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Pharmacology > Cell wall and membrane active antibiotics > Flashcards

Cell wall and membrane active antibiotics Flashcards

1
Q

List the B lactams

A
  • Penicillins
  • cephalosporins
  • carbapenams
  • mono act and
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2
Q

What are the naturally occurring penicillins

A

Penicillin G and penicillin V

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3
Q

What’s penicillin G mode of administration

A

IV and IM

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4
Q

What is penicillin V mode of administration

A

Oral

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5
Q

What’s the mechanism of action of natural penicillins

A

Bind to penicillin binding proteins to block cross linking of peptidoglycan in cell wall

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6
Q

What are the uses of natural penicillins

A

Against gram + organisms, some gram - mainly N meningitidis and spirochete T pallium (Blactamase sensitive)

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7
Q

Natural penicillins adverse effects

A

Drug induced interstitial nephritis, hypersensitivity reactions

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8
Q

What is penicillin G indicated for

A

Erysipleas by S pyogens
Gas gangrene by C perfringes
Endocarditis by S viridans

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9
Q

List the antistaphylococcal penicillins

A

Nafcillin
Dicloxacillin
Cloxacillin
Methicillin

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10
Q

antistaphylococcal penicillins mechanism of action

A

Same as natural penicillins

Bind to penicillin binding proteins to block cross linking of peptidoglycan in cell wall

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11
Q

antistaphylococcal penicillins indications

A

Given for S aureus except MRSA

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12
Q

Why can’t antistaphylococcal penicillins work on MRSA

A

They have altered PBP

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13
Q

Why are antistaphylococcal penicillins resistant to B lactamase

A

They have Bulky R group blocking access to B lactam

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14
Q

antistaphylococcal penicillins adverse effects

A

Hypersensitivity and interstitial nephritis

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15
Q

List extended spectrum penicillin

A

Amoxicillin

Ampicillin

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16
Q

Amoxicillin mode of administration

A

Oral

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17
Q

Ampicillin mode of administration

A

I.V

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18
Q

What are extended spectrum penicillin sensitive to?

A

Penicillinase

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19
Q

How to protect extended spectrum penicillin against B lactamases

A

By combining them with B lactamases inhibitors like (Clavulanic acid and sulbactam)

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20
Q

What are extended spectrum penicillin given for ?

A

Giver for HHELPSS

  • H influenza
  • H pylori
  • E coli
  • listeria monocytogenes
  • proteus mirabilis
  • shigella
  • salmonella
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21
Q

What makes augmentin

A

Amoxicillin + clavulanic acid

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22
Q

What makes Unasyn

A

Ampicillin + sulbactam

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23
Q

List antispeudomonal penicillins

A

Ticarcillin

Piperacillin

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24
Q

Which B lactamase inhibitor ticarcillin

A

Clavulunic acid

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25
Q

Which B lactamase inhibitor piperacillin

A

Tazobactam

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26
Q

Why do we add B lactamase inhibitors to antispeudomonal penicillins

A

They are B lactamase sensitive

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27
Q

Antispeudomonal penicillins clinical uses

A

Given for P arguenosa and gram - rods

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28
Q

List all B lactamase inhibitors

A 
CAST 
Clavulanic acid 
Avibactam 
Sulbactam 
Tazobactam
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29
Q

Piperacillin + tazobactam gives coverage against

A

Bacteroides species

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30
Q

What also covers bacetroides species

A

Ampicilin and sulbactam

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31
Q

What does Hyper sensitivity to penicillin presents with

A

Skin rash
Urticaria
Anaphylactic shock

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32
Q

Adverse effects of penicillins

A

Drug induced Coombs + haemolytic anemia
Nephritis -> methicillin
Neurotoxicity

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33
Q

Penicillin x cephalosporins cross reactivity

A

Patents with penicillin allergy can be safely given cephalosporins if—>
1- allergy is not suggestive of IgE mediated
2- reaction occurred more than 10 years ago

34
Q

What are cephalosporins

A

B lactam drugs that inhibit cell wall synthesis; but less susceptible to penicillinase

35
Q

List the Bacteria not covered by 1st to 4th generation of cephalosporins

A 
LAME 
Listeria monocytogenes
Atypicals
MRSA 
Enteroccoci
36
Q

What are the drugs of first generation cephalosporins

A

Cefazolin and cephalexin

37
Q

What is first generation cephalosporins used for

A

Gram + cocci and PEcK ( proteus mirbilis, E. coli, klebsiella)

38
Q

What is cefazolin specially used for

A

It is used before surgery to prevent S aureus wound infection

39
Q

What are the drugs of second generation cephalosporins

A

Cefuroxime, Cefozitin and Cefotetan

40
Q

What are second generation cephalosporins used for

A

Gram + cocci and PEcK ( proteus mirbilis, E. coli, klebsiella) and HENS ( H influenza, Entrobacter, Neisseria and Serratia)

41
Q

What does cefoxitin and cefotetan cover on their own while other second generation doesn’t cover

A

B. Fragilis

42
Q

What are the third generation cephalosporins

A

Ceftriaxone and ceftazidime

43
Q

What are third generation cephalosporins used for

A

Serious gram negative infections resistant to other B lactamas

44
Q

Special characteristic of ceftriaxeone and clinical uses due to it

A

Can cross BBB to CSF to treat meningitis, gonorrhea and Lyme disease

45
Q

What is Cefotaxime

A

It’s a 3rd generation cephalosporins that acts like Ceftriaxeone

46
Q

Special characteristic of Ceftazidime

A

Works agains Pseudomonas arugenosa

47
Q

What are the drugs of fourth generation cephalosporins

A

Cefepime

48
Q

What are the 4th generation cephalosporins used for

A

They have increased activity against Pseudomonas

49
Q

What are the drugs of 5th generation cephalosporins

A

Ceftaroline

50
Q

What is ceftaroline 5th generation cephalosporins used against

A

It covers MRSA

51
Q

Cephalosporins adverse effects

A

Disulfram like reaction, allergic reaction and nephrotoxicity

52
Q

What happens in disulfram like reactions

A

Disulfram blocks aldehyde dehydrogenase —> build up of acetaldehyde

53
Q

What drugs cause disulfram like reactions

A

Cephalosporins, sulfonamides and metronidazole

54
Q

Why should we not take cephalosporins with aminoglycosides

A

Because that increases nephrotoxicity

55
Q

What are the drugs of carbapenams

A 
DIME 
Doripenem
Imipenem
Meropenem
Ertapenem
56
Q

When are carbapenams given

A

Given when there is a 10/10 life threatening infection

57
Q

Carbapenams mechanism of action

A

Imipenem is a broad spectrum B lactamase resistant carbapenem

58
Q

What are carbapenams always administered with and why

A

Cilastin - it inhibits dihydropeptidase to decrease metabolism of drug in renal tubules to reduce nephrotoxicity

59
Q

Carbapenems adverse effects

A

They can cause seizures

60
Q

Which drugs are monobactam

A

Aztreonam

61
Q

What is azetreonam a monobactam active against

A

Aerobic gram negative bacilli, resistant to B-lactamases

62
Q

Vancomycin mode of administration

A

IV

63
Q

When is vancomycin given orally

A

Exclusively given orally for pseudomembranous colitis

64
Q

Vancomycin mechanism of action

A

Inhibits cell wall peotidoglycan formation by binding to D-ala-D-ala

65
Q

How can bacteria become resistant to vancomycin

A

By altering their D-ala-D-ala to D-ala-D-lac

66
Q

Vancomycin clinical uses

A

Active against gram positive only —> MRSA, streptococci, entrococci and C. Difficile

67
Q

Vancomycin adverse effects

A

Nephrotoxicity, ototoxicity and red man syndrome

68
Q

Which bacteria has emerging resistance against vancomycin

A

Enterococcus fascium

69
Q

What is bacitracin used for

A

Gram positive bacteria like Staph and strep

70
Q

What is fosfomycin mechanism of action

A

Blocks cell wall synthesis by inhibiting enolpyruvate transferase

71
Q

Which drug can be given to pregnant women with UTI?

A

Fosfomycin

72
Q

Fosfomycin clinical uses

A

UTI by Ecoli and E. decal is and FIRST LINE for acute cystitis

73
Q

Daptomycin mechanism of action

A

It’s a bacteriocidal, lipopeptide that disrupts cell membrane of gram + cocci by creating transmembrane channels

74
Q

What is used for skin infections by MRSA

A

Daptomycin daily I.V

75
Q

DAPTOMYCIN clinical uses

A

Used in MRSA, VRE - vancomycin resistant enterococci -> not used for pneumonia

76
Q

Daptomycin side effects

A

Myopathy and rahbdomyolysis

77
Q

List the polymyxin drugs

A

Polymyxin B and E

78
Q

What is another name for polymyxin E

A

Colistin

79
Q

Polymyxin mechanism of action

A

Disrupts cell membrane integrity causing leakage of cellular components

80
Q

Polymyxin clinical uses

A

Against gram negative bacteria

- multi drug resistant gram negative bacteria !!

81
Q

Polymyxins adverse effects

A

Nephrotoxicity, neurotoxicity and respiratory failure

Pharmacology (33 decks)

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