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Pharmacology > Exam 2: Inhibitor Of Cell Wall Synthesis I > Flashcards

Exam 2: Inhibitor Of Cell Wall Synthesis I Flashcards

1
Q

What is the composition of peptidoglycan?

A
  • A backbone of alternating sugars, NAGs and NAMs
  • A chain of 4 amino acids links to NAM
  • A peptide bridge that cross links the tetrapeptide chains
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2
Q

What is the target of all Beta Lactam antibiotics?

A

Penicillin binding proteins

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3
Q

What is the enzyme that facilitates transglycosylation and transpeptidation?

A

Penicillin binding protein

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4
Q

What causes cell death from antibiotics that inhibit cell wall synthesis?

A

Osmotic lysis

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5
Q

What is transglycosylation?

A

Joining of the NAG and NAMs together

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6
Q

What is transpeptidation?

A

Forming cross links of pentapeptides

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7
Q

What are the 5 areas that inhibitors of cell wall synthesis target?

A

1) transglycosylation
2) transpeptidation
3) NAG reduction to NAM
4) transport across the inner membrane
5) Amino acid mimicry

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8
Q

What are the natural penicillins?

A

Penicillin B
Penicillin V
Benzathine penicillin
Proclaine Penicillin G

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9
Q

What are the penicillinase resistant penicillins?

A

Nafcillin
Dicloxicillin
Oxacillin
*Methicillin

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10
Q

What are the extended spectrum pencillins?

A

Ampicillin

Amoxicillin

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11
Q

What are the antipseudomonal penicillins?

A

Piperacillin

Ticarcillin

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12
Q

What does pencillinase do?

A

It binds to the beta-lactam ring and hydrolyzes the ring, inactivating the antibiotic

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13
Q

What has the highest antibacterial activity against certain G+ bacteria, including anaerobic bacteria?

A

Natural penicillins

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14
Q

What are natural penicillins inactivated by?

A

B-lactamase (penicillinase)

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15
Q

How are natural penicillins elimated from the body?

A

Active transport in the kidney

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16
Q

If an drug is acid resistant, what should the route of administration be?

A

PO

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17
Q

Do natural penicillins have antipseudomonal activity?

A

No.

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18
Q

What type of bacteria are penicillinase resistant pencillins effective against?

A

G positive, but lower activity when compared to natural penicillins.
-No antipseudomonal activity

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19
Q

How are penicillinase resistant penicillins excreted from the body?

A

Hepatic metabolism and renal excretion

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20
Q

What is the mechanism of resistance for MRSA?

A

It produces an alternate PBP, which decreases the affinity of B-lactam antibiotics for PBPs

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21
Q

Can B-lactams be used to treat MRSA?

A

No, except for ceftaroline

22
Q

What kind of bacterial do extended spectrum penicillins work on?

A
  • Extended G- coverage (E. Coli, salmonella, shigella, H influenzae).
  • Lower G+ coverage
  • No antipseudomonal activity
23
Q

What is the drug of choice for lysteria infections?

A

Extended spectrum penicillins (Ampicillin, Amoxicillin)

24
Q

What are the 4 types of B-lactam antibiotics?

A

Penicillins, cephalosporins, monobactrams, and carbapenems

25
Q

Are extended spectrum penicillins acid resistant? What does this mean?

A

Yes, they are taken orally

26
Q

What ampicillin rash?

A

A generalized dull maculopapular rash generally appearing 3-14 days after the start of therapy. This is not an allergic or hypersensitivity reaction and patient does not need to be taken off of the ampicillin

27
Q

What bacteria do antipseudomonal penicillins target?

A

Major use is for pseudomonas aeruginosa and acinetobacter (lethal), but also targets bacteria covered by extended spectrum penicillins plus some additional enteric gram negative bacilli.

28
Q

How are antipseudomonal penicillins excreted?

A

Renal excretion

29
Q

Are antipseudomonal penicillins acid resistant? What does this mean?

A

No they are acid sensitive, they must be taken parenterally

30
Q

When treating P. Aeruginosa with an antipseudomonal penicillin, what else should be given to avoid resistance?

A

Aminoglycosides

31
Q

What does the addition of a beta lactamase inhibitor do to antibiotics such as ampicillin, amoxicillin, or piperacillin?

A

It extends the spectrum because it doesn’t let beta lactamase break down the drug

32
Q

If you have a combination product with a beta lactamase inhibitor, will it work against MRSA?

A

Nope

33
Q

What Beta lactamase inhibitor is ampicillin normally paired with?

A

Sulbactam, which forms Unasyn

34
Q

What Beta lactamase inhibitor is amoxicillin normally paired with?

A

Clavulanic acid, which formed augmentin

35
Q

What Beta lactamase inhibitor is piperacillin normally paired with?

A

Tazobactam, which forms Zosyn

36
Q

What Beta lactamase inhibitor is Ticarcillin normally paired with?

A

Clavulanic acid, which forms Timentin

37
Q

What are the toxicities that penicillin can have?

A
  • Allergy
  • electrolyte imbalance
  • GI disturbance
  • Superinfection
38
Q

What are the 5 pharmacokinetic factors of penicillins?

A

1) good tissue penetration
2) bad CNS penetration
3) mostly renal elimation (except for penicillinase resistant)
4) filtration and tubular excretion
5) Probenecid inhibits renal elimination

39
Q

What prescriptions are given for H. Pylori (Gram -)?

A

Bismuth + metronidazole + tetracycline or amoxicillin

40
Q

What prescriptions are given for lysteria (gram +) species?

A

Ampicillin and possibly aminoglycosides

41
Q

How is strep pneumoniae (gram +)treated?

A

Penicillin

42
Q

How is strep pyogenes (gram +)treated?

A

Penicillin and Clindamycin

43
Q

How is strep agalactiae (gram +) treated?

A

Penicillin and possible aminoglycosides

44
Q

How is Viridans strep (gram +)treated?

A

Penicillin

45
Q

How is methicillin resistant bacteria (gram +) treated?

A

Vancomycin

46
Q

How are the leptospira and treponema species (spirochetes) treated?

A

Penicillin

47
Q

How is early Borrelia Burgdorferi treated?

A

Amoxicillin

48
Q

What is the DOC for N. Meningitides, S. Pneumoniae, Strep A and B, enterococcus, Actinomyces, Leptospira, and treponema?

A

Natural penicillins

49
Q

What is the DOC for Beta lactamase staphylococcus aureus (MSSA)?

A

Penicillinase resistant pencillins (Nafcillin, Dicloxacillin, Oxacillin)

50
Q

What is the gold standard antibiotic treatment for G+ infections?

A

Natural Penicillins

51
Q

What are the three other antibiotics that are cell wall inhibitors, but not B-lactams?

A
  • Vancomycin
  • Bacitracin
  • Fosfomycin

Pharmacology (25 decks)

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