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Phar 747 Infectious Disease > Unit 1 > Flashcards

Unit 1 Flashcards

1
Q

penicillin G

A 
Natural penicillin.
Very active against sensitive bacteria.
Gram + only.
Very acid labile.
Readily hydrolyzed by B-lactamases.
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2
Q

penicillin V

A 
Natural penicillin.
Very active against sensitive bacteria.
Gram + only.
Less acid labile than penicillin V because of modification.
Readily hydrolyzed by B-lactamases.
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3
Q

methicillin

A

B-lactamase Resistant Penicillin.
Less potent but more resistant.
Very acid labile.
Even more acid labile than penicillin G - side chain electron rich.

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4
Q

Nafcillin

A

B-lactamase Resistant Penicillin.
Most active of class.
Orally active.

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5
Q

Isoxazoyl Penicillins

A 
B-lactamase Resistant Penicillins.
Oxacillin - H, H.
Cloxacillin - Cl, H.
Dicloxacillin - Cl, Cl.
Each are orally active.
Very good resistance.
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6
Q

Ampicillin

A 
Aminopenicillin.
NH2 extends spectrum to Gram -.
NH2 in R-form.
Prodrug form Bacampicillin for GI absorption (Diarrhea, microbiome damage).
Vulnerable to B-lactamase.
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7
Q

Amoxicillin

A 
Aminopenicillin.
NH2 extends spectrum to Gram -.
Para-hydroxyampicilin
NH2 in R-form.
2x as potent as ampicillin.
Combine with clavulanic acid.
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8
Q

Carbenicillin

A 
Extended Spectrum Penicillin.
A-Carboxypenicillin subclass.
Most active type of penicillin towards Gram-, including Ps. aeruginosa.
Decarb in acid to form PenG.
B-lactamase sensitive.
Acid labile - prodrugs available.
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9
Q

Ticarcillin

A

Extended Spectrum Penicillin.
A-Carboxypenicillin subclass.
Most active type of penicillin towards Gram-, including Ps. aeruginosa.
Thiphene analog of carbenicillin: 2-4x as potent vs. Ps. aeruginosa.
W/ B-lactamase Inhib or aminoglycoside to extend spectrum.

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10
Q

Pipericillin

A

Extended Spectrum Penicillin.
A-Acylureidopenicillin Subclass.
Ampicillin derivative.
Most active type of penicillin towards Gram-, including Ps. aeruginosa.
2,3-diketopiperazine substituent.
Retains good Gram+ activity.
B-lactamase sensitive - bulk not close enough to carbonyl sidechain.

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11
Q

Azlocillin/Mezlocillin

A

Extended Spectrum Penicillin.
A-Acylureidopenicillin Subclass.
Ampicillin derivative.
Most active type of penicillin towards Gram-, including Ps. aeruginosa.
Both more potent than carbenicillin towards Ps. aeruginosa.
Acid labile.
B-lactamase sensitive.

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12
Q

Cephalothin

A 
Cephalosporin.
First Generation.
Good Gram+, Modest Gram-.
Not orally active
Good B-lactamase resistance; most resistant of First Gen.
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13
Q

Cefazolin

A 
Cephalosporin.
First Generation.
Good Gram+, Modest Gram-.
Parenteral.
Longest t1/2 of First. Gen.
Good B-lactamase resistance.
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14
Q

Cephalexin

A 
Cephalosporin.
First Generation.
Good Gram+, Modest Gram-.
Side-chain like Ampicillin.
Orally active - Methyl at C-3.
Good B-lactamase resistance.
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15
Q

Cefproxil

A 
Cephalosporin.
Second Generation.
Good Gram+, Decent Gram-.
Side-chain like Amoxicillin.
Orally active.
Good B-lactamase resistance.
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16
Q

Cefuroxime

A 
Cephalosporin.
Second Generation.
Good Gram+, Decent Gram-.
Oxime ether - syn config.
Anti-config: poor B-lactamase resistance.
CSF penetration - Meningitis.
Axetil prodrug - absorption.
Good B-lactamase resistance.
17
Q

Cefoxitin

A

Cephamycin

?

18
Q

Cefotaxime

A

Cephalosporin.
Third Generation.
Decent Gram+, Good Gram-.
Syn-oxime ether - potent and very B-lactamase resistant.
Aminothiazole - increased activity, especially in Enterobacteria.
Good B-lactamase resistance.

19
Q

Ceftriaxone

A 
Cephalosporin.
Third Generation.
Decent Gram+, Good Gram-.
Most widely used injectable cephalosporin.
Good B-lactamase resistance.
20
Q

Cefepime

A 
Cephalosporin.
Fourth Generation.
Good Gram+, Good Gram-.
Parenteral.
Quarternary amine - good leaving group; results in charge; good for gram-.
100% excreted in urine - UTIs.
Can cross BBB - Meningitis.
21
Q

Ceftaroline fosamil

A 
Cephalosporin.
Fifth Generation.
Prodrug.
Good Gram+, Gram- good but less than 4th Gen, especially with Ps. aeruginosa.
Active against MRSA.
CAPB and acute bacterial skin infections
Parenteral.
Fosamil is the P containing group on the right.
22
Q

Aztreonam

A

Monobactam.
Weak antibacterial activity but highly resistant to B-lactamase.
Many Gram-, but no Gram+.
Parenteral.
Aztreonam lysine - lyophilized for inhalation for Ps. aeruginosa in CF patients.

23
Q

Clavulanic Acid

A 
B-lactamase Inhibitor.
Class One.
Oxapenam.
Weak broad antibacterial.
Inhibits many B-lactamases.
Synergistic with many B-lactams.
w/ Amoxicillin = Augmentin.
w/ Ticarcillin = Timentin.
24
Q

Sulbactam

A

B-lactamase Inhibitor.
Class One.
Weak antibiotic activity.
Potentiates activity of ampicillin and carbenicillin.

25
Q

Tazobactam

A

B-lactamase Inhibitor.
Class One.
Broad B-lactamase inhibition.
Goes with Pipericillin.

26
Q

Thienamycin

A

B-lactamase Inhibitor.
Class Two.
A Carbapenem - double bond increases reactivity.
Developed as an antibiotic but used as an inhibitor now.
Good antibacterial activity however.
Unstable in concentrated solution - polymerizes.
Easily inactivated by DHP-1.

27
Q

Imipenem

A

Carbapenem Antibiotic.
Formimide derivative of Thienamycin.
True antibiotic.
Stable against Serine B-lactamases and inhibits many Gram- B-lactamases.
Co-Admin. with Cilastatin; inhibits DHP-1.
Seizure in 2%

28
Q

Meropenem

A 
Carbapenem Antibiotic.
Newer than Imipenem.
Extremely broad spectrum.
Better in-vivo for Ps. Aer than Imipenem.
Stable against Serine B-lactamases.
No Cilastatin required.
Only slow hydrolysis by DHP-1.
Good CSF penetration.
Fewer seizures.
29
Q

Ertapenem

A 
Carbapenem Antibiotic.
Newer type.
Resistant to DHP-1.
Stable against Serine B-lactamases.
Not against Ps. Aer.
1g/day dosing.
30
Q

Doripenem

A 
Carbapenem Antibiotic.
Newer type.
Extremely broad spectrum.
Includes anaerobes and great for Pseudomona.
Only slowly hydrolyzed by DHP-1.
Stable against Serine B-lactamases.
IV.
31
Q

Bacitractin A

A 
Bacitracin - Peptide Antibiotic
Gram+ only.
Topical.
Often Combined w/ Polymyxin.
Blocks the diphosphatase that converts Di to Mono by binding the Di with a Mg2+: it blocks translocation.
32
Q

Vancomycin

A

Prototypical Glycopeptide Antibiotic.
Gram+ only.
Usually reserved for B-lactamase resistant strains.
IV.
Inhib Transglycosylation and Transpeptidation; strong non-covalent complex with D-Ala-D-Ala terminus of lipid II and/or peptidoglycan.

33
Q

Telavancin

A

Glycopeptide Antibiotic.
Vancomycin derivative.
Added lipid tail.
Multiple mechanisms.

34
Q

Dalbavancin

A 
Glycopeptide Antibiotic.
Teicoplanin derivative.
Lipid tail added.
NAG replaced with N,N-dimethylpropionamide.
Active vs VanB.
Greater potency.
35
Q

Oritavancin

A

Glycopeptide Antibiotic.
Chlorobiphenyl derivative of chloroeremomycin.
Active vs VanA and VanB

36
Q

Polymyxins/Colistins

A

Peptide Antibiotic
Decapeptide - seven in the ring, three as a linear extension, which has a fatty acid tail.
Detergent like.
Inserts into lipid A of the LPS layer of Gram-; Gram- activity only.
Fatty acid tail into lipid bilayer.
Cationic head into anionic phospholipid head groups.

37
Q

Gramicidin

A 
Peptide Antibiotic
15 linear peptides.
Alternate b/w D and L.
Not charged.
N-term capped with formyl.
C-term capped with ethanolamine.
Helical structure formed.
Inserts into Gram+ membranes; takes two Gramicidins to span membrane.
Cytoplasmic cations escape.
Topical only.
38
Q

Daptomycin

A

Peptide Antibiotic.
Branched cyclic lipopeptide.
Gram+ and MRSA.
Oligomerization with Ca2+; inserts into membrane; disruption.

39
Q

Quinupristin/dalfopristin

A

Peptide Antibiotic; Streptogramins.
Combo product; synergistic together.
Must get within cell and appears to do so.
Each binds different parts of bacterial ribosomes and block protein synthesis.

Phar 747 Infectious Disease (2 decks)

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