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pharmacology 3 > inhibitors of cell wall synthesis part 1 > Flashcards

inhibitors of cell wall synthesis part 1 Flashcards

1
Q

importance of bacterial cell wall? (4points)

A 
Surround and protect the cell
Provides rigidity 
Act as an attachment site 
Resist pressure changes 
If cell wall is lost, the cell will burst and will die
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2
Q

what is the role of the R group in penicillins?

A

determines stability to enzymes and acids, the antibacterial spectrum and hypersensitivity.

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3
Q

Name the enzyme that penicillins activate, which is responsible for the breakdown of peptidoglycans

A

autolysin

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4
Q

name the components of gram - bacterial cell wall

A

lipopolysaccharide
outer membrane
peptidoglycan
cytoplasmic membrane

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5
Q

name the components of gram + bacterial cell wall

A

peptidoglycan

cytoplasmic membrane

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6
Q

Are penicillins effect against mircroorganisms devoid of a cell wall?

A

no

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7
Q

name the natural penicillins

A 
penicillin G (benzyl penicillin)
penicillin v (phenoxymethyl penicillin)
procaine penicillin (benzyl penicillin procaine)
benzathine penicllin
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8
Q

all natural penicillins are unstable? true or false

A

true

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9
Q

penicillin G is used to treat

a. meningitis in children
b. nosocomial infections
c. nephrotoxcicity

A

meningitis in children

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10
Q

Name a drug effective against primary and secondary syphilis

A

penicllin

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11
Q

in gonorrhoea, penicillin resistant strains are treated with which 2 drugs?

A

ceftriaxone with septinomycin as a backup

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12
Q

why is penicllin G started initially and penicillin V continued when the clinical symptoms disappear?

A

such is done because the absorption of penicillin V is unpredictable

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13
Q

penicillin V is effective against anaerobes? true or false

A

true

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14
Q

name the antibacterial spectrum of penicllin g and penicillin v

A

G + cocci
G - cocci
G + bacilli
spirochetes

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15
Q

what is the common cause of penicillin G resistance?

A

mutations in one or more bacterial penicillin binding proteins

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16
Q

gonococcal opthalmia in neonates can be prevented by?

A

silver nitrate drops

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17
Q

what is the purpose of procaine in procaine penicillin? which route is it administered via?

A

procaine acts as an anesthetic by reducing pain at the site of injection.
given by IM route

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18
Q

when is benzathine penicillin used? what is its mechanism?

A

benzathine penicllin is used when prolonged low concentrations of benzyl penicillin are required.
benzylpenicillin dissociates and enters slowly into the bloodstream.

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19
Q

what are the indications of benzathine penicllin

A

rheumatic fever and early or latent syphilis, dosed every 2-4 weeks

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20
Q

antistaphylococcal penicillins are stable to penicillinase. True or false
name the antistaphylococcal penicillins

A

true
methicillin
cloxacillin

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21
Q

why is methicillin rarely used? when is it used?

A

rarely used because of its toxicity

used in MRSA

22
Q

cloxacillin is often prepared in combination with ___________.

A

amipicillin

23
Q

cloxacillin is unstable to acids but methicillin is stable. True or False?

A

false. methicillin is unstable and cloxacillin is stable.

24
Q

name the aminopenicillins and their stability status to penicillinase

A

ampicillin - unstable
amoxacillin - unstable
amoxacillin + clavulanic acid (augmentin) - stable

25
Q

aminopenicllins are unstable to acids. True or false

A

false. aminopenicllins are stable to acids

26
Q

what is the role of clavulanic acid in augmentin?

A

its is a beta lactamase inhibitor that protects the drug from enzymatic hydrolysis

27
Q

name a drug that cures listeria meningitis

A

ampicillin

28
Q

list an example of a drug used to combat sinusitis

A

ampicillin or amoxacillin

29
Q

name a drug used in the eradication of H.pylori

A

amoxacillin

30
Q

name two drugs used in dental surgical infections. One of them specifically works against oragnisms with penicillinase activity. identify which one.

A

amoxacillin used for prophylaxis in dental surgery

amoxacillin and clavulanic acid for severe dental infections (with penicillinase activity)

31
Q

name two drugs used in endocarditis infections

A

penicillin G and amoxacillin

32
Q

name the main activity that tazobactam imparts along with piparcillin

A

stability against penicillinase producing micro organisms.

33
Q

piparcillin is not effective against klebsiella. why?

A

due to constitutive penicillinase activity.

34
Q

antipseudomonal penicillins are unstable against acids. true or false?

A

true.

35
Q

piparcillin is active against. pseudomonas aeruginosa. true or false

A

true

36
Q

name the antipseudomonal penicillins

A

piparcillin

piparcillin + tazobactam

37
Q

name the penicillinase inhibitors. how do they work?

A

clavulanic acid
tazobactam
they are beta lactam structures with poor antibiotic activity but affinity to penicillinase enzyme so they block it and protect the drug.

38
Q

penicillin V can be given orally. true or false

A

true

39
Q

penicillins and aminoglycosides show synergism. why?

A

penicillins destroy the cell wall allowing aminoglycosides to enter and start inhibition of protein synthesis.

40
Q

penicillins and aminoglycosides should not be placed in the same infusion. why?

A

penicillin is - charged
aminoglycosides are + charged
they form an inacitve complex in the same infusion

41
Q

two reasons of natural resistance?

A

organism lacks cell wall

cell wall impermeable to penicillin

42
Q

three reasons of acquired resistance?

A

altered permeability
altered PBP
beta lactamase

43
Q

penicillin G penetrated the CSF when meninges are inflamed only. true or false

A

true

44
Q

penicillin G is given

a. oral
b. IV and IM
c. oral and IV
d. oral and IM

A

b. IV and IM

45
Q

penicillin G and penicillin V should be administered in the abscence of food. why? name other drugs with the same preference

A

delayed gastric emptying leads to prolonged contact with acidic environment
cloxacillin and augmentin

46
Q

amoxacillin has complete absorption so it is not used in the treatment of?

A

shigella and salmonella enteritis

47
Q

what is the primary route of excretion of penicillins

A

tubular secretion and glomerular filteration

48
Q

with penicillins, Impaired renal function requires dose adjustment. normal one hour but with impairment
___ hr.

A

10 hours

49
Q

what is penicillin combined with if prolonged release is desired? how does it work?

A

probenecid

inhibits penicillin secretion

50
Q

piparcillin + tazobactam is teratogenic because it crosses the placental barrier. true or false.

A

false. not teratogenic

51
Q

piparcillin + tazobactam crosses the BBB when meninges are not inflamed. true or false

A

false. only penetrates CSF when meninges are inflamed and as infection subsides BBB is re established.

52
Q

adverse reactions of penicillins (6 points)

A 
hypersensitivity 
diarrhoea 
nephrotoxicity 
neurotoxicity 
hematologic toxicities 
cation toxicity

pharmacology 3 (9 decks)

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