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Pharmacology > Beta Lactam Antibiotics > Flashcards

Beta Lactam Antibiotics Flashcards

1
Q

(-) cell walll synthesis by binding to penicillin binding proteins

A

PENICILLINS

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2
Q

NATURAL PENICILLINS

effective against gram (+) cocci EXCEPT penicillinase producing bacteria, meningococci, spirochetes, anaerobic cocci

A 
Penicillin G (IV)
Penicillin V (Oral)
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3
Q

ANTISTAPHYLOCOCCAL PENICILLINS

Active against most penicillinase producing staphylococci

A

Nafcillin
Oxacillin
Cloxacillin
Dicloxacillin

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4
Q

AMINOPENICILLLINS

Effective against gram (+) cocci, enterococci and Listeria monocytogenes

A

Ampicillin

Amoxicillin

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5
Q

Antipseudomonal Penicillins

A

Piperacillin - combined characteristics of extended spectrum penicillins and the other 3 anti pseudomonal penicillins
Sulbenicillin
Carbenicillin
Ticarcillin

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6
Q

(-) cell wall synthesis but are less susceptible to penicillinases

A

CEPHALOSPORINS

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7
Q

1ST GENERATION CEPHALOSPORIN

active against most gram (+) - Penicillin resistant S. aureus but NOT against enterococcus, MRSA, MRSE

gram (-) - E. coli, K. pneumoniae, and P. mirabilis

A 
Cefazolin - surgical prophylaxis
Cephalexin - respiratory tract infections
Cephalothin
Cefadroxil
Cephapirin
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8
Q

2ND GENERATION CEPHALOSPORIN

Improved activity against H. influenzae, M. catarrhalis, Neisseria meningitisis and N. gonorrhea

Staphylococci, Non enterococci, streptococcia nd some enterobacteriacea

A 
Cefoxitin
Cefaclor
Cefuroxime
Cefamandole
Cefonizid
Cefotetan
Cefprozil
Cefmetazole
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9
Q

Cephamycins

A

Cefoxitin
Cefotetan
Cefmetazole

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10
Q

3RD GENERATION

Excellent activity against N. gonorrhea, H. influenzae, M. catarrhalis and Enterobacteriaceae

Effective against S. pneumoniae, S. pyogenes and other Streptococci (EXCEPT Ceftazidime)

Modest activity against MSSA

A 
Ceftriaxone
Ceftazidime
Cefixime
Ceftizoxime
Cefpodoxime proxetil
Cefotaxime
Cefoperazone
Moxalactam
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11
Q

Natural Penicillin

A 
Penicillin G (IV)
Penicillin V (PO)
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12
Q

Anti-Staphylococcal Penicillins/Isoxazolyl Penicillin/Penicillinase-resistant Penicillins

A

IV

  • Nafcillin
  • Oxacillin

PO

  • Cloxacillin
  • Dicloxacillin

METHICILIN - off the market d.t. INTERSTITIAL NEPHRITIS

ISOXAZOYL PENICILLINS

  • Oxacillin
  • Cloxacillin
  • Dicloxacillin

*for IMPETIGO

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13
Q

Aminopenicillins

BROAD SPECTRUM

enhanced effect when used with beta lactamase (Clavulanic acid, Sulbactam)

synergistic effect with aminoglycosides

HELPME
Haemophilus influenzae
E.coli
Listeria monocytogenes
Proteus mirabilis
Moraxella catarrhalis
Enterococci
A

Ampicillin (IV)
*usually combined to Gentamicin (protein synthesis (-))

Amoxicillin (PO)

  • HELPS kill Enterococci
  • Haemophilus influenzae
  • E. coli
  • Listeria monocytogenes
  • Proteus mirabilis
  • Salmonella
  • Enterococci
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14
Q

beta lactam attached to THIAZOLIDINE RING

6-APA (aminopenicillamic acid)

A

PENICILLIN

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15
Q

How long will you give Benzathine Penicillin G as a secondary prophylaxis for RHF?

A

ARF w/o carditis
*every 21 days for 5 years or until 21 y/o whichever is longer

ARF W/ CARDITIS (-) valvular involvement
*every 21 days for 10 years or until 21 y/o whichever is longer

ARF w/ CARDITIS and VALVULAR INV
*every 21 days for 10 years or until 40 y/o whichever is longer

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16
Q

Penicillins

A

Pen G - iniinGect

Pen V - VIVIG (iniinom)

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17
Q

Coverage of Penicillins

A

Gram POSITIVE

no gram negative EXCEPT - Neisseria meningitidis, Treponema pallidum, Leptospira

little coverage for anaerobes EXCEPT Bacteroides fragilis (wala siyang coverage dito)

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18
Q

Aminopenicillins Coverage

A

gram (+)
gram (-)
anaerobes EXCEPT Bacteroides fragilis

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19
Q

AntiPseudomonal Penicillins

A

CARBOXYPENICILLINS

  • Carbenicillin
  • Ticarcillin

UREIDOPENICILLINS

  • Piperacillin - MOST POTENT
  • Azlocillin
  • Mezlocillin
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20
Q

Bactericidal

A
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21
Q

Common Adverse Effects of Penicillins

A

Hypersensitivity - cross sensitizing, cross reacting; IgE mediated

Maculopapular rash - occurs after 72 hrs; NOT IgE mediated
*common during infectious mononucleosis (Amoxicillin, Ampicillin)

GI disturbances
*diarrhea (Ampicillin), N/V, oral candidiasis

Hematologic disturbances (Ticarcillin)

Pseudomembranous colitis (Ampicillin)

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22
Q

1st Generation Cephalosporins

A

-CEPH including sounds like haha

Cefazolin (IV) 
Cephalexin (PO)
Cefadroxil
Cephalotin
Cephapirin
Cephradrine
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23
Q

Beta lactam attached to DIHYDROTHIAZINE ring

7-aminocephalosporanic acid (7-ACA)

A

CEPHALOSPORINS

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24
Q

2nd Generation Cephalosporins

A

CEF + VOWEL
PRO - CefPROzil
META - CefMETAzome
LORA - Loracarbef

Cefuroxime
Cefoxitin
Cefotetan
Cefmetazome
Cefamandole
Cefaclor
Cefonizid
Cefprozil
Loracarbef
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25
Q

3rd Generation Cephalosporins

A 
CEF + CONSONANT
MONEY - cefoPERAzone
TAXES - cefoTAXime
FIXERS - ceFIXime
MOXA (MX3)
Ceftriaxone
Ceftazidime
Ceftizoxime
Cefpodoxime proxetil
Moxalactam
Cefixime
Cefoperazone
Cefotaxime
26
Q

4th Generation Cephalosporins

A

Cefepime
Cefpirome
Ceftaroline

27
Q

5th Generation Cephalosporins

A

CeftaROLine

CeftobipROLe

28
Q

Coverage of 1st generation Cephalosporins

A

gram (+)
gram (-)
*PEcK - Proteus, E. coli, Klebsiella

29
Q

Coverage of 2nd generation Cephalosporins

A

HENPEcK

*H. influenzae, Enterobacter, Neisseria + anaerobes

30
Q

Has improved actions against pneumococcus and H. influenzae

A

Cefuroxime

31
Q

Have good activity against B. fragilis and are used for abdominal and pelvic infectuons

A

Cefotetan

Cefoxitin

32
Q

Coverage of 3rd generation Cephalosporins

A

HENPEckSSS

Serratia
Shigella
Salmonella

33
Q

Cephalosporins active against ANAEROBIC infections

A

CEPHAMYCINS
TETA META FOX

  • CefoTETAn
  • CefMETAzole
  • CeFOXitin
34
Q

3rd generation cephalosporins with coverage against PSEUDOMONAS

A

CefTAZidime
CefoPERAzone
CefTRIaxone - only some

35
Q

All 3rd gen cephalosporins have renal excretion EXCEPT

A

Cefoperazone

Ceftriaxone

36
Q

All 3rd gen cephalosporins can penetrate BBB EXCEPT

A

Cefoperazone

Cefixime

37
Q

The most active Cephalosporins against Penicillin-Resistant Streptococcus pneumoniae

A

Ceftriaxone

Cefotaxime

38
Q

Coverage of 4th generation Cephalosporins

A

LAHAT nung meron sa ibang generation

PSEUDOMONAS

39
Q

Coverage of 5th generation Cephalosporins

A

LAHAT nung meron sa ibang generation

MRSA

40
Q

Differ with penicillin in that the SULFUR atom of the thiazolidine ring has been externalized and replaced by a CARBON atom

A

Carbanepem

41
Q

Carbapenem

A

Imipenem-Cilastatin
Meropenem
Doripenem - VERY GOOD against Pseudomonas
Ertapenem

42
Q

Inhibits renal metabolism (hydrolysis) of IMIPENEM by DIHYDROPEPTIDASE

A

Cilastatin

43
Q

Carbanepems are active against Pseudomonas and Acitenobacter EXCEPT

A

Ertapenem

44
Q

Drug of choice for extended spectrum beta lactamase (ESBL) infections

A

CARBAPENEM

45
Q

Most EPILEPTOGENIC among beta lactam antibiotics

A

CARBAPENEM

IMIPENEM - pinaka!!!!

46
Q

Monobactam

A

Aztreonam

same coverage with Ceftazidime

  • gram (-) - HENPECKSSSSS
  • Pseudomonas

ADR
*transaminitis

47
Q

Penicillin Resistance

A

Enzymatic hydrolysis of beta lactam ring by formation of beta lactamases (penicillinases)
i.e. S. aureus

Structural changes in target PBPs
i.e. MRSA, Pneumococci, Enterococci

Changes in PORIN structures in outer cell wall impeding access to Penicillins and PBPs
i.e Pseudomonas aeruginosa

48
Q

DOC for syphilis

A

Penicillin

49
Q

Penicillin coverage

A

gram POSITIVE

NO gram negative EXCEPT:
Neisseria meningitidis
Treponema pallidum
Leptospira

LITTLE coverage against ANAEROBE EXCEPT Bacteroides fragilis (no coverage siya)

50
Q

Prolongs the effect of penicillin

A

Probenecid

51
Q

Long acting IM preparations of penicillin

A

Benzathine penicillin

Procaine penicillin

52
Q

SE of Aminopenicillins

A

Pseudomembranous colitis

53
Q

All cephalosporins have RENAL excretion EXCEPT

A

CefoPERAzone

Ceftriaxone

54
Q

Improved action against pneumococcus and H. influenzae

A

2nd Generation

Cefuroxime

55
Q

Good activity against B. fragilis (abdominal and pelvic infections)

A

2nd Generation

Cefotetan
Cefoxitin

56
Q

DOC for Gonorrhea

A

Ceftriaxone

Cefixime

57
Q

All 3rd generation penetrate BBB EXCEPT

A

Cefoperazone

Cefixime

58
Q

3rd generation with very good CNS penetration

A

Ceftriaxone

59
Q

3rd generation with very action on Pseudomonas

A

Ceftazidime

60
Q

Most active against Penicillin resistant S. pneumoniae

A

Ceftriaxone

Cefotaxime

61
Q

Novel Cephalosporin usually combined with Tazobactam used for the treatment of complicated UTI

A

Ceftozalone

62
Q

Novel Cephalosporin

Siderophore Cephalosporin

for the treatment of complicated UTI and pseudomonas

A

Cefiderocol

Pharmacology (72 decks)

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