What Are The Major Inhibitors Of Cell Wall Synthesis?

Front 1

what are all penicilans derived from?

Back 1

6 aminopenicillanic acid and contain a beta lactam ring essential for antibio activity.

Front 2

Are they polar compounds?
How are they excreted?

Back 2

yes, they are polar and are not metabolized extensively.

they are usually excreted unchanged in the urine via gf and ts, ts being inhibited by probenecid.

Front 3

where are ampilcilin and nafcilin partly excreted?

Back 3

bile

Front 4

what are the normal halflives for most penicilans?

Back 4

from one half to 1 hr.

Front 5

which penys are administered IM and what are there halflives?

Back 5

procaine and benzathine forms of peny with a long half life due to slow release into the bloodstream.

Front 6

when do they cross the bbb?

Back 6

only when the meninges are inflamed

Front 7

what is the MOA of beta lactams?

Back 7

bactericidal and act through the following steps.
1. binding of the drugs to specific receptors (peni binding receptors located in the bact. cytoplasm.
2. inhibit the transpeptidase enz that acts to cross link linear peptidoglycan chains which form part of the cell wall.
3. activation of the autolytic enzymes that cause lesions in the bac cell wall.

Front 8

what is a major mechanism for bacterial resistance?

Back 8

beta lactamases formation by most staphylococci and gram -

Front 9

what are used in combination with penys, to inhibit bacterial enzymes inactivation

Back 9

clavulanic acid, sulbactam, tazobactam

Front 10

what is responsible for the methacilin resitance in staph and for peni g resistance in pnuemococci?

in which bateria is a change in the porin structure in the outer membrane contribute to resistance?

Back 10

structural changes in the PBP

in gram- rods like pseudomonas aeruginosa, therefore impeding the access to PBP´s.

Front 11

what is the proto of the subclass of penys with limited spectrum of antibio act and are still susceptible to beta-lac?

which is the drug used for oropharyngeal infections?

Back 11

peni g and used in infections for strep, meningococci, gram + bacilli and spirochetes. DOG of syphylis, active against enterocci enhanced by aminoglycosidic antibiotics

peni-V

Front 12

how are most strains of staph aureus and n.gonorraea resistant to peny´s?

Back 12

through the production of beta lactamases.

Front 13

What are in the subclass of very narrow spectrum, peni-resistan drugs?

Back 13

methicillin (proto)
nafcilin, and oxacilin used to treat known staphylococcal infections. if resistant to methicilin (MRSA) then also resistant to others.

Front 14

what are the wider spectrum peni-suseptible drugs?

Back 14

ampicilin and amoxicilin broader activity than peni g used in similiar infections where peni g is used. include: enterococci, listeria monocytogenes, escherichia coli, proteus mirabilis, h influenza, and moraxella catarrahlis. when treating enterococci and listeria, ampicilin is synergistic with aminoglycosides.

Front 15

which drugs are used for gram- rods, pseudomonas, enterobacter, and in some cases, klebsiella species?

Back 15

peperacillin and ticarcillin, and also exhibit enhanced activity with penicilinases.

Front 16

what are the alergic rxs of penys?

Back 16

urticuria, severe pruritis, fever, joint pain, swelling, hemolytic anemia, nephritis and anaphalaxis

Front 17

which peni causes nephritis more often?

Back 17

methicilin

Front 18

which is with associated with neutopenia?

Back 18

nafcilin

Front 19

what are some antigenic determinants of peny´s?

Back 19

degredation products like penicilloic acid, and complete cross allerginicity between penis should be assumed.

Front 20

is the macular popular rash caused by which an alergic reaction?

Back 20

no, not an allergic reaction by ampicilin

Front 21

what is the proto of the subclass of penys with limited spectrum of antibio act and are still susceptible to beta-lac?

which is the drug used for oropharyngeal infections?

Back 21

peni g and used in infections for strep, meningococci, gram + bacilli and spirochetes. DOG of syphylis, active against enterocci enhanced by aminoglycosidic antibiotics

peni-V

Front 22

how are most strains of staph aureus and n.gonorraea resistant to peny´s?

Back 22

through the production of beta lactamases.

Front 23

What are in the subclass of very narrow spectrum, peni-resistan drugs?

Back 23

methicillin (proto)
nafcilin, and oxacilin used to treat known staphylococcal infections. if resistant to methicilin (MRSA) then also resistant to others.

Front 24

what are the wider spectrum peni-suseptible drugs?

Back 24

ampicilin and amoxicilin broader activity than peni g used in similiar infections where peni g is used. include: enterococci, listeria monocytogenes, escherichia coli, proteus mirabilis, h influenza, and moraxella catarrahlis. when treating enterococci and listeria, ampicilin is synergistic with aminoglycosides.

Front 25

which drugs are used for gram- rods, pseudomonas, enterobacter, and in some cases, klebsiella species?

Back 25

peperacillin and ticarcillin, and also exhibit enhanced activity with penicilinases.

Front 26

what are the alergic rxs of penys?

Back 26

urticuria, severe pruritis, fever, joint pain, swelling, hemolytic anemia, nephritis and anaphalaxis

Front 27

which peni causes nephritis more often?

Back 27

methicilin

Front 28

which is with associated with neutopenia?

Back 28

nafcilin

Front 29

what are some antigenic determinants of peny´s?

Back 29

degredation products like penicilloic acid, and complete cross allerginicity between penis should be assumed.

Front 30

is the macular popular rash caused by which an alergic reaction?

Back 30

no, not an allergic reaction by ampicilin

Front 31

which oral peny is associated with d and vom?

Back 31

ampicilin (also associated with psuedomembranous colitis).

Front 32

Gi upset can be caused by what?

Back 32

GI irritation or direct overgrowth of g+ or yeasts.

Front 33

what need to be cautioned when a patient as renal and cadiovascular ds.?

Back 33

toxic effects of Na and K when high doses of peni´s salts are used.

Front 34

what are cephalosporins derived from?

Back 34

7 aminocephalosporanic acid and also contain the betalactam ring. and classified as 1, 2, 3, and 4 generation in order of their introduction

Front 35

what is the major admin of cefs?

Back 35

parenterally and some orally.

Front 36

cefs with wide chains undergo what type of metabolism?

Back 36

hepatic but major elimination is through renal excretion via active tubular secretion.

Front 37

which are excreted mainly inthe bile?

Back 37

cefoperazone and ceftriaxone

Front 38

do 1 and 2 generation cefs enter the meninges when the brain is inflamed?

Back 38

no

Front 39

MOA?

Back 39

same as peni´s and are cidal against suseptibal organisms. due to their structure, cefs are less suseptible to penicillases produced by staph, but other bac produce cilases that inactivate cefs. most MRSA are also resistant to cefs.

Front 40

what are 1 gen cefs?

Back 40

cefazolin and cephalexin and used against gram + cocci including staphand common strep. e. coli and k. pneumonia are also sensitive. these can also be used in surgical prophilaxis in selected conditions.

what are they not affecive against? gram - cocci, entero cocci, meth resistan cocci and most gram - rods

Front 41

2 generation are?

Back 41

have an extended g - activity but less effective against g+

Front 42

which 2nd gen are used for bacteroides fragilis?

Back 42

cefotetan and cefoxitin

Front 43

which are used for h. influenza or moraxella catarrhalis?

Back 43

cefuroxime and cefactor

Front 44

what are the istics of 3rd gen?

Back 44

(cefoperazone, cefatoxime)increased g- activity of org. that are resistant to other beta lactams and ability to penetrate the bbb, except for cefoperazone and cefixime.

Front 45

what are most 3rd act against?

Back 45

enterobactor, providencia, serratia marcescens, and betalactamase producing stains of h. influenza and neisseria. (3rds, usually reserved for meningitis.)

Front 46

which is active against pseudomonas?

Back 46

ceftazidime

Front 47

act. against b. fragilis?

Back 47

ceftizoxime

Front 48

which are the DOC of gonorrhea?

Back 48

ceftriaxone (also for acute otitis media active for 10 days) and cefixime

Front 49

4th?

Back 49

cefipime, more resistant to betalactamases produced by g- including, enterobacter, heamophilus, neisseria.

Front 50

toxicity range from ?

Back 50

allergic rx to anaphilactic shock but occure less frecuently than with peny´s. incomplete cross reaction between penis and cefs. never give cefs to patient with anaphylaxis to peni´s.

Front 51

adverse effects?

Back 51

pain in the IM injection site and phlebitis after iv. may increase nephrotox of aminoglycosides when combined.

Front 52

which can cause hypoprothrombinemia and disulfiram like rxns?

Back 52

methylthiotetrazole group (cefoperazone, cefotetan, moxalactam--can decrease platelet fx and cause severe bleeding)

Front 53

which is the monobactam that preferentially binds to PBP3

Back 53

aztreonam, and adverse effects include possible super infection, vertigo and headache, and rare hepatotoxicity. NO cross rx with peni´s

Front 54

which have low suseptibility to betalactamases?

Back 54

carbapenams (imipenam--doc of enterobacter and meropenam), against g-cocci, g+rods, anaerobes

Front 55

adverse effects by imi are?

Back 55

gi distress, at high Cp cns toxicity (confusion, encephalopathy, seizures) mero--no seizures

Front 56

where are beta lactam inhibitors useless (clavu, etc)

Back 56

inducible chromosomal beta lactamases formed by enterobactor and pseudomonas.

Front 57

which binds to the d-ala, d-ala terminal of the nascent peptidoglycan and inhibits transglycosolation?

Back 57

vancomycin, therefore interferes with elongation and cross linkage. can become resistant when change end to d-ala, d-lactate.

used in MRSA, peni resistant pneumococci, and c.difficle!

Front 58

inhibits enolpyruvate transferase

Back 58

fosfomycin, therefore prevents formation of n-acetlymuramic acid, the precursor molecule of peptido glycan chain formation. synergistic with beta lactam and quinolone antibxs.

Front 59

interferes with the late stage cell wall formation in g+, and only used topically do to it´s nephrotox

Back 59

bacitracin

Front 60

blocks the incorp. of d-ala into the pentapetide chain of the peptidoglycan. used only to treat TB caused by organisms resistant to first line TB agents?

Back 60

cycloserine (potential neurotox---tremors, seizures, psychosis

Front 61

proto for 4?

Back 61

cefepime

Front 62

proto for 3?

Back 62

cefoperazone

Front 63

2?

Back 63

cefamandole

Front 64

1?

Back 64

cefazoline