Peptidoglycan Cell Wall Synthesis Inhibitors

Question 1

Penicillin G, V (oral) MOA? 1st line for?

Answer 1

MOA: Bind PBP (transpeptidases). Block transpeptidase cross-linking of peptidoglycan in cell wall.

1st Line: spirochetes (namely T. pallidum)=>Benzatheine

Question 2

Penicillin G, V (oral) Resistance?

Answer 2

1. β-lactamase
2. Change structure of PBP=>MRSA
3. Change Pores=>Gram (-)

Question 3

What is the Flu-like symptoms due to releasing of endotoxins after penicillin use?

Answer 3

Jarisch Herxheimer Rxn

Question 4

Amoxicillin and Ampicillin bugs that it works on?

Answer 4

HHELLPSS

H. influenzae, H. pylori, E. coli, Listeria monocytogenes, Proteus mirabilis, Salmonella, Shigella

Question 5

Amoxicillin and Ampicillin AE?

Answer 5

pseudomembranous colitis

Question 6

Naf for?

Answer 6

Staph

Question 7

Piperacillin, ticarcillin use? Especially in what kind of patients?

Answer 7

Pseudomonas

CF patients

Question 8

β-lactamase inhibitors use? what are they?

Answer 8

TASC.
Clavulanic Acid, Sulbactam, Tazobactam

Use: protect the antibiotic from destruction by β-lactamase

Question 9

1st generation cephalosporins?

Answer 9

cefazolin, -ph

Question 10

1st generation cephalosporins bugs? Where is it used?

Answer 10

PEcK
Proteus mirabilis, E. coli, Klebsiella pneumoniae.

Cefazolin used prior to surgery to prevent S. aureus wound infections

Question 11

2nd generations cephalosporins bugs?

Answer 11

cefoxitin, cefaclor, cefuroxime
HEN PEcKS
Haemophilus influenzae, Enterobacter aerogenes, Neisseria spp., Proteus mirabilis, E. coli, Klebsiella pneumoniae, Serratia

Question 12

What was the thinking behind making 2nd and 3rd generation cephalosporins?

Answer 12

Better Gram (-) and for BBB for meninigitis

Question 13

Ceftriaxone is what generation?

Answer 13

3rd

Question 14

Ceftriaxone is DOC for?

Answer 14

Meningitis, Gonorrhea, disseminated Lyme disease

Brain, Butt, Bully Skin

Question 15

Ceftriaxone AE?

Answer 15

disulfiram-like reaction

Question 16

Ceftriaxone resistance?

Answer 16

Structural change in penicillin-binding proteins (transpeptidases).

Question 17

Imipenem, meropenem Uniqueness? Always administered with?

Answer 17

β-lactamase– resistant carbapenem

Always administered with cilastatin (inhibitor of renal dehydropeptidase I)

With imipenem, “the kill is lastin’ with cilastatin

Question 18

Imipenem, meropenem AE?

Answer 18

CNS toxicity (seizures)=>Imibrainem
But Meropenem=>less

Question 19

Aztreonam uniqueness? Use?

Answer 19

Uniqueness=>can use with penicillin

Use: Gram-negative rods only

Question 20

Vancomycin MOA? Use?

Answer 20

MOA: binding to D-ala D-ala=>inhibits transglycosylation=>elongation of peptidogylcan chains

Use: MRSA

Question 21

Vancomycin AE?

Answer 21

NOT Red Man Syndrome

Nephrotoxicity, Ototoxicity, Thrombophlebitis
diffuse flushing—red man syndrome

Question 22

Vancomycin Mechanism of Resistance?

Answer 22

D-ala D-ala to D-ala D-lac

2 Dala’s for Dala and D-lac

Question 23

Protein Synthesis Inhibitors Mnemonic?

Answer 23

Buy AT 30 and CCEL at 50

Question 24

All of the Protein Synthesis Inhibitors are bacteriostatic except?

Answer 24

Aminoglycosides

Question 25

Aminoglycosides what are they?

Answer 25

Gentamicin, Neomycin, Amikacin, Tobramycin, Streptomycin

Question 26

How are aminoglycosides bacteriocidal?

Answer 26

Cause misreadings of mRNA

Question 27

Aminoglycosides MOA, Use?

Answer 27

MOA: binding of the 30S subunit
Require O2 for uptake=>only effective for aerobes

Severe gram-negative rod infections esp. Pseudomonas
Streptomycin DOC=>Bubonic plague and tularemia

Question 28

Aminoglycosides AE?

Answer 28

Aminoglycosides are NOT bacteriostatic

Nephrotoxicity, Neuromuscular blockade, Ototoxicity (especially when used with loop diuretics). Teratogen.

Question 29

Aminoglycosides side effect decreases Ach release (neuromsuclar blockade) is similar to what drug?

Answer 29

Botulinum

Question 30

Aminoglycosides Resistance?

Answer 30

Inactivate drug by acetylation, phosphorylation, or adenylation

Question 31

Which of the neosporin is associated with contact dermatitis?

Answer 31

Neomycin