Chapter 34: Bacterial and Mycobacterial Infections: Cell Wall Synthesis Flashcards Preview

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Flashcards in Chapter 34: Bacterial and Mycobacterial Infections: Cell Wall Synthesis Deck (28)
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1

Drug of choice for methicillin resistant staph aureus infections? MOA?

Vancomycin

Bind to the D ALa D Ala part of murein monomer...inhibits peptidoglycan glycosyltransferase --> murein monomers can't add to the growing chain

2

What is a common adverse effect of vancomycin, telavancin, and teicoplanin? How can it be avoided?

Red Man Syndrome: flushing and erythema

Can be avoided by slowing transfusion rate

3

Because of its toxicity, vancomycin is only used when?

Only used when multidrug resistance is present

4

What are the two different uses of Bacitracin?

Cutaneous and eye infections: Topical
Decontaminate c diff: Oral

Most commonly used topically so that systemic absorption does not occur and cause nephrotoxicity

5

Bacitracin MOA?

Inhibits dephosphorylation of bactoprenyl diphosphate by forming a complex with it

BACitracin --> BACtoprenyl

6

Which is more toxic to the liver, vancomycin or telavancin?

telavancin

"tele"vision is toxic

7

MOA of B lactams? How do penicillins differ from cephalosporins?

inhibit transpeptidase by forming covalent acyl enzyme intermediates "dead end"

suicide substrate inhibition

Penicillins are 5 MEMBERED RING; cephalosporins are 6

8

Penicillin G and penicillin V - are they B lactamase sensitive or resistant?

sensitive

9

What would you use to treat aerobic or anaerobic infections of the head/neck? i.e. a dental abscess?

Penicillin V

10

Penicillin can potentiate the effects of what drug?

anticoagulant effects of warfarin

"penicillin & wartime"

11

Which penicillins are used to mainly to treat skin and soft tissue infections?

METHICILLIN
Oxacillin
Cloxacillin
Dicloxacillin
Nafcillin

12

What is the drug of choice for uncomplicated ear, nose, throat infections? Endocarditis prevention? Combo therapy for h. pylori?

What is the stipulation with administration?

Amoxicillin

Because it is B lactamase sensitive, give it with a B lactamase inhibitor (Clavulanic acid)

13

Ampicillin is used in what scenarios?

Listeria meningitis and invasive enterococcal infections

"Get AMPed to write a LIST!!!!!"

also can be used in b lactamase producing bacteria like
1) staph aureus
2) h influenzae
3) e coli
4) klebsiella
5) anaerobes

14

Which penicillins have broad spectrum antibactericidal activity but are used mostly to treat p. aeruginosa?

carbenicillin
ticarcillin
piperacillin
mezlocillin

15

Cycloserine MOA and clinical app?

inhibit alanine racemase and D ala D ala ligase to prevent cell wall synthesis

m tuberculosis
"shake your tuber-cle like a cyclo-ne"

16

What drug would you use to treat gram negative urinary tract infections? MOA?

fosfomycin

PEP analogues - block production of murein monomers

17

Which cephalosporins may produce alcohol intolerance syndrome?

cefotetan
cefoperazone

18

Major clinical application of Ceftriaxone? 3rd gen

Enterobacteriacea (gram neg)

19

Which generation of cephalosporins have the best gram positive coverage?

First generation: cefazolin, cephalexin

20

Cefepime

Cephalosporin 4th generation
Used for p. aeruginosa and enterobacteriae
NOT approved for meningitis

21

Ceftaroline

MRSA
VRSA
= great for multidrug resistant staph aureus

22

What B lactam would you use for a patient allergic to penicillin?

Aztreonam

23

Daptomycin MOA and clinical app?

integrates into gram positive membranes to form pores --> cell death

complicated skin infections
R sided endocarditis from staph aureus

24

What are the major adverse effects and contraindications of daptomycin?

C diff
Don't use with statins

25

Mainstay of treatment for tuberculosis??

THE BIG FIVE
- ethambutol
- pyrazinamide
-isoniazid
-rifampin
-streptomycin

Combination therapy is a must

26

How many of the big five do you use if the patient has isoniazid resistance?

4

27

Why don't we use B lactams singularly to treat mycobacterium tuberculosis?

mycobacterium tuberculosis has very high b lactamase activity = highly resistant

28

Which antimycobacterial agent is associated with optic neuritis and requires frequent eye exams?

Ethambutol
E for Eye