Term
| penicillins and cephalosporins are the major antibiotics that |
|
Definition
| inhibit bacterial cell wall synthesis |
|
|
Term
|
Definition
| 4 member ring with three carbons and one nitrogen |
|
|
Term
| vancomycin is/is not a beta lactam |
|
Definition
|
|
Term
| narrow spectrum cephalosporings |
|
Definition
|
|
Term
| broad spectrum cephalosporin |
|
Definition
| 2nd 3rd and 4th generation |
|
|
Term
| Pencillins are derivative of |
|
Definition
6 aminopenicallanic acid
cotnain a beta lactam ring structure that is essential for antibacterial activity. |
|
|
Term
| penicillins vary in their resistance to _______ and therefore in their oral_______ |
|
Definition
gastric acid
bioavailability |
|
|
Term
| pencillins are ____ compunds that are not _____ extensivley |
|
Definition
|
|
Term
| penicillins are usually___ in the urine via |
|
Definition
excreted
glomerular filtration and tubular secretion. |
|
|
Term
|
Definition
|
|
Term
| nafcillin is excreted in the |
|
Definition
|
|
Term
| ____ undergoes enteroheepatic cyclign |
|
Definition
|
|
Term
| plasma half lives of penicillin |
|
Definition
|
|
Term
| procaine and benzathine forms of penicillin G are adminsitered ______ and have long half lives because________ |
|
Definition
intramuscularly
the active drug is released slowly into the blood stream |
|
|
Term
| most penicillins cross the blood brain barrier only when |
|
Definition
|
|
Term
| beta lactams are _______ drugs |
|
Definition
|
|
Term
| steps in beta lactam bactericidal action |
|
Definition
1) binding of drug to the penicillin binding protein in the cell membrane
2) inhibition of the transpeptidatyion reactiont hat cross links linearpeptidoglycan chain contituents of the cell wall
3) activation of autolytic enzyes that lesions the ell wall. |
|
|
Term
| enzymatic hydrolosis of beta lactam ring cuases |
|
Definition
| loss of antibacterial activity |
|
|
Term
| The formation of beta-lactamases by ______ and many gram______ organisms |
|
Definition
| staphlcocci and gram negative organizms is a cause of resitance. |
|
|
Term
| what inhibits beta lactamases? |
|
Definition
clavulanic acid
sulbactam
tazobacam |
|
|
Term
| what is another mechanism of resistance |
|
Definition
| structural changes in the penicillin binding protiens |
|
|
Term
| pneumococcus can get reistant to _______ by alterations int he |
|
Definition
penicillin G
penicillin binding protein |
|
|
Term
| METHICILLIN RSITANCE IS CAUSED BY |
|
Definition
| pbp alterations in staph aureus |
|
|
Term
| In some gram negative bacteria like _____, porin changes stop Pencillin from entering and binding to PBP |
|
Definition
|
|
Term
| narrow spectrum penicillinase suseptible agents |
|
Definition
penicllin G which
sterptococcus has developed resistance to (Pencillin resistance resistant strep pneumo) |
|
|
Term
|
Definition
| prototype of the subcalass of penicllins that have limited anti bacterial activit ynad are susceptible to beta lactamaases |
|
|
Term
| pencillin G is no good for...still good for |
|
Definition
penicliin G is good for syphillus
no good for gonohrrhea |
|
|
Term
|
Definition
| an oral drug used mainly in oropharyngeal infections |
|
|
Term
| Very narrow spectrum pencillinase resistant drugs |
|
Definition
methicillin
nafcillin
oxacillin
suspected staph inffections |
|
|
Term
wide spectrum penicillinase susceptible drugs
ampicillin and amoxicilin |
|
Definition
ampicilling and amxocillin
same as peniclling G but remains susceptible to penicillinases
in addition to pen G can do enterococci, listeria, ecoli, proteus heamophlius inf, moraxella
can be combined with inhibitiors of penicllinases |
|
|
Term
| piperacillin and ticarcillin |
|
Definition
activity against several gram - bacteria including
pseudomonas, enterobacter, and some klesiella
synergistic with aminoglycosides |
|
|
Term
| name all the pencillins we know |
|
Definition
g
V
methicllin
naficillin
oxacillin
ampicillin
amoxicillin
peracillin
ticarcilin |
|
|
Term
|
Definition
sterptococci
menigococci
gram positive bacilli
spirochetes |
|
|
Term
| many pneumococci are resistant to |
|
Definition
|
|
Term
|
Definition
dderviatives of 7 aminocephalosporanic acid
contain beta lactam ring |
|
|
Term
| pharmacokinetics of cepalosporin |
|
Definition
| some are given orally but most are parentally (iv or intramuscualar) |
|
|
Term
| what is the primary way of excreting cephalosporins |
|
Definition
| there is hepatic metaolismbut mainly remal excretion via tbular secretion |
|
|
Term
| Which ceph drugs are excreted in bile? |
|
Definition
|
|
Term
| even during inflammation _______ and ______ genereation cephalospornis do not cross the ________ |
|
Definition
|
|
Term
| mechanism of cephalosporin |
|
Definition
| same as penicillin bind to pbp precent transpeptidases |
|
|
Term
| cephalosporins are less suceptible to ______ than pencillin |
|
Definition
| penicillinases prduced by staphlococci |
|
|
Term
| many bacteria can still produce _______ ______ that provide resistnace to cephalosporin |
|
Definition
|
|
Term
| What is another way that resistance to cephalosporins can develop |
|
Definition
| decreased permeability o cephalosporin. |
|
|
Term
| MRSA is also resitant to ________ |
|
Definition
|
|
Term
| First generation cephalospron |
|
Definition
cefazolin (parenteral)
ceohalexin (oral)
active agains gram positve coci including staph and strep
e coli
k penumoniae
surgical proopholaxis
minimal effect against gram negatives, mrsa |
|
|
Term
|
Definition
less effective against gram pos
more effective against gram negative when compared with 1st gerenation drugs. |
|
|
Term
| clinic use of second generation |
|
Definition
bacteroides fragilis
h influenzae
moraxella |
|
|
Term
|
Definition
|
|
Term
cefamandole
cefuroximine
cefaclor |
|
Definition
m catrahallios
h influenzae |
|
|
Term
| 3rd generation characteristc |
|
Definition
ceftazidime
cefapperazone
cefotaxaime
icnreased activity against g- organisms resistant to other beta lactams
ability to penetrate the blood brain barier
except for (cefoperazone and cefixime) |
|
|
Term
| Third generations are active against |
|
Definition
| providenciam, serratia anbd beta lactamase producing h influenzae and neisseria |
|
|
Term
| most active antibiotics to PRSP |
|
Definition
ceftriaxone (parenteral)
cefiximide (oral) |
|
|
Term
| 3rd generation cephalosporins |
|
Definition
serious bbusiness infections....gonohrrhea exception
one injhection of ceftriaxone is as effective as 10 days of amoxicillin |
|
|
Term
|
Definition
more resistant to beta lactamases produced by fam negative ofganisms including enterobacter
h influenzae neisseria and some penicilling resistant penumococi
combines gram positive of first genreation with broad gram negative affect of thrid generation |
|
|
Term
| allergy to cephalosporins |
|
Definition
allergic reaction from skin rashes to anaphylactic shock
less frequently with cephalosporins than with penicllins
cross hypersensititbity should be assumed.
little cross sesnitivity bw cephalosporins and penicillins |
|
|
Term
| adverse cephalosporin events |
|
Definition
| pain at intramuscular injection sitse and phlebitis after iv admin |
|
|
Term
|
Definition
monobactam that is resistant to beta lactamases produced by klebsiella, pseudomonas, serratia
no activity against gram positive bnacteria or anerobes
inhibits cell wall syntehsis
administered iv and is eliminated via renal tubular secreation
half life prolonged in renal failure |
|
|
Term
|
Definition
contain beta lactam ring but different than peicilin
gram + cocci
for pseudomonas used along with an aminoglycoside.
administred parenreally
MRSA is resistant to these
drug of choice for enterobbacter
meropenem,, ertapenem, imipenem |
|
|
Term
| beta lactamase inhibitors |
|
Definition
clavulanic acid
sulbactam
tazobactan
fixed combinations with certain penicllins (hydrolyzable)
most active against plasmid econded beta lactamases such as those produced by gonococci, streptococi , ecoli and hinfluenzae |
|
|
Term
|
Definition
| bactericidal glycoprotien that binds to the dala dala terminal of the nascent peptidoglycan pentapeptide side chain and inhinits transglycosolation. itnerferes with corsslinking |
|
|
Term
|
Definition
| srious infection cause dby drug resistant gram positive prganizms |
|
|
Term
| vacp,ycin resistant enterococci are increasing |
|
Definition
|
|
Term
| vancomycin has a narrow spercturm of activityy |
|
Definition
|
|
Term
| teicoplanin is like which drug |
|
Definition
|
|
Term
| toxic effects of vancomucin |
|
Definition
| chills, fever, phlenitis, ototoxicity and nephrotoxicity |
|
|
Term
|
Definition
| antimetabolite inhibnitor of cytosolic enolpyruvate transferase prevention Nacetyl muriamic acid |
|
|
Term
|
Definition
peptide antibiotic that itnerferes with a late stage in cell wall snthesis in gram positvie organisms
because o fnephrotoxicity dont eat it |
|
|
Term
|
Definition
| blocks d-ala into pentapeptide side chain of the peptidoglycan -only used as n atlernative tb drug bbecause of neruotoxicity |
|
|
Term
|
Definition
new cyclic lipopeptide actiuve against vancomyicn resiustant straisn of entercoocci
may cause myopathy |
|
|
Term
|
Definition
| percentaghe of available binding sites that have O2 attached |
|
|
Term
| o2 saturation of arterial blood with Po2 of 100 mm Hg |
|
Definition
|
|
Term
| venous blood o2 saturation |
|
Definition
|
|
Term
oxygenated form of hemoglobin is the
deoxygenated form is |
|
Definition
|
|
Term
| advantages of physiology of the sigmoidal hg binding curve |
|
Definition
| flat upper poriton means that evenin oif the PO2 falls a but in alveolar gass, loading of O2 will be little affected |
|
|
Term
| steep lower part of the dissociation curve means that |
|
Definition
| peripheral tissue can withdraw o2 with small drops in capillary o2 |
|
|
Term
|
Definition
|
|
Term
| what causes a right shift |
|
Definition
lower affinity of o2 and hb
increase in h plus, tempartur and 2.3 DPG |
|
|
Term
| higher affinity of 02 and HGb is seen as |
|
Definition
| a left shift. this is caused by lower h plus, tmmeparature and 2,3 dpg |
|
|
Term
| a right shift means more unloading of o2 at a given p02 in capillary |
|
Definition
|
|
Term
|
Definition
|
|
Term
| carbon monoide interfreres with the 02 transport function of blood by combining with Hb to form |
|
Definition
|
|
Term
| CO binds to Hb ____ times more than oxygen |
|
Definition
|
|
