Cell Wall Synthesis Inhibitors

Question 1

Cell wall synthesis stage 1

Answer 1

synthesis and assembly of CW sub-units occurring in cytosol

Question 2

Cell wall synthesis stage 2

Answer 2

linear polymerization of sub-unites occurring at cell membrane

Question 3

Cell wall synthesis stage 3

Answer 3

cross-linking of peptidoglycan polymers at the cell wall - gives it strength

Question 4

Stage 2 inhibited by

Answer 4

bacitracin

vancomycin

Question 5

Stage 3 inhibited by

Answer 5

Penicillins

Cephalosporins

Question 6

PCN absorption

Answer 6

should be taken on empty stomach

Question 7

PCN distribution

Answer 7

poor tissue penetration - concentrates in liver, kidney, skin best
Can enter inflamed tissue or membranes more readily

Question 8

PCN metabolism

Answer 8

Excreted by the kidney and also in breast milk

Question 9

Penicillin G

Answer 9

prototypical PCN. now limited to hospitalized patients

Question 10

Penicillin V

Answer 10

acid resistant. Better absorbed than PCN G

Question 11

Penicillinase (beta-lactamase)

Answer 11

an enzyme produced by bacteria that inactivates certain penicillins

Question 12

Penicillinase-resistance PCN (ex)

Answer 12

Nafcillin

Oxacillin

Question 13

Extended spectrum PCN (ex)

Answer 13

Ampicillin
Amoxicillin
can be given with B-lactamase inhibitors

Question 14

Anti-pseudomonal PCN

Answer 14

Ticarcillin
Piperacillin
Parenteral route only

Question 15

Beta-Lactamase inhibitors (ex)

Answer 15

Clavulanic Acid
Sulbactam
Tazobactam

Question 16

Beta lactamase inhibitors MOA

Answer 16

potent, irreversible inhibitors of B-lactamase. will extend PCN spectrum ONLY if the resistance is due to B-lactamase

Question 17

PCN ADRs

Answer 17

hypersensitivity reactions. Type 1 is RARE and usually it’s a rash

Question 18

Vancomycin MOA

Answer 18

Inhibits cell wall synthesis at stage 2

Question 19

Vancomycin pharmacokinetics

Answer 19

Poor oral abs… administered IV

Excreted through kidneys

Question 20

Vancomycin ADRs

Answer 20

chills-fever-skin rash

pre-treat with acetaminophen and diphenhydramine

Question 21

Cephalosporin MOA

Answer 21

Cell wall synthesis inhibitors at stage 3

Question 22

Cephalosporin Pharmacokinetics

Answer 22

some PO and some IV
penetrate well into tissues and fluids but NOT BRAIN AND CSF (except 3rd gen)
requires dose adjustment in renal insufficiency

Question 23

3rd generation cepalosporins have good penetration into CSF

Answer 23

:)