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exam 3 - OTHER INFO lecture 1 Flashcards

1
Q

what two layers does the cell wall consist of and explain what they are?

A
  1. phospholipid bilayer (outer layer)
  2. peptidoglycan layer (thicker, has gram neg more than post)
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2
Q

what two components does the peptidoglycan layer have? what is the peptapeptide?

A
  1. n-acetylglycosamine, NAG
  2. n-acetylmuramic acid, NAM

they are opposing strands of amino sugars

peptapeptide DANGLES down from the NAM

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3
Q

what is the transpeptidase reaction? how does transpeptidase work?

A
  1. it is the formation and last stop of the peptidoglycan layer
  2. Transpeptidase is an enzyme that carries out the PCN binding protein
  • transpeptidase work by linking the terminal alanien and lysine to make ONE SOLID THICK BARRIER of the peptidoglycan layer
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4
Q

what is the MOA of b-lactam ABX? what happens if a bacteria has no cell wall?

A
  • they all INHIBIT THE protein binding protein (transpeptidase rx) that links the two opposing layers tg

No cell wall = death :(

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5
Q

what are the two PCN we learned? what is their unit? and pharmacokinetics?

A
  1. PCN G (benzyl) - IV
  2. PCN V (benzathine) - PO
    the PO is used for minor infection, has poor bioavail, and narrow spectrum

unit - 0.6mg

pharmacokinetics - IV and PO, subject to hepatic metabolism but not all prob around 75-80% then renal excretion

half life - 30-1 hour in normal people but if you have kidney disease then its longer so be careful

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6
Q

what is the semisynethic PCN called? what group does it now include?

A

ISOXAZOLYL PENICILLINS
it now include stappococci

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7
Q

what are the 5 drugs part of the ISOXAZOLYL PENICILLINS group? are they PO or IV?

A

MC-DNO
1. methicilin - 1st drug but stapococci develoepd resisitance to this quickly
2.cloxacillin - PO
3. dicloxacillin - FAMOUS! GIVEN PO OR IV - reapidly excrete by the kidney
4. Nafcillin - IV high rate of nephrotoxicity :( so not used often
5. Oxacillin - IV

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8
Q

when do u use isoxazolyl pcn?

A

it includes strapyloccoci so use it for S.epiderminis and MSSA

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9
Q

what enzyme hydrolzyes the bond between C and N in b-lactam ring?

A

b-lactamase (penicillinase) hydrolzyes the bond between C-N in B-lactam making it useless

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10
Q

what is the pentagon ring called in b-lactam? what does it have?

A

thiazoline ring - has a sulfar

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11
Q

what are the TWO B-lactam drugs that contains thaizoline?

A

monobactams
carbapenems

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12
Q

why/how would carbapenem be resistance to many b-lactamases?

A

it would be resistance bc although it does contain thaizoline ring, it DOES NOT HAVE SULFA in the ring itself (normaly it would) –> this alters the sterochemical configuration of the molecule

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13
Q

what is the pharmacokinetics for aminopenicillins?

A

excreted by the kidney make sure of renal failure

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14
Q

what are the three B-lactamase inhibitors?

A
  1. clavulante acid
  2. tazobactam
  3. sulbactam
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15
Q

what are the untowrd effect of PCN?

A
  1. anaphylaxis - can happen due to the degradation of the product that triggers a immune repsonse
  2. varing severity of anaphalyxis
  3. desensitzation in preg women
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16
Q

what are the untoward effects of PCN, naficillin, oxacillin, ampicillin, ampicllin+amoxicillin?

A
  1. PCN - casues seizurs when it builds up in the renals, GI upset too
  2. nafcillin - neutropenia (low WBC)
  3. oxacillin - hepatitis, so be careful w advance liver dz
  4. ampicillin - wipes out gut floor except C.DIFF now needs to tx that
  5. ampicillin and amoxicillin - dont give to viral infection since it will casue a BAD RASH
17
Q

what is the MOA for cephalosporin?

A

same moa as PCN
- the B lactam ring binds to the transpeptidase so that it prevents the formation of the cell wall

18
Q

what are the three drugs in cephalopsporin 1st gen?

A
  1. cefazolin
  2. cephelexin
  3. cephradine
  4. cefadroxil
19
Q

what are the four 2nd gen cephalosporin drugs?

A
  1. cefuroxime
  2. cefoxitime
  3. cefotetan
  4. cefaclor
20
Q

what are the four 3rd gen cephalosproin drugs?

A
  1. ceftriaxone
  2. cefotaxime
    • Ceftazidime and cefoperazone
21
Q

what is the 4th gen cephalosporin drug?

22
Q

what are the four untwoard effect of cephalosporin?

A
  1. allergy
  2. HYPOprothrombinemia
  3. Difulfiram like rx
  4. hemolytic anemia
23
Q

what are the 4 carbapenem drugs?

A
  1. imipenem
  2. meropenem
  3. doripenem
  4. ertapenem
24
Q

which carbapenem should be given with cilastatin?

25
what does dipeptidase do?
it breaks down imipenem to toxic products which can be harmfull so imipenem HAS TO BE GIVEN W cilastatin to prevent dipeptidase from doing its job
26
what are the untoward effects for carbapenems?
1. hypersensitivty 2. GI upset 3. seizures if it builds up in the kidney
27
whcih drugs is really bad at casuing seizures than other drugs?
imipenem :(
28
what is the pharmacokinets of monobactram and the half life?
given IV lives 2-3 hours excreted out in the kidney
29
what type of bacteria does vancomycin kill?
gram postive and C.diff (anaerobic)
30
what is the MOA of vancomycin and where does it come from?
- comes from streptococcus oreintalis - MOA = binds to terminal alanine of the peptidogylcan layer - bc of this alaine CANNOT CROSS LINK W LYSINE - PREVENTS CELL WALL FROM FORMING - cell DIES
31
why is vancomyin soooo famous?
its the FIRST TO KILL MRSA it also kills C.diff (anaerobic)
32
what is the pharmacokinetics for vancomycin and the untwoard effect?
- given IV except when tx C.diff then PO - half life 6 hours, excreted in the kidney so be careful w renal failure untoward effect: - REDMAN - ppl will get histamine release so u need to pre treat pt with (difenhidramina antihistamine) - nephrotoxcitiy - will accumlate in kidney
33
which med has a untoward effect of REDMAN
vancomycin
34
when is difenhidramina antihistamine given?
its given before giving pt vancomycin due to the RED MAN effects
35
when is daptomycin given?
when u are resistant to vancomycin
36
what are the two daptomycin drus and its MOA?
1. VRenterococcus faecalis 2. VRstaphAureus MOA = daptomycin goes into the bacteria creates a pore and bacteria dies from osmosis disequabillirum
37
what is daptomycin untoward effect and when can u NOT GIVE IT ?
- myotoxcitiy - so check CK levels to avoids rhabdo - YOU CANNOT GIVE IT TO PUL INFECTION - it can get in contact w surfactants and suraactants will destroy the drgu

pharm (13 decks)

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