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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
Reason why methicillin is no longer used
Interstitial nephritis
26
Penicillin associated with pseudomembranois colitis
Ampicillin
27
Combination associated with greater incidence of acute kidney injury
Piperacillin-tazobactam and vancomycin
28
Primary route of excretion of 1st generation cephalosporins
Glomerular filtration and tubular secretion
29
Drug interaction with 1st gen cephalosporin blocking tubular secretion
Probenecid
30
Only 1st gen parenteral cephalosporin used as surgical prophylaxis
Cefazolin
31
3rd gen Cephalosporin that is mainly excreted through the biliary tract and no dosage adjustment is required in renal insufficiency
Ceftriaxone
32
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
Cefepime (4th gen)
33
Cephalosporin used to treat MRSA
Ceftaroline fosamil
34
Normal half life of ceftaroline
2.7 hours
35
Drug class of aztreonam
Monobactam
36
Aztreonam is structurally similar with what cephalosporin? (Therefore potential for cross-reactivity)
Ceftazidime
37
Half life of aztreonam
1-2 hours
38
Carbapenem inactivated by dehydropeptidases
Imipenem
39
Carbapenems similar to imipenem but not degraded by dehydropeptidases
Doripenem and meropenem
40
Carbapenem that does not have activity against Pseudomonas and Acinetobacter, also not degraded by dehydropeptidases
Ertapenem
41
Which carbapenem cannot penetrate the CSF?
Ertapenem
42
Which carbapenem has the longest half life? What is its half life
Ertapenem 4 hours (others 1 hour)
43
Most common AE of carbapenems, more common with imipenem
Nausea, vomiting, diarrhea, skin rashes, reaction at infusion sites Excessive levels of imipenems- SEIZURE (other carbapenems less likely)
44
Antibiotic isolated from Amycolatopsis orientalis
Vancomycin
45
Mechanism of action (MOA) of vancomycin
Binding to D-Ala-D-Ala terminus of nascent peptidoglycan pentapeptide
46
True or false vancomycin is poorly absorbed from the intestinal tract
True
47
Oral vancomycin is recommended to treat ?
Clostridium difficile
48
AE of vancomycin
Phlebitis, Red man syndrome (due to release of histamine)
49
Glycopeptide that is very similar to vancomycin in MOA
Teicoplanin
50
Half life of teicoplanin
45-70 hours
51
Semisynthetic lipoglycopeptide derived from vancomycin
TelaVANCin
52
Half life of telavancin
8 hours
53
Associated with nephrotoxicity and potentially teratogenic
Telavancin
54
Semisynthetic lipoglycopeptides derived form teicoplanin
DalbavancIN, OritavancIN
55
It has in vitro activity against VRE
Oritavancin
56
Half life of dalvancin and oritavancin
More than 10 days
57
Lipopeptide fermentation product of streptomyces roseoporus
Daptomycin
58
Active against vancomycin-resistant starins of enterococci and S. aureus
Daptomycin
59
It can cause allergic pneumonitis in prolonged therapy
Daptomycin
60
It can cause mtopathy and creatine phosphokinase should be monitored
Daptomycin
61
Inhibits cytoplasmic enzyme enolpyruvate transferase, blocks the adsition of phosphoenolpyruvate to UDP-N-acetylglucosamine
Fosfomycin
62
Treatment of uncomplicated lower UTI in women amd prostatitis in men
Fosfomycin
63
First obtained from the Tracy starin of Bacillus subtilis
Bacitracin
64
Interferes with dephosphorylation in cyclng of the lipid carrier
Bacitracin
65
AE is highly nephrotoxic so only used topically
Bacitracin
66
Antibiotic produced by Streptomyces orchidaceous
Cycloserine
67
Almost exclusively for treating TB caused by strains of M. tb resistant to 1st line agents
Cycloserine
68
Inhibits alanine racemase, which converts L-alanine to D-alanine
Cycloserine
69
AE cns toxicity with headaches, tremors, acute psychosis, and convulsions
Cycloserine
70
AE of tetracyclines
GI Upset (N, V, D), BONE AND TEETH DEFORMITIES, impair hepatic fxn, fanconi syndrome, renal tubular acidosis.
71
Can produce acute cholestatic hepatitis
Erythromycin

Pharmacology (1 decks)

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