Antibiotics II: Inhibitors of Cell Wall Synthesis Flashcards

1
Q

Beta-lactams: bactericidal or bacteriostatic?

A

bactericidal

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2
Q

Beta-lactams: time-dependent or concentration-dependent?

A

time-dependent

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3
Q

Mechanism of cell wall disruption by beta-lactams?

A

irreversibly inhibits transpeptidase; most effective in log phase of growth; target PBPs (penicillin-binding proteins)

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4
Q

G+ mechanism of resistance

A

secretion of beta-lactamases

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5
Q

standard, narrow-spectrum

A

Penicillin G, Penicillin V

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6
Q

Targets of penicillin

A

G+»>G-; anaerobic bacteria

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7
Q

DOC for syphilis

A

penicillin G

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8
Q

Penicillinase-resistant, narrow spectrum

A

Nafcillin

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9
Q

Use for Nafcillin

A

Pen G-resistant staph (MSSA) endocarditis, SSTIs (no G- activity)

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10
Q

Aminopenicillins, broad-spectrum

A

Amoxicillin

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11
Q

MOA for amoxicillin

A

activity against G- bacteria due to increased penetration through porins

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12
Q

Major use of amoxicillin

A

URIs

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13
Q

Antipseudomonal, extended-spectrum

A

ticarcillin, piperacillin

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14
Q

DOC for nosocomial G- infections

A

ticarcillin, piperacillin

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15
Q

beta-lactamase inhibitor

A

clavulanic acid

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16
Q

half-life of beta-lactams

A

short (30-90 min)

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17
Q

single dose repository prep given IM used for syphilis and prevention of rheumatic fever

A

pen G benzathine

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18
Q

Reaction common during therapy for syphilis

A

Jarish-Herxheimer (inflammatory response after lysis of organism)

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19
Q

large IV doses cause sodium overload –> CHF

A

ticarcillin

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20
Q

Pneumococcal, Streptococcal

A

Pen G

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21
Q

Meningococcal, Neisseria, syphilis, anaerobes, Listeria

A

Pen V

22
Q

Staph. aureus, Staph. epidermis

A

Nafcillin

23
Q

H. influenzae, S. pneumoniae, E. coli

A

Amoxicillin

24
Q

P. aeruginosa, Enterobacter, B. fragilus, Klebsiella

A

Ticarcillin, Piperacillin

25
Q

1st generation vs. 5th generation cephalosporins

A

increasing activity against G- bacteria and anaerobes
increasing resistance to Beta-lactams
increasing penetration into CNS

26
Q

1st generation cephalosporin

A

cefazolin

27
Q

used immediately before surgery to prevent surgical site infections

A

cefazolin

28
Q

2nd generation cephalosporin

A

cefoxitin

29
Q

3rd generation cephalosporin

A

ceftriaxone

30
Q

Tx. of meningitis and gonorrhea + empiric chlamydia

A

ceftriaxone

31
Q

4th generation cephalosporin

A

cefepime

32
Q

empirical treatment of hospitalized patients when resistance due to extended spectrum beta-lactamases is suspected

A

cefepime

33
Q

Uses - multi-drug resistant infections, anaerobic and mixed infections

A

imipenem/cilastatin

34
Q

reason to combine imipenem with cilastatin

A

cilastatin is dipeptidase inhibitor that prevents renal inactivation

35
Q

narrow spectrum drug with activity against G- aerobic bacteria

A

aztreonam

36
Q

considered safe to give to patients with penicillin allergy

A

aztreonam

37
Q

tricyclic glycopeptide antibiotic

A

vancomycin

38
Q

MOA: prevent polymerization of cell wall precursors; blocks addition of NAM-NAG to polymer chain

A

vancomycin

39
Q

active only against G+ bacteria (S. aureus and S. epidermis)

A

vancomycin

40
Q

tx for VRSA and VRE

A

linezolid, daptomycin, quinupristin/dalfopristin

41
Q

treatment of CDAD

A

vancomycin, metronidazole(1st choice)

42
Q

alternative to penicillin in allergic patients w/ severe G+ infections

A

vancomycin

43
Q

Adverse reactions to vancomycin

A

ototoxic and nephrotoxic; “red man syndrome”, thrombophlebitis

44
Q

bactericidal phosphoenolpyruvate analogue

A

fosfomycin

45
Q

treatment of uncomplicated G- UTIs

A

fosfomycin

46
Q

inhibits production of murein monomers

A

fosfomycin

47
Q

enters bacterium via glycerophosphate transporter

A

fosfomycin

48
Q

inhibits bactoprenol dephosphorylation (lipid carrier)

A

bacitracin

49
Q

drugs that make up Neosporin

A

bacitracin, neomycin, polymyxin B

50
Q

Resistance to Vancomycin

A

variations in peptide terminus produce 1000-fold decrease in binding affinity