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Pharmacology 3 > B-Lactams and more! > Flashcards

B-Lactams and more! Flashcards

1
Q

B-lactams consist of Penicillin, Lactamase inhibitors, cephalosporins and Cephamycins, Carbapenems, Monobactams

What is there MOA?

A

Cross link is usually formed by transpeptidase but B-lactams inhibit this

Also known as PBP

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2
Q

B-lactams are _____ dependent and they are not active against?

A

Time dependent, not active against MRSA

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3
Q

How can bacteria be resistant to B-lactams and their derivatives? Theres 4

A
  1. Inactivation by amidases, B-lactamase, or carbapenamases
  2. Modification of PBP
  3. Imparied drug penetration to target PBPs
  4. Anitbiotic Efflux
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4
Q

What are the B-lactam inhibitors?

What do they do?

A

Clavulanic Acid, Sulbactam, Tazobactam

Protected hydrolyzed penicillins from inactivation. Extend Spectrum of the penicillin to strains that would otherwise be inactive.

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5
Q

Cephalosporin and Cephamycin what is their purpose?

What are some adverse rxns?

A

Increase gram negative coverage

Allergy, methylthiotetrazole containing cephs can cause bleeding and disulfiram like rxns

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6
Q

Carbapenems are not active against?

Impenem is administered with?

Good choice for?

A
  • Klebsiella pneumoniae
  • And carbapenemase producing strains
  • administered with a renal dehydropeptidase, cilastatin
  • Good for nosocomial infections and B-lactamase producing GN strains
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7
Q

Monobactams?

Limited to?

No activity againsts? _____ and _____

A
  • Aztreonam
  • Limited to aerobic GN rods (including P aeruginosa)
  • No activity against GP, or anaerobes
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8
Q

Vancomycin is only active against?

Binds to d-___d-___

Drug of choice for?

Can cause?

A
  • Gram positive
  • Binds to d-Ala-d-Ala preventing elongation
  • Drug of choice for MRSA
  • Time dependent killing
  • Redman syndrome
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9
Q

Cyclic Lipopeptide?

A

Daptomycin

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10
Q

What does daptomycin do?

Effects against? can cause?

A
  • Binds to the cell wall of gram positive causing death
  • Effective againsts MRSA, VRE (Vanco-resistant)
  • Allergic pneumonitis
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11
Q

Fosfomycin?

MOA?

Used to treat?

Same as?

A
  • Inhibits the bacterial wall synthesis by inhibiting the synthesis of the cell wall building blocks
  • Primarily used for uncomplicated lower UTI
  • Same as Nitrofurantoin
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12
Q

Tetracyclines?

A

Tetra, Doxy, Tige all cycline

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13
Q

Tetracyclines are good for treating?

Resistance? 3 ways

A
  • Rickettsia Mycoplasma, Chlamydia, Plasmodium
  1. Impaired influx or increased efflux
  2. Productin of proteins that interfere with tetracylcine
  3. Enzymatic inactivation
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14
Q

Macrolides?

A

Clari, Azithro, Erythro

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15
Q

Macrolides are used for?

Check for interactions with?

A

Respiratory infection, Avium, Chlamydia

P450 interaction

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16
Q

Macrolide resistance? 3 ways

A
  1. Impaired influx or increase efflux
  2. Production of esterases that hydrolyze macrolide lincosamide and streptogramin, MLS type B
  3. Modification of the ribosomal binding site by mutation or by macrolide inducible or constitutive methylase
17
Q

Lincosamides?

Derivative of the?

Good for?

what type of bacteria

Resistance?

A

Clindamycin

  • Of Lincomycin
  • skin and soft tissue infections cause by strep and staph
  • Same as macrolides
    • Impaired influx or increase efflux

Production of esterases that hydrolyze macrolide lincosamide and streptogramin, MLS type B

Modification of the ribosomal binding site by mutation or by macrolide inducible or constitutive methylase

18
Q

Streptogramins?

Rapidly ____ for most susceptible organisms ____ , _____ and ____ but not?

Resistance?

A
  • Quinupristin-dalfopristin in 30:70
  • bactericidal for MSSA, MRSA, and VRE
    • but not Entero Faecalis
    • slow with Entero Faesium
  • Same as macrolide
19
Q

Oxazolidinones?

MOA

GOOD for?

AE?

Resistnace?

A

Linezolid

  • Inhibits proteins synth by preventing formation of the ribosome complex
  • Good for MSSA, MRSA, VRE entero faecium
  • Hematologic AE: Thrombocytopenia myelosuppression
  • Different from other protein synth inhibitors
20
Q

Amino glycosides. 3 main things

A
  1. Irreversible inhbitors of protein synthesis, Block the initiation complex
  2. Miscoding of amino acids
  3. Block of translocation on mRNA
21
Q

Aminoglycosides?

______ dependent killing?

_____ killing with cell wall ___ in endocarditis

Good for?

AE?

A

Amikacin, Gentamicin, Tobramycin

  • Cocentration dependent killing
  • Synergisitc with cell wall inhibitors
  • Nephro and ototoxicity
22
Q

First, Second, Third, Fourth generation cephalosporins gone over in class?

A
  1. Cephalexin, Cefazolin
  2. Cefprozil, Cefuroxime
  3. Ceftriaxone, Cefotaxime
  4. Cefepime
23
Q

What generation cephalosporin/cephamycin can cross the BBB?

A

3rd and 4th

  • Ceftriaxone, Cefotaxime
  • Cefepime

Pharmacology 3 (20 decks)

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