• Shuffle
    Toggle On
    Toggle Off
  • Alphabetize
    Toggle On
    Toggle Off
  • Front First
    Toggle On
    Toggle Off
  • Both Sides
    Toggle On
    Toggle Off
  • Read
    Toggle On
    Toggle Off

Card Range To Study



Play button


Play button




Click to flip

Use LEFT and RIGHT arrow keys to navigate between flashcards;

Use UP and DOWN arrow keys to flip the card;

H to show hint;

A reads text to speech;

100 Cards in this Set

  • Front
  • Back
type of drug: penicillin G

type of drug: penicillin V

type of drug: nafcillin
Antistaphylococcal penicillins

type of drug: oxacillin
Antistaphylococcal penicillins

type of drug: cloxacillin
Antistaphylococcal penicillins

type of drug: dicloxacillin
Antistaphylococcal penicillins

type of drug: methicillin
Antistaphylococcal penicillins

type of drug: ampicillin
Extended-spectrum penicillins

type of drug: amoxicillin
Extended-spectrum penicillins

type of drug: ticarcillin
Antipseudomonal penicillins

type of drug? piperacillin
Antipseudomonal penicillins

what are the 2 places on gram positive cell walls that we attack with antibiotics?

peptide cross-links
what is a major virulence factor in gram negative cell walls?
beta lactamase
the outer membrane of gram negative cell wall has what property?
permeability barrier
what is the important peptidoglycan structure on the gram positive bacteria?
D-Ala D-Ala at the end

it is where vancomyosin binds
what blocks the adding of 2 D-ala's to the end of the peptide chain of thecell wall for bacteria?
Cycloserine prevents this from happening
what is bactoprenol?
it is responsible for carrying bacterial building blocks across the plasma membrane for cell wall synthesis
what does vancomycin do?

binds to the 2 d-ala's that attempt to put the building blocks into the cell wall of the bacteria

This prevents cross-linking & elongation of peptidoglycan (blocks transglycosylase)
what does bacitracin do?
prevents the recycling of bactoprenol (remember that bactoprenol is responsible for carrying bacterial building blocks across the plasma membrane for cell wall synthesis)
what does transpeptidase do?
builds amino acid cross link between building blocks of the bacterial cell wall
how does penicillin work? (b-lactams)
block transpeptidation step … block cross linking of peptidylglycan chains

penicllin looks like the alanine-alanine bridge, and uses up all the transpeptidase!
what are the 3 basic steps of synthesis of bacterial cell wall? what blocks each stage?
1: occurs in cytoplasm – provides building blocks (cycloserine blocks this)

2: : occurs as building blocks pass through the plasma membrane (vancomycin or bacitracin)

3:Occurs outside the plasma membrane and involves cross-linking of peptidylglycan strands (b-lactams)
What do autolysins do?
Look this up.. it was on slide 22
are beta-lactam bactericidal or static?
are beta-lactams time or concentration dependent?

Effect is directly proportional to amount of TIME the drug concentration at the site of infection is ABOVE the MIC of the organism

What is essential for b-lactams to work (2)? functions?

*** gotta know this one
1. intact beta-lactam ring is essential for binding to PBPs and antimicrobial activity

2. R side chain … determines spectrum of antibacterial activity and pharmacological properties (e.g., affinity for PBP, resistance to penicillinase, ability to penetrate G- outer membrane, resistance to stomach acid, PK)
what is the difference between Pen G and Pen V?
G: is acid labile … poor oral bioavailability

V: more stable in acid
so “better” oral availability
Remember: V is not IV
what is the b-lactam bond?
Pen G is ____ spectrum
what does Pen G mostly treat?

Gram Positives

note also treats: a few gram negatives (like Neisseriae meningococci)
some anaerobes and spirochetes (syphilis)
what are some of the bugs with resistnace to penicillin G?
> 90% of Staphylococcus a
~ 5 % of Streptococci
Most of Neisseria gonococci
Pen G no longer a DOC
what are 3 areas that penicillin cannot treat infection in?

Can penicillin cross the BBB? Can it be used in Meningitis?
Do not readily cross BBB
… but … with inflamed meninges
Penicillins more easily enter the CSF
Therapeutic levels can be reached

Meningitis …
Penicillin may be used
Often used in combination with another antimicrobial
Pen G has a short half-life, what can slow this process?

blocks renal tubular secretion of penicillin
if Pen G has a short half-life, how does it have a low/prolonged drug level?
it is given with benzathine which gives a slow release from the injection site
although Penicillin G has the lowest toxicity potential of all antimicrobials, what is the most common adverse effect?
Allergic (hypersensitivity) Reactions
what is a breakdown product of penicillin G? what is the importance of this?
Penicilloic acid

acts as a hapten.... making a huge immune reaction....leading to penicillin allergy
are diarrhea and GI intolerance allergic reactions of penicillin G?

but they do occur, just not allergic
aside from allergic reactions, what is a possible major problem with use of penicllin G?

Most likely at high doses (intrathecal admin or renal failure)
Coma, seizures, hyper-reflexia
what causes superinfections?
loss of normal flora from use of broad spectrum agents
what type of bacteria is generally resistant to penicillin g?
Gram negative
What is the most common resistance component to penicillin G?

Penicillinase production

(beta lactamase)
why does penicillin not affect mycoplasma?
NO CELL WELL (and that is the mech of action for penicillin
What happens in MRSA?
Beta-lactams can’t bind to target because transpeptidases are mutated
how do beta lactamases work?
break the beta lactam bond on the beta lactam ring
what type of b-lactamases give resistance? what do they give resistance to?

Plasmid encoded

mediate resistance to penicillins and 1st & 2nd generation cephalosporins
what are extended spectrum b-lactamases? where are these seen in most commonly (2)?

can hydrolyze penicillins AND CEPHALOSPORINS (all generations!)
--this is bad!

In gram negative bacteria: most commonly Klebsiella and e coli
what are the antistaphylococcal penicillins? 4
what are the b-lactamase resistant penicllins?
Antistaphylococcal penicillins:

will antistaphylococcal agents work against MRSA?

PBP (drug target) is altered in MRSA ... … and the drugs can’t bind!!
oxacillin causes what side-effect?
what are the 2 extended spectrum penicillins?
what would you want to use for gram negatives (e coli, n. meningitidis)? note: these would NOT work on beta-lactamase bugs
Extended spectrum penicillins : Ampicillin & Amoxicillin

Not effective against beta-lactamase producers

(3rd and 4th gen cephalosporins work against gram neg and would work against beta-lactamase bugs)
what is the only oral pen that food does not interfere with absorption?
Ampicillin & Amoxicillin spectrum of activity?

similar to Pen G (gram +) and extends to:

H influenzae
E. coli
Listeria sp.

clinical uses fro ampicillin and amoxicillin?


what do you normally use with ampicillin?
Ampicillin is frequently used (synergistic) with an


(gentamicin) for broad range coverage in serious infections
DOC for Listeria meningitis
why do you use a bactericidal drug in meningitis?
no immune response in spinal column!
what are the Antipseudomonal penicillins?

spectrum of activity for ticarcillin and piperacillin?
Pen G (gram pos) + HELPS + Pseudomonas, Klebseilla, and Serratia
ticarcillin and piperacillin are used with what?
in combination with an aminoglycoside
what has the broadest spectrum of the penecillins?
sodium overload is a potential with what penicillin drug?
Antipseudomonal penicillins (Ticarcillin & Piperacillin)
do beta lactamase inhibitors have antimicrobial activity?
not intrinsically they potentiate the effect of the anti-biotics
how do Beta lactamase inhibitors work?
Binds to B-lactamase and inactivates the enzyme
Because they look like a penicillin
Suicide inhibitors
Binding is irreversible
as you shift from 1-4 generation cephalosporins, what happens? (3)
increasing activity against Gram negative (decreasing against gram pos)

Increasing resistance to B-lactamases

Increasing ability to cross BBB
what class of cephalosporin can you use to treat meningitis?
3rd and 4th... able to cross the BBB

Note: penecillin can work b/c you have enough "leakiness" for it to fit in
Cephalexin is what kind of drug?
1st Generation

Cefazolin is what kind of drug?
1st Generation

Cefoxitin is what kind of drug?
2nd Generation

Cefaclor is what kind of drug?
2nd Generation

Cefprozil is what kind of drug?
2nd Generation

Ceftriaxone is what kind of drug?
3rd Generation

Ceftazidime is what kind of drug?
3rd Generation

Cefotaxime is what kind of drug?
3rd Generation

Cefdinir is what kind of drug?
3rd Generation

Cefepime is what kind of drug?
4th Generation

specturm of activity for cephalosporins?
… generally like ampicillin (G+ & HELPS) ... but varies with generation
cephalosporin: bactericidal or static?
what are the 2 resistances to cephalosporins?
Penicillinases and cephalosporinases
In general … cephs are more resistant to breakdown by what enzymes?
Penicillinases and cephalosporinases

Klebsiella, E Coli, Pseudomonas, Enterobacter, (ESBL can breakdown penicillins & cephs)
what is an adverse effect of cephalosporins? 2
ALLERGIC reactions

2 major clinical indications of cephalosporins?
Can be useful alternative for penicillin allergic patients (if mildly allergic)

Frequently used for surgical prophylaxis (especially 1st generation)
order gram positive coverage for the different generations of cephalosporins
order gram negative coverage for the different generations of cephalosporins
Resistance to beta lactamases increases from ___ to ___ generation
increases from 1st to 4th generation
Hypoprothrombinemia is a side-effect of what? what is it?

Coagulation abnormalities
Disturbs synthesis of vitamin K-dependent clotting factors
Alcohol intolerance is a side-effect of what? what is it?

disulfiram-like reaction--

Disulfiram is an agent that inhibits alcohol dehydrogenase, causing an increase of acetaldehyde, the agent that causes hangovers
what causes the adverse side effects of cephalosporins? what drugs is it in?

Due to methylthiotetrazole (MTT) group

Cefotetan (2nd generation)
Cefoperazone (3rd generation)
primary use for 1st generation cephalosporins? Specific drug?

Prophylaxis of surgical procedures

primary clinical use for 2nd generation cephalosporins? 4

soft tissue infections,
bone infections,
surgical prophylaxis

primary use for 3rd generation cephalosporin?
Nosocomial G- infections ... often in combination with AGs
1st gen cephalosporins are active against?
G+ plus Proteus, E. coli, Klebsiella

(Pen G + PEcK)
Cefazolin used for
surgical prophylaxis
Cefoxitin Cefaclor Cefprozil

are what drugs
2nd Generation

spectrum of coverage for 2nd gen cephalosporins?
G+ + H. influenza, Enterobacter, Neisseria, Proteus, E. coli, Klebsiella

what is primarily used to treat sinusitis, bronchitis, otitis media
lower respiratory tract infections ?
2nd gen cephalosporins
Allergic reactions
Blood dyscrasias (anemia, eosinophilia)
Pseudomembranous colitis

are side effects of what?
2nd Generation Cephalosporins