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pharm exam 2 > inhibitors of cell wall synthesis > Flashcards

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
Q

what group is Dicloxacillin (Cloxapen) in

A

Penicillinase-resistant penicillins

26
Q

route of administration of Dicloxacillin

A

oral

27
Q

what group is Oxacillin in

A

Penicillinase-resistant penicillins

28
Q

route of administration of Oxacillin

A

oral

29
Q

mechanism of resistance of MRSA

A
  • produces an alternate PBP which decreases affinity of the B-lactam Abx to PBP
30
Q

what is the only B-lactam that can be used to treat MRSA

A

Ceftaroline

31
Q

extended spectrum penicillins have what coverage

A
  • lower G+ coverage
  • extended G- coverage
32
Q

extended spectrum penicillins are ineffective against what organism

A

no antipseudomonal activity

33
Q

DOC for Lysteria infections

A

extended spectrum penicillins

34
Q

what group is ampicillin in

A

extended spectrum penicillins

35
Q

route of administration of extended spectrum penicillins

A

oral

36
Q

what group is amoxicillin in

A

extended spectrum penicillins

37
Q

what is the ampicillin rash

A
  • 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
Q

high percentage of patients with what infection will develop a ampicillin rash during therapy with ampicillin

A

infectious mononucleosis (EBV)

39
Q

coverage of antipseudomonal penicillins

A
  • extended spectrum penicillins plus some enteric G-
40
Q

major use of antipseudomonal penicillins

A
  • pseudomonas aeruginosa
  • acinetobacter
41
Q

can antipseudomonal penicillins be used as a seperate abx

A

NO

  • used in combination with aminoglycosides to prevent resistance
42
Q

what group is Pipercillin in

A

antipseudomonal penicillins

43
Q

what group is Ticarcillin in

A

antipseudomonal penicillins

44
Q

What are Clavulanic acid, Sulbactam, and Tazobactam

A

B-lactamase inhibitors

45
Q

function of B-lactamase inhibitors

A
  • added to ampicillin, amoxicillin, ticarcillin, piperacillin to extend the spectrum to include organisms that are resistant to B-lactamase (penicillinase)
46
Q

are the penicillins used in combo with B-lactamase inhibitors active against MRSA?

A

no

47
Q

Route of administration of ampicillin; sulbactam (Unasyn)

A

parenteral

48
Q

route of administration of amoxicillin; clavulanic acid (augmentin)

A

oral

49
Q

Route of administration of piperacillin; tazobactam (Zosyn)

A

IV

50
Q

route of administration of Ticarcillin; Clavulanic acid (timentin)

A

IV

51
Q

different functions of bacterial B-lactamase (penicillinase)

A
  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
Q

toxicity of penicillins

A

allergy

53
Q

abx choice for early infection of borrelia burgdorferi

A

amoxicillin or doxycycline

pharm exam 2 (9 decks)

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