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Beta Lactam Antibiotics Flashcards

1
Q

(-) cell walll synthesis by binding to penicillin binding proteins

A

PENICILLINS

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2
Q

NATURAL PENICILLINS

effective against gram (+) cocci EXCEPT penicillinase producing bacteria, meningococci, spirochetes, anaerobic cocci

A 
Penicillin G (IV)
Penicillin V (Oral)
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3
Q

ANTISTAPHYLOCOCCAL PENICILLINS

Active against most penicillinase producing staphylococci

A

Nafcillin
Oxacillin
Cloxacillin
Dicloxacillin

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4
Q

AMINOPENICILLLINS

Effective against gram (+) cocci, enterococci and Listeria monocytogenes

A

Ampicillin

Amoxicillin

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5
Q

Antipseudomonal Penicillins

A

Piperacillin - combined characteristics of extended spectrum penicillins and the other 3 anti pseudomonal penicillins
Sulbenicillin
Carbenicillin
Ticarcillin

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6
Q

(-) cell wall synthesis but are less susceptible to penicillinases

A

CEPHALOSPORINS

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7
Q

1ST GENERATION CEPHALOSPORIN

active against most gram (+) - Penicillin resistant S. aureus but NOT against enterococcus, MRSA, MRSE

gram (-) - E. coli, K. pneumoniae, and P. mirabilis

A 
Cefazolin - surgical prophylaxis
Cephalexin - respiratory tract infections
Cephalothin
Cefadroxil
Cephapirin
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8
Q

2ND GENERATION CEPHALOSPORIN

Improved activity against H. influenzae, M. catarrhalis, Neisseria meningitisis and N. gonorrhea

Staphylococci, Non enterococci, streptococcia nd some enterobacteriacea

A 
Cefoxitin
Cefaclor
Cefuroxime
Cefamandole
Cefonizid
Cefotetan
Cefprozil
Cefmetazole
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9
Q

Cephamycins

A

Cefoxitin
Cefotetan
Cefmetazole

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10
Q

3RD GENERATION

Excellent activity against N. gonorrhea, H. influenzae, M. catarrhalis and Enterobacteriaceae

Effective against S. pneumoniae, S. pyogenes and other Streptococci (EXCEPT Ceftazidime)

Modest activity against MSSA

A 
Ceftriaxone
Ceftazidime
Cefixime
Ceftizoxime
Cefpodoxime proxetil
Cefotaxime
Cefoperazone
Moxalactam
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11
Q

Natural Penicillin

A 
Penicillin G (IV)
Penicillin V (PO)
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12
Q

Anti-Staphylococcal Penicillins/Isoxazolyl Penicillin/Penicillinase-resistant Penicillins

A

IV

  • Nafcillin
  • Oxacillin

PO

  • Cloxacillin
  • Dicloxacillin

METHICILIN - off the market d.t. INTERSTITIAL NEPHRITIS

ISOXAZOYL PENICILLINS

  • Oxacillin
  • Cloxacillin
  • Dicloxacillin

*for IMPETIGO

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13
Q

Aminopenicillins

BROAD SPECTRUM

enhanced effect when used with beta lactamase (Clavulanic acid, Sulbactam)

synergistic effect with aminoglycosides

HELPME
Haemophilus influenzae
E.coli
Listeria monocytogenes
Proteus mirabilis
Moraxella catarrhalis
Enterococci
A

Ampicillin (IV)
*usually combined to Gentamicin (protein synthesis (-))

Amoxicillin (PO)

  • HELPS kill Enterococci
  • Haemophilus influenzae
  • E. coli
  • Listeria monocytogenes
  • Proteus mirabilis
  • Salmonella
  • Enterococci
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14
Q

beta lactam attached to THIAZOLIDINE RING

6-APA (aminopenicillamic acid)

A

PENICILLIN

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15
Q

How long will you give Benzathine Penicillin G as a secondary prophylaxis for RHF?

A

ARF w/o carditis
*every 21 days for 5 years or until 21 y/o whichever is longer

ARF W/ CARDITIS (-) valvular involvement
*every 21 days for 10 years or until 21 y/o whichever is longer

ARF w/ CARDITIS and VALVULAR INV
*every 21 days for 10 years or until 40 y/o whichever is longer

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16
Q

Penicillins

A

Pen G - iniinGect

Pen V - VIVIG (iniinom)

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17
Q

Coverage of Penicillins

A

Gram POSITIVE

no gram negative EXCEPT - Neisseria meningitidis, Treponema pallidum, Leptospira

little coverage for anaerobes EXCEPT Bacteroides fragilis (wala siyang coverage dito)

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18
Q

Aminopenicillins Coverage

A

gram (+)
gram (-)
anaerobes EXCEPT Bacteroides fragilis

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19
Q

AntiPseudomonal Penicillins

A

CARBOXYPENICILLINS

  • Carbenicillin
  • Ticarcillin

UREIDOPENICILLINS

  • Piperacillin - MOST POTENT
  • Azlocillin
  • Mezlocillin
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20
Q

Bactericidal

A
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21
Q

Common Adverse Effects of Penicillins

A

Hypersensitivity - cross sensitizing, cross reacting; IgE mediated

Maculopapular rash - occurs after 72 hrs; NOT IgE mediated
*common during infectious mononucleosis (Amoxicillin, Ampicillin)

GI disturbances
*diarrhea (Ampicillin), N/V, oral candidiasis

Hematologic disturbances (Ticarcillin)

Pseudomembranous colitis (Ampicillin)

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22
Q

1st Generation Cephalosporins

A

-CEPH including sounds like haha

Cefazolin (IV) 
Cephalexin (PO)
Cefadroxil
Cephalotin
Cephapirin
Cephradrine
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23
Q

Beta lactam attached to DIHYDROTHIAZINE ring

7-aminocephalosporanic acid (7-ACA)

A

CEPHALOSPORINS

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24
Q

2nd Generation Cephalosporins

A

CEF + VOWEL
PRO - CefPROzil
META - CefMETAzome
LORA - Loracarbef

Cefuroxime
Cefoxitin
Cefotetan
Cefmetazome
Cefamandole
Cefaclor
Cefonizid
Cefprozil
Loracarbef
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25
3rd Generation Cephalosporins
``` CEF + CONSONANT MONEY - cefoPERAzone TAXES - cefoTAXime FIXERS - ceFIXime MOXA (MX3) ``` ``` Ceftriaxone Ceftazidime Ceftizoxime Cefpodoxime proxetil Moxalactam Cefixime Cefoperazone Cefotaxime ```
26
4th Generation Cephalosporins
Cefepime Cefpirome Ceftaroline
27
5th Generation Cephalosporins
CeftaROLine | CeftobipROLe
28
Coverage of 1st generation Cephalosporins
gram (+) gram (-) *PEcK - Proteus, E. coli, Klebsiella
29
Coverage of 2nd generation Cephalosporins
HENPEcK | *H. influenzae, Enterobacter, Neisseria + anaerobes
30
Has improved actions against pneumococcus and H. influenzae
Cefuroxime
31
Have good activity against B. fragilis and are used for abdominal and pelvic infectuons
Cefotetan | Cefoxitin
32
Coverage of 3rd generation Cephalosporins
HENPEckSSS Serratia Shigella Salmonella
33
Cephalosporins active against ANAEROBIC infections
CEPHAMYCINS TETA META FOX * CefoTETAn * CefMETAzole * CeFOXitin
34
3rd generation cephalosporins with coverage against PSEUDOMONAS
CefTAZidime CefoPERAzone CefTRIaxone - only some
35
All 3rd gen cephalosporins have renal excretion EXCEPT
Cefoperazone | Ceftriaxone
36
All 3rd gen cephalosporins can penetrate BBB EXCEPT
Cefoperazone | Cefixime
37
The most active Cephalosporins against Penicillin-Resistant Streptococcus pneumoniae
Ceftriaxone | Cefotaxime
38
Coverage of 4th generation Cephalosporins
LAHAT nung meron sa ibang generation PSEUDOMONAS
39
Coverage of 5th generation Cephalosporins
LAHAT nung meron sa ibang generation MRSA
40
Differ with penicillin in that the SULFUR atom of the thiazolidine ring has been externalized and replaced by a CARBON atom
Carbanepem
41
Carbapenem
Imipenem-Cilastatin Meropenem Doripenem - VERY GOOD against Pseudomonas Ertapenem
42
Inhibits renal metabolism (hydrolysis) of IMIPENEM by DIHYDROPEPTIDASE
Cilastatin
43
Carbanepems are active against Pseudomonas and Acitenobacter EXCEPT
Ertapenem
44
Drug of choice for extended spectrum beta lactamase (ESBL) infections
CARBAPENEM
45
Most EPILEPTOGENIC among beta lactam antibiotics
CARBAPENEM IMIPENEM - pinaka!!!!
46
Monobactam
Aztreonam same coverage with Ceftazidime * gram (-) - HENPECKSSSSS * Pseudomonas ADR *transaminitis
47
Penicillin Resistance
Enzymatic hydrolysis of beta lactam ring by formation of beta lactamases (penicillinases) i.e. S. aureus Structural changes in target PBPs i.e. MRSA, Pneumococci, Enterococci Changes in PORIN structures in outer cell wall impeding access to Penicillins and PBPs i.e Pseudomonas aeruginosa
48
DOC for syphilis
Penicillin
49
Penicillin coverage
gram POSITIVE NO gram negative EXCEPT: Neisseria meningitidis Treponema pallidum Leptospira LITTLE coverage against ANAEROBE EXCEPT Bacteroides fragilis (no coverage siya)
50
Prolongs the effect of penicillin
Probenecid
51
Long acting IM preparations of penicillin
Benzathine penicillin | Procaine penicillin
52
SE of Aminopenicillins
Pseudomembranous colitis
53
All cephalosporins have RENAL excretion EXCEPT
CefoPERAzone | Ceftriaxone
54
Improved action against pneumococcus and H. influenzae
2nd Generation Cefuroxime
55
Good activity against B. fragilis (abdominal and pelvic infections)
2nd Generation Cefotetan Cefoxitin
56
DOC for Gonorrhea
Ceftriaxone | Cefixime
57
All 3rd generation penetrate BBB EXCEPT
Cefoperazone | Cefixime
58
3rd generation with very good CNS penetration
Ceftriaxone
59
3rd generation with very action on Pseudomonas
Ceftazidime
60
Most active against Penicillin resistant S. pneumoniae
Ceftriaxone | Cefotaxime
61
Novel Cephalosporin usually combined with Tazobactam used for the treatment of complicated UTI
Ceftozalone
62
Novel Cephalosporin Siderophore Cephalosporin for the treatment of complicated UTI and pseudomonas
Cefiderocol

Pharmacology (72 decks)

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