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Health Studies > roop medications week 9 > Flashcards

roop medications week 9 Flashcards

1
Q

-gram positive
-facultative anaerobic bacteria: this bacteria can grow and make ATP in both the presence or absence of oxygen
-lancet shaped: elongated round shaped
-usually found in pairs

A

S. pneumoniae

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2
Q

penicillin is a _____ring

A

beta lactam

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3
Q

first generation penicillin (G and V) inhibits____

A

peptoglycan on cell wall

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4
Q

what is the mechanism of action of penicillin to sensitive bacteria?

A

-inhibits bacterial cell wall synthesis by binding and inactivating proteins (penicillin binding proteins) present in the bacterial cell wall
-penicillin inhibits transpeptidation reaction and block cross linking of the cell wall. This results in lysis of the cell wall due to high internal osmotic pressure.

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5
Q

-has a beta lactam ring
-composed of cyclic amide and beta lactams are named so because the nitrogen atom is attached to beta carbon atom relative to the carbonyl

A

beta lactam antibiotic

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6
Q

what composes the beta lactam ring?

A

3 carbon and 1 nitrogen

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7
Q

what antibiotics fall into the beta lactam ring class?

A

penicillin, cephalosporins (4 generations), monobactams carbapenems, beta lactam inhibitors

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8
Q

are enzymes produced by bacteria that inactivate the antibiotics by hydrolyzing the peptide bond of the lactam ring

A

B-lactamases

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9
Q

what are the targets of beta lactamases?

A

penicillin binding proteins

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10
Q

includes ESBLs-degrade PCNs, some cephalosporins and occasionally carbapenems

A

class A of B-lactamases

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11
Q

zinc dependent enzymes that degrade all B-lactams except aztreonam

A

class B of B-lactamases

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12
Q

active against cephalosporins

A

class C of B-lactamases

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13
Q

includes cloxacillin degrading enzymes

A

Class D of B-lactamases

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14
Q

some class A and D enzymes are inhibited by B-lactamase inhibitors, ex ___ and ____

A

clavulanate and tazobactam

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15
Q

what does penicillinase resistant mean?

A

2nd generation, resistant to bacteria B-lactamase

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16
Q

discontinued in the U.S. due to lots of side effects such as nephritis

A

methicillin

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17
Q

highly resistant to penicillinase

A

nafcillin

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18
Q

not in the U.S.

A

cloxacillin

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19
Q

what are all the penicillinase resistant PCNs?

A

methicillin, nafcillin, oxacillin and dicloxacillin, cloxacillin

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20
Q

MRSA are resistant to all the ____ and the ____

A

penicillinase resistant PCN and the cephalosporins

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21
Q

In the U.S. what is the antibody used for MRSA?

A

vancomycin

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22
Q

middle ear infection

A

otitis media

23
Q

what is a hypersensitivity reaction?

A

it is an exaggerated immunologic response

24
Q

what can cause hypersensitivity reactions?

A

allergens or Haptens (animal dander)

25
Q

igE-Ag triggers mast cell mediators
-antigen: allergen
-onset: minutes

A

hypersensitivity type I

26
Q

IgG or IgM binds to cell surface, ADCC or complement
-antigen: cell surface molecule
-onset: few hours

A

Hypersensitivity type II

27
Q

immune complexes, inflammation
-antigen: soluble or particulate
-onset: few hours

A

Hypersensitivity type III

28
Q

cytokine (T cells, macrophages and CTL)
-antigen: chemical and intracellular
-onset: 1-3 days

A

Hypersensitivity type IV

29
Q

this means that PCN and their breakdown products combine with body proteins and act as haptens or allergens

A

PCN hypersensitivity

30
Q

what is the most abundant breakdown product of PCN that accounts for 75% of all hypersentivities?

A

penicilloyl (major allergen determinant)

31
Q

drug given for an infection with pseudomonas?

A

3rd generation cephalosporin, ceftazidime (Fortaz)

32
Q

what is the 1st generation of cephalosporin against?

A

gram positive bacteria

33
Q

what is the 2nd generation of cephalosporin against?

A

gram negative bacteria

34
Q

primarily against gram negative. Can penetrate the BBB when IV is given. used primarily for gonorrhea and disseminated Lyme disease

A

3rd generation cephalosporin

35
Q

4th generation cephalosporin, ____ can penetrate the CSF

A

cefepime

36
Q

5th generation cephalosporin, ____ used against MRSA

A

ceftaroline

37
Q

___active only against gram negative aerobic bacteria

A

aztreonam

38
Q

what sub-class of beta lactam antibiotics does aztreonam belong?

A

monobactams

39
Q

the carboxyl group on aztreonam, enhances ___

A

activity vs. Pseudomonas

40
Q

the amiothiazole oxime on aztreonam imparts ___

A

gram negative spectrum

41
Q

4alpha methyl group on aztreonam ________

A

increases B-lactamase stability

42
Q

1-sulfonic acid on aztreonam ______

A

activates B-lactam

43
Q

____is a B-lactamase inhibitor. It is part of the 1st generation of B-lactamase inhibitors.

A

clavulanic acid

44
Q

augmentin is ____generation

A

3rd

45
Q

what are the beta lactamase inhibitor classes?

A

clavulanic Acid, sulbactam and Tazobactam

46
Q

-almost all have weak antibacterial activity
-important in combination with penicillins sensitive to B-lactamase degradation

A

B-lactamase inhibitors

47
Q

-natural product from streptomyces
-has a powerful and irreversible inhibition of B-lactamase enzymes because it will covalently bind to two positions in the active site
-normally used in combination with amoxicillin and other B-lactamase sensitive penicillins

A

calvulanic acid

48
Q

___is the most common carbapenems used

A

imipenem

49
Q

___turns baby teeth gray

A

chloramphenicol

50
Q

-broad antibacterial spectrum
-not absorbed well from the GI tract, so given IM and IV
-metabolized by renal dehydropeptidase

A

carbapenems

51
Q

Imipenem is marketed primarily in combination with ____

A

cilastatin

52
Q

what are the carbapenems?

A

Imipenem, meropenem, doripenem and ertapenem

53
Q

___inhibits renal dehydropeptidase thereby prolonging the action of the antibiotic

A

cilastatin

Health Studies (8 decks)

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