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PHRM 865 - Therapeutics V > exam 2 > Flashcards

exam 2 Flashcards

(71 cards)

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1
Q

What is the mechanism of action of Penicillins?

A

Inhibits cell wall synthesis by binding to and inhibiting PBPs

PBPs are penicillin-binding proteins essential for bacterial cell wall integrity.

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2
Q

What are the mechanisms of resistance for Penicillins?

A
  • β-lactamase production
  • Altered PBPs
  • Decreased penetration through outer cell membrane (GNO)

GNO refers to Gram-negative organisms.

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3
Q

Are Penicillins bactericidal or bacteriostatic?

A

Bactericidal (except enterococcus)

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4
Q

Is the action of Penicillins time-dependent or concentration-dependent?

A

Time-dependent

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5
Q

What is the mechanism of action of Cephalosporins?

A

Inhibits cell wall synthesis by binding to and inhibiting PBPs

Similar to Penicillins, Cephalosporins target PBPs.

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6
Q

What are the mechanisms of resistance for Cephalosporins?

A
  • β-lactamase production
  • Altered PBPs
  • Decreased penetration through outer cell membrane (GNO)
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7
Q

Are Cephalosporins bactericidal or bacteriostatic?

A

Bactericidal (except enterococcus)

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8
Q

Is the action of Cephalosporins time-dependent or concentration-dependent?

A

Time-dependent

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9
Q

What is the mechanism of action of Carbapenems?

A

Inhibits cell wall synthesis by binding to and inhibiting PBPs

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10
Q

What are the mechanisms of resistance for Carbapenems?

A
  • β-lactamase production
  • Altered PBPs
  • Decreased penetration through outer cell membrane (GNO)
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11
Q

Are Carbapenems bactericidal or bacteriostatic?

A

Bactericidal

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12
Q

Is the action of Carbapenems time-dependent or concentration-dependent?

A

Time-dependent

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13
Q

What is the mechanism of action of Monobactams?

A

Inhibits cell wall synthesis by binding to and inhibiting PBPs

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14
Q

What are the mechanisms of resistance for Monobactams?

A
  • β-lactamase production
  • Decreased penetration through outer cell membrane (GNO)
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15
Q

Are Monobactams bactericidal or bacteriostatic?

A

Bactericidal

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16
Q

Is the action of Monobactams time-dependent or concentration-dependent?

A

Time-dependent

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17
Q

What is the mechanism of action of Fluoroquinolones?

A

Inhibits DNA synthesis by inhibiting bacterial topoisomerases

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18
Q

What are the mechanisms of resistance for Fluoroquinolones?

A
  • Mutation in genes that code for DNA gyrase or topoisomerase IV (change in binding site)
  • Efflux
  • Decreased penetration through outer cell membrane (GNO)
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19
Q

Are Fluoroquinolones bactericidal or bacteriostatic?

A

Bactericidal

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20
Q

Is the action of Fluoroquinolones time-dependent or concentration-dependent?

A

Concentration-dependent

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21
Q

What is the mechanism of action of Macrolides?

A

Inhibits protein synthesis by binding to 50S ribosomal subunits

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22
Q

What are the mechanisms of resistance for Macrolides?

A
  • Efflux (mef)
  • Change in ribosomal binding site (erm)
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23
Q

Are Macrolides bactericidal or bacteriostatic?

A

Bacteriostatic

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24
Q

Is the action of Macrolides time-dependent or concentration-dependent?

A

Time-dependent

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25
What is the mechanism of action of Aminoglycosides?
Inhibits protein synthesis by irreversibly binding to 30S ribosomal subunits
26
What are the mechanisms of resistance for Aminoglycosides?
* Altered aminoglycoside uptake * Synthesis of aminoglycoside-modifying enzymes * Alteration in ribosomal binding sites (strepto)
27
Are Aminoglycosides bactericidal or bacteriostatic?
Bactericidal
28
Is the action of Aminoglycosides time-dependent or concentration-dependent?
Concentration-dependent
29
What is the mechanism of action of Vancomycin?
Inhibits 2nd stage of cell wall synthesis by binding to D-Ala-D-Ala cell wall precursors
30
What are the mechanisms of resistance for Vancomycin?
* Modification of the D-alanyl-D-alanine vancomycin binding site
31
Are Vancomycin and Dalbavancin bactericidal or bacteriostatic?
Bactericidal
32
Is the action of Vancomycin time-dependent or concentration-dependent?
Time-dependent
33
What is the mechanism of action of Quinupristin-dalfopristin?
Inhibits protein synthesis by binding to 50S ribosomal subunits
34
What are the mechanisms of resistance for Quinupristin-dalfopristin?
* Alteration in ribosomal binding site
35
Are Quinupristin-dalfopristin bactericidal or bacteriostatic?
Bacteriostatic
36
Is the action of Quinupristin-dalfopristin time-dependent or concentration-dependent?
Time-dependent
37
What is the mechanism of action of Linezolid?
Inhibits protein synthesis by binding to 50S ribosomal subunit near 30S interface
38
What are the mechanisms of resistance for Linezolid?
* Alteration in ribosomal binding site (rare)
39
Are Linezolid and Tedizolid bactericidal or bacteriostatic?
Bacteriostatic
40
Is the action of Linezolid time-dependent or concentration-dependent?
Time-dependent
41
Is the action of Tedizolid time-dependent or concentration-dependent?
Concentration-dependent
42
What is the mechanism of action of Daptomycin?
Causes membrane depolarization by inserting lipophilic tail in cell wall
43
What are the mechanisms of resistance for Daptomycin?
* Altered cell membrane binding through loss of membrane protein
44
Are Daptomycin and Telavancin bactericidal or bacteriostatic?
Bactericidal
45
Is the action of Daptomycin time-dependent or concentration-dependent?
Concentration-dependent
46
What is the mechanism of action of Telavancin?
Inhibits cell wall synthesis by binding to D-Ala-D-Ala cell wall precursors AND causes membrane depolarization by inserting lipophilic tail in cell wall
47
What are the mechanisms of resistance for Telavancin?
* Modification of the D-alanyl-D-alanine vancomycin binding site
48
What is the mechanism of action of Tetracyclines?
Inhibits protein synthesis by binding to 30S ribosomal subunits
49
What are the mechanisms of resistance for Tetracyclines?
* Tetracycline-specific efflux pumps * Ribosomal protection proteins * Enzymatic inactivation
50
Are Tetracyclines bactericidal or bacteriostatic?
Bacteriostatic
51
Is the action of Tetracyclines time-dependent or concentration-dependent?
Time-dependent
52
What is the mechanism of action of Trimethoprim-sulfamethoxazole?
Sequential inhibition of microbial folic acid synthesis pathway by inhibiting bacterial dihydropteroate synthetase and dihydrofolate reductase
53
What are the mechanisms of resistance for Trimethoprim-sulfamethoxazole?
* Mutation in dihydrofolate reductase or dihydropteroate synthase
54
Are Trimethoprim-sulfamethoxazole bactericidal or bacteriostatic?
Bactericidal
55
Is the action of Trimethoprim-sulfamethoxazole time-dependent or concentration-dependent?
Time-dependent
56
What is the mechanism of action of Polymyxins?
Binds to phospholipids in cell membrane causing displacement of Ca and Mg, leading to changes in cell wall permeability and leakage of cellular contents
57
What are the mechanisms of resistance for Polymyxins?
* Alteration in outer cell membrane (↓Ca or Mg content, ↓lipopolysaccharide content, ↓outer membrane proteins)
58
Are Polymyxins bactericidal or bacteriostatic?
Bactericidal
59
Is the action of Polymyxins time-dependent or concentration-dependent?
Concentration-dependent
60
What is the mechanism of action of Clindamycin?
Inhibits protein synthesis by binding to 50S ribosomal subunits
61
What are the mechanisms of resistance for Clindamycin?
* Alteration in ribosomal binding site (erm)
62
Are Clindamycin and Metronidazole bactericidal or bacteriostatic?
Clindamycin: Bacteriostatic; Metronidazole: Bactericidal
63
What is the mechanism of action of Metronidazole?
Prodrug activated by ferredoxins whose activated metabolites damage bacterial DNA
64
What are the mechanisms of resistance for Metronidazole?
* Altered growth requirements * Reduced transcription of ferredoxin gene
65
What antibiotic is the drug of choice for Methicillin-Susceptible Staphylococcus aureus (MSSA)?
Nafcillin (IV)* Dicoxacillin Cefazolin
66
What antibiotic is considered a potential drug of choice for Methicillin-Resistant Staphylococcus aureus (MRSA)?
Vancomycin*
67
What is the drug of choice for Enterococcus spp. susceptible to Ampicillin?
Ampicillin* (IV or PO, depending on infection) If patient can't receive ampicillin, then vanc
68
What is the drug of choice for Vancomycin-Resistant Enterococcus spp. (VRE) that is susceptible to ampicillin?
Ampicillin
69
What are the preferred antibiotics used for Pseudomonas aeruginosa?
* Piperacillin* Cefepime Amikacin (with other B-lactams)
70
What antibiotic is used for atypical bacteria such as Legionella, Mycoplasma, Chlamydia?
Erythromycin, Clarithromycin or Azithromycin* Levofloxacin, Ciprofloxacin, Delafloxacin, Moxifloxacin* Doxycycline† and Tetracycline analogs
71
What is the treatment for Clostridioides difficile colitis?
Oral Vancomycin

PHRM 865 - Therapeutics V (2 decks)

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