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125 Cards in this Set
- Front
- Back
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bac cell walls all contain rigid --- -- in addition to -- ---
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cell walls
cell membranes |
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purpose of cell wall:
confer ------ protects cells from ----- |
confer stability
protects cells from swelling |
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which lack an outer membrane: gram positive or negative
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positive
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which has an outer lipopolysaccharide membrane covering thin cell membrane
gram neg or pos? |
gram negative
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which has a peptidoglycan thick cell wall
gram pos or neg |
gram positive
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what does pcn inhibit
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pcn binding protein:
enzymes that put together the cell wall |
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t/f
not necessary for the beta lactam ring to be intact for effectiveness |
f
beta lactamase chews up and renders med it inactive |
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cell wall has a peptidogylcan strnad w/ ---- and --
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n-acetylglucosamine
n-acetylmurrmic acid |
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cross-link adjacents strands to give lattice structure for walls
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tranpeptidases
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transpeptidases cross link adjacent strands to give --- structure for wall
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lattice
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pcn binding proteins are enzymes responsible for assembly, ---,and --- of peptidoglycan cell wall
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maintenance
regulation |
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some pbp's
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transpepttidases
carboxypeptidase transglycosylase |
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pbp-1 in e coli:
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elongation of cell wall
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pbp 2 in e coli
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maintains rod shape
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pbp 3 in el coli
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formation of septum on division
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b lactams form -- bonds w/ pbp's transpeptidases inhibitiing activity
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covalent
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vancomycin binds end of polypeptide chain to prevent -----
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elnongation
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bacitracin inhibits --- --- bringing strand out of cell
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lipid carrier
so can't get out to form cell wall |
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b lactam's
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pcn's
cephalosporins monobactams carbapenams b lactamase inibitors |
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b lactamase is a -- inibitor
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suicide
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b lactam ring essential for --- effects
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antimicrobial
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t/f
b lactams are bacteriostatic |
f
bactericidal |
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b lactam agents inhibit gram -- organisms
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neg and pos
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individual b lactam agents differ w/ respect to
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bacteria
pk parenteral vs. oral resistnace affinityfor different pbp subgroups |
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t/f
pcn g effective orally |
f
no. . .chewed up by gastric acid |
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route of pcn g
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parenteral
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pcn v route
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oral
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pcnase resistant meds
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methacillin
dicloxacillin nafcilin oxacillin |
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pcn g and v used to tx
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streptococcal and pneumococcal infections
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pcnase resistant meds used to tx
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pcnase producing staph infections
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broad spectrum pcn's
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ampicillin
amoxicillin bacampicillin amox + clavulanic acid ampicililn + sulbactam |
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broad spectrums pcns used to tx
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s pyrogens
s pneumonaiae h influenzae |
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what is amox and ampicilin given w/ clavulanic and sulbactam respectively
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suicide inhibitor, so inhibitor chewed up and more pcn active
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antipseudomonal pcn's
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pipercillin
ticarcillin ticarcillin + clavulanic acid piperacillin + tazobactam |
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antipseudomonal pcn's used for
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p aeruginosa
proteus enterobacter |
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why do pcn's have good oral bioavailabitiy
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acid stability
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t/f
absorption of pcn decreased by food |
t
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pcn's have limited --- solubility
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lipid
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t/f
pcn's don't distribute well into tissues |
f
distributes well |
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how are pcns eliminated
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active tubular secretion
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what can you give w/ pcn so there's more available in the blood
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probenecid
it's transported by the same pcn transporters. . . so probencid will be eliminated while pcn stays in the blood |
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t/f
pcn found in breast milk |
t
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when do u adjust the pcn dose
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renal insufficiency
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allergy/sensitivity to pcn
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envioronmental exposure:
cows, milk, chicken, turkey |
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cns irritation by pcn
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seizures
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gi irritation by pcn
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diarrhea
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resistance of pcn occurs when:
production of ---- addition of or lack of specific binding to --- cell membrane doesn't --- after pcn binds pcn's inactive against organisms w/o ---- --- (mycoplamsa) |
b-lactamases
pbp's lyse cell wall |
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misuses of pcn:
selection of -- strains -- infections transfer of --- to other orgtanism via plasmids |
resistant
super b-lactamase |
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cephalosporin's are structurally similar to ---
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pcn's
semi-synthetic |
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t/f
cephalosporins are used as 1st line agents |
f
not used as 1st line agents |
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cephalopsorins have increasing gram ---- activitity w/ each generation
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negative
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cephalopsporins have cross-sensitivity w/ ---
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pcn's
so watch for hypersensitivity |
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t/f
cephalosporins have good oral absorption |
f
poor oral absortpion; most given parenteral |
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1st gen cephalo
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cefazolin
cephalexin cephradine cefadroxil |
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which 1st gen cephalo are oral
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cephalexin
cephradine cefadroxil |
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1st gen cephalosporins are used to tx
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stretococci
s aureus |
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2nd gen cephalo:
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cefuroxime
cefprozil cefmetazole loracarbef |
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which 2nd gen ceph are orals?
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cefprozil
loracarbef |
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what are 2nd gen ceph used to tx
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e coli
klebsiella proteus h influenzae moraxella catarrhalis |
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3rd gen cephal
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cefotaxime
cefpodoximine cefibuton cefdinir cefditoren ceftizoxime cefoperazone ceftazidime |
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3rd gen cepha used to tx
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enterobacteriacae
p aeruginosa serratia nisseria gonorrhea pseudomonas |
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4th gen cephalo's
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cefepine
(lactamase resistant) similar to 3rd gen |
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5th gen cephalo's
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ceftobiprole
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5th gen cephal used to tx
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mrsa
enterococcus pseudomonas |
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ae of cephalo:
ci w/ . . . |
pcn allergy
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cephalosporins are -- toxic
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nephrotoxic. . removal of some agents
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the methothiotetrazole ring of cephalosporins interfere w/ --- ---
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vit K. . . causing bleeding
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cephalosporins will have -- like rxn
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disulfiram
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blleding disorders can occur w/ which cephalo
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cefmatazole (2nd gen)
cefoperazone (3rd gen) |
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carbapenems:
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imipenem
meropenem ertapenem dorapenem |
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broadest spectrum b-lactams
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carbapenems
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carbapenems fight against
gram ----- aerobes/anerobes --- ----- |
pos and neg
anaerobes pseudomonas aeruginosa |
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which carbapenem is active against pseudomonas aeruginosa
not? |
dorapenem
not: ertapenem |
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carbapenem route
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IV
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how is carbapenam excreted
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kidney
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what metabolizes imipenem into a nephrotoxic compound
what do you compound w/ to prevent this |
dehydropeptidase
cilastatin (inhibits the enzyme) |
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indications for carbapenems:
mixed aerobic and anaerobic -------- infections ---- resistant organism serious -- infectis --- acquired infections abd and complicated ---- infections |
mixed aerobic and anaerobic intraadominal infections
multi-drug resistant organisms nosocomial infection (imipenem and meropenem) community (ertapenem) urinary (dorapenem) |
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which carbe do you use for serious nosocomial infections?
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imipenem
meropenem |
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community acquired infections:
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ertapenem
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abd and complicated urinary infections:
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dorapenem
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sensitivity of carbapenems w/ other ---
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b-lactams
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seizures w/ which carbapenems
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imipenem. . . dose related
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blood probs w/ carbapenems
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anemia
throbocytopenia altered bleeding time |
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aztreoname tx gram --- and ----
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gram -
p aeruginosa |
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t/f
aztreonam used for ----- resistant strains |
multi drug
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route of aztreonam
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iv
im |
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aztreoname tx gram --- and ----
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gram -
p aeruginosa |
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how is aztreoname excreted
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renal
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t/f
aztreonam used for ----- resistant strains |
multi drug
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ae of azetreonam
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n/v/d
seizures bone marrow suppression |
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route of aztreonam
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iv
im |
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how is aztreoname excreted
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renal
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ae of azetreonam
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n/v/d
seizures bone marrow suppression |
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t/f
cross rxn w/ aztreonam and b-lactams |
f
altough similar structure |
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vanco used for gram ----
--- -- resistant entercocci --cocci |
positive
mrsa pcn resistant streptococci |
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route of vanco
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parenteral
oral |
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when do you used oral vanco
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c-diff
cuz stays completely in gi tract |
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vanco reserved for ---- ---
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severe infections
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what can occure due to c diff
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pseudomembranous colitis
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1st choice for c diff
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metronidazole
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how is vanco excreted
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renally. . . nephrotoxicity!
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ae of vanco
why have fever, chills and shock w/ vanco |
release of histamines
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vanc can cause -- syndrom
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redman. . .histamine release. . . head and neck
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---toxicity due to vanco; given w/ other ---toxins
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ototoxicity
ototoxins (aminoglycosides, cisplatin) |
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how does daptomycin have a unique moa
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binds to ends not to binding proteins
cyclic lipopeptide |
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t/f
daptomycin is bacteriostatic |
f
bactericidal |
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daptomycin binds to cell membrane resulting in ---- and loss of membrane potential and cell death, no known resistance mechanisms
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depolarization
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what are the resistence mechanisms of daptomycin
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none known
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daptomycin is a broad spectrum gram ----
also used for -- resistent bacteria ---cocci |
positive
vancomycin staphylococci streptococci |
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daptomycin route
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iv
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daptomycin has high/low protein binding
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high
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dosing of daptomycin
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q day
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how is dapto excreted
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renal
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if CrCl is less than 30mL/min, how do you dose
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q 48 hrs
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what is daptomycin inactivated by
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pulmonary surfactant
binds to phosphatidylgylcerol in membrane and is sequestered so it is inactive |
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t/f
daptomycin used in pneumonias |
f
due to inactivation by surfactant |
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fosfomycin blocks 1st step of --- synthesis
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peptidoglycan
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when do you give single dose tx of fosfomycin
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uncomplicated uti due to e coli or enterococci faecalis
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fosfomycin -- and --- unchanged in urine
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concentrated
excreted |
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ae of fosfomycin
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diarrhea
n/v vaginitis asthenia (muslce weakness) |
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bacitracin is a cyclic ---
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polypeptide
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bacitracin blocks the -- --- moleucle ot move peptidoglycan to cell wall
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lipid carrier
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bacitracin used for gram -- bacteria
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gram positive
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why is bacitracin used mainly topically
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nephrotoxic
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why use bacitracin for c diff
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cuz stays in gi tract
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