B-Lactams Antibiotics with other B-lactamase inhibitors Flashcards

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1
Q

CLASS I 𝝱-lactamase Inhibitors

A
  • Clavam (Clavulanic acid)
    -> Amoxicillin and Clavulanic acid (Co-
    amoxiclav)
  • Penams (Sulbactam, Tazobactam)
    -> Ampicillin and Sulbactam
    (Sultamicillin)
    -> Piperacillin and Tazobactam
    (Tazocin®, Piptaz®)
    -> Ceftolozane and Tazobactam
  • Diazobicyclocarbamoyl sulfate (Avibactam)
    -> Ceftazidime and Avibactam
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2
Q

CLASS II 𝝱-lactamase Inhibitors

A

Carbapems

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3
Q

Narrow spectrum antibiotics and resistant to β-lactamases.

A

monobactams

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4
Q

monobactams are active against gram negative rods primarily through _____ but not against gram-positive bacteria or anaerobes

A

binding to PBP3

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5
Q

first clinically useful monobactam

A

aztreonam

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6
Q

monobactams are limited only to _______(including Pseudomonas aeruginosa), and no activity against gram positive and anaerobes

A

aerobic gram negative rods

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7
Q

are monobactams cross reactive with penicillins?

A

no

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8
Q

toxicity levels of monobactams?

A

relatively non-toxic

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9
Q

Widest spectrum among the β-lactam antibiotics.

A

carbapenems

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10
Q

what is carbapenems used for?

A

for empiric therapy associated with wide variety of microorganisms

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11
Q

clinically useful carbapenems

A
  • Imipenem
  • Meropenem
  • Ertapenem
  • Doripenem
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12
Q

clinically useful carbapenems

A
  • Imipenem
  • Meropenem
  • Ertapenem
  • Doripenem
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13
Q

what are carbapenems active against?

A
  • gram negative rods (including Pseudomonas aeruginosa)
  • gram positive bacteria
    -anaerobes
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14
Q

list some carbapenems

A
  • Imipenem (IV)
  • Doripenem
  • Ertapenem
  • Metropenem
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14
Q

list some carbapenems

A
  • Imipenem (IV)
  • Doripenem
  • Ertapenem
  • Metropenem
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15
Q

what inactivates by renal dehydropeptidase (add cilastatin) and may cause seizures in patients with renal failure

A

Imipenem (IV)

16
Q

irritating and formulated with (1% lidocaine)

A

Ertapenem (IM/IV)

17
Q

are carbapenems cross reactive with penicillins?

A

yes

18
Q

mechanism of action of vancomycin

A
  • Directly bind to the d-alanyl-d-alanine portion of the pentapeptide, which blocks the transpeptidation.
  • It also inhibits a second enzyme,
    transglycosylase.
19
Q

clinical uses of vancomycin

A
  • Effective agent against Pseudomembranous colitis
  • Drug of choice for resistant infections such as MRSA and MRSE
20
Q

adverse effect of vancomycin where redness and rashes appear on the skin

A

red man syndrome

21
Q

bloodstream infections and endocarditis caused by (MRSA)

A

methicillin-resistant staphylococci

22
Q

combined with vancomycin for mengitidis caused by a penicillin-resistant strain of pneumococcus

A

combination with cefotaxime, ceftriaxone,
or rifampin

23
Q

adverse reaction of vancomycin that results in swelling or inflammation of the large intestine

A

pseudomembranous colitis (PO)

24
Q

another adverse reaction of vancomycin

A

red man syndrome

25
Q

mechanism of action of bacitacin

A

Prevent the dephosphorylation of the
phospholipid that carries the peptidoglycan subunit across the cell membrane. This blocks the regeneration of the lipid carrier and inhibits cell wall synthesis.

26
Q

clinical use for bacitracin

A

for topical application to skin, wounds or mucous membranes

27
Q

mechanism of action for cycloserine

A

Inhibit cell wall synthesis by inhibiting the
activity of alanine racemase and d-alanyl-d-alanine ligase.

28
Q

clinical uses of cycloserine

A

used as a second-line drug in the treatment of tuberculosis

29
Q

mechanism of action for polymyxins

A

Bind to cell membranes rich in
phosphatidylethanolamine and destroying
membrane functions of active transport and permeability barrier

30
Q

clinical use of polymyxins

A

were used primarily topically and rarely for systemic infections because of their toxicity and poor distribution to tissues

30
Q

clinically useful members of polymyxins

A
  • Polymyxin E (colistin)
  • Polymyxin B
31
Q

act as cationic detergents (attach to and disrupt bacterial cell membranes); against gram (-) bacteria

A

Polymyxin B and E

32
Q

for multidrugresistant bacteria INHIBITOR OF PROTEIN SYNTHESIS

A

Colistin (polymyxin E)