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PHRM 865 - Therapeutics V > exam 2 > Flashcards

exam 2 Flashcards

1
Q

What is the mechanism of action of Penicillins?

A

Inhibits cell wall synthesis by binding to and inhibiting PBPs

PBPs are penicillin-binding proteins essential for bacterial cell wall integrity.

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2
Q

What are the mechanisms of resistance for Penicillins?

A
  • β-lactamase production
  • Altered PBPs
  • Decreased penetration through outer cell membrane (GNO)

GNO refers to Gram-negative organisms.

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3
Q

Are Penicillins bactericidal or bacteriostatic?

A

Bactericidal (except enterococcus)

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4
Q

Is the action of Penicillins time-dependent or concentration-dependent?

A

Time-dependent

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5
Q

What is the mechanism of action of Cephalosporins?

A

Inhibits cell wall synthesis by binding to and inhibiting PBPs

Similar to Penicillins, Cephalosporins target PBPs.

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6
Q

What are the mechanisms of resistance for Cephalosporins?

A
  • β-lactamase production
  • Altered PBPs
  • Decreased penetration through outer cell membrane (GNO)
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7
Q

Are Cephalosporins bactericidal or bacteriostatic?

A

Bactericidal (except enterococcus)

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8
Q

Is the action of Cephalosporins time-dependent or concentration-dependent?

A

Time-dependent

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9
Q

What is the mechanism of action of Carbapenems?

A

Inhibits cell wall synthesis by binding to and inhibiting PBPs

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10
Q

What are the mechanisms of resistance for Carbapenems?

A
  • β-lactamase production
  • Altered PBPs
  • Decreased penetration through outer cell membrane (GNO)
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11
Q

Are Carbapenems bactericidal or bacteriostatic?

A

Bactericidal

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12
Q

Is the action of Carbapenems time-dependent or concentration-dependent?

A

Time-dependent

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13
Q

What is the mechanism of action of Monobactams?

A

Inhibits cell wall synthesis by binding to and inhibiting PBPs

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14
Q

What are the mechanisms of resistance for Monobactams?

A
  • β-lactamase production
  • Decreased penetration through outer cell membrane (GNO)
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15
Q

Are Monobactams bactericidal or bacteriostatic?

A

Bactericidal

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16
Q

Is the action of Monobactams time-dependent or concentration-dependent?

A

Time-dependent

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17
Q

What is the mechanism of action of Fluoroquinolones?

A

Inhibits DNA synthesis by inhibiting bacterial topoisomerases

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18
Q

What are the mechanisms of resistance for Fluoroquinolones?

A
  • Mutation in genes that code for DNA gyrase or topoisomerase IV (change in binding site)
  • Efflux
  • Decreased penetration through outer cell membrane (GNO)
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19
Q

Are Fluoroquinolones bactericidal or bacteriostatic?

A

Bactericidal

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20
Q

Is the action of Fluoroquinolones time-dependent or concentration-dependent?

A

Concentration-dependent

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21
Q

What is the mechanism of action of Macrolides?

A

Inhibits protein synthesis by binding to 50S ribosomal subunits

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22
Q

What are the mechanisms of resistance for Macrolides?

A
  • Efflux (mef)
  • Change in ribosomal binding site (erm)
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23
Q

Are Macrolides bactericidal or bacteriostatic?

A

Bacteriostatic

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24
Q

Is the action of Macrolides time-dependent or concentration-dependent?

A

Time-dependent

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25
Q

What is the mechanism of action of Aminoglycosides?

A

Inhibits protein synthesis by irreversibly binding to 30S ribosomal subunits

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26
Q

What are the mechanisms of resistance for Aminoglycosides?

A
  • Altered aminoglycoside uptake
  • Synthesis of aminoglycoside-modifying enzymes
  • Alteration in ribosomal binding sites (strepto)
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27
Q

Are Aminoglycosides bactericidal or bacteriostatic?

A

Bactericidal

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28
Q

Is the action of Aminoglycosides time-dependent or concentration-dependent?

A

Concentration-dependent

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29
Q

What is the mechanism of action of Vancomycin?

A

Inhibits 2nd stage of cell wall synthesis by binding to D-Ala-D-Ala cell wall precursors

30
Q

What are the mechanisms of resistance for Vancomycin?

A
  • Modification of the D-alanyl-D-alanine vancomycin binding site
31
Q

Are Vancomycin and Dalbavancin bactericidal or bacteriostatic?

A

Bactericidal

32
Q

Is the action of Vancomycin time-dependent or concentration-dependent?

A

Time-dependent

33
Q

What is the mechanism of action of Quinupristin-dalfopristin?

A

Inhibits protein synthesis by binding to 50S ribosomal subunits

34
Q

What are the mechanisms of resistance for Quinupristin-dalfopristin?

A
  • Alteration in ribosomal binding site
35
Q

Are Quinupristin-dalfopristin bactericidal or bacteriostatic?

A

Bacteriostatic

36
Q

Is the action of Quinupristin-dalfopristin time-dependent or concentration-dependent?

A

Time-dependent

37
Q

What is the mechanism of action of Linezolid?

A

Inhibits protein synthesis by binding to 50S ribosomal subunit near 30S interface

38
Q

What are the mechanisms of resistance for Linezolid?

A
  • Alteration in ribosomal binding site (rare)
39
Q

Are Linezolid and Tedizolid bactericidal or bacteriostatic?

A

Bacteriostatic

40
Q

Is the action of Linezolid time-dependent or concentration-dependent?

A

Time-dependent

41
Q

Is the action of Tedizolid time-dependent or concentration-dependent?

A

Concentration-dependent

42
Q

What is the mechanism of action of Daptomycin?

A

Causes membrane depolarization by inserting lipophilic tail in cell wall

43
Q

What are the mechanisms of resistance for Daptomycin?

A
  • Altered cell membrane binding through loss of membrane protein
44
Q

Are Daptomycin and Telavancin bactericidal or bacteriostatic?

A

Bactericidal

45
Q

Is the action of Daptomycin time-dependent or concentration-dependent?

A

Concentration-dependent

46
Q

What is the mechanism of action of Telavancin?

A

Inhibits cell wall synthesis by binding to D-Ala-D-Ala cell wall precursors AND causes membrane depolarization by inserting lipophilic tail in cell wall

47
Q

What are the mechanisms of resistance for Telavancin?

A
  • Modification of the D-alanyl-D-alanine vancomycin binding site
48
Q

What is the mechanism of action of Tetracyclines?

A

Inhibits protein synthesis by binding to 30S ribosomal subunits

49
Q

What are the mechanisms of resistance for Tetracyclines?

A
  • Tetracycline-specific efflux pumps
  • Ribosomal protection proteins
  • Enzymatic inactivation
50
Q

Are Tetracyclines bactericidal or bacteriostatic?

A

Bacteriostatic

51
Q

Is the action of Tetracyclines time-dependent or concentration-dependent?

A

Time-dependent

52
Q

What is the mechanism of action of Trimethoprim-sulfamethoxazole?

A

Sequential inhibition of microbial folic acid synthesis pathway by inhibiting bacterial dihydropteroate synthetase and dihydrofolate reductase

53
Q

What are the mechanisms of resistance for Trimethoprim-sulfamethoxazole?

A
  • Mutation in dihydrofolate reductase or dihydropteroate synthase
54
Q

Are Trimethoprim-sulfamethoxazole bactericidal or bacteriostatic?

A

Bactericidal

55
Q

Is the action of Trimethoprim-sulfamethoxazole time-dependent or concentration-dependent?

A

Time-dependent

56
Q

What is the mechanism of action of Polymyxins?

A

Binds to phospholipids in cell membrane causing displacement of Ca and Mg, leading to changes in cell wall permeability and leakage of cellular contents

57
Q

What are the mechanisms of resistance for Polymyxins?

A
  • Alteration in outer cell membrane (↓Ca or Mg content, ↓lipopolysaccharide content, ↓outer membrane proteins)
58
Q

Are Polymyxins bactericidal or bacteriostatic?

A

Bactericidal

59
Q

Is the action of Polymyxins time-dependent or concentration-dependent?

A

Concentration-dependent

60
Q

What is the mechanism of action of Clindamycin?

A

Inhibits protein synthesis by binding to 50S ribosomal subunits

61
Q

What are the mechanisms of resistance for Clindamycin?

A
  • Alteration in ribosomal binding site (erm)
62
Q

Are Clindamycin and Metronidazole bactericidal or bacteriostatic?

A

Clindamycin: Bacteriostatic; Metronidazole: Bactericidal

63
Q

What is the mechanism of action of Metronidazole?

A

Prodrug activated by ferredoxins whose activated metabolites damage bacterial DNA

64
Q

What are the mechanisms of resistance for Metronidazole?

A
  • Altered growth requirements
  • Reduced transcription of ferredoxin gene
65
Q

What antibiotic is the drug of choice for Methicillin-Susceptible Staphylococcus aureus (MSSA)?

A

Nafcillin (IV)*
Dicoxacillin
Cefazolin

66
Q

What antibiotic is considered a potential drug of choice for Methicillin-Resistant Staphylococcus aureus (MRSA)?

A

Vancomycin*

67
Q

What is the drug of choice for Enterococcus spp. susceptible to Ampicillin?

A

Ampicillin* (IV or PO, depending on infection)
If patient can’t receive ampicillin, then vanc

68
Q

What is the drug of choice for Vancomycin-Resistant Enterococcus spp. (VRE) that is susceptible to ampicillin?

A

Ampicillin

69
Q

What are the preferred antibiotics used for Pseudomonas aeruginosa?

A
  • Piperacillin*
    Cefepime
    Amikacin (with other B-lactams)
70
Q

What antibiotic is used for atypical bacteria such as Legionella, Mycoplasma, Chlamydia?

A

Erythromycin, Clarithromycin or Azithromycin*
Levofloxacin, Ciprofloxacin, Delafloxacin, Moxifloxacin*
Doxycycline† and Tetracycline analogs

71
Q

What is the treatment for Clostridioides difficile colitis?

A

Oral Vancomycin

PHRM 865 - Therapeutics V (1 decks)

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