Inhibitors Of Cell Wall Synthesis Flashcards by Lauren F

What is bacitracin’s spectrum?

Gram +

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What are the 4 natural penicillins?

Penicillin G

Benzathine penicillin

Procaine penicillin G

Penicillin V

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What is the DOC for salmonella?

TMP-SMZ

Quinolone

Cephalosporin (3rd gen)

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How is bacitracin administered?

Topical

Rarely parenterally

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What is the DOC for Helicobacter Pylori?

tetracycline or amoxicillin + bismuth+ metronidazole

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What are the two major uses for antipseudomonal penicillins?

Pseudomonas

Acinetobacter

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What is the DOC for Strep pneumoniae?

Penicillin

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Are B-lactamase inhibitors helpful against MRSA

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Do 2nd gen cephalosporins have any antipseudomonal activity?

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What is the DOC for surgical prophylaxis?

Cefazolin

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What effect will protein synthesis inhibitors have on the action of cell wall synthesis inhibitors?

It will prevent the action of cell ICWS drugs because it will prevent the production of autolysins

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What causes the loss of cell wall integrity after B-lactam treatment?

The bacteria’s own autolysins that are constantly degrading the old cell wall

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Why is vancomycin a drug of last resort?

Due to the emergence of VRE (vancomycin resistant enterococci)

And the need for effective MRSA treatment

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What happens when you combine fosfomycin with a B-lactam, aminoglycoside, or fluoroquinolone?

Synergistic effect

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Is ampicillin rash a hypersensitivity reaction?

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What is the spectrum of fosfomycin?

G+ and G-

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Do extended spectrum penicillins have any antipseudomonal activity?

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Do natural penicillins have any antipseudomonal activity?

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what is the DOC for Neisseria gonorrhoeae?

Ceftriaxone

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What are the 2 antipsuedomonal penicillins?

Piperacillin

Ticarcillin

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What must imipenem be given with? Why?

Cilastatin. Because imipenem is inactivated by human renal dihydropeptidases and cilastatin will inhibit them.

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What is another name for penicillinase producing staph aureus?

MSSA

Methicillin sensitive staph aureus

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What is the DOC for moraxella catarrhalis?

TMP-SMZ

Cephalosporin (2nd or 3rd gen)

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What cephalosporin has the broadest coverage against enterobacteriaceae, MSSA, and Pseudomonas?

Cefepime

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What is the only natural penicillin that is oral?

Penicillin V

Does cefepime (4th gen ceph) have any antipseudomonal activity?

Yes

What are the two sugars in the backbone of peptidoglycan?

NAM NAG

Which first gen cephalosporin is oral?

Cephalexin

Does ampicillin rash itch, cause fever, or arthrlagias?

No, that would be some sort of hypersensitivity reaction, and you would want to take them off the medication

What two steps of of cell wall synthesis are done by penicillin binding proteins?

Transglycosylation- joining NAG-NAM Transpeptidation- cross linking the peptides

What is the DOC for listeria?

Ampicillin +/- aminoglycoside

What is the DOC for MSSA? (Penicillinase producing S. Aureus)

Penicillinase-resistant penicillins (Nafcillin, Dicloxacillin Oxacillin)

What is the only 4th gen cephalosporin?

Cefepime | Aka granddaddy of cephalosporins

What is the DOC for MRSA

Vancomysin

What are the second generation cephalosporins?

Cefaclor- oral Cefuroxime Cefprozil-oral

What 3rd generation cephalosporins can penetrate the CNS?

Ceftriaxone Cefotaxime sodium

What is the spectrum of antipseudomonal penicillins?

The same as extended spectrum penicillins, but with additional coverage of gram negative bacilli and pseudomonas

What are the main toxicities of cephalosporins?

Superinfection (esp with cefepime) Disulfiram-like reaction Allergy - 10% cross reactivity with PCN allergy GI symptoms- esp diarrhea Dose dependent renal tubular necrosis-synergistically with aminoglycosides

What are the “other” B-lactam drugs that are not penicillins or cephalosporins?

Monobactams-aztreonam Carbapenems- imipenem, meropenem, ertapenem

How does Fosfomycin inhibit cell wall synthesis?

Prevents NAG from becoming NAM

As you go from 1st gen to 3rd gen cephalosporins, what happens to G+ and G- coverage?

G+ coverage goes down G- coverage goes up (At 4th generation (cefepime) you get better G+ coverage)

What is the DOC for early Borrelia burgdorferi?

Amoxicillin

Are antipseudomonal penicillins susceptible to B-lactamase?

Yes

Why don’t we use bacitracin parenterally?

Serious nephrotoxicity

Does aztreonam have any cross sensitivity with other B-lactams?

No...good for PCN allergic pts

What is vancomycin’s spectrum?

EXCLUSIVELY gram +

When do you give Vancomycin orally?

Superinfections of: Staphylococcus Clostridium Difficile

What is the DOC for late Borrelia burgdorferi?

Ceftriaxone

What do you HAVE to give antipseudomonal penicillins with?

Aminoglycoside | Pseudomonas is hypermutable

What is the DOC for E. Coli, Klebsiella, or Proteus?

Cephalosporin (1st or 2nd gen) Bactrim

What are the 3 drugs in Neosporin?

Bacitracin- G+ Neomycin G- Polymyxin G-

What is the DOC for Staph aureus that does not produce B-lactamase

Penicillin

What are the 4 classes of penicillins?

Natural penicillins Penicillinase resistant Extended spectrum Antipseudomonal

What is the DOC for penicillin resistant strep pneumoniae?

Ceftriaxone | Non PCN resistant would be treated with penicillin

What drug can cause seizures in high levels?

Impinenem

How does bacitracin inhibit cell wall synthesis?

Inhibits the transportation of NAG-NAM across the inner membrane

Are natural penicillins readily inactivated by penicillinase?

Yes

What are the 3rd generation cephalosporins?

Ceftriaxone Cefotaxime Sodium Ceftazidime Cefixime-oral (Tri-tax-taz- fix me)

What class of drugs have the highest activity against G+ bacteria?

Natural penicillins

Are most G+ cocci susceptible to first generation cephalosporins?

Yes, including MSSA. They could be an alternative for PCN allergic people

What is the DOC for B-lactamase producing enterobacter infections?

Imipenem or Meropenem

What are the 3 carbapenems?

Imipenem Meropenem Ertapenem

What are the B-lactamase inhibitors?

Clavulanic acid Sulbactam Tazobactam

What is the DOC for Neisseria gonorrhoeae?

Ceftriaxone Cefixime

Does 5th gen ceph (Ceftaroline) have antipseudomonal activity?

What are the penicillins that can be taken orally?

VODKA Penicillin V Oxacillin Doxacillin K -nothing A- Ampicillin/amoxicillin

What is MRSA’s mechanism of resistance?

Producing an alternate PBP that no B-lactam can bind to | **except for ceftaroline

What makes ertapenem different from imipenem and meropenem?

Less active against pseudomonas

What is the only B-lactam that is active against MRSA and VRSA?

Ceftaroline | Can bind to the mutated PBP

What is the unnamed/5th gen cephalosporin?

Ceftaroline fosamil

What is used for uncomplicated lower UTIs in women?

Fosfomycin

What is the DOC for Group A Strep pyrogenes

Penicillin Clindamycin

What are the adverse effects of vancomycin?

Ototoxic Nephrotoxic “Red man” syndrome

What is aztreonam’s spectrum?

Aerobic G- rods ONLY | Including pseudomonas, Serratia, klebsiella, proteus

What are the 2 first generation cephalosporins

Cefazolin Cephalexin- oral

What is the major side effect of penicillins?

Allergy

Would Cefepime make a really good drug to use for empirical therapy?

Yes, it has a very broad coverage and is resistant to B-lactamases

Will B-lactam antibiotics be effective in a non-growing cell?

What are the 2 antipseudomonal penicillins?

Piperacillin Ticarcillin

What are the 4 penicillinase resistant penicillins?

Nafcillin Dicloxacillin Oxacillin Methicillin** lab use only

What is the mechanism of action of cephalosporins?

Block transpeptidation of peptidoglycan | They are B-lactam

What is the advantage that Cephalosporins have over Penicillins?

They have increased resistance to B-lactamase

Do 3rd gen cephalosporins have Pseudomonal activity?

Yes. | Ceftazidime combined with an aminoglycoside. Remember pseudomonas always gets 2

What is the DOC for listeria?

Extended spectrum penicillins- Ampicillin or amoxicillin

What step of cell wall synthesis is inhibited by B-lactam antibiotics?

Transpeptidation (cross-linking)

What drug should NOT be used in neonates, as it displaces bilirubin?

Ceftriaxone | Not OK for baby with Gonorrhea

What are the 2 extended spectrum antibiotics?

Ampicillin Amoxicillin

What is the DOC for Viridans streptococci?

Penicillin

What 4 antibiotics sometimes have B-lactamase inhibitors combined with them?

Ampicillin Amoxicillin Piperacillin Ticarcillin

How does vancomycin work?

Prevents transpeptidation by binding to the terminal D-ala-D-ala

What is the DOC for enterococcus species?

Penicillin +/- aminoglycoside

What is the DOC for Staph aureus that produces B-lactamase

Penicillinase-resistant penicillin

What is the only monobactam?

Aztreonam

What is the spectrum of imipenem and meropenem?

Broad spectrum

What is the DOC for C. Diff superinfections?

Oral vancomycin

Do natural penicillins have good CNS penetration?

No, not unless there is inflammation

When you add an inhibitor to ampicillin does it stay oral?

No it becomes parenteral. Amoxicillin+inhibitor stays oral (augmentin)

Inhibitors Of Cell Wall Synthesis Flashcards

(97 cards)