Pharm 34 Bacterial and Mycobacterial Infections: Cell Wall Synthesis

Question 1

mechanism:

inhibit murein monomer synthesis, PEP analogue, synergistic with B lactams, aminoglycosides, and fluoroquinolones

Answer 1

Fosfomycin, Fosmidomycin

Question 2

treats:
Gram - urinary tract infections
E. Coli, Klebsiella serratia, clostridia

Answer 2

Fosfomycin, Fosmidomycin

Question 3

mechanism:

inhibit murein monomer synthesis through alanine racemase and D-ala-d-ala ligase, may cause seizures

Answer 3

Cycloserine

Question 4

treats:

M. tuberculosis, M. avium complex

Answer 4

Cycloserine

Question 5

mechanism:

inhibit murein monomer synthesis by inhibiting dephosphorylation of bactoprenyl diphosphate

Answer 5

Bacitracin

Question 6

treats:
cutaneous and eye infections (topical)
C. difficile (gi)
Vancomycin resistant enterocci (oral)

Answer 6

Bacitracin

Question 7

mechanism:
Inhibitor of murein polymer synthesis by binding to D-ala-D-ala terminus and inhibiting PGT which prevents addition of monomers to chain

Answer 7

Vancomycin, Telavancin

Question 8

treats:
MRSA (IV)
Skin infections with Straph/Strep (IV)
C. Difficile enterocolitis (oral)

Answer 8

Vancomycin, Telavancin

Question 9

adverse effects:
“Red man Syndrome”
Resistance when bacteria form D-Ala-D-lactate instead

Answer 9

Vancomycin, Telavancin

Question 10

mechanism and contraindication:
inhibit polymer cross linking, B- lactams inhibit transpeptidase forming covalent dead end, all have 5 membered accessory ring attached. Hypersensitivity is contraindiction

Answer 10

Penicillin (all “cillins”)

Question 11

Treats:
S. aureus and S. pyogenes, oral anaerobes, meningitisids, clostridia, syphillis.
IV preparation
potentiate anticoagulant effects of warfarin
B- lactamase sensitive

Answer 11

Penicillin G

Question 12

treats:
Same as penicillin G, but is Oral
B-lactamase sensitive
potentiate effect of warfarin

Answer 12

Penicillin V

Question 13

treats:
skin and soft tissue infections, methicillin sensitive S. Aureus
B-lactamase resistant

Answer 13

Oxacillin, Cloxacillin, Dicloxacillin, Nafcillin, methicillin

Question 14

treats:

B-lactamase inhibitor works on S. aureus, H. influenzae, E. coli, klebsiella, anterobacter, anaerobes

Answer 14

Clavulanic Acid/Amoxicillin

Question 15

treats:

B-lactamase inhibitor works on S. aureus, H. influenzae, E. coli, klebsiella, anterobacter, anaerobes

Answer 15

Sulbactam/Ampicillin

Question 16

treats:
Broad spectrum, + charged amino group on side chain allows diffusion through porins of Gram - bacteria.
invasive enterococcal infections and listeria meningitis

Answer 16

Ampicillin

Question 17

treats:

Broad spectrum, ear, nose, throat infections, combo for H. pylori

Answer 17

Amoxicillin

Question 18

mechanism:
Broad spectrum, mostly against P. aeruginosa, Carboxyl group side chain confers resistance to B-lactamases
also treatsHospital acquired pneumonia from resistant gram - organisms

Answer 18

Carbenicillin, Ticarcillin

Question 19

treats:

Broad spectrum, similar to carbenicillin/ticarcillin but also treats klebsiella, enterococci as well as P. aeruginosa

Answer 19

Piperacillin, Mezlocillin

Question 20

Mechanism:
inhibit polymer cross linking, B-lactam ring with 6 membered accessory ring attached.
Contra: hypersensitivity that can also cross react with penicillins

Answer 20

Cephalosporins mechanism and contra

start “cef”

Question 21

1st generation
Gram + coverage sensitive to B-lactamases
Treats: proteus mirabilis, E. Coli, Klebsiella pneumonia

Answer 21

Cefazolin, Cephalexin

Question 22

2nd Generation: broader Gram - coverage, more B lactamase resistant
H. Influenzae (CAP)

Answer 22

Cefuroxime

Question 23

2nd Generation: broader Gram - coverage, more B lactamase resistant
H. Influenzae, Enterobacter spp., neisseria spp, P. mirabilis, e. coli, K pneumoniae (pelvic and intraabdominal infections)

Answer 23

Cefotetan, Cefoxitin

Question 24

3rd generation
CNS penetration
B-lactamase resistant
active against enterobacteriaceae but less active on Gram + than 1st generation
N. gonorrhoeae, Borrelia burgdorferi, H. influenzae, CefTRIaxone

Answer 24

Cefotaxime, Ceftizoxime, Ceftriaxone, Cefoperazone, Ceftazidime

Question 25

4th generation, B-lactamase resistant | Enterobacteriaceae, neisseria, H. influenzae, P. aeruginosa, Gram + organisms

Answer 25

Cefepime

Question 26

5th generation | MRSA, VRSA, S. pneumoniae, moraxella catarrhalis, haemophilus influenzae

Answer 26

Ceftaroline

Question 27

mechanism: | Monobactam. inhibit polymer cross linking similar to penicillin

Answer 27

Aztreonam

Question 28

treats: Gram - bacteria used in penicillin allergic patients

Answer 28

Aztreonam

Question 29

mechanism: | Similar to penicillin, inhibits polymer cross linking

Answer 29

Carbapenems (have "penem")

Question 30

Carbapenems

Answer 30

Imipenem/Cilastatin, Meropenem, Dorpenem, Etapenem

Question 31

treat: All gram + and - bacteria except MRSA, VRE, and legionella decrease valproate levels

Answer 31

Carbapenem

Question 32

Cilastatin administered with...

Answer 32

Imipenem, inhibits renal dehydropeptidase I which inactivates imipenem

Question 33

mechanism: Inhibitor of cell membrane stability by integrating into Gram + membranes that creates pores and leads to K+ efflux, depolarization, cell death

Answer 33

Daptomycin

Question 34

treats: | complicated skin infection, bacteremia, right sided endocarditis from S. aureus

Answer 34

Daptomycin

Question 35

Daptomycin should not be co administered with?

Answer 35

Statin due to increased myopathy risk

Question 36

mechanism: decrease arabinogalactan synthesis by inhibiting arabinosyl transferase that adds arabinose units to growing arabinogalactan chain

Answer 36

Ethambutol

Question 37

treats: | Mycobacteriostatic, can cause optic neurotics and visual changes

Answer 37

Ethambutol

Question 38

mechanism: | prodrug converted to pyrazinoic acid which inhibits fatty acid synthetase 1 (FAS1)

Answer 38

Pyrazinamide

Question 39

treats: | Mycobacterium, dont take if hepatic dysfunction or gout

Answer 39

Pyrazinamide

Question 40

mechanism: | inhibit mycolic acid synthesis by targeting fatty acid synthetase 2 (FAS2)

Answer 40

Isoniazid, Ethionamide

Question 41

treats: Mycobactericidal, combo with rifampin and streptomycin neurotoxicity prevented by pyridoxine supplemntation

Answer 41

Isoniazid, ethionamide