Antibacterial Agents Overview Flashcards

1
Q

Cell Wall Synthesis Inhibitors

A

Penicillins, cephalosporins, carbapenems, and miscellaneous drugs

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2
Q

Active on cell walls, inhibiting transpeptidase and promoting cross-linking for a stronger wall

A

Penicillins

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3
Q

Penicillins are ________ on cell walls, inhibiting _____________ and promoting cross-linking for a stronger wall

A

active; transpeptidase

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4
Q

Defense mechanisms of Cell Wall Synthesis Inhibitors

A

Beta-lactamase enzymes countered by inhibitors like clavulanic acid

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5
Q

Resistance mechanisms of Penicillins:

A

Beta-lactamase, structural changes in proteins, or alterations in the outer wall.

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6
Q

Cell walls have sites that are amenable to ___________

A

transpeptidation

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7
Q

Cross-linking is facilitated by proteins acting on _____________ of the cell wall, linking them together

A

peptidoglycans

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8
Q

Penicillins have a ________ ring that binds to the protein

A

B-lactam

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9
Q

By inhibiting the penicillin binding protein, __________ of the cell wall will occur.

A

autocatalysis

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10
Q

B-lactamases (penicillinases) ___________ the B-lactam ring

A

break down

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11
Q

mechanism of most types of resistance

A

B-lactamases (penicillinases) break down the B-lactam ring

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12
Q

The breaking down of the B-lactam rings are countered by inhibitors of these enzymes

A

Clavulanic acid (i.e. amoxicillin-clavulanate)
Sulbactam (ampicillin sulbactam)
Tazobactam (i.e. piperacillin-tazobactam)

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13
Q

amoxicillin-clavulanate

A

Clavulanic acid

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14
Q

ampicillin sulbactam

A

Sulbactam

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15
Q

piperacillin-tazobactam

A

Tazobactam

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16
Q

Changes in the porin structures in the outer wall (i.e. pseudomonas aeruginosa are seen in __________ resistance

A

methicillin resistance

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17
Q

Penicillins that have very narrow spectrum

A

Methicillin, nafcillin, oxacillin

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18
Q

__________________ are resistant to all penicillins

A

methicilin resistant staphylococcus aureus

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19
Q

Penicillin linked to interstitial nephritis

A

Methicillin

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20
Q

Penicillin associated with neutropenia

A

Nafcillin

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21
Q

Penicillins that have wider spectrum but are still susceptible to B-lactamases

A

Ampicillin, amoxicillin

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22
Q

Ampicillin, amoxicillin are enhanced when used with ____________

A

clavulanate

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23
Q

In ______________ infections, ampicillin is complementary with ________

A

eneterococcal; aminoglycosides

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24
Q

Penicillins that have strong activity against gram-negative organisms

A

Piperacillin, ticarcillin

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25
Q

Penicillins that have compelmetary actions with aminoglycosides

A

Piperacillin, ticarcillin

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26
Q

These are susceptible to penicillinases, used with tazobactam to limit resistance

A

Piperacillin, ticarcillin

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27
Q

Piperacillin, ticarcillin are susceptible to penicillinases, used with _________ to limit resistance

A

tazobactam

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28
Q

First generation cephalosporins

A

Cefalozin, cephalexin

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29
Q

Used in surgical infections

A

First generation cephalosporins (Cefalozin, cephalexin)

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30
Q

Minimal effectiveness against gram-negative bacteria

A

First generation cephalosporins (Cefalozin, cephalexin)

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31
Q

Second generation cephalosporins

A

Cefotetan, cefoxitina, cefamandole, cefuroxime, cefactor

32
Q

More active against gram-negative

A

Second generation cephalosporins (Cefotetan, cefoxitina, cefamandole, cefuroxime, cefactor)

33
Q

Will also work against Haemophilus influenzae

A

Second generation cephalosporins (Cefotetan, cefoxitina, cefamandole, cefuroxime, cefactor)

34
Q

Third generation cephalosporins

A

Ceftazidime, cefoperazone, cefotaxime, ceftriaxone

35
Q

Even more active against gram-negative

A

Third generation cephalosporins (Ceftazidime, cefoperazone, cefotaxime, ceftriaxone)

36
Q

Will often work against organisms that are resistant to penicillin

A

Third generation cephalosporins (Ceftazidime, cefoperazone, cefotaxime, ceftriaxone)

37
Q

We only use these drugs in serious infections

A

Third generation cephalosporins (Ceftazidime, cefoperazone, cefotaxime, ceftriaxone)

38
Q

Fourth generation cephalosporins

A

Cefepime,

39
Q

More resistant to B-lactamases

A

Fourth generation cephalosporins (Cefepime, ceftaroline)

40
Q

Eneterobacter, Haemophilus, Neisseria

A
41
Q

has activity in infections caused by methicillin resistant staphylococci

A

Ceftaroline

42
Q

less likely to cause rashes and allergic reactions than penicillins

A

Cephalosporins

43
Q

Anti-infectives

A

Ceftaroline, ceftobiprole
Ceftaroline
Ceftobiprole

44
Q

Community acquired pneumonia

A

Ceftaroline

45
Q

Skin/soft tissue infections, inlucidng MRSA

A

Ceftaroline

46
Q

Hospital acquired pneumonia

A

Ceftobiprole

47
Q

Resistant to B-lactamases

A

Aztreonam

48
Q

No activity against gtam-positive drugs

A

Aztreonam

49
Q

Binds to penicillin-binding protein 3 (PBP3)

A

Aztreonam

50
Q

Half-life is prolonged in renal failure

A

Aztreonam

51
Q

Aztreonam ADE

A

GI upset
Vertigo, headache
No cross allergy with penicillins

52
Q

Broad-spectrum activity against gram positives, gram negatives, anaerobes, and Pseudomonas.

A

Carbapenems

53
Q

Carbapenems that are chemically unique, but still containing a B-lactam ring

A

Imipenem, doripenem, meropenem

54
Q

Low susceptibility to penicillinases

A

Imipenem, doripenem, meropenem

55
Q

Very susceptible to renal dehydropeptidases

A

Imipenem, doripenem, meropenem

56
Q

Imipenem, doripenem, meropenem are very susceptible to renal dehydropeptidases, thus Administered with ______________

A

silastatin

57
Q

Imipenem, doripenem, meropenem are wide ranging activity against:

A

gram -positive cocci
Gram-negative rods
Anaerobes
Pseudomonas and acinetobacter species

58
Q

Used for severe infections, especially against resistant strains.

A

Vancomycin

59
Q

Binds to a bacterial glycoprotein, causing “red man syndrome” (histamine release-induced severe cutaneous flushing).

A

Vancomycin

60
Q

histamine release-induced severe cutaneous flushing

A

Red man syndrome

61
Q

Bactericidal glycoprotein that binds to the alanine terminal of the peptidoglycan

A

Vancomycin

62
Q

Resistant organisms have an altered terminal - decreased affinity for vancomycin

A

Vancomycin

63
Q

Used for serious infections only

A

Vancomycin

64
Q

Vancomycin does not cross the blood brain barrier - used ____________

A

intrathecally

65
Q

Used orally for luminal infections of the gut

A

Vancomycin

66
Q

Toxicity of Vancomycin

A

Red man syndrome
Phlebitis, otototxicity, nephrotoxicity

67
Q

Topical treatment and decontamination for Staphylococcus colonization.

A

Bacitracin

68
Q

Bacitracin is used in caution due to potential __________.

A

nephrotoxicity

69
Q

Used in topical treatment and decontamination syndromes

A

Bacitracin

70
Q

Used in staphylococcus colonization of the skin

A

Bacitracin

71
Q

Marked nephrotoxicity - not used parenterally

A

Bacitracin

72
Q

Cyclic lipopeptide for vancomycin-resistant strains.

A

Daptomycin

73
Q

Requires close monitoring of creatinine kinase levels due to potential muscle disease.

A

Daptomycin

74
Q

Cyclic lipopeptide

A

Daptomycin

75
Q

For the treatment of VRE and VRSA

A

Daptomycin

76
Q

During treatment of Daptomycin, creatinine kinase during treatment must be monitored because it is _____________

A

myopathic