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Boards Pharm 01: Antimicrobials > 1. Antibiotics - Cell Envelope > Flashcards

1. Antibiotics - Cell Envelope Flashcards

(48 cards)

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1
Q

Penicillin - Available Drugs

A

Penicillin G - IV form
Penicillin V - PO
Prototype B-Lactam antibiotic

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2
Q

Penicillin - MOA

A

Bactericidal

  1. Bind penicillin binding proteins
  2. Block transpeptidase cross-linking of peptidoglycan
  3. Activate autolytic enzymes
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3
Q

Penicillin - Clinical Use

A

GRAM + = Strep. pneumonia, Strep. pyogenes, Actinomyces

  • SYPHILIS
  • Benzathine Penicillin G for prophylaxis for syphilis
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4
Q

Penicillin - Toxicities

A

Hypersensitivity rxn, hemolytic anemia.

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5
Q

Penicillin - Resistance

A

B-Lactamase cleaves the B-Lactam ring

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6
Q

Penicillinase Resistant Penicillins - Available Drugs

A

Methicillin
Nafcillin
Dicloxacillin

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7
Q

Penicillinase Resistant Penicillins (Methcillin, Nafcillin, Dicloxacillin) - MOA

A

Bactericidal

  1. Bind penicillin binding proteins
  2. Block transpeptidase cross-linking of peptidoglycan
  3. Activate autolytic enzymes

Penicillinase resistant due to bulkier R group

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8
Q

Penicillinase Resistant Penicillins (Methcillin, Nafcillin, Dicloxacillin) - Clinical Use

A

STAPH. aureus (not MRSA)

“use NAF for STAPH”

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9
Q

Penicillinase Resistant Penicillins (Methcillin, Nafcillin, Dicloxacillin) - Toxicities

A

Hypersensitivity rxn, methicillin-interstitial nephritis

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10
Q

Penicillinase Resistant Penicillins (Methcillin, Nafcillin, Dicloxacillin) - Resistance

A

MRSA resistant due to altered PBP target site.

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11
Q

Aminopenicillins - Available Drugs

A

Ampicillin

Amoxicillin

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12
Q

Aminopenicillins (Ampicillin, Amoxicillin) - MOA

A

Bactericidal

  1. Bind penicillin binding proteins
  2. Block transpeptidase cross-linking of peptidoglycan
  3. Activate autolytic enzymes

“AmOxicillin has better Oral bioavailability”

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13
Q

Aminopenicillins (Ampicillin, Amoxicillin) - Clinical Use

A 
Haemophilus influenza
E. coli
Listeria monocytogenes
Proteus mirabilis
Salmonella
Shigella
Enterococci

“Aminopenicillins HELPSS kill ENTEROCOCCI”

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14
Q

Aminopenicillins (Ampicillin, Amoxicillin) - Toxicities

A

Hypersensitivity rxn, ampicillin rash, pseudomembranous collitis

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15
Q

Aminopenicillins (Ampicillin, Amoxicillin) - Resistance

A

B-Lactamase cleaves the B-Lactam ring

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16
Q

Antipseudomonal Penicillins - Available Drugs

A

Ticarcillin
Carbenicillin
Piperacillin

“TCP - Takes Care of Pseudomonas”

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17
Q

Antipseudomonal Penicillins (Ticarcillin, Carbenicillin, Piperacillin) - MOA

A

Bactericidal

  1. Bind penicillin binding proteins
  2. Block transpeptidase cross-linking of peptidoglycan
  3. Activate autolytic enzymes
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18
Q

Antipseudomonal Penicillins (Ticarcillin, Carbenicillin, Piperacillin) - Clinical Use

A

PSEUDOMONAS spp.

Gram (-) rods

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19
Q

Antipseudomonal Penicillins (Ticarcillin, Carbenicillin, Piperacillin) - Toxicities

A

Hypersensitivity rxn

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20
Q

B-Lactamase Inhibitors - Available Drugs

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A

Clavulonic Acid
Sulbactam
Tazobactam

“CAST”

21
Q

B-Lactamase Inhibitors (Clavulonic Acid, Sulbactam, Tazobactam) - MOA

Study These Flashcards
A

Block activity of B-Lactamase / Penicillinase

22
Q

B-Lactamase Inhibitors (Clavulonic Acid, Sulbactam, Tazobactam) - Clinical Use

Study These Flashcards
A

Added to penicillin antibiotics to protect the drug from destruction by B-lactamase / Penicillinase

23
Q

Cephalosporins - MOA

Study These Flashcards
A

Bactericidal

  1. Bind penicillin binding proteins
  2. Block transpeptidase cross-linking of peptidoglycan
  3. Activate autolytic enzymes
24
Q

1st Gen. Cephalosporins - Available Drugs

Study These Flashcards
A

Cefazolin

Cephalexin

25
1st Gen. Cephalosporins (Cefazolin, Cephalexin) - Clinical Use
Gram (+) cocci Proteus mirabilis E. coli Klebsiella pneumoniae "PEcK"
26
2nd Gen. Cephalosporins - Available Drugs
Cefoxitin Cefaclor Cefuroxime
27
2nd Gen. Cephalosporins (Cefoxitin, Cefaclor, Cefuroxime) - Clinical Use
``` Gram (+) cocci Haemophilus influenzae Enterobacter aerogenes Neisseria spp. Proteus mirabilis E. coli Klebsiella pneumoniae Serratia marcescens ``` "HEN PEcKS"
28
3rd Gen. Cephalosporins - Available Drugs
Ceftriaxone Cefotaxime Ceftazidime
29
3rd Gen. Cephalosporins (Ceftriaxone, Cefotaxime, Ceftazidime) - Clinical Use
Serious Gram (-) infections resistant to other B-lactams. - CEFTRIAXONE - MENINGITIS, GONORRHEA (treatment and prophylaxis) CEFTAZIDIME - PSEUDOMONAS
30
4th Gen. Cephalosporins - Available Drugs
Cefepime
31
4th Gen. Cephalosporins (Cefepime) - Clinical Use
Increased activity against PSEUDOMONAS and Gram (+)'s
32
Cephalosporins - Toxicities
Hypersensitivity rxn (Cross sensitivity with penicillins in 5-10% of patients) Vitamin K deficiency Increases nephrotoxicity of aminoglycosides Disulfiram-like rxn with EtOH
33
Cephalosporins - Resistance
Less susceptible to penicillinases than the penicillins. ``` Organisms not covered by Cephalosporins are LAME - Listeria Atypicals MRSA Enterococci ```
34
Aztreonam - MOA
Monobactam | Bind PBP3 --> Prevent cell wall synthesis
35
Aztreonam - Clinical Use
GRAM (-) RODS ONLY For penicillin allergic or those with renal insufficiency who cannot tolerate aminoglycosides.
36
Aztreonam - Toxicities
Usually non-toxic No cross sensitivity with penicillins or cephalosporins Some GI upset
37
Aztreonam - Resistance
Resistant to B-lactamases
38
Carbapenams - Available Drugs
Imipenem(/Cilistatin) - Always given in combo | Meropenem
39
Carbapenams (Imipenam, Meropenam) - MOA
Bactericidal 1. Bind penicillin binding proteins 2. Block transpeptidase cross-linking of peptidoglycan 3. Activate autolytic enzymes
40
Carbapenams (Imipenam, Meropenam) - Clinical Use
Gram (+) cocci Gram (-) Rods Anaerobes Extremely wide spectrum but use limited by side effects.
41
Carbapenams (Imipenam, Meropenam) - Toxicities
GI distress Skin rash CNS toxicity - seizures - at high plasma levels - (Imipenam >> Meropenam)
42
Vancomycin - MOA
Bactericidal "pay 2 Dalas (dollars) for VANdalizing" Inhibit cell wall mucopeptide formation by binding D-ala D-ala portion of cell wall precursors.
43
Vancomycin - Clinical Use
``` GRAM (+) ONLY Serious multi-drug resistant organisms - S. aureus - MRSA - Enterococci (not VRE) - C. diff. ```
44
Vancomycin - Toxicities
``` "does NOT have many problems" Nephrotoxicity Ototoxicity Thrombophlebitis diffuse flushing - red man syndrome - prevent with pre-treatment with antihistamines and slower infusion rate ```
45
Vancomycin - Resistance
Change of D-ala D-ala to D-ala D-lac.
46
Cell Envelope Antibiotics - Available Drugs
``` Beta Lactams - Penicillins - Cephalosporins - Carbapenams - Monobactams (Aztreonam) - Beta Lactamase Inhibitors Vancomycin ```
47
Cilistatin - MOA
Inhibit renal dehydropeptidase I
48
Cilistatin - Clinical Use
Administered in combination with Imipenam to prevent degradation of Imipenam in renal tubules.

Boards Pharm 01: Antimicrobials (7 decks)

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