Lecture 18 Flashcards

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1
Q

What chemical do agents that suppress wall synthesis attack?

A

Murein

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2
Q

If there is no murein in a cell wall, what happens to the cell?

A

It bursts (lysis or plasmoptysis)

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3
Q

Natural forms for antibiotics that supress cell wall synthesis tend to be what spectrum?

A

Narrow

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4
Q

What are the three types of penicillin?

A
  1. Natural 2. Semi-synthetic 3. Repository
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5
Q

Natural penicillins fall under what spectrum?

A

Narrow spectrum, most effective against G+

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6
Q

Why are natural penicillins best against G+ verses G-?

A

G+ have more murein in the cell wall

a higher osmotic pressure (20-30atm)

G- have an outer membrane which blocks the penicillin

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7
Q

Are natural penicillins effective against all G+?

A

No, only against growing bacteria

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8
Q

Name 4 bacteria that naturall penicillins are good against

A
  1. Group A streptococci (like streptococci pyrogenes) because they never developed resistance
  2. Clodtridium perfringens (gas gangrene)
  3. Neisseria meningitis (G-)
  4. Treponema palligum (G-, syphillis)
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9
Q

What is natural penicillin isolated from?

A

The mold, penicillium

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10
Q

What is the common name for Benzyl Penicillin?

A

Penicillin G

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11
Q

What is the mode of action for Benzyl Penecillin?

A

Suppression of cell wall synthesis

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12
Q

What is the common name for Phenoxymethyl Penicillin?

A

Penicillin V

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13
Q

What natural penicillin is able to resist the acid in your stomach, making it possible to take it orally?

A

Phenoxymethyl Penicillin (aka Penicillin V)

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14
Q

What is the mode of action for Phenoxymethyl penicillin?

A

Suppression of cell wall synthesis

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15
Q

What are repository penicillins?

A

Time-released capsules created by taking penicillin G and making it less soluble

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16
Q

Name 2 repository penicillins

A
  1. Procane penicillin 2. Benzathine penicillin
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17
Q

What is the mode of action for procane penicillin?

A

Suppression of cell wall synthesis

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18
Q

What is the mode of action for benzathine penicillin

A

Suppression of cell wall synthesis

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19
Q

What is benzathine penicillin used to treat

A

Infections of syphilis that are less than 1 year old

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20
Q

What advantage do repository penicillins have over natural penicillins?

A

Despite having lower levels of it in the blood stream, repository penicillins last all day so that the patient doesn’t need injections hourly

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21
Q

Name 4 semi-synthetic penicillins

A
  1. Ampicillin 2. Amoxicillin 3. Carbencillin 4. Tricarcillin
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22
Q

What is the chemical makeup of ampicillin?

A

penicillin G with an amino group attached, making it broad spectrum

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23
Q

Is ampicillin broad spectrum or narrow spectrum?

A

Broad

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24
Q

Ampicillin is a DOC for what?

A

Very resistant UTIs caused by proteus mirabilis

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25
Q

What is the mode of action of ampicillin?

A

Suppression of cell wall synthesis

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26
Q

Amoxicillin is penicillin G with what group attached to it?

A

an OH group

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27
Q

Is amoxicillin broad or narrow specturm?

A

Broad

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28
Q

What is the mode of action for Carbencillin?

A

Suppression of cell wall synthesis

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29
Q

Carbencillin was the first drug effective against what organism?

A

Pseudomonas aerasinosa, but it is no longer used to treat it because there are more effective drugs on the market

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30
Q

What is the mode of action for Tricarcillin?

A

Suppression of cell wall synthesis

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31
Q

Tricarcillin is a DOC for?

A

pseudomonas aerasinosa

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32
Q

Ticarcillin is ____ times more active against ________ than carbenicillin

A

Ticarcillin is 2-4 times more active against pseudomonas than carbenicillin

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33
Q

Name 5 Beta-Lactamase resistant penicillins

A
  1. Methicillini 2. Oxcillin 3. Cloxacillin 4. Augmentin 5. Zosyn
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34
Q

What does MSSA stand for?

A

Methicillin Sensitive Staph Areus

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35
Q

What does MRSA stand for?

A

Methicillin Resistant Staph Aureus

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36
Q

Why is MRSA resistant to all forms of penicillin?

A

They have a secondary mode of resistance, involving penicillin binding proteins, which are proteins that block pinicillin activity as well as build up murein. They also have efflux pumps, which get rid of toxins in the cells, making them resistant to aminoglycosides

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37
Q

What was the first B-lactamase penicillin?

A

Methicillin, but it is not longer used in America

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38
Q

What is the mode of action for methicillin?

A

Suppression of cell wall synthesis

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39
Q

Oxacillin is used to treat what?

A

More serious infections (systemic, IV, never orally)

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40
Q

What is the mode of action for Oxacillin?

A

Suppression of cell wall synthesis

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41
Q

What is the mode of action for cloxacillin?

A

Suppression of cell wall synthesis

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42
Q

How is cloxacillin administered?

A

Orally

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43
Q

What is the mode of action for augmentin?

A

Suppression of cell wall synthesis

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44
Q

How does augmentin work?

A

It is combined with a clarulanic acid (the suicide substrate) which binds irreversibly with the active site of penicillinase

45
Q

What is the mode of action for zosyn?

A

Suppression of cell wall synthesis

46
Q

Zosyn is a DOC for?

A

Pseudomonas aeruginosa

47
Q

How does Zosyn work?

A

Combination of pipercillin and tazobactam. The Tazobactam acts as a suicide substrate, binding irreversibly to the active site of penicillinase

48
Q

Name 4 non-penicillin drugs that suppress cell wall synthesis

A
  1. Cephalosporines 2. Carbapenems 3. Bacitracin 4. Vancomycin
49
Q

What are cephalosporines produced by?

A

A mold of the genus cehpalosporium

50
Q

Chemically, how are cephalosporines different from penicillin

A

Cephaosporines have two side groups instead of the single side group that penicillin has

51
Q

What are the names of the modified cephalosporines? What generation is each one?

A

Gen 1 - Cephalothin and Cephalexin (keflex) Gen 2 - Cefotiam Gen 3 - Moxalactam, Cetotaxine, and Ceftriaxone 4. Cefepime

52
Q

What generation of cephalosporines are narrow spectrum, and only active against G+

A

Gen 1 - Cephalothin and Cephalexin (keflex)

53
Q

What is the mode of action of generation 1 cephalosporines?

A

Suppression of cell wall synthesis

54
Q

What is the mode of action for generation 2 cephalosporines?

A

Suppression of cell wall synthesis

55
Q

What is the mode of action for genertion 3 cephalosporines?

A

Suppression of cell wall synthesis

56
Q

What is the mode of action for generation 4 cephalosporines?

A

Suppression of cell wall synthesis

57
Q

What are generation 1 (Cephalothin and Cephalexin) used to treat?

A

I is used to treat patients with staphylococci and streptococci, our used in surgery as a prophylactic

58
Q

Why do cephalosporines make a good penicillin substitute?

A

Good penicillin substitutes because they are not broken down by penicillinase (but they can be broken down by cephalosporinase), and can be used when the patient is allergic to penicillin

59
Q

What are generation 2 (Cefotiam) cephalosporines used against?

A

Since they are better at attacking G- bacteria, gen 2 is used against Aterobacter proteus (G-) and hamophilus (G-), as well staph and strept

60
Q

In what generation do cephalosporines become broad specturm?

A

3rd, with Moxalactam and Cetotaxine and Ceftriaxone

61
Q

Cefepime is a a DOC against what?

A

Klebsiella pneumonae, which has a capsule making it very resistant

62
Q

Is cefepime broad or narrow spectrum?

A

Broad

63
Q

Are carbapenems more or less active that 3-4th generation of cephalosporines?

A

More

64
Q

Primaxin is an example of what?

A

Carbapenems

65
Q

What is primaxin (chemically)?

A

Imipenem (a cabepenem) and cilastatin (used to make sure the dipeptidase in your kidney doesn’t break down the imipenem)

66
Q

What is Priamin used against?

A

Genus Acinetobacter, which are commonly super bugs

67
Q

Some strains of klebsiella pneumoniae are consitered superbugs because they contain what enzyme?

A

carbapenemase

68
Q

Whats does CRE stand for?

A

Carbapenem resistant enterococci

69
Q

What is the mode of action for carbapenem?

A

Suppression of cell wall synthesis

70
Q

What is bacitracin isolated from?

A

Isolated from the bacillus

71
Q

What does bacillus produce in addition to bacitracin?

A

polymixins (narrow spectrum) and polypeptides (narrow spectrum for G+)

72
Q

Where is bacitracin found?

A

In triple antibiotics

73
Q

What is in a triple antibiotic?

A

Polymyxin B (G-Bacitracin (G+) Neomycin (broad)

74
Q

What is the most of action for bacitracin?

A

Suppression of cell wall synthesis

75
Q

Vancomycin is isolated from what?

A

Streptomyces

76
Q

Vancomycin is a DOC for what?

A

MRSA and systemic infections

77
Q

What is the toxicity or vancomycin? How often is it prescribed?

A

High toxicity, often prescribed, which is resulting in resistant organisms

78
Q

What are the two modes of action for antimetabolites

A
  1. Competitive inhibition 2. pH
79
Q

Define competitive inhibition

A

Having a structural analogue attack the active site of the enzyme/chemical in question

80
Q

What is the normal pH of cells?

A

close to 7

81
Q

Are are some antimetabolite agents with competitive inhibition as their mode of action?

A
  1. Sulfonamides 2. Sulfones 3. Isoniazid 4. Trimethoprim 5. PAS (p-aminosaliclic acid) 6. Quinie, chloroquine, primaquine
82
Q

Sulfonamides have what mode of action?

A

Competitive inhibition

83
Q

Give 5 examples of a sulonamide

A
  1. Sulfanilamide 2. Sulfadiazine 3. Sulfisoxazole 4. Sulfamethoxazole 5. Bactrim PCP
84
Q

Describe sulfanilamide

A

A type of sulfonamide that is either static or inhibitory, and no longer used today

85
Q

What is sulfadiazine used for?

A

Burn patients, because it has AgNO3 in it

86
Q

What is sulfisoxazole used for?

A

Uncomplicated urinary tract infections commonly caued by e.coli and preventing rheumtic fever, which is caused by streptococcus pyrogenes

87
Q

Define uncomplicated urinary tract infection

A

Not exposed to instrumentation like a catheter, blockage, or antibiotic therapy

88
Q

Suldamethoxazole is combined with what for a synergistic effect? Why?

A

trimethoprime (bactrim). It works in two places in the PABA pathway

89
Q

Bactrim PCP is used to what?

A

Prevent pneumonia and treat superficial MRSA

90
Q

Do sulfones use the PABA pathway?

A

Yes, they react at similar spots of sulfonamides

91
Q

What is an example of a sulfone

A

Dapsone

92
Q

Dapsone is used as a DOC for what?

A

Mycobacterium leprae

93
Q

What is another name for Isoniazid?

A

INH - isonicotinic hydrazide

94
Q

Isoniazid is a DOC for what?

A

mycobacterium tuberculosis

95
Q

What vitamin does isoniazid resemble?

A

vitamin B

96
Q

How does isonazid work?

A

Prevents mycolic acid from being incorporated into the cells walls of the mycobacterium

97
Q

Trimethoprim is a part of what other antibiotic?

A

Bactrum

98
Q

What makes trimethoprim synergistic

A

Works at the second point in the PABA pathway

99
Q

PAS stands for what?

A

p-aminosalicylic acid

100
Q

PAS is a DOC for?

A

resistant strains of tuberculosis

101
Q

MDR TB stands for what?

A

Multiple resistant tuberculosis (resistant to both INH and ritampin)

102
Q

XDR TB stands for what?

A

Extensively/Extremely drug resistant tuberculosis (resistant to INH, ritampin, any foluoroquinolone (ciprofloxicin), plus any injectable aminoglycocides (capreomycine, kanamycine, amikacin))

103
Q

Quinie, chloroquine, and primaquine are used against what disease?

A

Malaria

104
Q

Quinie, chloroquine, primaquine are isolated from what?

A

Bark of a cinchona tree

105
Q

How does quinie work?

A

Quinie makes the food vacuoles of malaria so alkyline that it makes it hard to break down the hemoglobin

106
Q

What is the name of this pathway?

A

PABA (its on the freaking picture)

107
Q

What drugs act at the first part of the pathway?

A

Sulfonamides and Sulfones

108
Q

What drugs work on the second part of the pathway?

A

Trimethoprime