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Pharmacology > Exam 4 - Drugs That Weaken The Bacterial Cell Wall > Flashcards

Exam 4 - Drugs That Weaken The Bacterial Cell Wall Flashcards

1
Q

How do penicillins work?

A

*Bactericidal
They weaken the cell wall, causing bacteria to take up excessive water and rupture

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2
Q

What type of bacteria is penicillin more effective at killing and why?

A

Gram-positive bacteria because there are only two layers of cell envelope that is easily accessible for the penicillin

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3
Q

What are beta-lactamases?

A

Enzymes that render penicillin inactive
Bacteria can produce a large variety of these enxymes specific for penicillins (and other beta-lactam antibiotics)

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4
Q

How do bacteria become resistant to antibiotics, specifically penicillin?

A

Penicillinases (a type of beta-lactamase)

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5
Q

Classifications of penicillins

A

Narrow spectrum penicillins (pencillinase-sensitive)
Narrow spectrum penicillins (pencillinase-resistant)
Broad spectrum penicillins
Extended spectrum penicillins

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6
Q

Prototype penicillin

A

Penicillin G (Benzylpenicillin)

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7
Q

What type of bacteria does penicillin G kill?

A

Numerous gram-positive and some gram-negative organisms

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8
Q

What is the most common cause of drug allergy?

A

*Penicillins

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9
Q

If a pt has a penicillin allergy, what should you ask them?

A

What their reaction to it was
Mild or anaphylaxis

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10
Q

What should you do for a pt who says they have had a mild reaction to penicillin, vs. a history of anaphylaxis?

A

Mild: consider cephalosporin
*Anaphylaxis: avoid administration of penicillin or cephalospirin

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11
Q

Possible timings of penicillin allergy

A

Immediate (reaction in 2-30 mins)
Accelerated (reaction in 1-72 hrs)
Late (reaction takes days or weeks to develop)

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12
Q

What symptoms occur with anaphylaxis?

A

Laryngeal edema
Bronchoconstriction
Severe hypotension

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13
Q

*Treatment of anaphylaxis

A

*Epinephrine
*Respiratory support (if needed)

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14
Q

How to prevent a penicillin allergy

A

Skin testing

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15
Q

Drug interactions of penicillin

A

Aminoglycosides (may still be given together but cant be mixed in same IV bag)

Penicillin V

Probenecid

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16
Q

Penicillinase-Resistant Penicillins in the US

A

Nafcillin
Oxacillin
Dicloxacillin

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17
Q

What does MRSA stand for?

A

Methicillin-resistant staphylococcus aureus

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18
Q

Another name for broad spectrum penicillins

A

Aminopenicillins

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19
Q

Examples of broad-spectrum penicillins

A

Ampicillin (Principen)
Amoxicillin

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20
Q

Adverse effects of broad spectrum penicillins

A

Rash
Diarrhea

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21
Q

How can broad spectrum penicillins be administered?

A

PO
IV

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22
Q

Another name for Extended spectrum penicillins

A

Antipseudomonal penicillins

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23
Q

Example of extended spectrum penicillin

A

Piperacillin

24
Q

Key points about penicillins

A

Bacteriocidal
Low toxic unless you’re allergic

25
*Most widely used group of antibiotics
*Cephalosporins
26
Structure of cephalosporins
Beta-lactam ring (similar to penicillin structure)
27
Key points about cephalosporins
Bactericidal Low toxicity
28
How are cephalospirins typically administered?
Parenterally
29
How to cephalosporins work?
Bind to penicillin-binding proteins (PBP’s), disrupt cell wall synthesis, and cause cell lysis
30
Explain the generations of Cephalosporins
5 generations Gen 1 &2 are more mild Get stronger as you get to gen 5 3, 4, 5th gen more resistant than 1st and 2nd
31
What is 1st generation of cephalosporins used for?
Prophylaxis against infection in surgical patients
32
What are second generation cephalosporins used for?
More activity against gram-negative bacteria (used in combinations)
33
What are 3rd generations cephalosporins used for?
Highly effective against gram-negative organisms *Able to penetrate to CSF in effective concentrations *B/c of this, used to treat meningitis
34
What are 4th generation cephlosporins used for?
Healthcare and hospital associate pneumonias Including those resistant to Pseudomonas
35
What are 5th generation cephalosporins used to treat?
Infections associated with MRSA
36
Examples of 1st generation cephalosporins
Cephalexin (Keflex) Cefazolin (Ancef)
37
Examples of 2nd generation cephalosporins
Cefoxitin (Mefoxin) Cefaclor (Ceclor)
38
Examples of 3rd generation cephalosporins
Ceftazidime (Fortaz) Cefotaxime (Claforan)
39
Example of fourth generation cephalosporin
Cefepime (Maxipime)
40
Example of 5th generation cephalosporin
Ceftaroline (Teflaro)
41
Drug interactions with cephalosporins
Probenecid Alcohol Drugs that promote bleeding Calcium Ceftriaxone
42
Adverse effects of cephalosporins
Allergy - hypersensitivity, rash Bleeding Thrombophlebitis
43
What are carbapenems?
Beta-lactam antibiotics that have an extremely broad antimicrobial spectrum And are *Not active against MRSA
44
Prototype Carbapenem
Imipenem (Primaxin)
45
Other types of carbapenems
Meropenem (Merrem IV) Ertapenem (Invanz)
46
What is Imipenem (Primaxin) used for?
Gram pos and neg bacteria Most effective beta-lactam antibiotic for use against *anaerobic bacteria
47
Adverse effects of carbapenems
GI interactions Rash
48
How does Vancomycin work?
Inhibits cell wall synthesis (much stronger antibiotic)
49
Uses of vancomycin
*Severe infections only MRSA Staphylococcus epidermidis C. Diff
50
Administration of vancomycin
IV (must be given slowly over an hour) And now can be given PO
51
Adverse effects of Vancomycin
*Renal failure Ototoxicity *Red man syndrome Thrombophlebitis (common) Thrombocytopenia (rare) Allergy
52
S/S that occur when Vancomycin is given too quickly
Flushing Tachycardia Hypotension
53
Antibiotic used only for gram negative aerobic bacteria
Class: Monobactams Drug: Aztreonam (Azactam)
54
Administration of Aztreonam (Azactam)
Must be given IV or IM
55
Antibiotic used for VAP (vent acquired pneumonia)
Class: lipoglycoproteins Drug: Telavancin (Vibativ)
56
Administration of Vibativ
IV
57
Adverse effects of Vibativ
Prolong QT interval

Pharmacology (16 decks)

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