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FOM > Cell Wall Inhibitors > Flashcards

Cell Wall Inhibitors Flashcards

1
Q

Aztreonam spectrum:

A

Gram-negative rods (pseudomonas); monocyclic B-lactam use on penicillin-allergic patients

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2
Q

What are the penicillinase-sensitive penicillins?

A

Penicillin V (oral), Penicillin G (IV), Benzathine (IM injection)

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3
Q

spectrum of anti-psuedomonal penicillins

A

broad activity against gram(-)

pseudomonas

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4
Q

anti-pseudomonal penicillins

A

ticarcillin

piperacillin

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5
Q

What is administered with penicillinase-sensitive penicillins and why?

A

Probenecid to lengthen the half-life of the drugs; prevents renal excretion of weak acids

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6
Q

What are the penicillinase-resistant penicillins

A

Nafcillin, Dicloxicillin

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7
Q

What is the spectrum for penicillinase-sensitive penicillins?

A

Gram +

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8
Q

What is the spectrum for penicillinase-resistant penicillins

A

MSSA, other staph infections

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9
Q

What is ampicillin used specifically to treat?

A

pseudomembranous colitis

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10
Q

What is the spectrum for the aminopenicillins?

A

Wider spectrum, can treat Gram -

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11
Q

What is ampicillin used specifically to treat?

A

pseudomembranous colitis

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12
Q

Spectrum for Ist gen. Cephalosporins

A

Gram + cocci

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13
Q

Spectrum for 2nd gen. Cephalosporins

A

more Gram - activity, weaker Gram + activity

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14
Q

Spectrum for 3rd gen. Cephalosporins

A

Streptococci and more serious Gram -

can cross blood-brain barrier

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15
Q

What Cephalosporin generation is strong against C. diff?

A

3rd generation

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16
Q

Spectrum for 4th gen. Cephalosporins

A

Broad spectrum (Gram +, Gram -, pseudomonas)

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17
Q

Spectrum for 5th gen. Cephalosporins

A

MRSA that is resistant to other beta-lactams

18
Q

What is the general mechanism of action for cephalosporins?

A

beta-lactams, bactericidal

sensitive to beta-lactamases

19
Q

ticarcillin is often given in combination with _____ to reduce susceptibility to penicillinases

A

clavulanate

20
Q

piperacillin is often given in combination with ____ to reduce susceptibility to penicillinases

A

tazobactam

21
Q

why are penicillins combined with probenecid?

A

penicillins have a short half-life

probenecid impairs renal secretion of weak acids –> increases the life of penicillins

22
Q

why are penicillins combined with beta-lactamase inhibitors?

A

beta-lactamase inhibitors bind irreversibly to beta-lactamases –> prevent the beta-lactamase cleavage of the beta-lactam ring –> allows the beta-lactam drug to be effective

23
Q

T/F: Aztreonam is sensitive to beta-lactamases

A

True

24
Q

Carbapenems spectrum

A

Broad spectrum, but MRSA is resistant; MUST BE GIVEN WITH CILASTATIN

25
Q

Carbapenem delivery:

A

IV only (no oral); MUST BE GIVEN WITH CILASTATIN

26
Q

Carbapenem side effects

A

GI stress, renal dysfunction

27
Q

Describe how renal enzyme react with carbapenems

A

Form a toxic nephrotoxic metabolite; given with cilastatin to prevent this

28
Q

Polymixin B mechanism of action

A

binds phophatidylethanolamine in membrane, creates holes; binds LPS and pulls out of cell membrane

29
Q

Polymixin B spectrum

A

Treat multidrug resistant Gram - bacilli (pseudomonas and Klebsiella)

30
Q

Polymixin B side effects

A

nephrotoxicity

31
Q

Daptomycin mechanism of action

A

Bind cell membrane, aggregates, depolarizes membrane–>cell death/bactericidal

32
Q

Daptomycin spectrum

A

only Gram + (particularly Vanco-resistant MRSA)

33
Q

Daptomycin side effects

A

binds surfactants also, causing pneumonia

34
Q

Daptomycin resistance mechanism

A

addition of positive lysines to cell surface; repels positive charged drug

35
Q

Vancomycin spectrum

A

C. diff, MRSA; poorly absorbed

36
Q

Vancomycin mechanism

A

Binds aa on cell wall precursor to inhibit release from bactroprenol carrier–>inhibits transglycosylase

37
Q

Vancomycin resistance mechanism

A

enterococci (and some staphylococcus) change the aa sequence to prevent binding

38
Q

What drugs will have increased efflux as the resistance mechanism?

A

cephalosporins, aztreonam

39
Q

What drugs will have an altered drug target as the resistance mechanism?

A

beta-lactams, Vancomycin

40
Q

What drugs will have drug inactivation as the resistance mechanism?

A

penicillins, cephalosporins,

FOM (11 decks)

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