Chapter 71-Intro to PCN Flashcards

1
Q

What is the primary action of PCN?

a) bactericidal
b) bacteriostatic

A

Answer a)bactericidal

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2
Q

What is another name for penicillins?

a) beta-lactimase antibiotics
b) beta-lactim antibiotics
c) penicillinases
d) none of the above

A

Answer: b)beta-lactim antibiotics

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3
Q

What is primary MOA for penicillin?

a) 50s ribosome binding
b) inhibit transpeptidases
c) activation of autolysis
d) disrupt the cell wall
e) one or more of the above

A

Answer: e) one or more of the above

The primary MOA is disrupting the cell wall. This is achieved by inhibiting transpeptidases (enzymes that strength cell wall) and activating autolysis (breaks bonds in cell wall).

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4
Q

Where does PCN like to bind?

a) ribosomes
b) cell envelope
c) PBPs
d) none of these

A

Answer: c)PBPs

PCPs (penicillin-binding proteins) are the target of PCN. They are found on the membrane.

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5
Q

When can penicillin work?

a) when the cell is dying/weak
b) when the cell is growing
c) when the cell is dividing
d) all the time
e) one or more of the above

A

Answer: e) one or more of the above

PCN can only work during growth and division because that is the only time PBPs are expressed (penicillin binds to this on the bacteria)

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6
Q

How are human cells affected by penicillin?

a) all are destroyed
b) they are untouched
c) some are destroyed
d) some are damaged

A

Answer: b) they are untouched

Human cells do not have a cell wall for PCN to weaken/attach to. Therefore they are unaffected.

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7
Q

How does bacteria become resistant to PCN?

a) PCN is inactivated by enzymes
b) Proteins (PBP) are created which have high affinity for penicillin so the free circulating amount is higher
c) PBP are created which have a low affinity for penicillin
d) None of the above
e) One or more of the above

A

Answer: e)one or more of the above

Resistance can occur:

If penicillin can’t reach target PBP; if PCN is inactivated by bacterial enzymes; and if there is PBP produced which has a low affinity for penicillin (less binds)

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8
Q

Gram negative cell envelope has _____ layers and gram positive cell envelope has _____ layers.

A

Gram negative cell envelope has 3 layers and gram positive cell envelope has 2 layers.

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9
Q

Penicillin is more active against gram ____ bacteria.

A

Positive (it only has 2 layers in its’ envelope).

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10
Q

Beta-lactamases specific to penicillin are called:

A

penicillinases

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11
Q

What enzymes can cleave a beta-lactim ring?

a) beta-lactamases
b) penicillinases
c) carbapenemases
d) one or more
e) none

A

Answer: d) one or more

By cleaving the beta-lactim ring, beta-lactimases/penicillinases (specific to penicillin) the antibiotic is rendered inactive.

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12
Q

Gram _____ bacteria make a lot of penicillinases/beta-lactamases.

A

Gram positive. Gram negative bacteria make small amounts.

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13
Q

Which type of MRSA is more serious and harder to treat?

a) health care-associated MRSA
b) community-acquired MRSA

A

Answer: a

Note: MRSA used to be sensitive to penicillin but became resistant. Now it is resistant to methicillin

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14
Q

Penicillin G is more effective on most gram _____ bacteria.

A

Gram positive.

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15
Q

Which penicillin is referred to as “penicillin”?

a) Pen G
b) Pen V
c) Pen VK
d) none of the above

A

Answer: a) Pen G

Called “penicillin” as it was the first penicillin available

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16
Q

Penicillin is considered (broad/narrow) spectrum.

A

Answer: narrow

which makes it safer

17
Q

Pen G is metabolized/eliminated primarily by:

a) liver
b) kidneys
c) both

A

Answer: b)kidneys

Eliminated primarily as unchanged drug

18
Q

True or false, in penicillin allergy the dose does not matter?

A

True. The dose does not matter but prior exposure is necessary. This can occur through foods and other things.

19
Q

True or false, penicillin is considered the least toxic of all antibiotics?

A

True.

20
Q

True or false, if a patient has a mild PCN allergy, it is safe to give them cephalosporin.

A

True. Cross reaction sensitivity to cephalosporins in that situation is low at 1%

21
Q

Anaphylaxis occurs more with ____ antibiotic than any other.

a) macrolide
b) tetracycline
c) clindamycin
d) penicillin

A

Answer: d)penicillin

22
Q

Pen ___ is stable in stomach acid whereas Pen ___ is not.

A

Pen V is stable in stomach acid unlike Pen G

23
Q

What benefits do penicillinase-resistant penicillins have?

A

Answer: they can resist penicillinase which would normally render penicillin inactive/useless

Also: they are highly resistant to inactivation by beta-lactamases

24
Q

Penicillinase-Resistant Penicillins are (broad/narrow) spectrum whereas penicillins are (broad/narrow) spectrum.

A

Both are NARROW spectrum

25
Q

Ampicillin and amoxicillin are considered (broad/narrow) spectrum penicillins.

A

Broad

26
Q

Are broad spectrum penicillins inactivated by beta-lactamases?

A

Yes. Thus they will not work for S. aureus.

27
Q

Which is an example of a broad-spectrum penicillin?

a) ampicillin
b) piperacillin
c) amoxicillin
d) pen V
e) pen VK

A

Answer: a & c

28
Q

True or false, extended-Spectrum Penicillins are inactivated by beta-lactamases (penicillinases).

A

True.

29
Q

Which is an example of an extended-spectrum penicillin?

a) ampicillin
b) piperacillin
c) amoxicillin
d) pen V
e) pen VK

A

Answer: b) piperacillin (it is the only one)

30
Q

When you combine a penicillin with a beta-lactamase inhibitor, what can occur?

a) the penicillin degrades more quickly
b) the spectrum of penicillin extends
c) kidney toxicity can occur due to high levels of penicillin
d) beta-lactam cannot be expressed on the penicillin and it is not effective

A

Answer: b) extends the spectrum of the penicillin

Basically: prohibits the organism from creating the enzyme which breaks down penicillin