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Pharm exam 4 > Call Wall/Membrane Targets > Flashcards

Call Wall/Membrane Targets Flashcards

1
Q

what classes of drugs target cell wall/membranes

A

Penicillins

Beta lactamase inhibitiors

cephalosporins

monobactam (Aztreonam)

glycopeptides (vancomysin)

polypeptides (Bacitracin)

carbapenems

phophoenolpyruvate (fosfomycin)

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2
Q

what type agents are target the cell membrane

A

Lipopeptides (daptomycin)

Detergents (polymxinB)

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3
Q

___ antibiotics bind selectively to different PBPs and this contributes to sensitivity of bacterial strains to individual penicillins andchephalosporin antibacterials

A

B-lactam

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4
Q

Peptidoglycan is maintained by the enzymes that create the bonds between ____ peptidoglycan monomers and between ____ chains in the layer

A

NAM-NAG

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5
Q

what compounds do beta lactams include

A

penicillins

cephalosporins

monobactams

carbapenems

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6
Q

are beta lactam compounds bacteristatic or bactericidal

A

bactercidal

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7
Q

what are the natural and synthetic penicillin compounds?

A

natural: Penicillin G and V
synthetic: amoxicillin

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8
Q

What penicillins are beta-lactamase resistant

narrow or very narrow spctrum?

A

methicillin

nafcilin

oxacilin

*very narrow

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9
Q

Do natural or synthetic agents have a broader spectrum of activity

A

synthetic

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10
Q

MOA of penicillin compounds

A

bind and inhibit PBP enzymes

PBPs play important wall in synthesis and maintenance of bacterial cell wall peptidoglycans

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11
Q

Key adverse effects of penicillins

A

hypersensitivity

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12
Q

do penicllins treat gram negative or positive

A

+

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13
Q

Penicllin G or V: which one is given orally and which is given parenterally?

A

G = parenteral

V = oral

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14
Q

Pencillin G and V: narrow or very narrow or broad spectrum?

A

narrow

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15
Q

what are the broad spectrum penicillins

A

Ampicillin

Amoxicillin

Ticarcilin

Peperacilin

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16
Q

Ampicillin

Amoxicillin

Ticarcilin

Peperacilin

narrow or very narrow or broad spectrum?

A

broad spectrum

gram + and -

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17
Q

what broad spectrum penicillins should be combined with beta lactamase inhibitor

A

Ticarcillin

Piperacillin

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18
Q

which penicillin penetrates CSF of inflamed meninges of newborns

A

Ampicillin

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19
Q

B-lactamase inhibitor that can be used in combo with penicllin antibiotics

A

Clavulanic acid

e..g Amocillin and clavulanic acid = augmentin

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20
Q

what compound is used frequently if penicillins are not well tolerated

A

cephalosporin

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21
Q

Cephalosporins are more resistant to ____ compared to pencillins

A

beta-lactamase

22
Q

MOA of cephalosporins

A

bind to and inhibit PBPs (penicillin binding protein)

23
Q

key adverse effect of cephalosporins

A

hypersensitivity

24
Q

cefazolin and cephalexin:

  1. generation?
  2. gram - or +?
  3. beta lactamase sensitivity?
  4. CSF penetration?
A
  1. first generation
  2. +
  3. sensitive
  4. No
25
Q

Cefotetan, cefaclor, cefuroxime:

  1. generation?
  2. gram - or +?
  3. beta lactamase sensitivity?
  4. CSF penetration?
A
  1. 2nd generation
    • and some -
  3. less sensitivity then 1st generation
  4. Cefuroxime (parenteral) only
26
Q

Ceftriaxone, cefotaxime, cefdinir, cefixime (tri fixing dinner taxes)

  1. generation?
  2. gram - or +?
  3. beta lactamase sensitivity?
  4. CSF penetration?
A
  1. 3rd generation
  2. both
  3. increased resistance
  4. Ceftrixone and cefotaxime
27
Q

Cefepime

  1. generation?
  2. gram - or +?
  3. beta lactamase sensitivity?
  4. CSF penetration?
A
  1. 4th generation
  2. both
  3. greatest resistance
  4. penetrates CSF
28
Q
  1. Name a monobactam compound.
  2. gram + or gram -
  3. important features?
  4. beta-lactamase sensitivity?
A
  1. Aztreonam
  2. gram -
  3. penetrates CSF (for serious infections)*
  4. resistant
29
Q

MOA of monobactam (Aztreonam)

A

inhibit PBPs

30
Q

key adverse effect of monobactams (Aztreoname)

A

hypersensitivity (less than penicillin and cephalosporin)

31
Q

which cell wall synthesis inhibitor/beta lactam antibiotics has the broadest spectrum of activity and are the most potent

A

Carbapenems (doripenem, imipenem**, ertapenem, meropenem)

32
Q

what carbapenem is inactivated in the kidney?

what is it administered with to prevent inactivation?

A

Imipenem

cilastatin

33
Q

Carbapenems key pharmacological effect is related to the ability of these agents to do what?

A

penetrate tissues and fluids very well - important for empriical tx of life threatening infections

34
Q

Key adverse effects of carbapenems?

A

GI: nausea, vomiting, diarrhea

35
Q

what cell wall synthesis inhibitor is used to treat MRSA and C. diff

A

Vancomycin (glycopeptide)

36
Q

due to resistance development 1 use of vancomycin is limited to C. diff tx. Slow 2 is primary delivery route.

A
  1. oral

2. IV infusion

37
Q

MOA of vancomycin

A

Binds to D-ala-D-ala pentapeptide and acts as a steric inhibitor – prevents elongation of peptidoglycan cell wall structure

38
Q

Key adverse effects of vancomysin (glycopeptide antibiotic)

A

flushing (red neck or “red man syndrome”)

39
Q

can vancomycin be used to treat meningitis?

A

Yes - penetrates CNS only when inflamed

40
Q

what type of bacteria does vancomycin target

A

gram +

41
Q

Bacitracin:

Targets gram 1 bacteria

Its use is restricted to __2_

A
  1. +

2. topical and opthalmic ointments

42
Q

MOA of bacitracin

A

blocks incorporation of AA and nucleid acids into cell wall

43
Q

Fosfomycin (phosphoenolpyruvate):

  1. commonly used in treating what?
  2. MOA
A
  1. uncomplicated UTI in females; safe in pregnancy

2. blocks early step in cell wall synthesis by preventing synthesis of UDP-N-acetylmuramic acid

44
Q

Daptomycin (targets CM) is useful in treating what?

A

gram +, including MRSA (like vancomycin)

45
Q

MOA of daptomycin

A

binds to membrane and causes depolarization of membrane - bactericidal

insertion into membrane is Ca2+ dependent

46
Q

key adverse effects of daptomycin

A

musculoskeletal system: myopathy, rhabdomyolysis

47
Q

___ is a detergent (CM target) that is often used topically to tx skin infections in combo with bacitracin

A

Polymyxin B

48
Q

what bacteria does polymyxin B target

A

gram -

49
Q

MOA of polymyxin B (detergent)

A

bidns to phospholipids in cell membrane and disrupts structure, specifically LPS

50
Q

if someone has a penicillin allergy what drug may be used instead

A

Aztreonam (monobactam)

51
Q

what drug is repelled by organism acquiring a + charge

A

daptomycin

Pharm exam 4 (15 decks)

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