Antibiotics That Act On Cell Wall Flashcards by Lana Ghneim

What are the antibiotics that act on cell wall?

B-lactams (penicillins, cephalosporins, carbapenems, monobactams)
vancomycin
-vancins

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Describe structure of penicillins

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

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Describe the structure of cephalosporins.

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

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Describe the structure of carbapenems.

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

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Describe the structure of monobactams.

B-lactam ring

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How do antibiotics inhibit cell wall synthesis?

They inhibit transpeptidase enzyme responsible for forming transpeptide bond

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Name of monobactam drug?

Aztreonam

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

safest

- adverse effects

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Penicillins are the DOC during ……

Pregnancy

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

Sensitivity

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What spectrum do natural penicillins cover?

G +ve

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List the natural penicillins.

Penicillin V K

Penicillin G

Penicillin G Benzathine

Penicillin G Procaine

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Penicillin V is the DOC for?

Sore throat

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

Syphillus

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

Longer duration of action

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What are the 2 aminopenicillins?

Amoxicillin

Ampicillin

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What spectrum do aminopenicillins cover?

Broad spectrum, but doesnt cover MDR causing nosocomial infections

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Amoxicillins are combined with?

Clavulanic acid, a b-lactamase inhibitor

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How are amoxicillins administered?

What are they DOC for?

Orally

DOC for otitis media and h.pylori

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What are ampicillins combined with?

How are they administered?

Sulbactam, b-lactamase inhibitor

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What spectrum do extended spectrum penicillins cover?

Broad spectrum, cover MDR causing nosocomial infections

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What is the name of extended spectrum penicillin?

Piperacillin

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Piperacillin is combined with?

Tazobactam, a b-lactamase inhibitor

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Piperacillin is the DOC in?

Pseudomonas

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What are the multidrug resistant bacteria?

- pseudomonas aeruginosa - e. Coli - klebsiella - acinetobacter baumanii

Describe the process of staph aureus resistance.

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

What are anti-staphylococcal penicillins used for?

For penicillin resistant staph aureus

What are the anti-staphylococcal penicillins?

Methicillin Oxacillin Nafcillin Dicloxacillin

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

Vesicant (tissue irritant) Must only be taken IV in the central line ONLY

What should we do in case of nafcillin extravasation?

- cold packs | - hyaluronidase injection

Penicillin adverse effects?

Seizures Rash Diarrhea

Penicillins are contraindicated in?

Patients with sulfa allergy

Penicillin drug interactions?

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

List all the types of penicillins:

- natural penicillins - aminopenicillins - extended spectrum penicillins - anti-staphylococcal penicillins

MOA of cephalosporins

Inhibit cell wall synthesis

Cephalosporins dont cover?

Atypical and enterococcus

First generation cephalosporins spectrum and names?

G+ve Cefazolin Cefalexin

Second generation cephalosporins spectrum and names?

Spectrum: ⬇️ g+ve than first ⬆️ g-ve than second (Cefotetan and Cefoxitin are g-ve anaerobic) Cefuroxime Cefotetan Cefoxitin

Third generation cephalosporins spectrum and names?

Group 1: - cefotaxime - ceftriaxone Broad spectrum Group 2: - ceftazidime G-ve including pseudomonas

Fourth generation spectrum and names?

Cefepime Broad spectrum, including pseudomonas

Fifth generation spectrum and names?

Ceftaroline Broad spectrum including MRSA (not pseudomonas)

Adverse effects of cephalosporins

Seizures Rash GIT upset

Ceftriaxone is contraindicated in? Why?

Neonates (0-28 days) Because it results in biliary sludgine, and kernictrun

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

N-methylthiotetrazole - ⬆️ risk of bleeding - disulfuram rxn (dont take with alcohol)

Ceftazidim is used in combination with?

Avibactam

Why is ceftazidime/avibactam combination used?

For carbapenem resistant bacteria

Drug interactions of cephalosporins?

Cefuroxime and cefpodoxime need acidic media for absorption Cant be taken with peptic ulcer drugs

MOA of carbapenems?

Inhibit cell wall synthesis

Route of administration of carbapenems?

IV 💉🩹

What spectrum do carbapenems cover?

Broad spectrum, reserved for MDR g-ve nosocomial infections

Carbapenems do not cover?

Atypical MRSA VRSA

What is imipenem/cilastatin combination used for?

To inhibit dipeptidase enzyme produced by kidney

Etrapenem doesnt cover?

Pseudomonas

List carbapenems:

- imipenem - meropenem - etrapenem

Adverse effects of carbapenems?

Seizures

Adverse effects of carbapenems are less severe with?

Meropenem Etrapenem

Carbapenems are contraindicated in?

In penicillin allergy

Drug interactions of carbapenems?

Decrease serum concentration of valproic acid

MOA of monobactams?

Inhibit cell wall synthesis

Name of monobactam drug?

Aztreonam

Spectrum of aztreonam?

G-ve including pseudomonas

Can aztreonam be used in penicillin allergy?

Yes

Vancomycin MOA?

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

Where is vancomycin used?

In hospitals

IV vancomycin is used for?

MRSA

Oral vancomycin is used for?

Clostridium defficile Due to its hydrophilicity, it remains in the gut

Vancomycin adverse effects?

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

Drug interactions of vancomycin?

With nephrotoxic drugs and ototoxic drugs

Nephrotoxic drugs that vancomycin interacts with?

Aminoglycosides Amphotericin B Loop diuretics Cisplatin NSAID’s Polymixin

Ototoxic drugs that vancomycin interacts with?

Loop diuretics Cisplatin Aminoglycosides

MOA of lipoglycopeptides -vancins?

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

Lipoglycopeptides drug names?

Telavancin Oritavancin Dalbavancin

Telavancin route of administration?

IV 💉🩹

Telavancin is contraindicated in?

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

Telavancin adverse effects?

Nephrotoxic Red man syndrome Metallic taste Doesn’t ⬆️ bleeding risk but interferes with coagulation tests (INR, PT)

Oritavancin adverse effects?

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

Dalbavancin adverse effects?

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

Antibiotics That Act On Cell Wall Flashcards

(77 cards)