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PPP-3 > Antibiotics: Cell wall inhibitors > Flashcards

Antibiotics: Cell wall inhibitors Flashcards

1
Q

What antibiotics are bacteriostatic?

A

Tetracyclines, linezolid, macrolides, clindamycin, and sulfonamides

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2
Q

What antibiotics are bacteriocidal?

A

B-lactams, glycopeptides, daptomycin, aminoglycosides, quinolones, metronidazole

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3
Q

What is the MOA of B-lactams, cephalosporins, monobactam, and carbapenems?

A

Inhibit transpeptidase PBPs which is an enzyme that catalyzes the final cross-linking step in peptidoglycan synthesis –> leads to cell lysis aka bactericidal
- Note that cephalosporins are more stable

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4
Q

What are first generation penicillins?

A

Penicillin G (iv) and penicillin V (po)

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5
Q

What are indications for penicillin G and penicillin V?

A

(+)= s. pyogenes
- Others include for spirochetes like syphilis

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6
Q

What are second generation penicillins?

A

Methicillin, oxacillin, dicloxacillin, nafcillin

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7
Q

What are indications for oxacillin, dicloxacillin, and nafcillin?

A

(+)= S. aurerus (MRSA or MSSA)

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8
Q

What are third generation penicillins?

A

Amoxicillin and ampicillin

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9
Q

What are indications for amoxicillin and ampicillin?

A

“HELP”
(+)= streptococcus, listeria monocytogenes
(-)= haemophilus influenza, escherichia coli, proteus mirabilis

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10
Q

What are B-lactamase inhibitors?

A

Clavulanic acid and tazobactam (only used in combination w amoxicillin)

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11
Q

What are indications for amoxicillin + B-lactamase inhibitors?

A

“HNPEK” + anaerobes
(+)= streptococcus, staphylococcus, enterococcus faecalis, listeria monocytogenes
(-)= haemophilus influenza, neisseria ssp, proteus mirabilis, escherichia coli, klebsiella

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12
Q

What are fourth generation penicillins?

A

Piperacillin (iv)

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13
Q

What are indications for piperacillin + B-lactamase inhibitors?

A

“HNPEK/CaPES”
(+)= streptococcus, staphylococcus, enterococcus faecalis, listeria monocytogenes
(-)= haemophilus influenza, neisseria ssp, proteus mirabilis, escherichia coli, klebsiella
(-)= citrobacter, acinetobacter, pseudomonas, enterobacter, serratia

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14
Q

What are side effects for penicillin, monobactams, and carbapenems?

A
  1. Hypersensitivity reactions (rash, fever, joint swelling, pruritus, leukopenia, anaphylactic shock)
  2. GI distress (diarrhea)
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15
Q

What are first generation cephalosporins?

A

Cefazolin and cephalexin

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16
Q

What are indications for cefazolin and cephalexin?

A

“PEK”
(+)= streptococci and staphylococci
(-)= proteus mirabilis, escherichia coli, klebsiella

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17
Q

T/F: cefazolin can be used for surgical prophylaxis

A

True

18
Q

What are second generations cephalosporins?

A

Cefuroxime, cefoxitin, and cefotetan

19
Q

T/F: cefazolin can be used for meningitis as well

A

False, only the second gen cefuroxime can be used for meningitis since it passes the BBB

20
Q

What are indications for cefuroxime, cefoxitin, and cefotetan?

A

“HNPEK”
(+)= streptococci and staphylococci
(-)= haemophilus influenzae, neisseria ssp, proteus mirabilis, escherichia coli, klebsiella

21
Q

What else can cefoxitin and cefotetan be used for?

A

They are also active against B.fragilis

22
Q

What are third generation cephalosporins?

A

Ceftriaxone, cefotaxime, and ceftazidime

23
Q

What are indications for ceftriaxone, cefotaxime, and ceftazidime?

A

“HNPEK”
(+)= streptococci and staphylococci
(-)= haemophilus influenzae, neisseria ssp, proteus mirabilis, escherichia coli, klebsiella

“CaPES”
- Citrobacter, acinetobacter, pseudonomas (only ceftazidime), enterobacter, serratia

  • Also used for empirical management of sepsis and meningitis
24
Q

What is the fourth generation cephalosporin?

A

Cefepime (iv)

25
Q

What are indications for cefepime?

A

Used for nosocomial infections
- Gram +, -, and pseudomonas

26
Q

What is the fifth generation cephalosporin?

A

Ceftaroline (iv)

27
Q

What are indications for ceftaroline?

A

(+)= broad + MRSA
(-)= broad but not active against pseudomonas

28
Q

What are side effects of cephalosporins?

A
  1. Hypersensitivity
  2. GI distress
  3. Intolerance to alcohol (disulfiram like effect) and specifically from cefotetan
  4. Potentially nephrotoxic (1st gen mainly)
29
Q

What drug is a monobactam?

A

Aztreonam (iv)

30
Q

What are the indications of aztreonam?

A

“HNPEK + CaPES” aka aerobe gram negative rods

(-)= haemophilus influenzae, neisseria ssp, proteus mirabilis, escherichia coli, klebsiella
(-)= citrobacter, acinetobacter, pseudomonas, enterobacter, serratia

31
Q

What drug would you use if you are allergic to penicillin and cephalosporin & need activity against a gram-negative rod?

A

Use aztreonam

32
Q

What drug is a carbapenem?

A

Meropenem

33
Q

What are indications of carbapenems?

A
  • Gram positive cocci
  • Gram negative rods (pseudomonas)
  • Anaerobes
  • Empiric tx for severe life threatening infections like sepsis and meningitis
34
Q

What drug is a glycopeptide?

A

Vancomycin

35
Q

What is the MOA of vancomycin?

A

Bind to D-Ala-D-Ala to prevent their cross-linking and is bactericidal

36
Q

What are indications for vancomycin?

A

Only effective against gram positive= streptococci, MRSA, enterococci, c diff

37
Q

What are side effects for vancomycin?

A
  1. Hypersensitivity (flushing but decrease this by infusing slowly)
  2. Ototoxicity (mainly if used w aminoglycosides)
  3. Nephrotoxicity
38
Q

Which drug is a cell membrane active agent or lipopeptide?

A

Daptomycin

39
Q

What is the MOA of daptomycin?

A

Interfere w inner membrane and create channels (pores) where bacterial electrolytes leak which disturbs homeostasis and is bactericidal

40
Q

What are indications for daptomycin?

A

Only active against gram += VRE, MRSA, VRSA and do NOT use in pneumonia

41
Q

What are side effects seen with daptomycin?

A

Can cause muscle pain and weakness so monitor CK activity (and interact w statins)

PPP-3 (21 decks)

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