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Pharmacology Block 3 > Antibacterials - Cell Wall and Membrane > Flashcards

Antibacterials - Cell Wall and Membrane Flashcards

1
Q

What are common characteristics of cephalosporins?

A

Distribute throughout body well
Same Mechanism as penicllins
Most are IM/IV
Similar resistance to B-lactamases as Penicillin

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2
Q

What are the 1st generation cephalosporins best at treating?

A

Treat primarily gram positive - Strep and Staph

Cefazolin and Cephalexin

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3
Q

What are the therapeutic uses for Cefazolin and Cephalexin?

A

Uncomplicated Skin infections

Prophylaxis for surgery to prevent infection at incision site

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4
Q

What cephalosporin has best coverage of Strep/Staph (gram positives) with a longer half-life than most?

A

Cefazolin - IM and IV only

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5
Q

What 1st generation is primarily oral use with a short half life?

A

Cephalexin

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6
Q

What happens to the effectiveness to gram positives with increasing generations?

A

1st generation are best at gram positive including staph, but increasing generations have less gram positive effectiveness and more gram negative

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7
Q

What 2nd generation cephalosporin can penetrate the CSF and treat Haemophilus?

A

Cefuroxime

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8
Q

What 2nd generation Cephalosporin is good for anaerobes?

A

Cefoxitin

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9
Q

What makes 2nd generation Cephalosporin different from 1st generation?

A

They more gram negative coverage and less gram positive coverage and they can tolerate SOME B-lactamases.

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10
Q

What is the first line therapy against bacterial meningitis as empiric treatment?

A

Ceftriaxone

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11
Q

What is a unique attribute of Ceftriaxone?

A

Very long half-life compared to most B-lactams and is the ONLY treatment for Gonorrhea.

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12
Q

What are attributes of 3rd generation Cephalosporins?

A

They are most effective against B-lactamase positive - Gram Negative strains, less effective against gram positive strains.

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13
Q

What 3rd gen cephalosporin has extended effectiveness against pseudomonas?

A

Ceftazidime

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14
Q

What cephalosporin drug has extended effectiveness with B-lactamases?

A

Cefepime

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15
Q

What are common side effects of Cephalosporins?

A

Cross reactivity to penicillins, less chance in 3rd generation compared with 1st/2nd generation.
Also has risk of n/v/d and C.Diff development

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16
Q

What kind of bacteria contain extended-spectrum B-lactamases?

A

Gram Negative - mostly GI bacteria

–inactivate all penicillins and most cephalosporins–

17
Q

What is the only treatment for bacteria with extended spectrum B-lactamases?

A

Carbapenems — Imipenem, broad spectrum

18
Q

What is typically used for mixed infections and/or unknown infections?

A

Imipenem + Cilastatin, for extended half life

19
Q

What are common side effects of Imipenem?

A

Cross allergies with penicillin and cephalosporins
Seizures, dizziness, confusion
n/v/d

20
Q

What antibiotic does not have any cross reactivity with B-lactams and is only used for gram negative aerobic only?

A

Aztreonam - IM/IV only, resistant to many B-lactamases

21
Q

Common side effects of Aztreonam?

A

Seizures, EKG changes, n/v/d - C.Diff

22
Q

How does Vancomycin work?

A

Binds the peptide end of forming peptidoglycan preventing formation and cross linking.

23
Q

What kind of organisms does Vancomycin target and when is it used?

A

Gram Positive. Only used for severe infections and mostly IV dosing. MRSA, Strep Pneumo, penicillin allergic individuals.

24
Q

What are common side effects of Vancomycin?

A

Red Man Syndrome from histamine release
Nephrotoxicity/Ototoxicity
Phlebitis

25
Q

What antibiotic has a unique mechanism of inhibiting enolpyruvyl transferase preventing cell wall production?

A

Fosfomycin

26
Q

What is Fosfomycin used for in the United States?

A

Uncomplicated UTIs
E. Coli and Enterococcus
Off-Label – can be used for extended spectrum b-lactamase strains
–very expensive–

27
Q

What is a topical only antibiotic that is effective for gram positive?

A

Bacitracin - inhibits recycling of molecules used to produce the cell wall

28
Q

What topical drug targets the cell membrane in gram negative organisms?

A

Polymyxin B - Topical Use Only

–binds LPS on outer membrane–

29
Q

What antibiotic is used against gram positives that targets the cell membrane depolarizing?

A

Daptomycin

30
Q

What can Daptomycin treat and what area of the body is it ineffective for?

A

Complicated Skin infections including MRSA

–Not for Pneumonia–

31
Q

What are beneficial qualities of Daptomycin?

A

No cross resistance with B-lactams or Cephalosporins

32
Q

What is a unique side effect of Daptomycin?

A

Can cause elevated CPK levels and muscle pain/weakness

Pharmacology Block 3 (19 decks)

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