Inhibitors Of Bacterial Cell Wall Synthesis

Front 1

Name 5 groups of beta-lactams

Back 1

1. Penicillins

2. Cephalosporins

3. Oxapenams

4. Monobactams

5. Carbapenams

Front 2

Narrow spectrum penicillins?

Back 2

Penicillin V,G

Cloxacillin

Flucoxacillin

Front 3

Broad spectrum penicillins?

Back 3

Amoxicillin

Ampicillin

Front 4

Applications of Penicillins?

Back 4

1. Streptococcal, meningococcal infections

2. Neurosyphillis

Front 5

Name 3 oxapenams.

Back 5

Clavulanic acid, Sulbactam, Tazobactam

Front 6

Name 1st generation cephalosporins?

Back 6

Cefazolin, Cephalexin

Front 7

Name 2nd generation cephalosporins

Back 7

Cefuroxime axetil, Cefactor

Front 8

Name 3rd generation cephalosporins?

Back 8

Cefotaxime

Ceftaxime

Ceftriaxone

Front 9

Name a 4th generation cephalosporin?

Back 9

Cefepime

Front 10

Name 3 Carbapenams?

Back 10

Imipenem, Meropenem, Tienam

Front 11

What class is Aztreonam?

Back 11

Monobactam

Front 12

What class is vancomycin in?

Back 12

Glycopeptides.

Front 13

How are Penicillins administered?

Back 13

Pen V, G - Parenteral and IM

Ampicillin - Oral

Front 14

Describe PK of Penicillins?

Back 14

Poor absorption after oral administration except amoxicillin. Should not be given with food.

Distribution: Widely distributed but poor penetration across CSF. Can cross BBB during meningitis.

Front 15

What is Augmentin made up of?

Back 15

Clavulanic acid and Amoxicillin

Front 16

Uses of Augmentin?

Back 16

Acute otitis media

Front 17

What is Unasyn made up of?

Back 17

Sulbactam and Ampicillin

Front 18

What is Unasyn used for?

Back 18

Treatment of mixed intra-abdominal and pelvic infections

Front 19

What is Tazocin made up of?

Back 19

Tazobactam and Piperacillin

Front 20

PK of cephalosporins?

Back 20

Distribution: Widely distributed esp 3rd gen cephalosporins in CSF

Metabolism: Minimal like penicillins

Excretion: Kidneys

Front 21

What are 1st gen cephalosporins used for?

Back 21

Skin and soft tissue infections

Front 22

What are 2nd gen cephalosporins used for?

Back 22

Respiratory tract infections, pelvic inflammation, diabetic foot infection

Front 23

What are 3rd gen cephalosporins used for?

Back 23

Meningitis, community-acquired pneumonia

Front 24

What are 4th gen cephalosporins used for?

Back 24

Nosocomial infections, against MRSA.

Front 25

Adverse effects of cephalosporins?

Back 25

1. Hypersensitivity - as with penicillin. Patients with hx of anaphylaxis with penicillin should NOT be given a cephalosporin

2. Diarrhoea (esp with orally administered cephalosporins)

3. Thrombophlebitis - acute pain at injection sites ->give slowly

Front 26

Drug-drug interactions of Cephalosporins?

Back 26

1. Cefazolin + aminoglycosides or vancomycin increases risk of nephrotoxicity

2. Cefazolin + warfarin -> increase anticoagulant effect

Front 27

How are carbapenems administered?

Back 27

Parenteral

Front 28

How is Aztreonam administered?

Back 28

Parenteral

Front 29

Distribution of Aztreonam?

Back 29

Distribution: Wide, enters CSF well

Front 30

How is Vancomycin administered?

Back 30

Oral and IV only

Front 31

Describe PK (excretion) of vancomycin?

Back 31

Renal impairment leads to significant accumulation in the blood

Front 32

Spectrum of activity for cephalosporins?

Back 32

Narrow (1st and 2nd), Broad (3rd), Narrow (4th)

Front 33

Spectrum of activity for carbapenems?

Back 33

Broad

Front 34

Clinical application of carbapenams?

Back 34

Serious infectious such as pneumonia and sepsis. (most of the bacteria)

Front 35

Adverse effects of carbapenams

Back 35

1. GIT related symptoms

2. Superinfections (because it is broad)

3. Seizures (rarely)

Front 36

DDI of carbapenams

Back 36

No cross-allergenicity with penicillins

Front 37

DDI of monobactams (Aztreonam)?

Back 37

No cross-allergenicity with penicillins

Front 38

Spectrum of activity for vancomycin?

Back 38

Narrow (only against gram-positive bacteria)

Front 39

Adverse effects of vancomycin?

Back 39

1. Red-neck/red man syndrome (rash due to histamine release when administered too quickly). Give antihistamine or prolong infusion time.

2. Thrombophlebitis

3. Increased nephrotoxicity and ototoxicity when used with AMG.

In renal impaired patients reduce parenteral dose.

Front 40

DDI of vancomycin?

Back 40

Don't use vancomycin with AMG.

Front 41

DDI of penicillins?

Back 41

1. Oral Contraceptives -> decrease effectiveness

2. Potassium-sparing diuretics ->hyperkalemia

3. Aminoglycosides -> don't administer together

Front 42

Name a non-beta-lactam bacterial cell wall synthesis inhibitor

Back 42

Vancomycin

Front 43

Beta-lactams mechanism of action?

Back 43

1. Bactericidal

2. Inhibits transpeptidation reation, halting peptidoglycan synthesis in bacteria, cell dies.

Front 44

Name a non-beta-lactam bacterial cell wall synthesis inhibitor?

Back 44

Vancomycin

Front 45

Mechanism of action of vancomycin?

Back 45

Bactericidal