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Pharmacology > Exam 4 - Drugs That Weaken The Bacterial Cell Wall > Flashcards

Exam 4 - Drugs That Weaken The Bacterial Cell Wall Flashcards

1
Q

How do penicillins work?

A

*Bactericidal
They weaken the cell wall, causing bacteria to take up excessive water and rupture

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2
Q

What type of bacteria is penicillin more effective at killing and why?

A

Gram-positive bacteria because there are only two layers of cell envelope that is easily accessible for the penicillin

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3
Q

What are beta-lactamases?

A

Enzymes that render penicillin inactive
Bacteria can produce a large variety of these enxymes specific for penicillins (and other beta-lactam antibiotics)

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4
Q

How do bacteria become resistant to antibiotics, specifically penicillin?

A

Penicillinases (a type of beta-lactamase)

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5
Q

Classifications of penicillins

A

Narrow spectrum penicillins (pencillinase-sensitive)
Narrow spectrum penicillins (pencillinase-resistant)
Broad spectrum penicillins
Extended spectrum penicillins

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6
Q

Prototype penicillin

A

Penicillin G (Benzylpenicillin)

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7
Q

What type of bacteria does penicillin G kill?

A

Numerous gram-positive and some gram-negative organisms

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8
Q

What is the most common cause of drug allergy?

A

*Penicillins

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9
Q

If a pt has a penicillin allergy, what should you ask them?

A

What their reaction to it was
Mild or anaphylaxis

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10
Q

What should you do for a pt who says they have had a mild reaction to penicillin, vs. a history of anaphylaxis?

A

Mild: consider cephalosporin
*Anaphylaxis: avoid administration of penicillin or cephalospirin

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11
Q

Possible timings of penicillin allergy

A

Immediate (reaction in 2-30 mins)
Accelerated (reaction in 1-72 hrs)
Late (reaction takes days or weeks to develop)

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12
Q

What symptoms occur with anaphylaxis?

A

Laryngeal edema
Bronchoconstriction
Severe hypotension

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13
Q

*Treatment of anaphylaxis

A

*Epinephrine
*Respiratory support (if needed)

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14
Q

How to prevent a penicillin allergy

A

Skin testing

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15
Q

Drug interactions of penicillin

A

Aminoglycosides (may still be given together but cant be mixed in same IV bag)

Penicillin V

Probenecid

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16
Q

Penicillinase-Resistant Penicillins in the US

A

Nafcillin
Oxacillin
Dicloxacillin

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17
Q

What does MRSA stand for?

A

Methicillin-resistant staphylococcus aureus

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18
Q

Another name for broad spectrum penicillins

A

Aminopenicillins

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19
Q

Examples of broad-spectrum penicillins

A

Ampicillin (Principen)
Amoxicillin

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20
Q

Adverse effects of broad spectrum penicillins

A

Rash
Diarrhea

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21
Q

How can broad spectrum penicillins be administered?

A

PO
IV

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22
Q

Another name for Extended spectrum penicillins

A

Antipseudomonal penicillins

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23
Q

Example of extended spectrum penicillin

A

Piperacillin

24
Q

Key points about penicillins

A

Bacteriocidal
Low toxic unless you’re allergic

25
Q

*Most widely used group of antibiotics

A

*Cephalosporins

26
Q

Structure of cephalosporins

A

Beta-lactam ring (similar to penicillin structure)

27
Q

Key points about cephalosporins

A

Bactericidal
Low toxicity

28
Q

How are cephalospirins typically administered?

A

Parenterally

29
Q

How to cephalosporins work?

A

Bind to penicillin-binding proteins (PBP’s), disrupt cell wall synthesis, and cause cell lysis

30
Q

Explain the generations of Cephalosporins

A

5 generations
Gen 1 &2 are more mild
Get stronger as you get to gen 5

3, 4, 5th gen more resistant than 1st and 2nd

31
Q

What is 1st generation of cephalosporins used for?

A

Prophylaxis against infection in surgical patients

32
Q

What are second generation cephalosporins used for?

A

More activity against gram-negative bacteria (used in combinations)

33
Q

What are 3rd generations cephalosporins used for?

A

Highly effective against gram-negative organisms
*Able to penetrate to CSF in effective concentrations
*B/c of this, used to treat meningitis

34
Q

What are 4th generation cephlosporins used for?

A

Healthcare and hospital associate pneumonias
Including those resistant to Pseudomonas

35
Q

What are 5th generation cephalosporins used to treat?

A

Infections associated with MRSA

36
Q

Examples of 1st generation cephalosporins

A

Cephalexin (Keflex)
Cefazolin (Ancef)

37
Q

Examples of 2nd generation cephalosporins

A

Cefoxitin (Mefoxin)
Cefaclor (Ceclor)

38
Q

Examples of 3rd generation cephalosporins

A

Ceftazidime (Fortaz)
Cefotaxime (Claforan)

39
Q

Example of fourth generation cephalosporin

A

Cefepime (Maxipime)

40
Q

Example of 5th generation cephalosporin

A

Ceftaroline (Teflaro)

41
Q

Drug interactions with cephalosporins

A

Probenecid
Alcohol
Drugs that promote bleeding
Calcium
Ceftriaxone

42
Q

Adverse effects of cephalosporins

A

Allergy - hypersensitivity, rash
Bleeding
Thrombophlebitis

43
Q

What are carbapenems?

A

Beta-lactam antibiotics that have an extremely broad antimicrobial spectrum
And are *Not active against MRSA

44
Q

Prototype Carbapenem

A

Imipenem (Primaxin)

45
Q

Other types of carbapenems

A

Meropenem (Merrem IV)
Ertapenem (Invanz)

46
Q

What is Imipenem (Primaxin) used for?

A

Gram pos and neg bacteria

Most effective beta-lactam antibiotic for use against *anaerobic bacteria

47
Q

Adverse effects of carbapenems

A

GI interactions
Rash

48
Q

How does Vancomycin work?

A

Inhibits cell wall synthesis (much stronger antibiotic)

49
Q

Uses of vancomycin

A

*Severe infections only
MRSA
Staphylococcus epidermidis
C. Diff

50
Q

Administration of vancomycin

A

IV (must be given slowly over an hour)
And now can be given PO

51
Q

Adverse effects of Vancomycin

A

*Renal failure
Ototoxicity
*Red man syndrome
Thrombophlebitis (common)
Thrombocytopenia (rare)
Allergy

52
Q

S/S that occur when Vancomycin is given too quickly

A

Flushing
Tachycardia
Hypotension

53
Q

Antibiotic used only for gram negative aerobic bacteria

A

Class: Monobactams
Drug: Aztreonam (Azactam)

54
Q

Administration of Aztreonam (Azactam)

A

Must be given IV or IM

55
Q

Antibiotic used for VAP (vent acquired pneumonia)

A

Class: lipoglycoproteins
Drug: Telavancin (Vibativ)

56
Q

Administration of Vibativ

A

IV

57
Q

Adverse effects of Vibativ

A

Prolong QT interval

Pharmacology (16 decks)

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