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Antibiotics > Antibiotics That Act On Cell Wall > Flashcards

Antibiotics That Act On Cell Wall Flashcards

1
Q

What are the antibiotics that act on cell wall?

A
  • B-lactams (penicillins, cephalosporins, carbapenems, monobactams)
  • vancomycin
  • -vancins
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2
Q

Describe structure of penicillins

A

B- lactam ring attached to a 5-membered ring with sulfur

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3
Q

Describe the structure of cephalosporins.

A

B-lactam ring attached to a 6 membered ring with sulfur

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4
Q

Describe the structure of carbapenems.

A

B-lactam ring attached to 5-membered ring without sulfur

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5
Q

Describe the structure of monobactams.

A

B-lactam ring

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6
Q

How do antibiotics inhibit cell wall synthesis?

A

They inhibit transpeptidase enzyme responsible for forming transpeptide bond

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7
Q

Name of monobactam drug?

A

Aztreonam

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8
Q

Penicillins are considered the ………… antibiotics with the least ……….

A
  • safest

- adverse effects

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9
Q

Penicillins are the DOC during ……

A

Pregnancy

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10
Q

We must perform a ………… test before administering penicillins

A

Sensitivity

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11
Q

What spectrum do natural penicillins cover?

A

G +ve

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12
Q

List the natural penicillins.

A

Penicillin V K

Penicillin G

Penicillin G Benzathine

Penicillin G Procaine

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13
Q

Penicillin V is the DOC for?

A

Sore throat

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14
Q

Penicillin G Benzathine is the DOC for? Its given …?

A

Syphillus

IM

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15
Q

How do penicillin g benzathine and penicillin g procaine differ from the other natural penicillins?

A

Longer duration of action

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16
Q

What are the 2 aminopenicillins?

A

Amoxicillin

Ampicillin

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17
Q

What spectrum do aminopenicillins cover?

A

Broad spectrum, but doesnt cover MDR causing nosocomial infections

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18
Q

Amoxicillins are combined with?

A

Clavulanic acid, a b-lactamase inhibitor

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19
Q

How are amoxicillins administered?

What are they DOC for?

A

Orally

DOC for otitis media and h.pylori

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20
Q

What are ampicillins combined with?

How are they administered?

A

Sulbactam, b-lactamase inhibitor

IV

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21
Q

What spectrum do extended spectrum penicillins cover?

A

Broad spectrum, cover MDR causing nosocomial infections

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22
Q

What is the name of extended spectrum penicillin?

A

Piperacillin

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23
Q

Piperacillin is combined with?

A

Tazobactam, a b-lactamase inhibitor

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24
Q

Piperacillin is the DOC in?

A

Pseudomonas

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25
Q

What are the multidrug resistant bacteria?

A
  • pseudomonas aeruginosa
  • e. Coli
  • klebsiella
  • acinetobacter baumanii
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26
Q

Describe the process of staph aureus resistance.

A

Staph aureus ➡️ penicillin ➡️ penicillin resistant staph aureus ➡️ methicillin ➡️ MRSA ➡️ vancomycin ➡️ VRSA ➡️ Linezolid

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27
Q

What are anti-staphylococcal penicillins used for?

A

For penicillin resistant staph aureus

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28
Q

What are the anti-staphylococcal penicillins?

A

Methicillin

Oxacillin

Nafcillin

Dicloxacillin

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29
Q

Nafcillin is known to be a ……… and must only be taken …….

A

Vesicant (tissue irritant)

Must only be taken IV in the central line ONLY

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30
Q

What should we do in case of nafcillin extravasation?

A
  • cold packs

- hyaluronidase injection

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31
Q

Penicillin adverse effects?

A

Seizures

Rash

Diarrhea

32
Q

Penicillins are contraindicated in?

A

Patients with sulfa allergy

33
Q

Penicillin drug interactions?

A
  • all b-lactams (except nafcillin) ⬆️ anticoagulant effect of warfarin
  • probencid: ⬇️ elim of penicillins from blood 🩸
34
Q

List all the types of penicillins:

A
  • natural penicillins
  • aminopenicillins
  • extended spectrum penicillins
  • anti-staphylococcal penicillins
35
Q

MOA of cephalosporins

A

Inhibit cell wall synthesis

36
Q

Cephalosporins dont cover?

A

Atypical and enterococcus

37
Q

First generation cephalosporins spectrum and names?

A

G+ve

Cefazolin

Cefalexin

38
Q

Second generation cephalosporins spectrum and names?

A

Spectrum: ⬇️ g+ve than first ⬆️ g-ve than second

(Cefotetan and Cefoxitin are g-ve anaerobic)

Cefuroxime

Cefotetan

Cefoxitin

39
Q

Third generation cephalosporins spectrum and names?

A

Group 1:

  • cefotaxime
  • ceftriaxone

Broad spectrum

Group 2:

  • ceftazidime

G-ve including pseudomonas

40
Q

Fourth generation spectrum and names?

A

Cefepime

Broad spectrum, including pseudomonas

41
Q

Fifth generation spectrum and names?

A

Ceftaroline

Broad spectrum including MRSA (not pseudomonas)

42
Q

Adverse effects of cephalosporins

A

Seizures

Rash

GIT upset

43
Q

Ceftriaxone is contraindicated in? Why?

A

Neonates (0-28 days)

Because it results in biliary sludgine, and kernictrun

44
Q

Cefotetan has a side chain called? Why is this significant?

A

N-methylthiotetrazole

  • ⬆️ risk of bleeding
  • disulfuram rxn (dont take with alcohol)
45
Q

Ceftazidim is used in combination with?

A

Avibactam

46
Q

Why is ceftazidime/avibactam combination used?

A

For carbapenem resistant bacteria

47
Q

Drug interactions of cephalosporins?

A

Cefuroxime and cefpodoxime need acidic media for absorption

Cant be taken with peptic ulcer drugs

48
Q

MOA of carbapenems?

A

Inhibit cell wall synthesis

49
Q

Route of administration of carbapenems?

A

IV 💉🩹

50
Q

What spectrum do carbapenems cover?

A

Broad spectrum, reserved for MDR g-ve nosocomial infections

51
Q

Carbapenems do not cover?

A

Atypical

MRSA

VRSA

52
Q

What is imipenem/cilastatin combination used for?

A

To inhibit dipeptidase enzyme produced by kidney

53
Q

Etrapenem doesnt cover?

A

Pseudomonas

54
Q

List carbapenems:

A
  • imipenem
  • meropenem
  • etrapenem
55
Q

Adverse effects of carbapenems?

A

Seizures

56
Q

Adverse effects of carbapenems are less severe with?

A

Meropenem

Etrapenem

57
Q

Carbapenems are contraindicated in?

A

In penicillin allergy

58
Q

Drug interactions of carbapenems?

A

Decrease serum concentration of valproic acid

59
Q

MOA of monobactams?

A

Inhibit cell wall synthesis

60
Q

Name of monobactam drug?

A

Aztreonam

61
Q

Spectrum of aztreonam?

A

G-ve including pseudomonas

62
Q

Can aztreonam be used in penicillin allergy?

A

Yes

63
Q

Vancomycin MOA?

A

Inhibit cell wall synthesis by binding to D-alanyl D-alanine

64
Q

Where is vancomycin used?

A

In hospitals

65
Q

IV vancomycin is used for?

A

MRSA

66
Q

Oral vancomycin is used for?

A

Clostridium defficile

Due to its hydrophilicity, it remains in the gut

67
Q

Vancomycin adverse effects?

A

Ototoxicity

Nephrotoxicity

Red man syndrome (infusion rxn due to high infusion rate ~ do not infuse faster than 1 g/hr)

68
Q

Drug interactions of vancomycin?

A

With nephrotoxic drugs and ototoxic drugs

69
Q

Nephrotoxic drugs that vancomycin interacts with?

A

Aminoglycosides

Amphotericin B

Loop diuretics

Cisplatin

NSAID’s

Polymixin

70
Q

Ototoxic drugs that vancomycin interacts with?

A

Loop diuretics

Cisplatin

Aminoglycosides

71
Q

MOA of lipoglycopeptides -vancins?

A

Inhibit cell wall synthesis by binding to D-alanyl D-alanine

72
Q

Lipoglycopeptides drug names?

A

Telavancin

Oritavancin

Dalbavancin

73
Q

Telavancin route of administration?

A

IV 💉🩹

74
Q

Telavancin is contraindicated in?

A
  • not used during pregnancy

- not used in QT prolongation (arrhythmic patients, or drugs that cause arrhythmia)

75
Q

Telavancin adverse effects?

A

Nephrotoxic

Red man syndrome

Metallic taste

Doesn’t ⬆️ bleeding risk but interferes with coagulation tests (INR, PT)

76
Q

Oritavancin adverse effects?

A
  • Doesn’t increase bleeding but interferes with coagulation tests (INR, PT)
  • red man syndrome
77
Q

Dalbavancin adverse effects?

A
  • Doesn’t increase bleeding, but interferes with coagulation tests (INR, PT)
  • red man syndrome

Antibiotics (4 decks)

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