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Pharmacology > L22: Penicillins - condensed > Flashcards

L22: Penicillins - condensed Flashcards

1
Q

What are the 4 subgroups of B-lactams?

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

What causes resistance to b-lactams?

A

Lactamase enzymes; altered penicillin binding protein

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3
Q

Which group to: nafcillin, oxacillin, cloxacillin, and dicloxacillin belong to (NO CD)?
A. Aminopenicillins
B. Antipseudomonal
C. Natural
D. Antistaphylococcal

A

D. Antistaphylococcal

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4
Q

Ampicillin and Amoxicillin belong to which group?
A. Aminopenicillins
B. Antipseudomonal
C. Natural
D. Antistaphylococcal

A

A. Aminopenicillins

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5
Q

Piperacillin, carbencillin and tiracarcillin belong to which group?
A. Aminopenicillins
B. Antipseudomonal
C. Natural
D. Antistaphylococcal

A

B. Antipseudomonal

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6
Q

True or False: Lactamase inhibitors are co-formulated with penicillins and other b-lactams to protect against degradatin by lactamase enzymes

A

True

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7
Q

B-lactams inhibit _____ ____ ____ crosslinking

A

transpeptidase-mediated peptidoglycan crosslinking

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8
Q

Transpeptidase mistakenly uses lactam as substrate, which leads to ____ ____

A

irreversible inhibition

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9
Q

True or False: When B-lactams are used, cell wall is weakened, leaving it vulnerable to osmotic stress and rupture. As a result, all non-replicating cells die

A

False - all replicating cells die

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10
Q

______: bacterial proteins that bind to penicillins and cephalosporins

A

Penicillin binding proteins

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11
Q

True or False: All bacteria with cell walls contain PBP’s

A

True

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12
Q

Alteration in penicillin binding protein result in resistance typical of ___

A

MRSA

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13
Q

True or False: Structural differences and mutations in PBP’s mean that they do not bind B-lactam drugs

A

True

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14
Q

What does the term “methicillin resistant” describe?

A

Organisms resistant to many b-lactams

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15
Q

MRSA/ORSA refers to resistance to almost all B-lactams, including all cephalosporins, except 5th gen agent known as ___

A

ceftaroline

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16
Q

What is the leading cause of surgical site infection in both tertiary and community acquired hospitals?

A

ORSA

17
Q

How can you identify B-lactamase production?

A

Nitrocefin test (uses substrate that changes color when degraded by lactamase)

18
Q

When are penicillins more effective?
A. log stage
B. stationary growth stage

A

A. log stage

19
Q

True or False: Bacteria that persist inside host cells are not accessible to B-lactams

A

True

20
Q

True or False: Penicillins are time dependent, bactericidal agents

A

TRue

21
Q

True or False: Probenacid keeps drugs like penicillins in circulation for longer

A

True

22
Q

Which antibiotic is drug of choice for syphilis?

A

Penicilin G

23
Q

Which was the first oral penicillin

A

Penicillin V/K

24
Q

True or False: Anti-staphylococcal penicillins are stable towards Staph penicilinases

A

true

25
Q

The bulky R group of ___ penicillins inhibits staph beta-lactamase enzymes

A

Anti-staphylococcal

26
Q

True or False: Ampicillin and amoxicillin are effective against HELP ME

A

True

27
Q

The amino group of aminopenicillins carries a ___ charge that facilitates passage through porins of gram (-)

A

positive

28
Q

True or False: Ampicillins is better than Amoxicillin for oral therapy

A

False - Amox > Amp

29
Q

B lactamase inhibitors protect penicillins from hydrolysis, thereby functioning as ____ inhibits of bacterial b-lactamase

A

irreversible suicide inhibitors

30
Q

True or False: Piperaciiin is a better anti-pseudomonal penicillin

A

True

31
Q

Although Piperacillin is inactive against most Staph, it is vulnerable to ___ lactamases

A

gram (+)

32
Q

Piperacilin + _____ has widest spectrum of penicillins

A

Tazobactam

33
Q

For S. aureus strain without resistance…..

A

Penicilin>oxacillin>vancomycin

34
Q

When fetal B-lactam allergies involve ___ or ___ failure

A

respiratory; CV

35
Q

How can you screen for a penicillin allergy?

A

Pre-Pen (major determinant)

36
Q

True or False: All b-lactams can cause serum-sickness like reaction

A

True

37
Q

true or false: failure rate for combo OC will go up after ABX

A

True

38
Q

True or False: Amoxicillin/ampicillin rash may look serious, but its not

A

True

39
Q

What may contribute to Amoxicillin/ampicillin rash?

A

Viral infection
- Not antibody mediate
- Does not increase risk of true penicillin allergy

Pharmacology (53 decks)

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