Pharmacology- Microbiology Antimicrobial

Front 1

Penicillin
-Mechanism

Back 1

1. Blocks Penicillin-binding proteins
2. Blocks transpeptidase cross-linking of cell wall
3. Activates autolytic enzymes

Front 2

Where are the Penicillin-binding proteins found?

Back 2

Found at transmembrane proteins in the cytoplasmic membrane so thats where penicillin acts

Front 3

Penicillin
-Clinical use

Back 3

Used for Gram-Positive Cocci (staph and strep), Gram-Positive rods (clostridium, listeria, and Bacillus), gram - rods and spirochetes

Front 4

Name all Gram + Cocci

Back 4

Staph and Strep

Front 5

Name Gram + Rods

Back 5

Listeria, clostridium, bacilli

Front 6

Name Gram - Cocci

Back 6

Neisseria gonorrhoeae, Neisseria Meningitis

Front 7

Penicillin
-Toxicity

Back 7

Hypersensitivity reaction, hemolytic anemia

Front 8

Methicillin
-Mechanism

Back 8

Same as penicillin. Narrow Spectrum; penicillinase resistant because of bulkier R group
Nafcillin and Dicloxaciilin in same group

Front 9

Methicillin
-Differences between penicillin

Back 9

penicillinase resistant because of bulkier R group
Nafcillin and Dicloxaciilin in same group

Front 10

Methicillin
-Toxicity

Back 10

Hypersensitivity reaction, and interstitial nephritis (Methicillin)
Nafcillin and Dicloxaciilin in same group

Front 11

Bacteriostatic antibiotics

Back 11

Erythromycin, Clindamycin, Sulfamethoxazole, Trimethoprim, Tetracycline, Choramphenicol
We're ECSTaTiC about baceteriostatics

Front 12

Bactericidal Antibiotics

Back 12

Vancomycin, Fluoroquinolones, Peniciilin, Aminoglycosides, Cephalosproins, Metronidazole
"CAMP For Vlad"

Front 13

Amoxicilin
-Mechanism

Back 13

Same as Penicillin. Wider Spectrum Penicillinase Sensitive
Ampicillin as well (aminopenicillins)

Front 14

Amoxicillin vs. Ampicillin

Back 14

Both aminopenicillins but AmOxicillin has greater Oral bioavailiabiity

Front 15

Ampicillin
-How do you enhance spectrum

Back 15

Combine with Clavulanic acid (penicillinase inhibitor)
Amoxicllin as well (aminopenicillins)

Front 16

Ampicillin
-Clinical use

Back 16

Extended-spectrum Penicillin- certrain Gram + bacteria and Gram - Rods (Haemophilus Influenzae, E.Coli, LIsteria Monocytogenes, Proteus mirabilis, Salmonella, enterococci)
HELPS to kill enterococci
Amoxicillin as well (aminopenicllins)

Front 17

Ampicillin
-Toxicity

Back 17

Hypersensitivity reaction, amipicillin rash; pseudomembranous colitls
Amoxiciilin as well (aminopenicilins)

Front 18

Piperacillin
-Mechanism and others in group

Back 18

Same as penicillin. Extended spectrum
Ticarcillin and Carbenicillin (Anti-pseudomonais)

Front 19

Ticarcillin
-Clinical use

Back 19

Pseudomonas spp. and gram-negative rods;
Piperacillin and Carbenicillin (Anti-pseudomonais)

Front 20

Carbenicillin
-Susceptible to and how to avoid

Back 20

Susceptible to penicillinase so use with clavulanic acid (beta-lactamase inhibitor)
Ticarcillin and Piperacillin (Anti-pseudomonais)

Front 21

Piperacillin
Toxicity

Back 21

Hypersensitivity reaction
Ticarcillin and Carbenicillin (Anti-pseudomonais)

Front 22

Cephalosporin
-Mechanism

Back 22

Beta-Lactam drugs that inhibit cell wall synthesis but are less susceptible to penicillinases

Front 23

cefazolin
-Clinical use

Back 23

1st generation cephalosporin (also cephalexin)
Gram + cocci, proteus mirabilis, E. Coli, Klebisella (PEcK)

Front 24

Cefoxitin
-Clinical use

Back 24

2nd generation (cefaclor, cefuroxime)
Gram + cocci, Haemophilus infleunzae, Eneterobacter aerogenes, Neisseri spp., Proteus mirabilis, E. coli, Klebisella pneumoniae, Serratia macroscens
HEN PEcKS

Front 25

Cefepime
-Clinical use

Back 25

4th Generation cephalosporin
increase activity against pseudmonas and gram + organisms

Front 26

Ceftraxione
-Clinical use

Back 26

3rd generation cephalosporin (cefotaxine, ceftazidime)
Serious gram - organisms resistant to other Beta- Lactams, meningitis (most penetrate blood-brain barrier)
Ex. Ceftazidine for pseudomonas, ceftraxione for Gonorrhea

Front 27

Cephalosporins
-Toxicities

Back 27

Hypersensitivity reactions.
Cross-hypersensitivity with penicillins occurs in 5-10% of patients.
Increase nephrotoxicity of aminoglycosides;
disulfram-like reaction with ethanol

Front 28

Aztreonam
-Mechanism

Back 28

Monobactam resistant to Beta-lactamases. Inhibits cell wall synthesis (binds to PBP3).

Front 29

Azteronam
-Synergistic and allergies

Back 29

Synergistic with aminoglycosides
No allergy to penicillins

Front 30

Aztreonam
-Clinical use

Back 30

Gram - rods: Klebisella, Pseudomnoas, Serratia
Used for penicllin-allergic patients and those with renal insufficiency that can't handle aminoglycosides No activity against gram + organisms

Front 31

Aztreonam
-Toxicity

Back 31

usually nontoxic; GI upsets; No cross-sensitivity with penicillin and cephalosporins

Front 32

Imipenem
-Mechanism, always given with

Back 32

Broad-spectrum, Beta-lactamase resistant carbapenem; Given always with cilastatin

Also Meropenem

Front 33

Imipenem/Cilistatin
-Why the combo

Back 33

Cilistatin is an inhibitor of renal dihydropeptidase I to decrease inactivation in renal tubules
Also Meropenem

Front 34

Imipenem/Cilastatin
-Clinical use

Back 34

Gram + Cocci, Gram - rods, and anaerobes. Drug of choice for enterobacteria (toxic so used only for life-threatening infections or after other drugs have failed.

Front 35

Imipenem/Cilastatin
-Toxicity

Back 35

GI distress, skin rash, and CNS toxicity (seizures) at high plasma level
Meropenem has a reduced risk of seizures and is stable to dihydropeptidase I

Front 36

Vancomycin
-Mechanism and resistance

Back 36

Inhibits cell wall mucopeptide formation by binding D-ala D-ala portion of cell wall precursors
Resistance can occur with amino acid changes of D-ala D-ala to D-ala D-lac

Front 37

Vancomycin
-Clinical use

Back 37

Used for serious Gram + multidrug-resistant organisms including S. Aureus and Clostridium difficile (pseudomembranous colitis)

Front 38

Vancomycin
-Toxicity

Back 38

Nephrotoxicity, Ototoxicity, Thrombophlebitis, diffuse flushing- "red man syndrome" (can largely be prevented by pretreatment with antihistamines and slow infusion rates) Well tolerated in general- does NOT have many problems