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Flashcards in Antibacterial Agents II Deck (50):
1

Structurally, penicillin is a __________.

beta-lactam ring

2

There are three stages of bacterial cell wall synthesis that can be targeted by antibiotics. What are they?

(1) synthesis of cell wall parts in the cytosol; (2) polymerization of subunits at the cell membrane; and (3) cross linking of peptidoglycans at the cell wall

3

What antibiotics target stage 1 of cell-wall synthesis?

Fosfomycin and cycloserine

4

What antibiotics target stage 2 of cell-wall synthesis?

Bacitracin and vancomycin

5

What antibiotics target stage 3 of cell-wall synthesis?

Penicillins and cephalosporins

6

Beta-lactamases are _____________.

a generic term for enzymes that degrade beta-lactam rings; they are not one specific enzyme

7

Methicillin resistance occurs by ___________.

alterations in penicillin-binding proteins

8

Penicillin is ________ at neutral pH and thus does not ___________.

ionized; enter cells or cross basement membranes well

9

Penicillins are __________ excreted.

renally

10

Piperacillin and ticarcillin are great for _________, but they must be administered __________.

killing pseudomonas and anaerobic bacteria; parenterally

11

Name three beta-lactamase inhibitors.

Sulbactam, tazobactam (combined with piperacilln to become Zosyn), and clavulanic acid (combined with amoxicillin to become Augmentin)

12

What antibiotic is used to treat non-invasive streptococci infections?

Penicillin G

13

What drug should be given to those with enterococci-associated bacteremia and meningitis?

Penicillin G and ampicillin

14

Some adverse reactions to penicillins are ___________.

diarrhea (which is common), seizures, and encephalopathy

15

There is __________ reactivity between penicillins and cephalosporins, so if a patient has a sensitivity reaction to penicillin, then _________.

some; do not give cephalosporins (choose something totally unrelated, like a macrolide)

16

List the five categories of cell-wall inhibitors.

Vancomycin, penicillin, cephalosporins, carpapenems, and monobactams

17

Substitution at the R group can __________ penicillins.

(1) increase stability in the GI tract; (2) decrease renal excretion; (3) minimize bacterial resistance; and (4) increase bacterial susceptibility

18

Penicillinase is transferred via ________.

plasmids

19

Beta-lactamase is a generic term for __________.

enzymes that degrade penicillins and cephalosporins

20

MRSA is resistant by ____________.

altering its protein target (PBP2a)

21

Penicillins are _________ from intramuscular sites.

rapidly absorbed (because it is a neutral environment)

22

Penicillins penetrate tissues ________.

poorly

23

What are some characteristics of penicillin G?

It is the proto-typical penicillin; former antibiotic of choice, but now limited to hospitalized patients; given parenterally; susceptible to penicillinase.

24

Compared to penicillin G, Penicillin V is ________.

less effective, but better absorbed orally

25

What are the penicillinase-resistant penicillin drugs?

Nafcillin, oxacillin, veracillin, cloxacillin, and dicloxacillin

26

The penicillinase-resistant drugs are ________.

generally less potent than penicillin G and narrow-spectrum

27

How are extended spectrum penicillins different?

They are more hydrophilic (due to an extra amino or carboxyl group) and can thus pass through porins in Gram-negative bacteria more easily.

28

Most penicillins only work against _________; the exceptions are ________.

Gram-positive bacteria; amoxicillin, ampicillin, ticarcillin, and piperacillin, which work on some Gram-negative rods

29

Amoxicillin is not _________, but can be _________.

resistant to penicillinases; administered with a beta-lactamase inhibitor (such as clavulanic acid)

30

The only penicillins that work against Bacteroides fragilis and Pseudomonas are __________, but they have to be administered ___________.

Ticarcillin and Piperacillin; through an IV

31

There are three main beta-lactamase inhibitors: __________.

clavulanic acid, sulbactam, and tazaobactam

32

Of Gram-positive cocci, cephalosporins do not kill ________.

enterococcus (including VRE)

33

Haemophilus influenzae is known to cause __________.

pneumonia, sinusitis, otitis media, and menigitis

34

Treat Treponema pallidum with (the spirochete that causes syphilis) with _______.

penicillin G

35

The only drug that kills Borrelia burgdorferi (Lyme disease) is ________.

amoxicillin

36

Haptens are ___________.

small molecules that attach to larger molecules to form antigens

37

Vancomycin is administered ________.

parenterally, except in cases of Clostridial GI infections

38

What organisms does vancomycin kill?

All Gram-positive cocci (except VRE) and Clostridia

39

What is the main concern for adverse reactions with vancomycin treatment?

Ototoxicity, nephrotoxicity, and Red Man syndrome

40

Daptomycin targets _______ and can be used to kill ________, but it has restricted use.

cell membranes; MRSA, VRSA, and VRE

41

The lipoglycopeptides are ___________; they target __________; they should only be used in ___________.

oritavancin, dalbavancin, and telavancin; they same step as vancomycin, and so kill Gram-positive bacteria; patients with allergies to other drugs or infections with resistant strains

42

________ is the only cephalosporin that can kill MRSA.

Cefepime

43

Cephalosporins have a similar range of killing as amoxicillin, but they can't kill ________.

Enterococci

44

Keflex is ___________.

an orally administered, first-generation cephalosporin called cephalexin

45

Rocephin is __________, and it is unique for its ability to kill __________.

ceftriaxone; Neisseria gonorrhoeae

46

The carbapenems are bactericidal to everything except ___________.

E. faecium, VRE, Clostridia, and atypical bacteria

47

Monobactams only kill ___________.

Gram-negative aerobic bacteria

48

The best antibiotics for Gram-negative Neisseria are ____________.

3rd-generation cephalosporins (ceftriaxone and cefotaxime)

49

Like piperacillin and ticarcillin, second generation cephalosporins (cefaclor and cefuroxime) are active against __________.

Bacteroides fragilis

50

In addition to cefepime and ceftaroline, ________ all also kill MRSA.

vancomycin, clindamycin, tetracyclines, and macrolides

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