Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Exam 1 Drugs DPPHuckT > Beta-Lactam Antibiotics > Flashcards

Beta-Lactam Antibiotics Flashcards

1
Q

List important components to the structure of the penicillin. 3 things

A

4 membered nitrogen containing compound

sulfur containing 5 membered ring

then R group coming off of the amine(where you can make substitutions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what is so significant about the R-group on the Beta lactam ring and where is the site of hydrolysis by acid or B-lactamase

A

R-group determines stability to acid or B-lactamase hydrolysis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what is the structure and the list some components of the cephalosporin.

A

Six membered sulfur containing ring

4 membered nitro containing ring

R group in two locations

  1. off of the sulfur containing ring
  2. of of the nitro group
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the structure and list some components about Carbapenems

A

5 membered ring that is not sulfur containing; sulfur instead comes off of the ring(formamidine)

4 membered nitro containing ring

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what is the structure and list the components of the monobactems

A

no other ring coming off of the 4 membered nitro containing ring

sulfate and nitro group coming off the 4 membered nitro containing ring

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what are the 4 types of penicillins?

A

Penicillin G (Pen V is the oral prep)

Acid-stable or Antistaphylococcal (isoxazolyl)(ox, clox and icloxacillin, methicillin)

Extended-Spectrum (amoxicillin, ampicillin)

Antipseudomonal or ureido penicillins (piperacillin)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

list the different types of acid stable or antistaphylococcal penicillins

A

methicillin, oxacillin, cloxacillin, dicloxacillin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what are the different types of extended spectrum penicillin

A

amoxicillin and ampicillin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what are the types of antipseudomonal or ureido penicillin

A

piperacillin, carbenicillin, and ticarcillin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what are some organisms that penicillin G or the oral type penicillin V is used against?

A

use it against gram + bacteria

use it against non b-lactamase staph and strep

obligate anaerobes like actinomyces and clostridia

Treponium palidum(syphillis)

meningococcal and used to be good for neiserria gonorhea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what do you want to use acid stable or antistaphylococcal penicillins (meth-, oxa-, cloxa-dicloxacillin) against

A

against penicillanase producing staphylococcus aureus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what is extended spectrum (ampicillin and omaxicillin) used against

A

use against gram neg p mirabilis, H influenzae, E.coli, listeria moncytogens, salmonella shigella, and enterococcus faecalis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what is the antipseydomonal or ureido penicillins used against

A

pseudomonas aeruginosa, K pneumonia, serratia marcescens, and gram - rods

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

in peptidoglycan synthesis, what strands need to be crosslinked

A

NAM(N-acetyl muramic acid) and NAG(N-acetyl glucosamine) need to be crosslinked

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the mechanism of B-lactams

A

All of the β-lactams interfere with this process of crosslinking during peptidoglycan synthesis. This causes faulty linkage in the peptidoglycan and thus the structural integrity of the bacterial cell wall is compromised and so ultimately the bacterium die

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what are the requirements for B-lactams to be efficient and work properly

A
  1. Growing cultures are required
  2. Peptidoglycan cell wall producing bacteria
  3. Irreversibly inhibit the transpeptidation reaction
  4. Osmotic pressure causes the bacterial cell to burst-bactericidal
  5. activate autolysins in some organisms
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what are autolysins

A

The β-lactams activate autolysins in bacteria. Many organisms including bacteria are most vulnerable when they are dividing. So the autolysins are there for use by the bacteria so that they can open up their cell walls and then reseal them during cell division. So β-lactams can interfere with this process by activating autolysins and this contributes to their bactericidal activity.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

list the mechanisms of resistance for B-lactams

A
  1. B-lactamse breaks B-lactam ring (chromosomal or plasmid)
  2. Reduced binding to penicillin binding proteins; methicillin resistant staph aureus
  3. Decreased access to gram neg organisms via down regulationof porins
  4. Increased efflux pumps found in some gram neg organism
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

a few gram negative bacteria can confer resistance to B-lactams by

A

down regulation of porins: Gram negative bacteria require pores in their outer membrane so that things can get in and out but they can modify the size to inhibit the entry of antibiotics like β-lactam.

efflux pumps:A few Gram negative organisms have very active efflux pumps. So in this case the β-lactam gets into the periplasmic space between the inner membrane and the outer membrane but it can’t be concentrated at a high enough level to perform its actions effectively

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

if patient is suspected of having meningitis what penicillin would you use

A

extended spectrum penicilin; ampicillin or amoxicillin against listeria monocytonges

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

what are the orally active penicillins

A

Pen V, ampicillin, amoxicillin, and all of the isoxozolyl

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

which ones are given IV

A

pen G, piperacillin, and methicillin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

what is the definition of time dependent killing

A

plasma levels should be greater than the MIC for at least 70% of every 24 hrs…particularly gram - penicillin exhibits this

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

explain penicillins metabolism and its renal excretion if any

A

excreted via urine unchanged because there is no metabolism also it can be pumped(proximal tubule) and filtered through the renal system.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

can penicillin penetrate the CSF

A

no but it can during times of inflammation early during its onset before the meninges have healed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

what are the adverse effects of penicillins

A

rashes and anaphylaxis due to hypersensitivity

ampillicin can cause a maculopapular rash because of chemical reaction in skin not allergic

seizures with high doses due to penicillin interfering with GABA: neurotoxicity

nephritis

diarrhea because normal gut flora disrupted

platelet dysfunction

false positive for urinary glucose

cation toxicity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

what side effect does methicillin cause

A

nephritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

what side effect does ticarcillin cause

A

platelet dysfunction and cation toxicity

29
Q

which penicillins cause cation toxicity

A

ampicillin, ticarcillin, and piperacillin

30
Q

what is augmentin composed of and what is the side effect.

A

Augmentin is composed of amoxicillin and clavulanic acid(which is a beta lactamase inhibitor). The combination will effectively deal with penicillinase producing organism. However it can also cause a false positive for urinary glucose.

31
Q

what are the different adjunct medications given with penicillin

A

Probenecid and penicillin

Augmentin: (Clavulanic acid and amoxicillin)

32
Q

why do we give probenecid with penicillin

A

because it will decrease the rate of excretion of the penicillin by acting at the organic acid pump in the proximal tubule of the kidney, making penicillin rely only on glomerular filteration for its excretional methods

33
Q

what are the three different types of beta lactamase inhibitors?

A
  1. Clavulanic acid
  2. Tazobactam
  3. Sulbactam
34
Q

The mechanism of action, resistance, pharmacokinetics and adverse effects is similar to penicillin for cephalosporins except for what?

A
  1. Third generation cephalosporins are more resistant to beta lactamases
  2. There is a disulfiram-like effect when taken with alcohol
35
Q

what is the structure of cephalosporins

A
36
Q

What are the first generation cephalosporins

A

Cafazolin

37
Q

What are the second generation cephalosporins

A
  1. cefamandole
  2. cefonicid
  3. cefotetan
38
Q

what are the third generation cephalosporins

A
  1. Cerfoperzone
  2. Ceftriaxone
  3. Cefixime
  4. Ceftazidime
39
Q

what are the fourth generation?

A

Cefepime

40
Q

Which cephalosporins cause the disulfiram-like effect (Hypoprothrombinemia)? and what is this effect?

A

2nd generation cefamandole, cefotetan, cefonicid and 3rd generation cefoperazone

when some cephalosporins are taken with alcohol, you have a very serious adverse reaction to the drug. There’s changes in blood pressure, sweating, nausea, and vomiting. This occurs because if you drink alcohol and take that particular cephalosporin at the same time, you wind up with a lot of acetaldehyde which is a toxic compound.

41
Q

specifically how does second generation cefamandole play in the disulrifam like effect

A

has a tetra imidazole sulfur-containing entity and this is the part of the drug that inhibits acetaldehyde dehydrogenase. Acetaldehyde dehydrogenase normally converts acetaldehyde into acetic acid

42
Q

what is the spectrum of treatment from the 1st generation cephalosporins

A

mostly against gram + including the anaerobic streptococci

but also gram - PEcK

43
Q

what is the spectrum of treatment for 2nd generation cephalosporins

A

same as first gram positive and negative but with the addition of h. influenzae

and used to treat sinustis, otitis, and pneumonia

44
Q

what is third generation cephalosporins used against

A

Efective against gram-negative bacteria and used to treat serious gra-negative infections

45
Q

specifically the third generation cephalosporin ceftazidime is used to treat

A

pseudomonal

46
Q

fourth generation is used to

A

treat gram + and negative and serious gram-negative infections like meningitis, pseudomonas, enterobacter infections

47
Q

which cephalosporin would you use to treat gonorrhea

A

ceftriaxone and cefixime

48
Q

cefixime is taken how

A

orally

49
Q

Meningitis due to pneumococci and meningococci and h influenzae but not listeria monocytogenes is treated by

A

3rd generation cephalosporins

50
Q

what would you use for empiric therapy of sepsis of unknown origin in both immunocompetent and immunocompromised hosts

A

3rd generation cephalosporins

51
Q

what are the four different types of carbapanems

A

imipenem, meropenem, doripenem, dertapenem

52
Q

2nd generation have effects similar to

A

amoxicillin and ampicillin because they go against h. influenza and ecoli

53
Q

3rd generation are given

A

parenterally thats why they are given in the hospital

54
Q

. These drugs are usually reserved for a seriously ill patient where you don’t know what the etiological agent for the infection is yet. If you don’t treat the patient, there will be serious sequelae and even death. So you treat the patient

A

4th generation

55
Q

carbapanems are given and can enter

A

parenterally and CSF

56
Q

carbapenems are effective against

A

gram +, Gram _ aerobic and anerobic cocci and bacilli

57
Q

carbapenems are wide spectrum and can be used

A

in treatment of hospital acquired resistant infections

monotherapy for septicemia, neutropenic fever, intra-abdominal, lower respiratory tract, genitourinary, gynecological, skin and soft tissue, and skin and bone infections in patients who cannot tolerate a cephalosporin

58
Q

if i am a patient who is prescribed cefazolin for bone infection but cannot take it because of toleration

A

you can take a carabapenem

59
Q

what are the adverse effects

A

NVD, skin rashes, infusion site reactions; imipenem is convulsant at high doses(prolly cuz of CSF)

60
Q

what type of carbapenem is used to treat bacterial meningitis

A

meropenem

61
Q

monotherapy for septicemia, neutropenic fever, intra-abdominal, lower respiratory tract, genitourinary, gynecological, skin and soft tissue, and skin and bone infections in patients are treated with

A

Carabapenem

62
Q

What is the only monobactam

A

Aztreonam

63
Q

what drug spectrum is similar to aztreonam

A

aminoglycosides

64
Q

aztreonam targets

A

gram negative aerobic bacteria

65
Q

aztreonam works against

A

gram-negative rods(Klebsiella, pseudomons, serratia). it has no activity against gram-positive bugs or anaerobes

66
Q

adverse effects of aztreonam

A

injection site reactions; pain

67
Q

the aztreonam is fitered and secreted by

A

the kidney

68
Q

aztreonam can be used as an alternative to

A

aminoglycosides, penicillins and cephalosporins

69
Q

summary for aztreonam

A

Is a part of the monobactem B-Lactams

  • used to treat aerobic gram negative bacterial infections
  • It is not effective against gram positive or anaerobes
  • Given parenterally to patients; pain associated with the injection
  • This drug also penetrates well into the CSF without inflammation
  • Used as an alternative to aminoglycosides, penicillins, or cephalosporins

Exam 1 Drugs DPPHuckT (8 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions