Penicilin Bullshit Flashcards
Penicillins are _____ antibiotics originally derived from a mould ( ______________ ).
It was discovered in ____ by ________ (Scottish microbiologist) after he observed __________ around the mould.
Dorothy
β- lactam
Penicillium notatum
1928; Alexander Fleming
halo of inhibition
The chemical structure (R-__________) of penicillin was determined by _____________________ (British chemist) in _____.
C9H11N2O4S
Dorothy Crowfoot Hodgkin
1945
First chemical synthesis of penicillin:
_____ by _________ (American organic chemist
1957
John Clark Sheehan
Penicillins are β-lactam antibiotics consisting of a ________ joined to a _______ ring.
beta-lactam ring
thiazolidine
Penicillins are β-lactam antibiotics consisting of a ________ joined to a _______ ring.
Cephalosporins has its ________ joined to a ___-member _________ ring
beta-lactam ring
thiazolidine
β-lactam ring ; 6; dihydrothiazine
Penicillin
The ________ is essential for their antibacterial activity and its fusion to the ___-membered ______ ring makes the penicillins more reactive than _______________.
beta lactam ring
5; thiazolidine
monocyclic beta lactams
Penicillin
Different substitution at the _____ position differentiate types of penicillin.
R
The core penicillin structure without the R is known as _____ which has a molecular weight of _______
penam
246g/mol.
First generation penicillins
-__________ spectrum
-beta lactamase (sensitive or resistant?)
narrow
sensitive
First generation penicillins
Benzyl penicillin (________,________ )
benzathine benzyl penicillin (combination of __________ )
procaine benzyl penicillin (combination of ______ and ________ )
_______________________
Penicillin G, crystalline penicillin
2 penicillin G molecules with diphenylethylenediamine
procaine and Penicillin G
phenoxymethylpen icillin.
First generation penicillins
______________ (Penicillin G, crystalline penicillin)
________________(combination of 2 penicillin G molecules with diphenylethylenediamine)
____________(combination of procaine and Penicillin G)
____________________
Benzyl penicillin
benzathine benzyl penicillin
procaine benzyl penicillin
phenoxymethylpen icillin.
Example of a tablet first generation penicillin
phenoxymethylpen icillin.
Second generation penicillins
-_____ spectrum
-beta lactamase (sensitive or resistant?) but ____________________:
Examples: ____cillin, _____xacillin,_____ cillin (phased out), nafcillin, oxacillin
narrow
resistant
ineffective against methicillin-resistant bacteria
Cloxa; fluclo; methi
Third generation penicillins
-_______ spectrum
Examples :_________ (____cillin, ____cillin, and _____cillin).
Extended
Aminopenicillins
Amoxi
Ampi
Pivampi
Fourth generation penicillin
-_______ spectrum
-active against ________ spp and other gram-_______ bacteria
Carboxypenicillin (______); ureidopenicillins (_______); and Mecillinam (________)
extended
Pseudomonas
negative
Ticarcillin; Piperacillin; Pivmecillinam
Penicillins make use of their beta-lactam ring to bind to ____________ (________) thereby ______________________ which is responsible for maintenance of the integrity of bacteria cell wall.
transpeptidase enzyme
penicillin binding protein
inhibiting production of peptidoglycan
Penicillins mechanism of action
Imbalance in degradation and production of the peptidoglycan cell wall causes _____ of bacteria.
In addition cell death is also enhanced by the _______________ while production of peptidoglycan cross links has stopped due to inhibition of the activities of the transpeptidases by Penicillins.
death
continuous hydrolyses of the peptidoglycan
First generation penicillins
Benzyl penicillin injection: ____ , ______ , endocarditis, septicaemia, pneumonia, lung abscess
Benzathine penicillin injections:___, bejel, ____, _____ and upper RTI. oPenicillin V tablets: pneumonia, ear, skin, gum and throat infections
syphilis; meningitis
Yaws; pinta; syphilis
Second generation penicillins
Cloxacillin: Infections caused by ____, _______ and _______ species including
penicillinase producing ________ spp.
Pneumococci
Streptococci and Staphylococci
Staphylococci
Third generation penicillins
Amoxycillin: ____________ infections, in triple regimen to combat _______, typhoid fever, pneumonia, tonsilitis, bronchitis and UTI.
skin, nose, ear and throat
H. Pylori ulcer
Fourth generation penicillins
Ticarcillin: As injectable antibiotic mainly for infections caused by _______, ________ and other gram ____ bacteria infections. Also for UTIs, bone and joint infections.
Piperacillin: Combines with _______ as injectable antibiotic to treat ______ and skin, gynecological, and abdominal bacteria infections.
Pivmecillinam: ——— infection (Cystitis)
Pseudomonas aeruginosa
Proteus vulgaris
negative
tazobactam; pneumonia
Bladder
tazobactam is a _________
b-lactamase inhibitor
Penicillin shows a synergistic effect with __________, since the inhibition of ________ allows _______ to penetrate the bacterial cell wall more easily, allowing disruption of _________ within the cell.
aminoglycosides
peptidoglycan synthesis
aminoglycosides
bacterial protein synthesis
• Combining Penicillins with ____________ extend their antibacterial spectrum even though they have little or no antibiotic activity of their own.
B-lactamases inhibitors
Penicillins + Beta lactamases inhibitors
Examples include ________ with amoxicillin (Augmentin), ______ with ampicillin (Unasyn) and ________ with piperacillin (Zosyn)
clavulanic acid
sulbactam
tazobactam
Penicillins (Adverse effects)
• (Common or rare?) (≥ 1% of patients): _________, rash, urticarial, neurotoxicity, diarrhoea, nausea and superinfection including _________.
• (common or Rare?) (0.1–1% of patients): fever, _____, ______ , ______, seizures, pseudomembranous colitis and vomiting.
Common
hypersensitivity; candidiasis
Rare
erythema; dermatitis; angiooedema
The cephalosporins are bacter___ and broad spectrum β-lactam antibiotics first discovered in 1948, by __________ (Italian Pharmacologist) in form of antibacterial substance obtained from a mould, _______ ______
icidal
Giuseppe Brotzu
Cephalosporium acremonium.
the basic nucleus of cephalosporin
(____________________________) and developed it until the first cephalosporin ( _______ ) was synthesized in 1964.
7 amino-aminocephalosporic acid
cefalotin
Cephalosporins has structurally similarity with Penicillins except that the β-lactam ring is joined to a __-member ________ ring compared to the ___-member ________ ring structure of the Penicillins.
6; dihydrothiazine
5; thiazolidine
The basic structure of the cephalosporin is ______________
7-amino cephalosporanic acid
❑ First generation cephalosporin:
❖Activities
Have _____ spectrum of activity
(High or low?) toxicity.
Very active against gram __ve cocci
broad; low
+
First generation cephalosporin
Is Effective against gram –ve rods
T/F
T
First generation cephalosporin
Is Effective against gram +ve rods
T/F
T
First generation cephalosporin
have very little activity against some gram negative bacteria such as ________,_______,_______,_______ , Serratia and Acinetobacter.
Pseudomonas aeruginosa, Proteus vulgaris, Enterobacter, Citrobacter
First generation cephalosporin
Is active against anaerobes
T/F
Any exception?
T
Yes. It is ineffective against Bacteroides fragillis.
Some of the 1st generation cephalosporin can cross blood brain barrier.
T/F
F
None of them
First generation cephalosporins can
be used for treatment of meningitis
T/F
F
They can’t because they can’t cross BBB
Second generation cephalosporins and First generation cephalosporins
Who is more active against gram+ve bacteria and who is more active against gram -ve bacteria
First generation cephalosporins
Second generation cephalosporins
Who has more extended spectrum between first and second generation cephalosporins
Second
Third generation cephalosporin can cross the BBB
T/F
T
Second generation cephalosporins ,First generation cephalosporins and third generet cephalosporins
Who is most active against gram+ve bacteria and who is most active against gram -ve bacteria
First, then second, then third
Third, then second, then first
Third generation cephalosporins are not useful against meningitis caused by meningococci.
T/F
F
Third generation cephalosporins are usually used in treatment of ______ of unknown origin especially in ________ patients in in those individuals where cephalosporin possess least toxicity
sepsis
immunocompromised
______-generation cephalosporins have similar activity against G+ve organisms as first-generation cephalosporins.
Fourth
Fourth generation cephalosporins are __________ that can penetrate the ________ of Gram- ______ bacteria.
zwitterions
outer membrane
negative
Which generation of cephalosporins have a greater resistance to β-lactamases than the third-generation cephalosporins?
Fourth!
Fourth generation cephalosporins can’t cross the blood–brain barrier and are therefore ineffective in meningitis.
T/F
F
Can
Effective
Fourth generation cephalosporins are also used against Pseudomonas aeruginosa.
T/F
T
Fifth-generation cephalosporins
❑Examples: ___________ ,________,_______
Ceftobiprole, ceftaroline & ceftolozane.
_______ generation cephalosporins
Ceftobiprole has powerful _______ characteristics and appears to be less susceptible to _______
Fifth
antipseudomonal
development of resistance.
______ generation cephalosporins
❑ Ceftaroline has the antipseudomonal or VRE coverage of ceftobiprole.
T/F
Fifth
F
Doesn’t
______ generation cephalosporins
Ceftolozane is a new option for treatment of ________ Infections, and Complicated _____ Infections.
Ceftolozane is combined with the β-lactamase inhibitor ______.
Fifth
complicated Intra-abdominal
Urinary Tract
tazobactam
Cephalosporins disrupt _________ by binding to _________.
synthesis of the peptidoglycan
transpeptidases (penicillin-binding proteins (PBPs))
PBPs bind to the ________ at the end of ________ (peptidoglycan precursors) to _____ the peptidoglycan.
Beta-lactam antibiotics mimic the _________, thereby irreversibly inhibiting ___________________
D-Ala-D-Ala
muropeptides; crosslink
D-Ala-D-Ala site
PBP crosslinking of peptidoglycan
Which has broader gray negative coverage between cephalosporins and penicillins
Cephalosporins
Which one of of the cephalosporins is active against MRSA and enterococci.
no one
First-generation cephalosporins are active predominantly against Gram- _________ bacteria, and successive generations have increased activity against Gram- _______ bacteria often with reduced activity against Gram- ________ organisms
positive
negative
positive
Cephalosporins have No activity against Gram-positive organism such as methicillin-resistant staphylococci or enterococci
T/F
T
