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High Yield Pharm unit 6 > Cell Wall inhibitors > Flashcards

Cell Wall inhibitors Flashcards

1
Q

What is the mechanism of action of B lactams?

A
  1. Bind PBPs
  2. inhibit transpeptidation
  3. inhibit cross linking
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2
Q

What are the three mechanisms of resistance

A
  1. enzymatic destruction -B lactamase -PBP
  2. alternation in porin channel
  3. change affinity of PBPs
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3
Q

What is the drug of choice for MRSA?

A

vancomycin

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4
Q

What are the two drugs of the narrow spectrum penicillins?

A

penicillin G - parenteral

penicillin V - oral

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5
Q

What is the main therapeutic use for narrow spec?

A

syphillis
strep (s pneum, s viridans have resistance)
mouth anaerobes - actinomyces

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6
Q

What are the three drugs of “very narrow spectrum” penicillins?

A
  1. methicillin
  2. naficillin
  3. oxacillin
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7
Q

What are the main therapeutics of M,N,O?

A

S aureus (NOT MRSA)

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8
Q

What are the two aminopenicillins?

A

amoxicillin and ampicillin

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9
Q

Why are the two aminopenicillins considered “broad spectrum”

A

able to enter porin channels

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10
Q

What are the therapeutics of aminopenicillins? What are they specifically the drug of choice for?

A

HHELPSS

H - h pylori
H - H flu
E - ecoli, enterococcus - DRUG OF CHOICE
L - listeria
P - proteus
S - salmonella
S - shigella
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11
Q

What are the four drugs of the extended spectrum penicillins?

A
  1. ticaracillin
  2. piperacillin
  3. azlocillin
  4. carbinicllin
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12
Q

What are the extended spec penicillins mainly used for?

A

pseudomonas

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13
Q

Which of the groups of penicllins are B lactamase resistant?

A

very narrow spec - M,N,O

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14
Q

Name some B lactamse inhibitors?

A

clavulonic acid, sulfbactam, tazobactam

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15
Q

What is augmentin?

A

amoxicillin and clavulanate

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16
Q

How are penicillins eliminated?

A

active tubular secretion

except Naficillin and oxacillin - Bile

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17
Q

What are the first generation cephalosporins?

A

cefazolin, cephalexin

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18
Q

What are the second generation cephalosporins?

A

cefotetan, cefaclor, cefuroxime

19
Q

What are the third generation cephalosporins?

A

ceftriaxone, cefotaxime, cefdinir, cefixime

20
Q

what are the 4 organisms that cephalosporins aren’t effective against?

A 
LAME
L - listeria
A - atypicals
M - MRSA
E - Enterococci
21
Q

What is the fourth generation cephalosporin?

A

cefepime

22
Q

Which cephalosporins cross the BBB?

A

third and fourth generations plus cefuroxime

23
Q

How are the cephalosporins cleared?

A

renal clearance

except cefoperazone and ceftriaxone - eliminated in liver

24
Q

If there is allergies to lactams, what is your next drug of choice?

A

macrolides for gram positive

aztronam for gram negative rods

25
Q

Which antibiotics cause disulfiram like effects?

A

cefoperazone and metronidazole

26
Q

What are the carbapenams?

A

imipenem, meropenem, ertapenem, doripenem

27
Q

What are the carbapenams MOA?

A

inhibit cell wall synthesis

-resistant to B lactamases

28
Q

What are carbapenams mostly used for?

A

empirical use in nosocomial infections
abdominal polymicrobial infections
NOT MRSA

29
Q

What other drug is impinem always given with and why?

A

cilastatin

-prevent too rapid of metabolism

30
Q

How are carbapenams metabolized?

A

renal elimination

31
Q

What is the main s/e of carbapenams?

A

seizures

32
Q

What is the main use of aztreonam? Why are they a hidden gem?

A

IV drug used against gram neg rod - pseudomonas

-particularly useful if lactam allergy or renal dysfunction

33
Q

What is the MOA of vancomycin?

A

binds D-Ala-D- ala muramyl pentapeptide

-prevents elongation of peptidoglycan chains

34
Q

How does enterococcus have resistance to vancomycin? What do you use for VRE?

A

terminal D ala –> D lactate

linezolid and streptogratins

35
Q

What are the s/e of vancomycin?

A
  • red man syndrome - vasodilation by histamine
  • ototoxicity
  • nephrotoxicity
36
Q

When would you be worried ab a B lactam allergy?

A

if it is IgE mediated

37
Q

What is daptomycin used for?

A

VRE and VRSA

38
Q

What are the first generation cephalosporins used for?

A

PEcKs

P - proteus
Ec - E coli
K - klebsiella
S - surgical prophylaxis

39
Q

What drug is the drug of choice for surgical prophylaxis

A

Cefazolin

40
Q

What are the second gen cephalosporins used for

A

HEN PEcKs

all of the PEcKs +
H - H flu **
E - enterobacter
N - neisseria

41
Q

How is vanco given for C diff?

A

orally

42
Q

Which generation of cephs have inc incidence of C diff

A

third

43
Q

What drug specifically cannot be used for pneumonia? why?

A

daptomycin

inactivated by pulmonary surfactant

High Yield Pharm unit 6 (11 decks)

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