Chapter 16: Penicillin-Family Antibiotics

Front 1

What does penicillin do biologically?

Back 1

Beta-lactam ring inhibits the transpeptidase enzyme, arresting cell wall synthesis --> bacteriacidal.

Front 2

How can bacteria defend themselves from the penicillin family - 3 ways?

Back 2

1. Gram (-) bugs can alter their porins preventing penicillin penetration
2. Bacteria can have beta-lactamase enzymes
3. Bacteria can alter the molecular structure of the transpeptidase so the beta-lactam can't bind

Front 3

Describe the possible manifestations of an anaphylactic reaction to penicillin?

Back 3

Bronchospasm, urticaria, anaphylactic shock. Delayed rash is most common.

Front 4

List the 5 types of penicillins?

Back 4

Penicillin G, aminopenicillins, penicillinase-resistant penicillins, anti-pseudomonal penicillins, and cephalosporins.

Front 5

When is Penicillin G currently used?

Back 5

Pneumonia caused by Strep pneumo.
Strep pharyngitis.

Front 6

Describe the coverage of aminopenicillins?

Back 6

Broader than Penicillin G, hitting more gram (-)'s. In particular, E coli and the other enterics. Also effective against the gram (+) enterococcus.

Front 7

Which penicillin-family antibiotic is taken orally and used in the outpatient treatment of bronchitis, UTIs, and sinusitis?

Back 7

Amoxicillin

Front 8

What is the ampicillin-gentamicin combo used for?

Back 8

Broad gram (-) coverage.

Front 9

What does penicillin do biologically?

Back 9

Beta-lactam ring inhibits the transpeptidase enzyme, arresting cell wall synthesis --> bacteriacidal.

Front 10

How can bacteria defend themselves from the penicillin family - 3 ways?

Back 10

1. Gram (-) bugs can alter their porins preventing penicillin penetration
2. Bacteria can have beta-lactamase enzymes
3. Bacteria can alter the molecular structure of the transpeptidase so the beta-lactam can't bind

Front 11

Describe the possible manifestations of an anaphylactic reaction to penicillin?

Back 11

Bronchospasm, urticaria, anaphylactic shock. Delayed rash is most common.

Front 12

List the 5 types of penicillins?

Back 12

Penicillin G, aminopenicillins, penicillinase-resistant penicillins, anti-pseudomonal penicillins, and cephalosporins.

Front 13

When is Penicillin G currently used?

Back 13

Pneumonia caused by Strep pneumo.
Strep pharyngitis.

Front 14

Describe the coverage of aminopenicillins?

Back 14

Broader than Penicillin G, hitting more gram (-)'s. In particular, E coli and the other enterics. Also effective against the gram (+) enterococcus.

Front 15

Which penicillin-family antibiotics is taken orally and used in the outpatient treatment of bronchitis, UTIs, and sinusitis?

Back 15

Amoxicillin

Front 16

What is the ampicillin-gentamicin combo used for?

Back 16

Broad gram (-) coverage.

Front 17

What are methicillin, nafcillin, and oxacillin?

Back 17

Penicillinase-resistant drugs that can kill Staph aureus.

Front 18

What type of drugs are cloxacillin and dicloxacillin?

Back 18

Penicillinase-resistant penicillins.

Front 19

Describe the coverage of anti-pseudomonal penicillins?

Back 19

Expanded gram-negative rod coverage, especially against pseudomonas. Also active against anaerobes (Bacteroides) and many gram (+)s.

Front 20

What are the "pip and gent" and "ticar and gent" antibx combos used against?

Back 20

Pseudomonas.

Front 21

Clavulanic acid and sulbactam are what type of antibxs? What's their coverage?

Back 21

Beta-Lactamase inhibitors - provide broad coverage against the beta-lactamase producing gram (+)s, gram (-)s, and anaerobes.

Front 22

The newer cephalasporins are less effective against...?

Back 22

Gram (+)s.

Front 23

Which bugs are resistant to all cephalosporins?

Back 23

MRSA and the enterococci.

Front 24

Cephalothin, cefazolin, cephalexin - what type of antibxs?

Back 24

1st generation cephalosporins.

Front 25

Cefamandole, cefuroxime, and cefoxitin - what type of antibxs?

Back 25

2nd generation cephalosporins.

Front 26

Ceftriaxone, ceftazidime, ceftibuten - what type of antibxs?

Back 26

3rd generation cephalosporins.

Front 27

Name the 4th generation cephalosporin?

Back 27

Cefepime.

Front 28

When are 1st generation cephalosporins used?

Back 28

Alternatives to penicillin for staph and strep infections. Prophylaxis against skin infections before surgery.

Front 29

What is a good class of agents for community-acquired bacterial pneumonia with negative sputum? Why?

Back 29

2nd generation cephalosporins (cefuroxime), with good coverage of Strep pneumo and H flu.

Front 30

Which antibxs are used for the multi-drug resistant aerobic gram (-) organisms that cause nosocomial pneumonia, meningitis, sepsis, and urinary tract infections?

Back 30

3rd generation cephalosporins

Front 31

Which antibx has the best CSF penetration?

Back 31

Ceftriaxone.

Front 32

Imipenem - what is it?

Back 32

A new class of beta-lactam antibx that has the broadest antibacterial activity of them all.

Front 33

Which bugs are resistant to Imipenem?

Back 33

MRSA, some Pseudomonas, ajd mycoplasma (no cell walls)

Front 34

What agent must be given alongside imipenem? why?

Back 34

Cilastin - inhibits the digydropeptidase that the normal kidney produces that breaks down imipenem.

Front 35

What is Aztreonam? It is a magic bullet for which bugs?

Back 35

Monobactam. Effective against gram (-) aerobic bacteria.