Antimicrobials: Cell wall synthesis inhibitors Flashcards

1
Q

Bactericidal drugs

A

All cell wall synthesis inhibitors, aminoglycosides, Ketolides, quinolones, nitrofurantoin, sulfonamides + DHF reductase inhibitors, Metrondiazole

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2
Q

Bacteriostatic drugs

A

all protein synthesis inhibitors

Sulfonamides alone

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3
Q

Beta lactams

A
Penicillins
Cephalosporins
Monobactams
Carbapenems
B lactamase inhibitors
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4
Q

Other cell wall synthesis inhibitors

A

Glycopeptides (Vanco), lipopeptides, bacitracin and cycloserine

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5
Q

MOA of penicillin

A

Bind to penicillin binding proteins, prevent transpeptidation, inhibits cross linking of bacterial cell wall

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6
Q

Excretion of penicillin

A

Excreted unmetabolized by kidney

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7
Q

Resistant mechanisms of bacteria to penicillin

A

Beta lactamases, mutation of penicilin binding protein to decrease binding, upregulation of efflux channels

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8
Q

Adverse effects of penicillin

A

Hypersensitivity, GI upset

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9
Q

DOC for C. Dif

A

Metronidazole

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10
Q

What can help prevent resistance to penicillin

A

Beta lactamase inhibitors: clavulanic acid, sulbactam, tazobactam

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11
Q

Probenecid

A

blocks secretion of penicillin into urine and increases half life

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12
Q

Main drug for syphilis

A

Penicilin G

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13
Q

Methicilin

A

Beta lactamase resistant penicillin

Not used clinically due to risk of interstitial nephritis

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14
Q

Aminopenicillins

A

Beta lactamase sensitive– pair with beta lactamases inhibitors
Broad spectrum

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15
Q

Ampicillin

A

Active against G+ and G-
Poor absorption orally so given IV
Used for suspected listeria meningitis and aspiration pneumonia

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16
Q

Amoxicillin

A

Good oral absorption

Used for otitis media, community acquired pneumonia, sinusitis, GI/GU infections, H Pylori

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17
Q

Drug used in prophylaxis of dog, cat and human bite

A

Augmentin

Amoxicillin + Clavulanic Acid

18
Q

Combine aminopenicillins with what to increase synergy and decrease resistance

A

Amingoglycosides (Ex. gentamicin)

19
Q

Extended spectrum penicillins

A

Beta lactamase sensitive

Primarily used for severe nosocomial infections

20
Q

Tx/prophylaxis of group B strep in pregnancy

A

Penicillin

21
Q

Route of admin for Penicillin G

A

IV

22
Q

Route of admin for Penicilin V

A

Oral

23
Q

Piperacilin and ticarcillin

A

Against anaerobe bacteria such as pseudomonas

24
Q

Cephalosporins

A

Similar MOA as penicillin

25
Q

1st generation cephalosporin

A

Used primarily for surgical prophylaxis
G+ mostly and some G- bugs for UTI
Have “ph” in the name
Cefazolin + Cephalexin

26
Q

2nd generation cephalosporin

A

More G- and still G+
Cefuroxime
Used mostly for respiratory bugs
Hardly ever used as first line treatment

27
Q

3rd generation cephalosporin

A

Systemic and CSF entry–good for tx of meningitis
Treatment of community and hospital acquired pneumonia
First line treatment for gonorrhea

28
Q

First line tx for ghonorrhea

A

IM ceftriaxone: 3rd generation cephalosporin

29
Q

4th generation cephalosporin

A
Cefepime
Resistant to most Beta lactamases 
Penetrates CSF and good against pseudomonas 
Broad spectrum
Can enter CNS--can tx meningitis
30
Q

5th generation cephalosporin

A

Can treat MRSA

ceftaroline

31
Q

Adverse effects of cephalosporins

A

Hypersensitivity

32
Q

Monobactams

A

Active against G- rods only including pseudomonas
No cross allergy from penicillin or cephalosporins
Aztreonam
Can penetrate CSF–can tx meningitis

33
Q

Carbapenems

A

-penem
Active against anaerobes, G+ and G- rods
Broad spectrum
Can penetrate CSF
Big gun antibiotics–can treat serious infections, meningitis, sepsis

34
Q

Imipenem

A

Must be co-administered with cilastatin to decrease renal toxicity
Can cause seizures

35
Q

Vancomycin

A

Glycoprotein antibiotic active only against G+ bacteria
Resistant to beta lactamases
IV only

36
Q

Main indication for vancomycin

A

Blood stream infection due to MRSA

37
Q

Other indications for vancomycin

A

Meningitis, MRSA osteomyelitis, endocarditis

38
Q

Adverse effects of vancomycin

A

red man syndrome, thrombophlebitis at admin site

39
Q

Bacitracin

A

Prevents dephosphorylation of lipid carrier
Used predominantly as topical agent due to severe nephrotoxicity when given IV
Used primarily for skin infections

40
Q

Deptomycin

A

Active against G+ cell wall
Active against vanco resistant strains
MRSA coverage especially bacteremia

41
Q

Do not use deptomycin for

A

Pneumonia–antagonized by surfactant

42
Q

Major SE of deptomycin

A

Myopathy