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Pharmacology > Beta-Lactam & Other Cell Wall Membrane Active Antibiotics > Flashcards

Beta-Lactam & Other Cell Wall Membrane Active Antibiotics Flashcards

1
Q

The ring structure present in penicillin

A

Thiazolidine ring

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2
Q

Essential for the biologic activity of penicillins

A

Structural integrity of the 6-aminopenicillanic acid nucleus

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3
Q

Mechanism of action of penicillin and other beta-lactam

A

Inhibit bacterial growth by INTERFERING WITH THE TRANSPEPTIDATION REACTION OF BACTERIAL CELL WALL SYNTHESIS

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4
Q

Resistance in penicillin

A
  • AmpC beta-lactamase
  • extended-spectrum beta-lactamase (ESBLs)
  • Carbapenemase
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5
Q

Penicillins are stable in what condition?

A

Acidic.

It also binds to protein.

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6
Q

Absorption of most oral penicillins is impaired by food EXCEPT?

A

Amoxicillin

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7
Q

Which antistaphylococcal penicillin is NOT suitaboe for oral administration because GI absorption is erratic?

A

Nafcillin

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8
Q

When is the best time to give amoxicillin?

A

Anytime because it is not impaired by food (unlike all other penicillins which are impaired by food)

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9
Q

Why is IV Penicillin G preferred than IM?

A

There is irritation and local pain from IM injections

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10
Q

Give an example of highly protein bound penicillin

A

Nafcillin

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11
Q

Major route of excretion of penicillins

A

Kidneys (tubular secretion-90% and glomerular filtratioj-10%)

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12
Q

Normal half life of pen G

A

30 mins

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13
Q

Half life of ampicillin and extended spectrum penicillins

A

1 hour

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14
Q

Penicillin primarily cleared by biliary excretion

A

Nafcillin

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15
Q

Eliminated by both kidneys and biliary excretion

A

Oxacillin, dicloxacillin and cloxacillin

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16
Q

Timing of taking oral penicillin (except amox)

A

1-2 houra before or after a meal

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17
Q

Drug of choice (DOC) for syphilis (Treponema pallidum)

A

Pen G

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18
Q

Rout of administration of Pen V

A

Oral

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19
Q

Penicillins with prolonged drug levels

A

Benzathine penicillin and procaine penicillin G

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20
Q

First antistaph penicillin to be developed but is no longer used due to high rates of adverse effects (AE)

A

Methicillin

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21
Q

DOC for serious staph infections such as endocarditis

A

Oxacillin and nafcillin

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22
Q

Most of the serious adverse eddects of penicillins are due to?

A

Hypersensitivity

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23
Q

Penicillin associated with neutropenia and interstitial nephritis

A

Nafcillin

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24
Q

Penicillin that can cause hepatitis

A

Oxacillin

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25
Q

Reason why methicillin is no longer used

A

Interstitial nephritis

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26
Q

Penicillin associated with pseudomembranois colitis

A

Ampicillin

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27
Q

Combination associated with greater incidence of acute kidney injury

A

Piperacillin-tazobactam and vancomycin

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28
Q

Primary route of excretion of 1st generation cephalosporins

A

Glomerular filtration and tubular secretion

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29
Q

Drug interaction with 1st gen cephalosporin blocking tubular secretion

A

Probenecid

30
Q

Only 1st gen parenteral cephalosporin used as surgical prophylaxis

A

Cefazolin

31
Q

3rd gen Cephalosporin that is mainly excreted through the biliary tract and no dosage adjustment is required in renal insufficiency

A

Ceftriaxone

32
Q

It penetrates well into CSF and is cleared by the kidneys with a half life of 2 hours; pharmacokinetic properties are very similar to ceftazidime

A

Cefepime (4th gen)

33
Q

Cephalosporin used to treat MRSA

A

Ceftaroline fosamil

34
Q

Normal half life of ceftaroline

A

2.7 hours

35
Q

Drug class of aztreonam

A

Monobactam

36
Q

Aztreonam is structurally similar with what cephalosporin? (Therefore potential for cross-reactivity)

A

Ceftazidime

37
Q

Half life of aztreonam

A

1-2 hours

38
Q

Carbapenem inactivated by dehydropeptidases

A

Imipenem

39
Q

Carbapenems similar to imipenem but not degraded by dehydropeptidases

A

Doripenem and meropenem

40
Q

Carbapenem that does not have activity against Pseudomonas and Acinetobacter, also not degraded by dehydropeptidases

A

Ertapenem

41
Q

Which carbapenem cannot penetrate the CSF?

A

Ertapenem

42
Q

Which carbapenem has the longest half life? What is its half life

A

Ertapenem 4 hours (others 1 hour)

43
Q

Most common AE of carbapenems, more common with imipenem

A

Nausea, vomiting, diarrhea, skin rashes, reaction at infusion sites

Excessive levels of imipenems- SEIZURE (other carbapenems less likely)

44
Q

Antibiotic isolated from Amycolatopsis orientalis

A

Vancomycin

45
Q

Mechanism of action (MOA) of vancomycin

A

Binding to D-Ala-D-Ala terminus of nascent peptidoglycan pentapeptide

46
Q

True or false vancomycin is poorly absorbed from the intestinal tract

A

True

47
Q

Oral vancomycin is recommended to treat ?

A

Clostridium difficile

48
Q

AE of vancomycin

A

Phlebitis, Red man syndrome (due to release of histamine)

49
Q

Glycopeptide that is very similar to vancomycin in MOA

A

Teicoplanin

50
Q

Half life of teicoplanin

A

45-70 hours

51
Q

Semisynthetic lipoglycopeptide derived from vancomycin

A

TelaVANCin

52
Q

Half life of telavancin

A

8 hours

53
Q

Associated with nephrotoxicity and potentially teratogenic

A

Telavancin

54
Q

Semisynthetic lipoglycopeptides derived form teicoplanin

A

DalbavancIN, OritavancIN

55
Q

It has in vitro activity against VRE

A

Oritavancin

56
Q

Half life of dalvancin and oritavancin

A

More than 10 days

57
Q

Lipopeptide fermentation product of streptomyces roseoporus

A

Daptomycin

58
Q

Active against vancomycin-resistant starins of enterococci and S. aureus

A

Daptomycin

59
Q

It can cause allergic pneumonitis in prolonged therapy

A

Daptomycin

60
Q

It can cause mtopathy and creatine phosphokinase should be monitored

A

Daptomycin

61
Q

Inhibits cytoplasmic enzyme enolpyruvate transferase, blocks the adsition of phosphoenolpyruvate to UDP-N-acetylglucosamine

A

Fosfomycin

62
Q

Treatment of uncomplicated lower UTI in women amd prostatitis in men

A

Fosfomycin

63
Q

First obtained from the Tracy starin of Bacillus subtilis

A

Bacitracin

64
Q

Interferes with dephosphorylation in cyclng of the lipid carrier

A

Bacitracin

65
Q

AE is highly nephrotoxic so only used topically

A

Bacitracin

66
Q

Antibiotic produced by Streptomyces orchidaceous

A

Cycloserine

67
Q

Almost exclusively for treating TB caused by strains of M. tb resistant to 1st line agents

A

Cycloserine

68
Q

Inhibits alanine racemase, which converts L-alanine to D-alanine

A

Cycloserine

69
Q

AE cns toxicity with headaches, tremors, acute psychosis, and convulsions

A

Cycloserine

70
Q

AE of tetracyclines

A

GI Upset (N, V, D), BONE AND TEETH DEFORMITIES, impair hepatic fxn, fanconi syndrome, renal tubular acidosis.

71
Q

Can produce acute cholestatic hepatitis

A

Erythromycin

Pharmacology (1 decks)

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