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MS1 - Disease & Defense > Antibacterial Agents II > Flashcards

Antibacterial Agents II Flashcards

1
Q

Structurally, penicillin is a __________.

A

beta-lactam ring

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2
Q

There are three stages of bacterial cell wall synthesis that can be targeted by antibiotics. What are they?

A

(1) synthesis of cell wall parts in the cytosol; (2) polymerization of subunits at the cell membrane; and (3) cross linking of peptidoglycans at the cell wall

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3
Q

What antibiotics target stage 1 of cell-wall synthesis?

A

Fosfomycin and cycloserine

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4
Q

What antibiotics target stage 2 of cell-wall synthesis?

A

Bacitracin and vancomycin

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5
Q

What antibiotics target stage 3 of cell-wall synthesis?

A

Penicillins and cephalosporins

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6
Q

Beta-lactamases are _____________.

A

a generic term for enzymes that degrade beta-lactam rings; they are not one specific enzyme

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7
Q

Methicillin resistance occurs by ___________.

A

alterations in penicillin-binding proteins

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8
Q

Penicillin is ________ at neutral pH and thus does not ___________.

A

ionized; enter cells or cross basement membranes well

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9
Q

Penicillins are __________ excreted.

A

renally

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10
Q

Piperacillin and ticarcillin are great for _________, but they must be administered __________.

A

killing pseudomonas and anaerobic bacteria; parenterally

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11
Q

Name three beta-lactamase inhibitors.

A

Sulbactam, tazobactam (combined with piperacilln to become Zosyn), and clavulanic acid (combined with amoxicillin to become Augmentin)

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12
Q

What antibiotic is used to treat non-invasive streptococci infections?

A

Penicillin G

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13
Q

What drug should be given to those with enterococci-associated bacteremia and meningitis?

A

Penicillin G and ampicillin

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14
Q

Some adverse reactions to penicillins are ___________.

A

diarrhea (which is common), seizures, and encephalopathy

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15
Q

There is __________ reactivity between penicillins and cephalosporins, so if a patient has a sensitivity reaction to penicillin, then _________.

A

some; do not give cephalosporins (choose something totally unrelated, like a macrolide)

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16
Q

List the five categories of cell-wall inhibitors.

A

Vancomycin, penicillin, cephalosporins, carpapenems, and monobactams

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17
Q

Substitution at the R group can __________ penicillins.

A

(1) increase stability in the GI tract; (2) decrease renal excretion; (3) minimize bacterial resistance; and (4) increase bacterial susceptibility

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18
Q

Penicillinase is transferred via ________.

A

plasmids

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19
Q

Beta-lactamase is a generic term for __________.

A

enzymes that degrade penicillins and cephalosporins

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20
Q

MRSA is resistant by ____________.

A

altering its protein target (PBP2a)

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21
Q

Penicillins are _________ from intramuscular sites.

A

rapidly absorbed (because it is a neutral environment)

22
Q

Penicillins penetrate tissues ________.

A

poorly

23
Q

What are some characteristics of penicillin G?

A

It is the proto-typical penicillin; former antibiotic of choice, but now limited to hospitalized patients; given parenterally; susceptible to penicillinase.

24
Q

Compared to penicillin G, Penicillin V is ________.

A

less effective, but better absorbed orally

25
Q

What are the penicillinase-resistant penicillin drugs?

A

Nafcillin, oxacillin, veracillin, cloxacillin, and dicloxacillin

26
Q

The penicillinase-resistant drugs are ________.

A

generally less potent than penicillin G and narrow-spectrum

27
Q

How are extended spectrum penicillins different?

A

They are more hydrophilic (due to an extra amino or carboxyl group) and can thus pass through porins in Gram-negative bacteria more easily.

28
Q

Most penicillins only work against _________; the exceptions are ________.

A

Gram-positive bacteria; amoxicillin, ampicillin, ticarcillin, and piperacillin, which work on some Gram-negative rods

29
Q

Amoxicillin is not _________, but can be _________.

A

resistant to penicillinases; administered with a beta-lactamase inhibitor (such as clavulanic acid)

30
Q

The only penicillins that work against Bacteroides fragilis and Pseudomonas are __________, but they have to be administered ___________.

A

Ticarcillin and Piperacillin; through an IV

31
Q

There are three main beta-lactamase inhibitors: __________.

A

clavulanic acid, sulbactam, and tazaobactam

32
Q

Of Gram-positive cocci, cephalosporins do not kill ________.

A

enterococcus (including VRE)

33
Q

Haemophilus influenzae is known to cause __________.

A

pneumonia, sinusitis, otitis media, and menigitis

34
Q

Treat Treponema pallidum with (the spirochete that causes syphilis) with _______.

A

penicillin G

35
Q

The only drug that kills Borrelia burgdorferi (Lyme disease) is ________.

A

amoxicillin

36
Q

Haptens are ___________.

A

small molecules that attach to larger molecules to form antigens

37
Q

Vancomycin is administered ________.

A

parenterally, except in cases of Clostridial GI infections

38
Q

What organisms does vancomycin kill?

A

All Gram-positive cocci (except VRE) and Clostridia

39
Q

What is the main concern for adverse reactions with vancomycin treatment?

A

Ototoxicity, nephrotoxicity, and Red Man syndrome

40
Q

Daptomycin targets _______ and can be used to kill ________, but it has restricted use.

A

cell membranes; MRSA, VRSA, and VRE

41
Q

The lipoglycopeptides are ___________; they target __________; they should only be used in ___________.

A

oritavancin, dalbavancin, and telavancin; they same step as vancomycin, and so kill Gram-positive bacteria; patients with allergies to other drugs or infections with resistant strains

42
Q

________ is the only cephalosporin that can kill MRSA.

A

Cefepime

43
Q

Cephalosporins have a similar range of killing as amoxicillin, but they can’t kill ________.

A

Enterococci

44
Q

Keflex is ___________.

A

an orally administered, first-generation cephalosporin called cephalexin

45
Q

Rocephin is __________, and it is unique for its ability to kill __________.

A

ceftriaxone; Neisseria gonorrhoeae

46
Q

The carbapenems are bactericidal to everything except ___________.

A

E. faecium, VRE, Clostridia, and atypical bacteria

47
Q

Monobactams only kill ___________.

A

Gram-negative aerobic bacteria

48
Q

The best antibiotics for Gram-negative Neisseria are ____________.

A

3rd-generation cephalosporins (ceftriaxone and cefotaxime)

49
Q

Like piperacillin and ticarcillin, second generation cephalosporins (cefaclor and cefuroxime) are active against __________.

A

Bacteroides fragilis

50
Q

In addition to cefepime and ceftaroline, ________ all also kill MRSA.

A

vancomycin, clindamycin, tetracyclines, and macrolides

MS1 - Disease & Defense (59 decks)

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