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Pharmacology Exam IV > Anti-microbials IIa/b > Flashcards

Anti-microbials IIa/b Flashcards

(51 cards)

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1
Q

Cell Wall Synthesis Inhibitor Drug CLASSES (8)

A 
Penicillins
Cephalosporins
Monobactams
Glycopeptides
Polypeptides
Carbapenems
Phosphoenolpyruvate
Beta-lactamase inhibitor
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2
Q

Cell Membrane Targeting Drug CLASSES (2)

A

Lipopeptides

Detergents

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3
Q

Protein Synthesis Inhibitor Drug CLASSES (4)

A

Tetracyclines
Aminoglycosides
Macrolides
Others (clindamycin, chloramphenicol, linezolid)

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4
Q

DNA/RNA Synthesis Inhibitor drug CLASSES (4)

A

Sulfonamides
Trimethoprims
Fluoroquinolones
Metronidazole

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5
Q

Main components of bacterial cell wall

A

peptidoglycan

NAM-NAG-Pentapeptide repeating monomers

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6
Q

Penicillin Binding Proteins important for

A

LINKING PENTAPEPTIDE TO FORM PEPTIDOGLYCAN cell wall

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7
Q

Beta lactam compounds (4)

A

PENICILLINS
CEPHALOSPORINS
MONOBACTAMS
CARBAPENEMS

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8
Q

Cell wall synthesis inhibitors generally are ________

A

bactericidal

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9
Q

Penicillins MOA

Adverse effect?

A

bind and inhibit PBP enzymes

HYPERSENSITIVITY RXN - rash to anaphylaxis range

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10
Q

With hypersensitivity and penicillins, if someone has anaphylaxis hypersensitivity, what do you need to consider?

A

CROSS REACTIVITY with similar compounds (beta-lactam ring)

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11
Q

Narrow Spectrum Penicillin (2)

beta-lactamase sensisity?

A

Penicillin G and V

sensitive

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12
Q

Very narrow spectrum Penicillin (3)

beta-lactamase sensisity?

A

Methicillin
Nafcillin
Oxacillin

resistant

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13
Q

Broad spectrum Penicillins (2)

beta-lactamase sensisity?

A

Ampicillin
Amoxicillin

sensitive

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14
Q

Extended spectrum Penicillins (3)

beta-lactamase sensisity?

A

Piperacillin
Ticarcillin
Azlocillin

sensitive

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15
Q

Beta-lactamase inhibitor?

Adverse effects associated with?

A

CLAVULANIC ACID

Augmentin (amoxicillin + clavulanic acid)

Adverse effects are associated with whatever drug clavulanic acid is combined with

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16
Q

Cephalosporins MOA

Adverse effect?

A

Bind and inhibit PBP’s

HYPERSENSITIVITY

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17
Q

Changes from generation to generation of cephalosporins

A

INCREASE SPECTRUM OF ACTIVITY FROM 1ST TO 4TH

starts with gram positive and mores to include more gram negative

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18
Q

1st generation Cephalosporins (2)

beta lactamase sensitivity?

enter CNS?

A

Cefazolin
Cephalexin

sensitive

do not enter CNS

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19
Q

2nd Generation cephalosporins (3)

beta lactamase sensitivity?

enter CNS?

A

Cefotetan
Cefaclor
Cefuroxime

Sensitive

only cefuroxime enters CNS

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20
Q

3rd Generation cephalosporins (4)

beta lactamase sensitivity?

enter CNS?

A

Ceftriaxone
Cefotaxime
Cefdinir
Cefixime

sensitive

MOST ENTER CNS

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21
Q

4th Generation cephalosporins (1)

beta lactamase sensitivity?

enter CNS?

Study These Flashcards
A

Cefepime

resistant

ENTER CNS

22
Q

Monobactam MOA

Drug?

Specific for what type of bacteria?

Adverse reaction

CNS penetration?

Study These Flashcards
A

binds to and inhibits PBP

Aztreonam

GRAM NEGATIVE

HYPERSENSITIVITY

Passes into CNS easily

23
Q

Carbipenems (4)

Which is co-administered with cilastatin?

Study These Flashcards
A

Doripenem
Imipenem*** (co-administered)
Ertapenem
Meropenem

24
Q

Carbipenems MOA

Adverse reaction

beta lactamase sensitivity?

CNS penetration?

Study These Flashcards
A

bind to and inhibit PBP’s

GI UPSET

RESISTANCE

Penetrates CNS relatively well

25
Glycopeptide drug? MOA? Adverse effect? Good for treatment of? Penetrate CNS?
Vancomycin PREVENTS ELONGATION OF PEPTIDOGLYCAN CELL WALL --> binds D-ala-D-ala pentapeptide FLUSHING - red man syndrome resistant strains of bacteria (MRSA, enterococci, C. difficile) does not have good CNS penetration
26
Polypeptide drug? MOA? Commonly found in?
bacitracin blocks incorporation of amino acids and nucleic acids into cell wall TOPICAL OINTMENTS
27
Phosphoenolpyruvate drug? MOA? Commonly used in treatment of?
Fosfomycin blocks early step in cell wall synthesis by preventing synthesis of UDP-NAM UTI's
28
Protein synthesis inhibitors are typically _______
bacteriostatic
29
Steps of Prokaryotic Translation
1 - tRNA binds to A site 2 - peptide bond formed 3 - newly uncharged tRNA exits 4 - now longer chain translocates to P site
30
Aminoglycosides (6)
``` streptomycin gentamicin kanamycin amikacin tobramycin neomycin ```
31
Aminoglycosides MOA? Key adverse effects? typically bacteriostatic or cidal?
binds to 30S RIBOSOMAL SUBUNIT - blocks formation of INITIATION COMPLEX NEPHROTOXIC OTOTOXIC typically bacteriocidal
32
Macrolides (3)
erythromycin clarithromycin azithromycin
33
Macrolides MOA? Key adverse effect? typically bacteriostatic or cidal?
BINDS 50S SUBUNIT - impairs translocation of P site (step 4) GI UPSET bacteriocidal
34
Tetracyclines (4)
tetracycline minocycline tigecycline doxycycline
35
Tetracycline MOA key adverse effects? typically bacteriostatic or cidal?
30S SUBUNIT BINDING - prevents binding of new tRNA to A site (step 1) NUTRIENT INTERACTIONS - binds calcium - discoloration of bone/teeth ECOLOGICAL EFFECTS PHOTOSENSITIVITY bacteriocidal
36
Clindamycin MOA key adverse effect? Spectrum?
BINDS 50S SUBUNIT - prevents formation of initiation complex (step 1) and translocation to P site (step 4) GI --> HIGHLY ASSOCIATED WITH C. DIFFICILE Narrow spectrum
37
Chloramphenicol MOA Key adverse effects?
BINDS 50S SUBUNIT - prevents transpeptidation (step 2) BLOOD - RBC PRODUCTION SUPPRESSION GRAY BABY SYNDROME - glucuronic acid conjugation step inhibited
38
Linezolid MOA Key adverse effect? Good for what type of organisms?
INHIBITS PROTEIN SYNTHESIS - binds to P site of 50S RIBOSOME and inhibits very first charged tRNA from coming into complex (step 1) BLOOD - myelosuppression (pancytopenia) RESISTANT ORGANISMS
39
50 S binding drug classes (4)
Macrolides Clindamycin Chloramphenicol Linezolid
40
30 S binding drug classes (2)
Aminoglycosides | Tetracyclines
41
Sulfonamides (3)
sulfadiazine sulfamethoxazole sulfamethizole
42
Sulfonamides MOA Key adverse effect?
competitively inhibits DIHYDROPTEROATE SYNTHASE SKIN - hypersensitivty, photosensitivity, Steven-Johnson Syndrome
43
Trimethoprim MOA Key adverse effect? Commonly used for?
Inhibits bacterial DIHYDROFOLATE REDUCTASE BLOOD - bone marrow suppression, megaloblastic anemia, leukopenia, granulocytopenia UTI's (combined with sulfonamide)
44
TMP-SMX characteristic common clinical use?
SYNERGISTIC ACTIVITY OF SULFONAMIDES AND TRIMETHOPRIM UTI's
45
Fluoroquinolones Group 2 active against?
Ciprofloxacin Levofloxacin Ofloxacin better against gram negative, some gram positive
46
Fluoroquinolones MOA Key adverse effects (3)? clinical?
INHIBITS DNA TOPOISOMERASE II AND IV GI Drug-nutrient interactions - binds divalent cations Cardio - QT prolongation urinary, GI, respiratory, ANTHRAX, some STI's
47
Fluoroquinolones group 1 characteristic?
Norfloxacin least activity
48
Fluoroquinolones group 3 active against?
Gatifloxacin Gemifloxacin Moxifloxacin best against gram positive
49
Metronidazole MOA Key adverse effects (2)? Activity limited to?
PRODRUG - forms REACTIVE METABOLITES that bind to DNA and disrupt function GI Metabolism - DISULFIRAM LIKE REACTION ANAEROBIC BACTERIA
50
Daptomycin MOA Key adverse effect(1)?
CAUSES DEPOLARIZATION OF BACTERIAL MEMBRANE - ultimately bactericidal MUSCULOSKELETAL TOXICITY
51
Polymyxin B MOA
BINDS TO PHOSPHOLIPIDS - disrupts structure - specificaly LPS BINDING rare adverse effects TOPICAL most often

Pharmacology Exam IV (12 decks)

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