lect 14: inhib cell wall syn II Flashcards by Alex Steinmann | Brainscape

Q

what is the mechanism of action of cephalosporins

A

activate cell wall autolytic enzymes through blocking terminal cross-linking of peptidoglycan

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Q

structure of cephalosporins

A

beta-lactam ring structure

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Q

what is cephalosporins advantage over penicillins

A

cephalosporins have a R group that increases their resistance to B-Lactamase

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Q

what is the prototype first generation cephalosporins

A

cefazolin

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Q

what group is cefazolin in

A

first generation cephalosporins

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Q

what group is cephalexin in

A

first generation cephalosporins

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Q

route of administration of cefazolin

A

parenteral

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Q

route of administration of cephalexin

A

oral

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Q

what do first generation cephalosporins target

A

G+; G-
most G+ cocci are susceptible

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Q

what group of cephalosporins can be used for MSSA

A

first generation cephalosporins

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Q

what is the DOC for surgical prophylaxis

A

Cefazolin (first generation cephalosporin)

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Q

what do second generation cephalosporins target

A

G+
increased G- activity

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Q

what can second generation cephalosporins not work on

A

no antipseudomonal activity

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Q

what group is cefaclor in

A

second generation cephalosporins

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Q

what group is cefuroxime in

A

second generation cephalosporins

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Q

what group is cefprozil in

A

second generation cephalosporins

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Q

what is the prototype second generation cephalosporins

A

Cefaclor

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Q

which of the second generation cephalosporins can be administered parenterally

A

Cefuroxime

*the other two are administered orally

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Q

which of the cephalosporins are broad spectrum

A

third generation cephalosporins

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Q

what group is ceftriaxone (Rocephin) in

A

third generation cephalosporins

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Q

what group is Cefotaxime sodium (Claforan) in

A

third generation cephalosporins

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Q

which group is Ceftazidime (fortaz) in

A

third generation cephalosporins

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Q

which group is cefixime in

A

third generation cephalosporins

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Q

what is the only third generation cephalosporin that is administered orally

A

Cefixime

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Q

which two third generation cephalosporins are able to penetrate the CNS

A

Ceftriaxone
Cefotaxime sodium

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Q

what is the prototype third generation cephalosporins

A

Ceftriaxone

Q

which organism is Ceftriaxone specifically used against?

A

Neisseria

Q

what organism is Ceftazidime specifically used against

A

Pseudomonas Aeruginosa

Q

DOC of N. Gonorrhoeae? When should you not use it though?

A

Ceftriaxone

*avoid use in neonates, biliruben displacement

Q

what is the one fourth generation cephalosporins

A

Cefepime (Maxipime)

Q

what is the route of administration of Cefepime?

A

IV

Q

what does fourth generation cephalosporins (Cefepime) cover?

A

antipseudomonal
better G+ coverage
Broadest coverage

Q

What is the only “Unnamed” “Fifth” generation cephalosporin

A

Ceftaroline Fosamil

Q

What is the route of administration of Ceftaroline Fosamil

A

IV

Q

what does “Unnamed” “Fifth” generation cephalosporin specifically NOT cover

A

No antipseudomonal activity

Q

what does “Unnamed” “Fifth” generation cephalosporin (Ceftaroline fosamil) cover

A

MRSA and VRSA

* only beta lactame active against MRSA

Q

DOC for Moraxella catarrhalis

A

second or third generation Cephalosporins

Q

DOC for Neisseria Gonorrhoeae

A

Ceftriaxone

Q

DOC for E. coli; Klebsiella; Proteus infection

A

first or second generation Cephalosporins

Q

DOC for salmonella infection

A

third generation Cephalosporins

Q

DOC for penicillin resistant Steprococcus pneumoniae

A

Ceftriaxone

Q

DOC Borrelia Burgdorferi (late disease)

A

Ceftriaxone

Q

Toxicity of Cephalosporins

A

superinfection
Allergy
Diarrhea
Disulfiram-like reaction
dose dependent renal tubular necrosis

Q

what reaction can occur when a person taking Cephalosporins drinks alcohol

A

Disulfiram-like reaction

Q

If a patient is allergic to PCN, would you hesitate giving a Cephalosporin

A

yes, there is a 10% cross sensitivity with PCN

Q

What is the sole Monobactam drug

A

Aztreonam (Azactam)

Q

coverage of Aztreonam (Azactam)

A

only against aerobic G- (pseudomonas, serratia, klebsiella, proteus)
no activity against G+
no cross sensitivity with other B-lactams

Q

What group is Imipenem in

A

Carbapenems

Q

What group is Meropenem (Merrem) in

A

Carbapenems

Q

What group is Entrapenem (Invanz) in

A

Carbapenems

Q

Imipenem must be adminstered with what

A

Cilastatin

Q

route of adminstration of Imipenem and Meropenem

A

IV

Q

coverage of Imipenem and Meropenem

A

broad spectrum : anaerobes, G+, G-

Q

what can Imipenem cause that you should be weary of

A

seizures

Q

DOC for B-lactamase producing Enterobacter infections

A

Imipenem and Meropenem

Q

MOA of Vancomycin

A

prevents transpeptidation of the peptidoglycan chain-binds to the terminal D-ala-D-ala

* cell wall inhibitor that is not a B-lactams

* bactericidal

Q

coverage of Vancomycin

A

MRSA
G+ in PCN-allergic patients

Q

route of administration of Vancomycin when treating superinfections caused by staphylococcus and c-diff

A

orally

Q

Adverse effects of Vancomycin

A

Ototoxic
Nephrotoxic
“red man” syndrome: flushing from histamine release (not a hypersensitivity reaction)

Q

mechanism of action of Fosfomycin (Monurol)

A

inhibits cell wall synthesis at one of the first steps in the synthesis of peptidoglycan-prevents NAG to NAM reduction

Q

coverage of Fosfomycin (Monurol)

A

G+
G-

Q

MOA of Bacitracin

A

interferes with final dephosphorylation step in the phospholipid carrier cycle; can’t transport NAG-NAM across the inner membrane

Q

coverage of Bacitracin

A

G+
often used in combo with neomycin and polymyxins (G- coverage)

**Neosporin: topical

Q

toxicity of Bacitracin

A

nephrotoxicity (therefore rarely used parenterally)