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PharmQ1Questions > CellWallInhibitorsC > Flashcards

CellWallInhibitorsC Flashcards

1
Q

What is the consequence of cell wall inhibitors ?

A

Cell death

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2
Q

Cell wall inhibitors require what type of organism for maximum effect?

A

Actively proliferating microorganisms

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3
Q

What are the beta-lactam compounds?

A

Penicillin, cephs, carbapenems, monobactams and beta-lactamase inhibitors

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4
Q

What main characterist defines beta- lactam drugs?

A

Beta lactam ring

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5
Q

What are the beta lactams inherently unstable to ?

A

pH- destroyed in acid

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6
Q

Are beta lactams generally bacteriostatic or cidal?

A

Cidal- active against growing organisms

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7
Q

What is penicillin MOA?

A

Interferes with the last step in bacterial cell wall synthesis

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8
Q

Why does penicillin have no effect on protozoa, mycoplasma, viruses and fungus?

A

b/c they lack cell walls

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9
Q

What are the 3 ways bacteria are resistant to penicillin?

A

Produce beta lactamase (inactivates drug), modify PBP target, and impair penetration of drug to target PBP

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10
Q

What are the natural penicillins?

A

G or V

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11
Q

What are the natural penicillins highly active against? What are they not active against?

A

Active: Gram + cocci, Not active: staphylococcus

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12
Q

What are the indications for natural penicillin use? How are they administered?

A

Ts: URI/ LRI, throat, skin, and GU infections, G- IM, V- oral

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13
Q

What are the aminopenicillins and how do they differ from the naturals?

A

Ampicillin and amoxicillin, Have Pen G activity AND improved coverage of gram ñ cocci and enterobacteriaceae

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14
Q

What are the therapeutic uses of aminopenicillins?

A

URI ( otitis and sinusitis) uncomplicated UTI, meningitis, and salmonella

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15
Q

What is augmentin composed of?

A

Amoxicillin and calvulonic acid

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16
Q

What are the penicillinose-resistant penicillins?

A

Nafcillin, oxacillin, dicloxacillin

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17
Q

Do the penicillinose-resistant penicillins have a narrow or broad spectrum use?

A

Narrow

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18
Q

What are the indications for penicillinose-resistant penicillins ?

A

Tx staph infections with increased beta lactam production. Cellulitis and endocarditis

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19
Q

What are the penicillinose-resistant penicillins not active against?

A

Gram ñ or anaerobic organisms

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20
Q

What are the antipseudomonal penicillins? How do they differ from natural penicillins?

A

Piperacillin, ticarcillin, and carbenicillin. Pen G activity AND gram ñ coverage including pseudomonas

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21
Q

What are the beta-lactamse inhibitors and what do they act as?

A

Clavulanic acid, sulbactam, and tazobactam ì suicide inhibitorsî ñ potent, irreversible inhibitors of many lactamases

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22
Q

Adding B lactamase inhibitors increases coverage of what organisms?

A

H influenzae, staph, and moraxella catarrhalis

23
Q

Which penicillins are oral admin ONLY?

A

Pen V and amoxicillin with or without clavulanic acid

24
Q

Which penicillins are IV ONLY?

A

Antipseudomonal penicillins. Piperacillin with or without tazobactam

25
Q

Which penicillins are oral or IV?

A

Nafcillin , Ampicillin

26
Q

What are the depot forms of penicillin admin?

A

Procaine and benzathin penicillin G

27
Q

How are most penicillins eliminated?

A

Kidney, actively secreted into urine

28
Q

Which penicillins are excreted via biliary excretion?

A

Antipseudomonal and nafcillin

29
Q

What can block active secretion of penicillin?

A

Probenecid

30
Q

What are some ADRs of penicillin?

A

GI upset, diarrhea, and secondary infections

31
Q

What are drug specific penicillin reactions?

A

Oxacillin- hepatitis, Nafcillin- neutropenia, Ticarcillin/carbencillin- abnormal platelet aggregation

32
Q

What are the 2 PCN drug interactions?

A

TCN- tetracycline or other bacteriostatic agents, Anti-pseudomonal PCN affects warfarin metabolism

33
Q

Are cephalosporins bactericidal or static?

A

bacteriocidal

34
Q

How is there increases cephalosporin resistance?

A

Mutations carried on plasmids

35
Q

Cephalosporin generation 1 covers what type of organisms?

A

Aerobic gram +, Above the diaphragm, anaerobes/CA gram ñ Skin infections, acute otitis media, pharyngitis, UTI, prophylaxis for clean surgery, septic arthritis

36
Q

What are the 1st generation drugs and the routes?

A

Cefazolin ( IV), Cephalexin (PO)

37
Q

What are the 2 categories of 2nd generation cephs and their routes and indications

A

1-Added gram negative coverage, IV/PO- cefuroxime, cefaclor, cefprozil, Sinusitis, otitis, bronchitis, CAP, skin infections, UTI 2-added anaerobic coverage IV: cefotetan, cefoxitin Abdominal and gyno infections

38
Q

What was the main added feature for 3rd generation ?

A

Gram negative coverage and penetration of the BBB

39
Q

What are the 3rd generation cephs and their routes?

A

Oral: cefpodoxime, cefdinir, cefixine, cefditoren, cefibuten IV/ IM: cefotaxime, ceftriaxone(long Ω life) IV: ceftazidime- increased antipseudomonal coverage

40
Q

What are indications for use of 3rd generation cephs?

A

Wide variety of serious infections that may be resistant to other antimicrobial agents Broad spectrum Meningitis, pneumonia, sepsis, peritonitis, neisseria gonorrhea

41
Q

What is the 4th generation ceph? Can it be taken orally?

A

Cefepime, NO - IM/IV

42
Q

What does generation 4 have good coverage against? What is it used for?

A

Gram +, -, anaerobic ( h influenzae, n. meningitides, n. gonorrheae, p. aeruginosa )Intraabdominal infections, resp tract infections, skin infection

43
Q

Is vancomycin a bactericidal or static?

A

bactericidal

44
Q

What are the 2 mechanisms of vancomycin resistance?

A

Acquired or innate

45
Q

Does vancomycin work against gram ñ organisms?

A

NO, only gram +

46
Q

What is vancomycin reserved for?

A

Pt allergic to beta latams with serious gram + infections or MRSA

47
Q

When is oral vancomycin indicated?

A

c.diff induced colitis ONLY

48
Q

What are the ADR of vancomycin?

A

Red man syndrome, ototoxicity, nephrotoxicity

49
Q

What is ovitavanan used for?

A

Gram + , including MRSA

50
Q

What is daptomycin used for/ reserved for?

A

Omplicated skin infections, bacteremia, osteomyelitis, Reserved for: pt allergic to beta lactams, MRSA, enterococcus spp

51
Q

What is dalbavacin and what is it used for?

A

Lipoglycopeptide which prevents cross linking and stabilization of cell wall interfering w/ cell wall synthesis. Bactericidal against staph aureus and strep pyogens

52
Q

What are indications for dalbavacin ?

A

Skin infection and IVPB

53
Q

What are clinical uses of bacitracin?

A

Nephrotoxic, gram + cocci and bacilli so limited to topical use. Locally for wounds, antibiotic ointment, or cleaning wounds in surgery

PharmQ1Questions (13 decks)

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