Chapter 34: Bacterial and Mycobacterial Infections: Cell Wall Synthesis Flashcards
Drug of choice for methicillin resistant staph aureus infections? MOA?
Vancomycin
Bind to the D ALa D Ala part of murein monomer…inhibits peptidoglycan glycosyltransferase –> murein monomers can’t add to the growing chain
What is a common adverse effect of vancomycin, telavancin, and teicoplanin? How can it be avoided?
Red Man Syndrome: flushing and erythema
Can be avoided by slowing transfusion rate
Because of its toxicity, vancomycin is only used when?
Only used when multidrug resistance is present
What are the two different uses of Bacitracin?
Cutaneous and eye infections: Topical
Decontaminate c diff: Oral
Most commonly used topically so that systemic absorption does not occur and cause nephrotoxicity
Bacitracin MOA?
Inhibits dephosphorylation of bactoprenyl diphosphate by forming a complex with it
BACitracin –> BACtoprenyl
Which is more toxic to the liver, vancomycin or telavancin?
telavancin
“tele”vision is toxic
MOA of B lactams? How do penicillins differ from cephalosporins?
inhibit transpeptidase by forming covalent acyl enzyme intermediates “dead end”
suicide substrate inhibition
Penicillins are 5 MEMBERED RING; cephalosporins are 6
Penicillin G and penicillin V - are they B lactamase sensitive or resistant?
sensitive
What would you use to treat aerobic or anaerobic infections of the head/neck? i.e. a dental abscess?
Penicillin V
Penicillin can potentiate the effects of what drug?
anticoagulant effects of warfarin
“penicillin & wartime”
Which penicillins are used to mainly to treat skin and soft tissue infections?
METHICILLIN Oxacillin Cloxacillin Dicloxacillin Nafcillin
What is the drug of choice for uncomplicated ear, nose, throat infections? Endocarditis prevention? Combo therapy for h. pylori?
What is the stipulation with administration?
Amoxicillin
Because it is B lactamase sensitive, give it with a B lactamase inhibitor (Clavulanic acid)
Ampicillin is used in what scenarios?
Listeria meningitis and invasive enterococcal infections
“Get AMPed to write a LIST!!!!!”
also can be used in b lactamase producing bacteria like
1) staph aureus
2) h influenzae
3) e coli
4) klebsiella
5) anaerobes
Which penicillins have broad spectrum antibactericidal activity but are used mostly to treat p. aeruginosa?
carbenicillin
ticarcillin
piperacillin
mezlocillin
Cycloserine MOA and clinical app?
inhibit alanine racemase and D ala D ala ligase to prevent cell wall synthesis
m tuberculosis
“shake your tuber-cle like a cyclo-ne”
What drug would you use to treat gram negative urinary tract infections? MOA?
fosfomycin
PEP analogues - block production of murein monomers
Which cephalosporins may produce alcohol intolerance syndrome?
cefotetan
cefoperazone
Major clinical application of Ceftriaxone? 3rd gen
Enterobacteriacea (gram neg)
Which generation of cephalosporins have the best gram positive coverage?
First generation: cefazolin, cephalexin
Cefepime
Cephalosporin 4th generation
Used for p. aeruginosa and enterobacteriae
NOT approved for meningitis
Ceftaroline
MRSA
VRSA
= great for multidrug resistant staph aureus
What B lactam would you use for a patient allergic to penicillin?
Aztreonam
Daptomycin MOA and clinical app?
integrates into gram positive membranes to form pores –> cell death
complicated skin infections
R sided endocarditis from staph aureus
What are the major adverse effects and contraindications of daptomycin?
C diff
Don’t use with statins
