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68 Cards in this Set

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Compare PCN G with PCN V

- affective against what?
- administration
- acid resistance
Both gram positive bacteriocide

G -> IV
V -> Oral

V is more than G
Which PCN works well with Pseudomonas?
Carbenicllan
Amoxicillan/Ampicillan

- effective against which organism and why?
Gram positive and gram negative

b/c of ammonia group attached
List PCN's in each of these spectrum categories:

- limited spectrum
- broad spectrum
- extended spectrum
PCN G
PCN V

Amoxicillan
Ampicillan

Carbanecillan
Which PCN's are Beta-lactamase resistant?
Methicillan
Dicloxicillin

Cloxacillin
Oxacillan
Nafcillin
MD CON

DOC Na-Me
Difference between Methicillan and Oxacillan in terms of acid resistance.
Methicillan is acid-labile

Oxacillan is acid-stable
40% of antibiotics that are prescribed are what?
Cephalosporins
Cephalosporins:

- advantage over PCN x3
- disdadvantages x2
Broader spectrum
Greater Beta-lactamase resistance
Low cross reactions with PCN

Low Potency
High price
Cefamycin:

- structure
- structure implies what clinically x2
Same as cephalosporin, but has O in it.

Better Beta-lactamase resistance
Longer half life
Monobactam is only useful against what organism?
Gram Negative Aerobic
Another name for monobactum.
Aztreonam
Clavulanic acid:

- mechanism
- clinical use
Beta lactamase inhibitor

Can be used in conjunction with Beta-lactamase sensitive PCN (such as Amoxicillan / Ticarcillan)
Carbapenam:

- 2 examples
- Benefits
Iminpenum
Meropenum

Broad spectrum
Beta-lactamase resistant x2
List three antibiotics that are NOT Beta-lactams, but do INHIBIT PEPTIDOGLYCANS.
Bacitracin
Vancomysin
D-cycloserine
BVD
D-cycloserine does what?
Inhibits conversion of

- Ala to D-Ala
- D-Ala to D-ala-D-ala
Bacitracin does what?

Administered how?
Blocks conversion of:

- Lipid-PP to Lipid-P

Topically
Vancomysin does what?
Inhibits lipid carrier to transfer peptidoglycan.
List 5 of the 2003 leading causes of death with PROBABLE infectious disease involvement
Heart Dz (1)
CA (2)
Chronic Lower Respiratory Dz (4)

Kidney Dz (9)
Chronic Liver Dz (12)

*This year Nosocomial would be 4
Probably went to HCC in 124, then KC in 9-12
List 2 of the 2003 leading causes of death with DEFINITE infectious disease involvement
Pneumonia / Influenza (7)

Septicemia (10)
Definitely need to PIS after the 7-10 split
Top 10 leading causes of death account for what % of all deaths?
85%
Where do Ab come from?
Other Microorganisms
Many of todays Ab's are how different from the original Ab's?
Now, many are

Semi-synthetic or Synthetic
Who coined the term Antibiotic?
Waksman (Schatz)
What is the Central Concept of Antimicrobial action?
Selective toxicity

Organisms killed or inhibited WITHOUT damage to host
Ideal Agent would have what 5 qualities?
Selective Toxicity

Narrowest Spectrum

NO
- Elimination until After functioning
- Allergy (Hypersensitivity)
- Resistance by organism
List 4 possible diseases cured by PCN
1. Strep. Pharyngitis
2. Pneumococcal Pneumonia

3. Potentially fatal bacterial Meningitis
4. Potentially fatal bacterial Endocarditis
List some BacteriCIDAL drugs. x7
1. Beta-lactams
2. Rifamycin (Rifampin)
3. Aminoglycosides
4. Vancomycin
5. Anti-TB drugs

6. Quinolones

7. Anti-Folates (2 used)
BRAVA Q & A leads to death
List some BacterioSTATIC drugs. x4
1. Macrolides
2. Chloramphenicol
3. Anti-Folates (1 used)
4. Tetracycline
MCAT stats
What Ab's are both Bacteriocidal AND Bacteriostatic?
Anti-Folates

2 used for -cidal
1 used for -static
List the Antibiotics whose Mode of Action is on the CELL WALL SYNTHESIS. x7
Bacitracin

Carbapenems (Beta Lactam)
Cephalosporins (Beta Lactam)
CycloSerine

Monobactams (Beta Lactam)
Vancomycin
PCN (Beta Lactam)
B CCC MVP
List the Antibiotics whose Mode of Action is on the DNA SYNTHESIS. x2
Metronidazole

Quinolones
(Gyrase/Topoisomerase)
D-NA (Deena) took the METRO with QUIN
List the Antibiotics whose Mode of Action is on the DNA DIRECTED RNA POLYMERASE
Rifampin
List the Antibiotics whose Mode of Action is on the PROTEIN SYNTHESIS 30S INHIBITORS. x3
Aminoglycosides
Tetracycline
Spectinomycin
Buy protein AT 30 SPECTS

(First Aid - Buy AT 30, CELL at 50)
List the Antibiotics whose Mode of Action is on the PROTEIN SYNTHESIS 50S INHIBITORS. x3
Macrolides

Chloramphenical

Clindamycin
50's the average age for the MCC

(First Aid - Buy AT 30, CELL at 50)
List the Antibiotics whose Mode of Action is on the PROTEIN SYNTHESIS
Oxazolidinones
Lots of Protein in an OX
List the Antibiotics whose Mode of Action is on the CELL MEMBRANE
Polymyxins
CM - P
List the Antibiotics whose Mode of Action is on the FOLIC ACID METABOLISM
Sulfonamides
Trimethoprim
Dapsone
Folic Acid for preggos with STD
Measuring Turbidity means you measure what?
Particles of bacteria

(both live and dead)
While other Ab's stay the same, why does Streptomycin "plateau-out" on a Turbidity graph, but rapidly decline on a Viability graph.
Streptomycin is Bacteriocidal, but does NOT LYSE the cell.
List 5 Beta-Lactams
Cephalosporin
Carbapenum
Clavulanic acid

Monobactam
PCN
PCN G (Benzyl PCN)

- administered how?
- effective against?
- advantages
- disadvantages
- IV

- Gram + bacteria (HIGH activity)

- Narrow or Limited spectrum

- Beta-Lactamase sensitive
PCN G-IVes me limited sensitive
PCN V (Phenoxymethyl PCN)

- administered how?
- effective against?
- advantages
- disadvantages
- Orally

- Gram + bacteria (HIGH activity)

- Narrow or Limited spectrum

- Beta-Lactamase sensitive
Amino-PCN

- list 2
- benefit
- Ampicillin
- Amoxicillin

- Broad Spectrum
(HIGH activity to BOTH Gram + & Gram -)
Which 2 PCN's are Beta-Lactamase Resistant?

What is the major difference btw the two?
Methicillin - acid LABILE

Oxacillin - acid STABLE
MO resistant and LA-STs
What PCN has Extended Spectrum AND is used to Tx Pseudomonas?
Carbenicillin
Extend your belly by eating Pseudo-Carbs
List 2 differences btw PCN V and PCN G
PCN G is GIVen ---> IV
PCN V is taken ---> Orally

PCN V is more Acid Resistant
PCN Mode of Action
Inhibits Peptidoglycans'
synthesis & cross-linking
by binding PBP on the Transpeptidase

Thus, bacteria LYSE and can NOT reproduce
What does bacterial Transpeptidase do?

What targets Transpeptidases to inhibit its actions?
Cross-links amino acids of PG to the structure D-Ala-D-Ala

PCN
All Ab's whose MOA is the bacterial Cell Wall are...

- bacteriocidal or bacteriostatic? why?
Bacteriocidal

b/c weak cell wall will make them LYSE
The concept of using PCN (or Cell Wall targeting drugs) implies that the bacteria must be doing what?
Actively growing in order for Cell Wall Biosynthesis Inhibitors to work
Cephalosporins

- MOA
- Advantage over PCNs x3
- Disadvantage to PCNs x2
- Same as PCN

- Mo resistant to B-Lactamases
- Cross Reaction is lower than PCN
- Broader Spectrum ( both + & - )

- Potency is less
- Expensive
What Ab is most prescribed in the US?
Cephalosporins

(approx. 40%)
Cefamycins are similar to which PCN drug?

What are the differences structurally?
What are the differences clinically? x2
Cephalosporins

Has an Oxygen in the ring

More Stable to B-Lactamases
Longer half life
Someone who is allergic PCN may benefit from what other related drug?
Cephalosporin b/c of its Low Cross RxN with PCNs
Cephalosporins / Cefamycins

- how many generations?
- what are the demarcation btw generations
- 1st, 2nd, 3rd, & 4th
(possibly a 5th & 6th)

- No clear demarcation btw generations
- Tho 1st generation are NARROWER spectrum
T/F : 1st generation Cephalosporins / Cefamycins are not clinically useful.
False

1st generation cephalsporins / Cefamycins are still clinically useful
Monobactam

- Give an example
- MOA
- Targets?
- Why is it unique considering its MOA? x2
- Aztreonam

- Same as PCN

- Targets Gram NEGATIVE

- Does NOT bind Gram +
- Does NOT bind ANAEROBE PBPs
What is used as a B-Lactamase Inhibitor?
Clavulanic acid
Carbapenem

- give 2 drug names
- MOA
- benefits x2
- often used to Tx?
- Meropenem
- Imipenem

- Beta-Lactams (same as PCN)

- Broad Spectrum
- Beta-Lactamase Resistant

- Pseudomonas infections
("Pseudo-Carbs")
List 4 B-Lactam Inhibitor Combos
Amoxicillin & Clavulanic acid
Ticarcilin & Clavulanic acid

Ampicillin & Sulbactam
Piperacillin & Tazobactam
List 5 PCNs that are B-Lactamase STABLE
1. Nafcillin
2. Methicillin

3. Dicloxicillin
4. Oxacillin
5. Cloxacillin
Na-Me me a STABLE DOC
List 3 drugs that inhibit PG synthesis, but is NOT a Beta-Lactam
1. Bacitracin

2. Vancomycin

3. D-CycloSerine
BVD like the underwear company
D-Cycloserine

- MOA
- Used for what Tx?
- Inhibits PG (but NOT a B-lactam) by inhibiting 2 sequential steps in the biosynthesis of the D-Ala-D-Ala peptide

- Anti-TB drug
To Be Determined (TB-D)

Debo-CYCLes have 2 "Dala Dala" ($ $) signs
Bacitracin

- MOA
- Used for what Tx?
- Inhibits PG (but NOT a B-lactam) by inhibiting the DEphosphorylation of a Lipid carrier

- Topical use
- Found in Neosporin or other triple antibiotic ointments
BAC (blood alcohol level) stops me from taking a P off the LIP
Vancomycin

- MOA
- Used for what Tx?
- Inhibits PG (but NOT a B-lactam) by inhibiting the LAST step where the PG is TRANSFERRED to the growing PG.
Van's are useful in Transfer
Name a NON-Beta-Lactam drug that inhibits PG as well as being used for TB.
D-Cycloserine
The Attack on PG's

This drug inhibits DE-P-hosphorylation of a Lipid Intermediate.
Bacitracin
The Attack on PG's

This drug prevents precursors from being transferred/added to growing PG chain.
Vancomycin