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pharm > exam 3 - OTHER INFO lecture 1 > Flashcards

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?

A
  • Cefepime
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?

A

imipenem

25
Q

what does dipeptidase do?

A

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
Q

what are the untoward effects for carbapenems?

A
  1. hypersensitivty
  2. GI upset
  3. seizures if it builds up in the kidney
27
Q

whcih drugs is really bad at casuing seizures than other drugs?

A

imipenem :(

28
Q

what is the pharmacokinets of monobactram and the half life?

A

given IV lives 2-3 hours
excreted out in the kidney

29
Q

what type of bacteria does vancomycin kill?

A

gram postive and C.diff (anaerobic)

30
Q

what is the MOA of vancomycin and where does it come from?

A
  • 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
Q

why is vancomyin soooo famous?

A

its the FIRST TO KILL MRSA
it also kills C.diff (anaerobic)

32
Q

what is the pharmacokinetics for vancomycin and the untwoard effect?

A
  • 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
Q

which med has a untoward effect of REDMAN

A

vancomycin

34
Q

when is difenhidramina antihistamine given?

A

its given before giving pt vancomycin due to the RED MAN effects

35
Q

when is daptomycin given?

A

when u are resistant to vancomycin

36
Q

what are the two daptomycin drus and its MOA?

A
  1. VRenterococcus faecalis
  2. VRstaphAureus

MOA = daptomycin goes into the bacteria creates a pore and bacteria dies from osmosis disequabillirum

37
Q

what is daptomycin untoward effect and when can u NOT GIVE IT ?

A
  • 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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