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Zey øving > Inhibitors of bacterial cell wall synthesis 2 > Flashcards

Inhibitors of bacterial cell wall synthesis 2 Flashcards

1
Q

Third-generation cephalosporins

A

Cefdinir
Cefotaxime
Ceftazidime
Ceftriaxone

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2
Q

Third-generation cephalosporins active against

A

Wider range of gram-negative organisms including enteric gram-negative bacilli (Enterobacteriaceae), H. influenzae, and M. catarrhalis

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3
Q

Fourth-generation cephalosporin

A

Cefepime

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4
Q

Fourth-generation cephalosporin active against

A

P aeruginosa, Enterobacteriaceae, S aureus, and S pneumoniae. It is highly active against Haemophilus and Neisseria sp.

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5
Q

Carbapenem with high affinity for PBP-2

A

Imipenem

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6
Q

Carbapenem that binds both PBP-2 and PBP-3

A

Meropenem

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7
Q

Cefoxitin - Clinical use

A

Surgical prophylaxis for gram-neg

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8
Q

Cefoxitin - Adverse effects

A

Hypersensitivity (rare, cross-sensitivity to penicillins):
Anaphylaxis, fever, skin rashes, nephritis, granulocytopenia, hemolytic anemia

Local irritation: pain after IM injection, thrombophlebitis after IV

Renal toxicity (intersitial nephritis, tubular necrosis)

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9
Q

Ceftazidime - Clinical use

A

AVYCAZ: ceftazidime + avibactam

Intraabdominal infections
UTIs
Pneumonia

P. aeruginosa and other gram-negative bacteria

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10
Q

Ceftazidime - Special considerations

A

Resistant to some Class-C β-lactamases such as Amp C cephalosporins, TEM, SHV

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11
Q

Ceftazidime, Cefpodoxime, Cefotaxime, Ceftriaxone - Adverse effects

A

Hypersensitivity (rare, cross-sensitivity to penicillins):
Anaphylaxis, fever, skin rashes, nephritis, granulocytopenia, hemolytic anemia

Local irritation: pain after IM injection, thrombophlebitis after IV

Renal toxicity (intersitial nephritis, tubular necrosis)

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12
Q

Cefpodoxime, Cefotaxime - Clinical use

A

Gonorrhea

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13
Q

Ceftriaxone - Clinical use

A

Gonorrhea, UTIs, otitis, meningitis, pneumonia, Lyme disease – Gonococci, pneumococci, meningococci, B. burgdorferi, H. influenzae

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14
Q

Cefepime - Clinical use

A

Intraabdmonial infections
UTIs
Pneumonia
Skin and soft tissue infections

Drug-resistant gram-negative bacilli, including Citrobacter and Enterobacter species

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15
Q

Cefepime - Adverse effects

A

Drug induced encephalopathy
Hypersensitivity (rare, cross-sensitivity to penicillins):
Anaphylaxis, fever, skin rashes, nephritis, granulocytopenia, hemolytic anemia

Local irritation: pain after IM injection, thrombophlebitis after IV

Renal toxicity (intersitial nephritis, tubular necrosis)

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16
Q

Ceftaroline - Clinical use

A

Community-acquired pneumonia
Skin and soft tissue infections

MRSA, Drug resistant pneumococci

17
Q

Ceftaroline - Adverse effects

A

Hypersensitivity (rare, cross-sensitivity to penicillins):
Anaphylaxis, fever, skin rashes, nephritis, granulocytopenia, hemolytic anemia

Local irritation: pain after IM injection, thrombophlebitis after IV

Renal toxicity (intersitial nephritis, tubular necrosis

18
Q

Azetreonam - Clinical use

A

Aerobic gram-negative bacilli

Enterobacter, Citrobacter, Klebsiella, Proteus, P. aeruginosa

UTIs, gynecological, intra-abdominal, skin, lung infections
Pneumonia
Meningitis
Sepsis

19
Q

Azetreonam - Special considerations

A

Cross-sensitivity for penicillin is not common

Not stable to Amp C β-lactamase, extended spectrum β-lactamases

20
Q

Azetreonam - Adverse effects

A

Hypersensitivity reactions
Thrombophlebitis
Skin rashes
Increases level of serum aminotransferase

21
Q

Carbapenems - Clinical use

A

Active against gram (-) rods- P. Aeruginosa, and gram (+) org.
Endocarditis
Pneumonia
UTIs
Pelvic, skin, soft tissue, intra-abdominal inf.
Meningitis, febrile neutropenia,
sepsis

22
Q

Imipenem - Special considerations + Contraindications

A

Resistant to most b-lactamases but not carbapenemase of metallo b-lactamase.

Excessive levels of imipenem in patients with renal failure may lead to seizures

23
Q

Carbapenems - Adverse effects

A 
Cross-sensitivity with penicillin allergy
Seizures in patients with epilepsy 
Diarrhea
Vomiting
Anemia
Leukopenia
Thrombocytopenia
Altered bleeding time
24
Q

Imipenem - Interactions

A

Cilastatin: dehydropeptidase inhibitor that increases time of activity of imipenem.

25
Q

Vancomycin - Clinical use

A

Gram-positive cocci and bacilli, MRSA

Streptococcal and enterococcal infections caused by penicillin-resistant organisms, including endocarditis and necrotizing fasciitis

Meningitis caused by penicillin-resistant strain of pneumococcus (in combination with cefotaxime, ceftriaxone, or rifampin)

Bacillus, Clostridium, Cornyebacterium species

Bone and joint, skin and soft tissue infections
Pneumonia
Septicemia
Endocarditis

26
Q

Vancomycin, Telavancin - Adverse effects

A

Reduced nephro- and ototoxicity now compared to before
Hypotension and erythematous rash with to quick infusion (called red man syndrome)

Vestibular dysfunction (ataxia, vertigo, nystagmus, nausea)

Cochlear dysfunction (tinnitus, hearing loss)

Irritating to tissue –>phlebitis at site of injection

Chills, fever

27
Q

Vancomycin - Interactions

A

Aminoglycosides and amphothericin B: Increased nephrotoxicity

28
Q

Telavancin - Clinical use

A

Skin and soft tissue inf by MSSA+ MRSA + vancomycin-sensitive E. faecalis

29
Q

Telavancin - Contraindications

A

Do not administer to pregnant women, it is teratogenic

30
Q

Bacitracin - Clinical use

A

Gram-positive cocci, including staphylococci and streptococci

Skin and eye infections

Combined with polymyxin and neomycin

31
Q

Bacitracin - Special considerations

A

Used only for topical treatment

32
Q

Bacitracin - Adverse effects

A

Very nephrotoxic

33
Q

Fosfomycin - Clinical use

A

Enterococci and many gram-negative enteric bacilli, including E. coli, Citrobacter, Klebsiella, Proteus, Serratia marcescens

Uncomplicated UTIs by E. coli or E. faecalis

34
Q

Fosfomycin - Adverse effects

A

Diarrhea

35
Q

Bacitracin - MoA

A

Inhibition of regeneration of bactoprenol phosphate (C55-isoprenyl P)

36
Q

Fosfomycin - MoA

A

Inhibiton of enolpyruvyl transferase, blocks the addition of phosphoenolpyruvate to UDP-GlcNAc, prevents synthesis of UDP-MurNAc

37
Q

Cephalosporins - MoA

A

Binds to PBPs, inhibiting cross-linking of peptidoglycan -> inhibition of bacterial cell wall synthesis.

38
Q

Carbapenems - MoA

A

Binds to PBPs, inhibiting cross-linking of peptidoglycan -> inhibition of bacterial cell wall synthesis.

39
Q

Vancomycin - MoA

A

Binds to peptidoglycan and prevents cross linking. Inhibit cell wall synthesis.

Zey øving (7 decks)

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