Wk 2 Antimicrobials - Penicillin Flashcards
How do antimicrobials work that inhibit the synthesis of cell walls?
They weaken the cell wall allowing fluid to come into the cell. The cell then swells and bursts causing lysis and death
6 examples of antimicrobials with the MOA of inhibition of cell wall synthesis
Penicillins Cephalosporins Carbapenems Vancomycin Aztreonam Televancin
What is beta lactam?
An enzyme that fights antibiotics
What are beta lactam antibiotics?
β-lactam antibiotics are antibiotics that contain a beta-lactam ring in their chemical structure.
What classes of antibiotics are beta lactam antibiotics?
Penicillins
Cephalosporins
Carbapenems
Monobactams
How did antibiotics come to have the beta lactam ring?
Scientists injected it into the antibiotic to make it more effective against bacteria that contain the ring, so that the antibiotic can breakdown the cell wall
What are the two main groups of beta lactam antibiotics?
Penicillins and cephalosporins
Four beta-lacatmase inhibitors that scientists combined with antibiotics to make them effective against a broader range of microbial species.
Clavulanic acid,
sulbactam,
tazobactam,
avibactam
Beta-lactam antibiotics are not effective against bacteria that…
Produce beta-lactamase
What do we do to treat microbes that produce the beta-lacatmase?
Combine a beta lactam antibiotic with another type of antibiotic
What type of combination is ampicillin-sulbactam?
beta-lactamase inhibitor antibiotic combination
What type of combination is amoxicillin-clavulanic acid
beta-lactamase inhibitor antibiotic combination
What is the trade name for amoxicillin-clavulanic acid combination?
Augmentin
Ticarcillin-clavulanic acid is what type of drug combination?
beta-lactamase inhibitor antibiotic combination
What is the trade name for ticarcillin-clavulanic acid combo?
Timentin
What type of drug combo is Piperacillin-tazobactam?
beta-lactamase inhibitor antibiotic combination
What is the trade name for the drug combo piperacillin-tazobactam?
Zosyn
What type of drug combo is ceftazidime-avibactam?
beta-lactamase inhibitor antibiotic combination
What is the trade name for the drug combo ceftazidime-avibactam?
Avycaz
Naturally occuring antimicrobial that started as mold
penicillin
When was penicillin discovered and by who?
1896 by a medical student
Penicillin was re-discoverd by who and when?
Dr. Fleming in 1928
When was penicillin mass produced?
1943
By 1947, what happened to penicillin?
Bacteria became resistant
What is the MOA of penicillin?
Beta-lacatmase inhibitor antibiotic:
Disrupts the synthesis of the bacteria cell wall
Penicillin disrupts the synthesis of the bacterial cell wall by inhibiting __
transpeptidases
What are transpeptidases?
An enzyme essential for bacterial cell wall synthesis
One requirement for penicillins to work
Bacteria must be growing and dividing
What is autolysis?
In biology, autolysis, more commonly known as self-digestion, refers to the destruction of a cell through the action of its own enzymes
By inhibiting transpeptidases, penicillins cause bacterial __
autolysis
What are three adverse reactions of penicillins?
urticaria, pruritus, angioedema
What is urticaria?
Hives or red, itchy welts that result from a skin reaction
What is pruritus?
itchy skin
What is angioedema?
a reaction similar to hives that affects deeper layers of the skin especially around the eyes, cheeks or lips
What type of rash is common in kids that are allergic to pencillin?
maculopapular rash
What is a maculopapular rash?
rash characterized by a flat, red area on the skin that is covered with small confluent bumps
What drug is common for the maculopapular rash if a child is allergic to penicillins?
ampicillin
What route of administration would you see more adverse effects?
IV
Penicillin works against which main types of bacteria?
Streptococcus, enterococcus, staphylococcus
Does penicillin treat gonorrhea?
Yes
What is peritonitis?
a redness and swelling (inflammation) of the tissue that lines your belly or abdomen (peritoneum)
4 other adverse effects of penicillins
GI distress
oral/vaginal candidiasis
Generalized rash
Anaphlyaxis
Penicillins generally only work on gram-__ bacteria, unless we get into the extended spectrum
positive
What are the four different types of penicillins?
Natural penicillins
Penicillinase-Resistant penicillins
Aminopenicillins
Extended-spectrum penicillins
What are 2 drugs that are natural penicillins?
Penicillin G and Penicillin V
What is the scientific name of penicillin G?
Benzylpenicillin
What is the scientific name of penicillin V?
Phenoxymethylpenicillin
What is a drug that is a penicillinase-resistant pencillin?
Nafcillin
What two drugs are aminopenicillins?
amoxicillin and ampicillin
What drug is an extended-spectrum penicillin?
piperacillin
What are 3 common drug interactions with penicillins?
NSAIDs, oral contraceptives, and warfarin
What is the weakest type of penicillin?
Natural penicillins
What is the strongest type of penicillin?
Extended-spectrum penicillins
Penicillin G and V are typically given in which routes?
IV or IM, but there are PO forms available
What types of bacteria does penicillin g and v work on?
gram positive and gram negative cocci, anaerobic bacteria, spirochetes
What are spirochetes?
a flexible spirally twisted bacterium, especially one that causes syphilis
How long is the half life of penicillin G and V?
about 30 minutes
What is the exception to the 30 minute half-life of penicillin g and v?
kidney dysfunction, then it will last longer
Which are the least toxic of all the penicillins?
Natural penicillins (g and v)
If someone has a penicillin allergy, they are allergic to…
ALL the different types of penicillin
Sometimes penicillin g or v is used in combination with ___
aminoglycosides
Why is penicillin g and v sometimes used in combination with aminoglycosides?
Helps penicillin get into the cell and disrupt the bacterial cell wall synthesis even further
What type of penicillin is nafcillin?
penicillinase-resistant penicillin
What is the drug of choice for penicillinase-resistant penicillins?
nafcillin
Why is methicillin no longer the drug of choice for penicillinase-resistant penicillins?
MRSA, it’s no longer used in practice
What routes is nafcillin given?
IV only
What are oral formulations of nafcillin?
cloxacillin and oxacillin - not used as much
Ampicillin and amoxicillin are what type of penicillins?
aminopenicillins
What is augmentin?
amoxicillin-clavulanic acid combination
The chemical structure of ampicillin makes it more effective against which type of bacteria?
gram-negative
What routes is ampicillin given?
PO or IV
Why is amoxicillin a better option than ampicillin if given orally?
It is more bioavailable
What is bioavailability?
the proportion of a drug or other substance which enters the circulation when introduced into the body and so is able to have an active effect
What was the first broad spectrum penicillin?
ampicillin
What are two common adverse effects with ampicillin?
diarrhea and rash
Ampicillin is kidney-__
sensitive
What does kidney-sensitive mean when referring to antibiotics?
Okay to give to someone with renal disease
What type of drug combination is ampicillin/sulbactam?
beta-lactamase inhibitor antibiotic combination
What is the trade name of ampicillin/sulbacatam?
Unasyn
Amoxicillin has __ side effects compared to ampicillin
less
Amoxicillin is very commonly prescribed in __ patients
pediatric
Amoxicillin doses are sometimes higher because of what?
Streptococcus resistance
What routes is amoxicillin given?
Only PO
What is amoxicillin commonly used to treat?
ENT, GU, and skin infections
What type of penicillin is piperacillin?
extended-spectrum penicillin
Piperacillin is always given with what?
Beta lactamase inhibitor
Ticarcillin is always given with what?
Beta lactamase inhibitor
What is piperacillin-tazobactam trade name?
Zosyn
What type of drug combination is piperacillin-tazobactam?
beta-lactamase inhibitor antibiotic combination
Piperacillin is really good for what type of infections?
Pseudomonal
Pseudomonal infections are typically __-acquired.
hospital
Piperacillin can affect __ function.
Platelet
Piperacillin is not good for what type of patients?
Renal dysfunction
Ticarcillin is what type of drug?
extended spectrum penicillin
What are two unique side effects of ticarcillin?
sodium overload and interferes with platelet function