Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Ok Pharmacology... Let's Do This... Be Gentle > Cell Wall Synthesis Inhibitors > Flashcards

Cell Wall Synthesis Inhibitors Flashcards

1
Q

what are the 5 cell wall synthesis inhibitors

A
  1. penicillins
  2. vancomycin
  3. cephalosporins
  4. carbapenems
  5. monobactams
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

substitutions at the R group of a penicillin can modify what 3 properties

A
  1. increased acid stability in the gut
  2. minimize bacteria resistance dt penicillinase
  3. extend spectrum via increased bacterial penetration
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

which 2 penicillins have been modified to have increased gut stability

A

penicillin V

amoxicillin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

which penicillin has been modified to minimize bacterial resistance due to penicillinase

A

dicloxacillin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

which penicillin has been modified to extend spectrum via increased bacterial penetration

A

piperacillin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what are the 3 stages of bacterial cell wall synthesis

A
  1. synthesis and assembly of cell wall subunits in the cytosol
  2. linear polymerization of subunits in cell membrane
  3. cross-linking of peptidoglycan polymers at the cell wall
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

which 2 abx act on stage 1 of bacterial cell wall synthesis

A

fosfomycin

cycloserine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

which 2 abx act on stage 2 of bacterial cell wall synthesis

A

bacitracin

vancomycin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

which 2 abx act on stage 3 of bacterial cell wall synthesis

A

penicillins

cephalosporins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

abx that inhibit cell wall synthesis are

A

bactericidal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

vancomycin acts on stage 2 of bacterial cell wall synthesis and targets

A

transglycosylase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

penicillins and cephalosporins act on stage 3 of bacterial cell wall synthesis and target

A

transpeptidase and carboxypeptidase

→ PBP: penicillin binding proteins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

production of beta-lactamase is via a __

and is induced in the presence of __

A

plasmid

penicillin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what are the 3 beta lactamase enzymes that we need to know

A
  1. penicillinases → NSBL
  2. cephalosporinases → ESBL
  3. carbapenemases
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

penicillinases (NSBL) have no major activity against

A

cephalosporins

carbapenems

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

penicillinases are found in what 3 bacteria

A
  1. s. aureus
  2. klebsiella
  3. e.coli
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

cephalosporinases (ESBL) are commonly found in which class of bacteria

A

gram negative rods

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

name 2 bacteria that contain cephalosporinases

A
  1. e. coli
  2. k. pneumoniae
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

cephalosporinases remain sensitive to

A

carbapenems

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

both penicillinases and cephalosporinases can be inhibited by

A

beta-lactamase inhibitors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

what are the 3 inhibitors of NSBL and ESBL

A
  1. amox/clauv → Augmentin
  2. piper/taz → Zosyn
  3. sulbact/amp → Unasyn
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

what drug inhibits all of the beta lactamases

A

avibactam w. ceftazidime (Avycaz)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

carbapenemases are also called

A

KPC-NDM-1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

carbapenemases (KPC-NDM-1) are only inhibited by

A

avibactam w. ceftazidime

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

what 2 main bacteria contain carbapenemases

A

e. coli

klebsiella

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

what are the 2 types of altered penicillin binding proteins

A
  1. acquisition of new PBP
  2. altered structure of existing PBP
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

which type of altered PBP causes resistance to all beta lactam inhibitors

A

acquisition of new PBP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

which bacteria is an example of acquisition of a new PBP

A

staphylococcus spp (MRSA)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

altered structure of existing PBP causes what type of resistance

A

gradual increase in resistance to penicillins and cephalosporins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

what 2 bacteria are examples of altered structure of existing PBP

A

strep pneumo

neissereia gonorrheae

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

porin channels are found in what class of bacteria

A

gram negative

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

what is the clinical significance of porin channels

A

conduit for hydrophilic abx to get inside

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

which bacteria has mutated to alter the structure or # of porin channels to increase resistance

A

pseudomonas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

MSSA are resistant to all ___

due to production of ___;

with the exception of

A

penicillins

penicillinase (NSBL)

dicloxacillin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

MRSA are resistant to all ___

due to __

A

beta lactams

alteration of PBP2a

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

MRSA is sensitive to

A

inhibitors of cell wall synthesis stage 2 → vancomycin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

what gram positive cocci is penicillin used for

A

streptococci

s. aureus

enterococci

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

what gram negative cocci is penicillin used for

A

neisseria meningititis

m. catarrhalis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

name 4 infxns that streptococci is associated with

A
  1. pharyngitis
  2. PNA
  3. sinusitis
  4. otitis media
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

what 3 penicillins are used for streptococci

A

Pen G

Pen V

Augmentin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

enterococci are commonly associated with what 3 infxns

A
  1. bacteremia
  2. meningitis
  3. UTI
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

what 3 penicillins are commonly used for enterococci

A
  1. Pen G
  2. Ampicillin (plus aminoglycoside)
  3. Ampicillin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

what gram negative rods are penicillins used for

A

e. coli

pseudomonas species

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

e. coli are commonly associated with what 3 infxns

A

UTI

diarrhea

hemorrhagic colitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

what penicillins are used for e. coli

A

ampicillin

augmentin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

what penicillin is used for pseudomonas

A

piperacillin-tazobactam (Zosyn)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

penicillins are never used for what 3 bacteria

A

MRSA

neisseria gonorrhea

c.diff

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

what anaerobe is Zosyn used for

A

bacteroides fragilis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

oral absorption of penicillins depends on

A

acid stability

50
Q

oral absorption of Pen G is

A

poor and unreliable

51
Q

oral absorption of pen v and amoxicillin is

A

excellent

52
Q

piperacillin and ticaracillin are administered via

A

IV only

53
Q

IM absorption of penicillins are dependent on

A

salt form

54
Q

IM absorption of penicillins are rapid in __

and delayed from __

A

aqueous solutions

suspensions → procaine, benzathine

55
Q

IM suspension penicillin is used against organisms that are susceptible to

A

low but sustained levels of Pen G → syphilis and endocarditis

56
Q

penicillins are distributed throughout __

and penetrate into cells and tissues __

A

body water

poorly

57
Q

can penicillins enter inflamed tissues or membranes like CSF, joint, and eye

A

yes

58
Q

penicillins are excreted 90% by __

and require __ dosing

A

tubular secretion

renal

59
Q

what are the classes of penicillins

A
  1. prototype penicillins
  2. pen g
  3. pen v
  4. penicillinase (NSBL) resistant penicillins
  5. extended spectrum penicillins
  6. amoxicillin and ampicillin
  7. piperacillin and ticarcillin
60
Q

pen G is powerful and expensive and used

A

IV for hospitalized pt w. serious infxns

61
Q

prototype penicillins have __ antimicrobial spectrum

A

narrow

62
Q

pen g is a __ penicillin

A

prototypical

63
Q

pen V is an __ resistant penicillin

and is absorbed better than __

A

acid

pen g

64
Q

what is an example of a penicillinase (NSBL) resistant penicillin

A

Nafcillin

65
Q

penicillinase (NSBL) resistant penicillins are __ susceptible to beta lactamase than cephalosporins

A

less

66
Q

penicillinase (NSBL) resistant penicillins are __ spectrum

and used against __

A

narrow

gram (+) cocci

67
Q

extended spectrum penicillins penetrate through __

of __

A

porins

gram (-) organisms

68
Q

amoxicillin requires __ frequent dosing than ampicillin

and a common side effect is __

A

less

diarrhea

69
Q

what are the 2 anti pseudomonal penicillins

A

piperacillin

ticarcillin

70
Q

piperacillin and ticarcillin must be administered

A

parenterally

71
Q

piperacillin and ticarcillin are useful for pseudomonas and what other 2 infxns

A

b. fragilis

enterococci

72
Q

pen g is sensitive to __

and __

A

acid

penicillinase

73
Q

in terms of adverse rxns, penicillins are virtually __

with the exception of

A

non toxic

hypersensitivity rxns

74
Q

hypersensitivity rxns are __ by pt’s

A

over reported

75
Q

type I penicillin rxns are potentially __

but are __

A

life threatening

rare

76
Q

what is the most common hypersensitivity rxn related to penicillins

A

maculopapular rash or morbiliform rash → generally mild and reversible

77
Q

what is a common side effect of penicillins

A

diarrhea

78
Q

what are the two penicillins most commonly associated w. diarrhea

A

augmentin

ampicillin

79
Q

first gen cephalosporins have coverage against what class of bacteria

A

gram (-) AND gram (+)

80
Q

second gen cephalosporins have especially good activity against

A

gram (-)

81
Q

second gen cephalosporins are commonly used for what type of infxn

A

respiratory

82
Q

third gen cephalosporins have good __ coverage

and also excellent activity against __

A

(-)

strep pneumo → (+)

83
Q

relative to penicillins, cephalosporins have (3)

A
  1. broader spectrum against (-) bacteria
  2. less susceptibility to NSBL
  3. low cross-reactivity in penicillin sensitive pt
84
Q

first gen cephalosporins have good coverage against ___

so are used frequently for __

and __

A

MSSA

surgical prophylaxis

skin infxns

85
Q

what 3 (-) rods are 1st gen cephalosporins used for

A

e. coli

proteus

klebsiella

86
Q

what 2 gram negative infxns are 1st gen cephalosporins indicated in

A

UTIs

PNA

87
Q

2nd gen cephalosporins have increased __ coverage compared to 1st gen

A

(-)

88
Q

name 5 gram (-) infxns that 2nd gen cephalosporins are commonly used in

A
  1. PNA
  2. UTIs
  3. otitis media
  4. sinusitis
  5. peritonitis
89
Q

3rd gen cephalosporins have best activity against what type of bacteria

but also cover __

A

(-)

streptococci

90
Q

4th gen cephalosporins are more resistant to

A

chromosomal and extended spectrum beta lactamases (ESBL)

91
Q

4th gen cephalosporins have good activity against what 2 bacteria

A

pseudomonas

strep pneumo

92
Q

4th gen cephalosporins cover some anaerobes, but not

A

b. fragilis

93
Q

5th gen cephalosporin has some __

but better __

A

(-)

(+)

94
Q

5th gen cephalosporin has good coverage against (3)

A

MRSA → can bind to PBP2a

strep pneumo

e. faecalis

95
Q

5th gen cephalosporin has limited __ activity

and no __ coverage

A

anaerobe

pseudomonas

96
Q

__ stable cephalosporins can be given orally

A

acid

97
Q

cephalosporins penetrate well into most tissues and fluids, including __

but they do NOT penetrate the __

and CSF

A

placenta

brain

CSF

98
Q

what cephalosporin does have good CNS penetration

A

3rd gen → Ceftriaxone

99
Q

cephalosporins are primarily excreted via the __

and do require __ dosing

A

kidneys

renal

100
Q

no cephalosporins should be given to what pt population

A

pt w. hx of type 1 immediate sensitivity to penicillin

101
Q

allergy/hypersensitivity rxns to cephalosporins are __ than with penicillins

A

less severe

102
Q

cephalosporin cross reactivity with penicillins is __

and is greatest with __

A

< 1%

1st gen

103
Q

what are 2 adverse rxns related to cephalosporins

A
  1. GI distress
  2. superinfxn
104
Q

superinfections are more of a concern with which generations of cephalosporin

A

2nd and 3rd → broader spectrum

105
Q

all cell wall synthesis inhibitors are

A

bactericidal

106
Q

vancomycin inhibits stage __ of cell wall synthesis

A

2

107
Q

vancomycin blocks ___ polymerization

via binding to __ cell wall precursor

A

glycopeptide

D-alanyl-D-alanine

108
Q

resistance to vancomycin is via

A

alternative cell wall terminal peptide D-ala-D-lac

109
Q

resistance to vancomycin is __ mediated

A

plasmid

110
Q

vancomycin resistance is seen almost exclusively in

A

enterococci (VRE)

111
Q

__ resistance to vancomycin is rare

A

s. aureus (VRSA)

112
Q

what gram (+) infxns is vancomycin used for

A

staph/strep

severe skin and soft tissue

meningitis

PNA

endocarditis

sepsis

113
Q

vancomycin is replacing __

as first choice against __

A

metrondiazole

c.diff

114
Q

antibiotic-associated diarrhea (CDAD) is due to

A

c.diff

115
Q

vancomycin has poor __ absorption,

but is used orally for __

A

oral

c.diff

116
Q

vancomycin is excreted mainly via the __

and does require __ dosing

A

kidneys

renal

117
Q

what is the most common adverse rxn associated w. vancomycin

A

nephrotoxicity

118
Q

nephrotoxicity w. vanco is increased with use of

A

aminoglycosides

119
Q

redman syndrome is associated with

A

infusion of vanco

120
Q

ototoxicity with vancomycin is

A

rare

Ok Pharmacology... Let's Do This... Be Gentle (6 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions