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Pharmacology > Mechanisms of Action > Flashcards

Mechanisms of Action Flashcards

1
Q

what inhibits cell wall synthesis (bactericidal)?

A

Penicillin, amoxicillin, cephalexin

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2
Q

What inhibits protein synthesis (bacteriostatic)?

A

azithromycin

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3
Q

antifungals, such as __________, inhibit a CYP450 enzyme, which prevents the production of __________

A

fluconazole

ergosterol

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4
Q

Bacteria can resist antibiotics by preventing access to the _____, _____ the antibiotic, ______ the antibiotic, or rapid ______ of the antibiotic

A

antibiotic
degrading the antibiotic
altering the antibiotic
extrusion of the antibiotic

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5
Q

beta-lactamases can ________ the antibiotic and has a role in antibiotic resistance

A

disable

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6
Q

carbapenams are highly _______ to hydrolysis by penicilinases. often given to very ill patients

A

resistant

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7
Q

target proteins can be disguised, which occurs in _________ and penicillin binding proteins

A

MRSA

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8
Q

penetration of the drug is deterred only in _______ _______ species (because drug has to enter through the porins in the outer cell wall)

A

gram negative

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9
Q

discharge is a form of antibiotic resistance, when a _____ _____ transports antibiotic back across the outer membrane of out of the bacteria

A

proton pump

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10
Q

most beta-lactams end in -____, -____, or start with ceph-

A
  • cillin

- penem

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11
Q

beta-lactams bind to penicillin-binding protein at the active site and prevent _________ (peptidoglycan chains require this to be strong)

A

crosslinking

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12
Q

the most prevalent mechanisms for antibiotic resistance are inactivation of antibiotic by ________ and modification of ______ (low affinity to bind to antibiotic)

A

B-lactamase

penicillin-binding proteins

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13
Q

gram _______ are most susceptible to beta lacams

A

gram positive (rely on the peptidoglycan chains in their cell wall)

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14
Q

mycoplasma don’t have a cell wall (no peptidoglycan to inhibit), so _______ won’t work

A

beta latams

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15
Q

the three general categories of penicillin are:

A

penicillins
antistaphylococcal penicillins
extended-spectrum penicillins

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16
Q

penicillins are polar, so ______cellular concentrations will be higher than _____cellular

A

extracellular

intracellular

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17
Q

penicillin is rapidly excreted by the kidneys in its active form, so it’s great for _____

A

UTIs

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18
Q

penicillin V have the greatest activity against ________, ______, and non-beta-lactamse anaerobes

A

gram positive

gram negative cocci

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19
Q

penicillin V are not effective against gram _____ ______

A

negative rods

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20
Q

resistance is high for PCNs, so seldom used as ______ treatment

A

empiric

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21
Q

penicillin V (oral) treats mild to moderate infections because of its ______________.

A

poor bioavailability

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22
Q

Downside of penicillin V is its dosing of ______ a day

A

4 times

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23
Q

penicillin VK is combined with _______ so it is protected against _________

A

potassium

gastric acid

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24
Q

penicillin should be given ______ food

A

without

25
Q

GI (nausea, vomiting) and ________

A

hypersensitivy (skin most common)

26
Q

bacteriostatic antibiotics (tetracyclines) may lead to antagonism of _______ activity of penicillin V

A

bactericidal

27
Q

OCPs are excreted by liver, estradiol is reabsorbed. With penicillin, this may _____ efficacy of OCPs

A

reduce

28
Q

antistaphococals are specific for targeting ______ (only gram positive!)

A

staph

29
Q

amoxicillin can be given 2-3 times a day, versus 4. Better _____, greater ______

A

tolerated

better bioavailability

30
Q

the most active of the beta-lactams agains strep infections are _______ (moderate against gram neg)

A

amoixicillin

31
Q

________ are poor against staph

A

amoxicillin

32
Q

absorption of _______ isn’t affected by food

A

amoxicillin

33
Q

amoxicilin is excreted ______ in the ______

A

unchanged

urine

34
Q

continue treatment with penicillin if the rash is ______, which is common with amoxicillin

A

morbilliform (looks like measles)

35
Q

amoxicillin 500 mg #20

take 2 tab PO daily x 10 days with food

A

example drug card

36
Q

_____ have synergistic activity with aminoglycosides

A

penicillin VK, amoxicillin

37
Q

beta-lactamase inhibitors can be added to amoxicillin in order to ______ the activity to include gram ____ bacteria

A

extend

gram negative

38
Q

the 3 beta-lactamase inhibitors are:

A

clavulanate
sulbactam
tazobactam

39
Q

amoxicillin with clavulanate is a _______ synthesis inhibitor with a _______ inhibitor

A

cell wall

beta lactamase

40
Q

clavuanic irrersibly binds ____ _____ produced by a number of gram neg and positive.

A

beta lactamases

41
Q

beta lactamases are not active against antibiotics, but they ________ the penicillins spectrum of activity

A

increase

42
Q

Amox-Clav #28
875 mg 1 tab PO BID X 14 days

Cephalexin #40
250 mg 1 tab PO QID x 10 days

A

drug example

43
Q

the are ____ generations of cephalosporins. The higher the generation, the ____ the gram negative coverage improves

A

5

higher (gram positive coverage decreases)

44
Q

cephalosporins have the greatest activity against ____ ____ and least againast gram ____

A

gram positive

gram negative

45
Q

_____ is very active against gram-positive cocci, but not against MRSA

A

cephalexin

46
Q

2nd generation cephalosporins are _____ as 1st generation, with addition of some _______ anaerobes

A

heterogeneous

added gram negative

47
Q

3rd generation has expanded gram _____ coverage, but decreased gram positive coverage

A

negative

48
Q

4 generation cephalosporins is helpful with ______ and _____, also covers staph auras, hemophilus, neisseria

A

enterobacter

pseudomonas

49
Q

5th generation cephalosporins has improved gram _____ activity (good for MRSA!)

A

positive

50
Q

all beta-lactams lack activity against _____ and ____

A

mycoplasma and chlamydia

51
Q

only ____ generation cephalosporin is anti mRSA

A

5th

52
Q

_______ have higher affinity to PBP (more potent)

A

carbapenems

53
Q

carbapenems are commonly used in ______ and the ICU

A

hospitals

54
Q

imipenem is always paired with _______, because it would otherwise be inactivated in the kidney by enzymes. Cilastatin inactivates them.

A

Cilastatin

55
Q

Monobactams have a very ______ spectrum; only bind to PBP in _____, _____

A

PBP
enterobactera
Pseudomonas aeruginosia

56
Q

__________ penicillin is works against pesudomonas aeurginosa. Not good against staph.

A

antipseudomonal

57
Q

_______ is commonly prescribed for otitis media, sinusitis, skin infections, pneumonia

A

amoxicillin and clavulanate (Augmentin)

58
Q

if there are no beta-lactamases, you should not prescribe a drug with ________ bc it won’t be beneficial

A

clavulanic acid

Pharmacology (10 decks)

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