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Flashcards in B-Lactams and more! Deck (23):
1

B-lactams consist of Penicillin, Lactamase inhibitors, cephalosporins and Cephamycins, Carbapenems, Monobactams

What is there MOA?

Cross link is usually formed by transpeptidase but B-lactams inhibit this

Also known as PBP

2

B-lactams are _____ dependent and they are not active against?

Time dependent, not active against MRSA

3

How can bacteria be resistant to B-lactams and their derivatives? Theres 4 

  1. Inactivation by amidases, B-lactamase, or carbapenamases
  2. Modification of PBP
  3. Imparied drug penetration to target PBPs
  4. Anitbiotic Efflux 

4

What are the B-lactam inhibitors?

What do they do? 

Clavulanic Acid, Sulbactam, Tazobactam 

Protected hydrolyzed penicillins from inactivation. Extend Spectrum of the penicillin to strains that would otherwise be inactive. 

5

Cephalosporin and Cephamycin what is their purpose?

What are some adverse rxns?

Increase gram negative coverage 

Allergy, methylthiotetrazole containing cephs can cause bleeding and disulfiram like rxns

6

Carbapenems are not active against? 

Impenem is administered with? 

Good choice for?

  • Klebsiella pneumoniae 
  • And carbapenemase producing strains 
  • administered with a renal dehydropeptidase, cilastatin
  • Good for nosocomial infections and B-lactamase producing GN strains 

7

Monobactams?

Limited to?

No activity againsts? _____ and _____

  • Aztreonam
  • Limited to aerobic GN rods (including P aeruginosa) 
  • No activity against GP, or anaerobes 

8

Vancomycin is only active against?

Binds to d-___d-___

Drug of choice for?

Can cause?

  • Gram positive 
  • Binds to d-Ala-d-Ala preventing elongation
  • Drug of choice for MRSA
  • Time dependent killing
  • Redman syndrome

9

Cyclic Lipopeptide?

Daptomycin

10

What does daptomycin do?

Effects against? can cause?

  • Binds to the cell wall of gram positive causing death 
  • Effective againsts MRSA, VRE (Vanco-resistant)
  • Allergic pneumonitis 

 

11

Fosfomycin?

MOA?

Used to treat?

Same as?

 

  • Inhibits the bacterial wall synthesis by inhibiting the synthesis of the cell wall building blocks
  • Primarily used for uncomplicated lower UTI
  • Same as Nitrofurantoin

12

Tetracyclines?

Tetra, Doxy, Tige all cycline

13

Tetracyclines are good for treating?

Resistance? 3 ways 

 

  • Rickettsia Mycoplasma, Chlamydia, Plasmodium
  1. Impaired influx or increased efflux
  2. Productin of proteins that interfere with tetracylcine
  3. Enzymatic inactivation 

14

Macrolides?

Clari, Azithro, Erythro

15

Macrolides are used for?

Check for interactions with?

Respiratory infection, Avium, Chlamydia

P450 interaction 

 

16

Macrolide resistance? 3 ways 

  1. Impaired influx or increase efflux 
  2. Production of esterases that hydrolyze macrolide lincosamide and streptogramin, MLS type B
  3. Modification of the ribosomal binding site by mutation or by macrolide inducible or constitutive methylase

17

Lincosamides?

Derivative of the?

Good for? 

what type of bacteria

Resistance?

Clindamycin 

  • Of Lincomycin
  • skin and soft tissue infections cause by strep and staph
  • Same as macrolides 
    • Impaired influx or increase efflux 

      Production of esterases that hydrolyze macrolide lincosamide and streptogramin, MLS type B

      Modification of the ribosomal binding site by mutation or by macrolide inducible or constitutive methylase

18

Streptogramins?

Rapidly ____ for most susceptible organisms ____ , _____ and ____ but not?

Resistance?

 

  • Quinupristin-dalfopristin in 30:70
  • bactericidal for MSSA, MRSA, and VRE
    • but not Entero Faecalis
    • slow with Entero Faesium 
  • Same as macrolide

 

19

Oxazolidinones?

MOA

GOOD for?

AE?

Resistnace?

Linezolid

  • Inhibits proteins synth by preventing formation of the ribosome complex
  • Good for MSSA, MRSA, VRE entero faecium 
  • Hematologic AE: Thrombocytopenia myelosuppression
  • Different from other protein synth inhibitors

 

20

Amino glycosides. 3 main things

 

  1. Irreversible inhbitors of protein synthesis, Block the initiation complex
  2. Miscoding of amino acids
  3. Block of translocation on mRNA

21

Aminoglycosides?

______ dependent killing?

_____ killing with cell wall ___ in endocarditis

Good for?

AE?

Amikacin, Gentamicin, Tobramycin

  • Cocentration dependent killing
  • Synergisitc with cell wall inhibitors
  • Nephro and ototoxicity 

 

22

First, Second, Third, Fourth generation cephalosporins gone over in class?

  1. Cephalexin, Cefazolin
  2. Cefprozil, Cefuroxime
  3. Ceftriaxone, Cefotaxime
  4. Cefepime 

 

23

What generation cephalosporin/cephamycin can cross the BBB?

3rd and 4th 

  • Ceftriaxone, Cefotaxime
  • Cefepime