irreversible inhibition of B lactamase
clavulanate tazobactam sulbactam
38
effective only against plasmid encoded b lactamase | not effective in inhibiting the inducible chromosomal B lactamases
B lactamase inhibitors
39
anti pseudo monal penicillins
piperacillin ticarcium mezlocillin azlocillin
40
increase activity against gram - rods including pseudo aeruginosa lactamase sensitive tx both gram + and -
anti pseudo monal penicillins
41
synergy with ahminoglycosides against pseudomonas and enterococcal species most eliminated by active PCT secretion (inhibited by probenecid)
penicillins
42
active against aerobic gram - rods resistant to lactamase no cross allergy with penicillin
aztreonam - monobactam
43
cystic fibrosis px - use for pseudomonas inf., inhalation route available
aztreonam - monobactam
44
carbapenems
imipenem ertapenem meropenem doripenem
45
MOA: same as penicillin, resistant to lactamase, renal elimination
carbapenems
46
treat pseudomonas inf., activity on both gram + and -; anaerobic infections
carbapenems
47
GI, fever and skin rash
carbapenems SE
48
inactivated by dehydropeptidase in renal tubule
imipenem
49
inhibits dehydropeptidase in renal tubule preventing degradation of imipenem
cilastatin
50
causes seizure in 33% px
imipenem
51
less seizure potential then imipenem
meropenem
52
activity against gram + and MRSA
vancomycin
53
inhibition of cell wall syn. by directly binding D ala - D ala oligopeptides (inhibits transglycosylase and transpeptidase)
vancomycin
54
resistant to B lactams and ineffective against vancomycin
altered PBPs
55
resistance: conversion of D ala in the proteoglycan chain to D lactate by plasmid expressing converting enzyme
vancomycin
56
poorly absorbed in GIT, requires IV route
vancomycin
57
oral med treats clostridium difficile colitis
vancomycin
58
SE: ototoxicity, nephrotoxicity, Red mans syndrome
vancomycin
59
uncontrolled histamine release - fever, flushing, pain [can be prevented by diphenhydramine]
red mans syndrome
60
antibiotics for C Dif. colitis
Co amoxicillin and clavulanic acid clindamycin cephalosporin ciprofloxacin
61
loose stool with or without mucus or blood | Dx: detect cytotoxin of C Dif in blood
C Dif colitis
62
1) metronidazone 2) oral vancomycin 3) fidaxomicin: inhibits RNA poly 4) only gram + aerobic and anaerobic bacteria - reduces recurrence
treatments for C Dif colitis
63
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
daptomycin
64
inhibits daptomycin
surfactant
65
not destroyed by penicillinase
Cephalosporins
66
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
Cephalosporins
67
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
Cephalosporins
68
1st gen Cephalosporins
cephalexin | cefazolin
69
none enter CNS activity against gram + tx: cellulitis, strep pyogenes activity against gram - UTI bugs [proteus, e coli, klebsiella]
1 st gen Cephalosporins
70
2nd gen Cephalosporins
cefuroxime cefotetan cefoxitin cefamandole
71
only 2nd gen with CNS entry
cefuroxime
72
2nd gens that treat anaerobes
cefotetan | cefoxitin
73
treat gram + and - | activity against H flu, neisseria, serratia, enterobacter, proteus, e coli, klebsiella,
2nd gen Cephalosporins
74
contain MTT group and inhibit Vit K epoxide reductase like warfarin
cefamandole cefotetan cefoperazone
75
causes disulfiram like rxn with ethanol
MTT
76
bleeding disorder because free MTT inhibits vit k epoxide reductase
hypo prothrombinemia
77
3rd gen Cephalosporins
ceftriaxone cefotaxime ceftazidime cefoperazone
78
all enter CNS except cefoperazone work on gram - mostly and some gram + no activity against listeria, MRSA and enterococci
3rd gen Cephalosporins
79
used to treat meningitis
ceftriaxone | cefotaxime
80
treat pseudomonas infection
ceftazidime | cefoperazone
81
binds to albumin competing with bilirubin, increase free bilirubin; in neonate (kernicterus), so not used in neonates binds to Ca2+, biliary sludge
ceftriaxone SE
82
gonorrhea treatment
ceftriaxone, IM - one dose
83
chlamydia treatment
azithromycin, oral - one dose
84
STD treatment: treat co infection treat sex partners for last 60 days treat if positive test avoid sexual intercourse for 7 days
3rd gen Cephalosporins
85
cover staph and pseudomonas resistance to most lactamases enter CNS
4th gen - cefepime
86
FDA tx of common acquired bacterial pneumonia Treats MRSA has high affinity for PBP2A = better activity
5th gen - ceftaroline
87
has PBP2A | most B lactams have low affinity fo this
MRSA
88
ADR: same ad penicillin, nephritis, hemolytic anemia, hypersensitivity rxn, cross rxn with penicillin 5%-10%
5th gen - ceftaroline

Pharm Block 3 (11 decks)

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