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inhibitors of cell wall synthesis Flashcards

1
Q

structure conferring cell wall rigidity and resistance to osmotic lysis in both G+ and G- bacteria

A

peptidoglycan

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2
Q

difference between G+ and G-

A
  • G+: peptidoglycan is the only layered structure external to the cell membrane and it is thick
  • G-: outer membrane external to a very thin peptidoglycan
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3
Q

peptidoglycan is composed of a backbone of what two alternating sugars

A
  • N-acetylglucosamine (NAG) and N-acetylmuramic acid (NAM)
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4
Q

a chain of four amino acids is linked to what sugar in the peptidoglycan

A

N-acetylmuramic acid (NAM)

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5
Q

a peptide bridge cross links the tetrapeptide chains in the peptidoglycan. Which two amino acids are connected

A

D-gln and D-ala

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6
Q

inhibition of any stage of the synthesis, export, or assembly of peptidoglycan leads to what

A

bacterial cell death

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7
Q

how are abx that inhibit cell wall synthesis bactericidal

A
  • cell death due to osmotic lysis
  1. ​loss of cell wall integrity is due to bacteria’s autolysins which cleave peptidoglycan bonds in normal course of cell growth
  2. with abx, autolysis proceeds without normal cell wall repair
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8
Q

name the 4 B-lactams abx

A
  1. penicillins
  2. cephalosporins
  3. monobactams
  4. carbapenems
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9
Q

name the 4 natural penicillins. which is the prototype?

A
  1. penicillin G
  2. Benzathine penicillin
  3. Probaine Penicillin
  4. Penicillin V
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10
Q

name the 3 penicillins that are penicillinase resistant. which is the prototype?

A
  • Nafcillin
  • Dicloxacillin
  • Oxacillin
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11
Q

name the penicillins that have extended spectrum. which is the prototype?

A
  • Ampicillin
  • Amoxicillin
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12
Q

name the penicillins that are antipseudomonal. which is the prototype?

A
  • piperacillin
  • ticarcillin
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13
Q

what is the mechanism of action of penicillins

A

prevent transpeptidation (cross links pentapeptides of peptidoglycan)

  • prevent the action of penicillin binding protein
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14
Q

what group of abx has the highest antibacterial activity against certain G+ bacteria

A

natural penicillins

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15
Q

coverage of natural penicillins

A
  • Highest coverage against certain G+
  • some G- coverage
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16
Q

natural pencillin don’t cover what organisms

A
  • inactivated by B-lactamase (penicillinase): not effective against strains of S. aureus
  • No antipseudomonal activity
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17
Q

route of Penicillin G

A
  • IV
  • IM
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18
Q

route of Benzathine penicillin

A

IM

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19
Q

route of Procaine penicillin G

A

IM

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20
Q

route of Penicillin V

A

oral

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21
Q

coverage of Penicillinase-Resistant Penicillins

A
  • lower activity against G+
  • some G-
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22
Q

what is the DOC for penicillinase producing S. aureus (MSSA)

A

Penicillinase-resistant penicillins

23
Q

what group is Nafcillin in

A

Penicillinase-resistant penicillins

24
Q

route of administration of Nafcillin

A
  • parenteral
25
what group is Dicloxacillin (Cloxapen) in
Penicillinase-resistant penicillins
26
route of administration of Dicloxacillin
oral
27
what group is Oxacillin in
Penicillinase-resistant penicillins
28
route of administration of Oxacillin
oral
29
mechanism of resistance of MRSA
* produces an **alternate PBP** which decreases affinity of the B-lactam Abx to PBP
30
what is the only B-lactam that can be used to treat MRSA
Ceftaroline
31
extended spectrum penicillins have what coverage
* lower G+ coverage * extended G- coverage
32
extended spectrum penicillins are ineffective against what organism
no antipseudomonal activity
33
DOC for Lysteria infections
extended spectrum penicillins
34
what group is ampicillin in
extended spectrum penicillins
35
route of administration of extended spectrum penicillins
oral
36
what group is amoxicillin in
extended spectrum penicillins
37
what is the ampicillin rash
* occurs in 5-10% of children receiving extended spectrum penicillins * dull, red, maculopapular rash * onset: 3-14 after start of Abx \*\*rash is not allergic
38
high percentage of patients with what infection will develop a ampicillin rash during therapy with ampicillin
infectious mononucleosis (EBV)
39
coverage of antipseudomonal penicillins
* **extended spectrum penicillins plus** some enteric G-
40
major use of antipseudomonal penicillins
* pseudomonas aeruginosa * acinetobacter
41
can antipseudomonal penicillins be used as a seperate abx
NO * used in combination with **aminoglycosides** to prevent resistance
42
what group is Pipercillin in
antipseudomonal penicillins
43
what group is Ticarcillin in
antipseudomonal penicillins
44
What are Clavulanic acid, Sulbactam, and Tazobactam
B-lactamase inhibitors
45
function of B-lactamase inhibitors
* added to ampicillin, amoxicillin, ticarcillin, piperacillin to _extend the spectrum_ to include organisms that are resistant to B-lactamase (penicillinase)
46
are the penicillins used in combo with B-lactamase inhibitors active against MRSA?
no
47
Route of administration of ampicillin; sulbactam (Unasyn)
parenteral
48
route of administration of amoxicillin; clavulanic acid (augmentin)
oral
49
Route of administration of piperacillin; tazobactam (Zosyn)
IV
50
route of administration of Ticarcillin; Clavulanic acid (timentin)
IV
51
different functions of bacterial B-lactamase (penicillinase)
1. alteration of PBP 2. decreased permeability of bacteria cell to PCN 3. autolytic enzymes not being activated -\> forming tolerant organisms (bacteria become dormant) 4. lack of cell wall
52
toxicity of penicillins
allergy
53
abx choice for early infection of borrelia burgdorferi
amoxicillin or doxycycline

pharm exam 2 (9 decks)

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