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2012-02-10 11:47:56
HUSOP DA EXAM1 Penicillins

Questions from the Penicillin lecture
Show Answers:

  1. The main mechanism of action of penicillins is __________.
    Interfering with bacterial cell wall synthesis
  2. What does the variable side chain of penicillins dictate?
    Antibacterial and pharmacological characteristics.
  3. The _________ is the highly reactive 3-carbon, nitrogen part of a penicillin.
    Beta-lactam ring or center
  4. Penicillins inhibit ____________.
  5. What is the role/function of transpeptidase?
    It cross links peptides found in the peptidoglycan cell wall, connecting parallel chains.
  6. As cross linking of peptides is inhibited, the bacteria_____________
    Cell wall weakens, and the cell dies.
  7. By what two mechanisms may bacteria be killed? Describe each one.
    Lytic and non-lytic. Lytic involves membrane rupture and non-lytic involves loss of membrane potential.
  8. Penicillin __________ binds ___________resulting a number of different outcomes depending which ________ bound.
    covalently, PBP's
  9. Name and describe the three mechanisms by which penicillin resistance occurs.
    Decreased affinity of PBP's for B-lactams, inability of B-lactams to access site of action, and enzymatic degradation
  10. What is the enzyme that degrades B-lactams?
  11. Gram positive tend to have _______ penicillinases, but gram negative bacteria _________.
    More, have effective penicillinases due to their location
  12. Where are genes for B-lactamases found?
    Chromosome or plasmid and can be transferred
  13. What is the most common adverse effect associated with penicillins?
    Hypersensitivity reactions
  14. Immediate immune reactions to penicillin is ______ mediated whereas later reactions are ______ mediated.
    IgE, IgG or IgM
  15. Fatalities involving ______________ have occurred with low doses or even skin testing with penicillin.
  16. Name five other adverse reactions to penicillin.
    Maculopapular rash, uticarial rash (hives), fever, bronchospasm, vasculitis, serum sickness, exfoliative dermatitis, Stevens-Johnson syndrome, acute anaphylaxis, angioedema, and contact dermatitis
  17. Name three less commmon adverse reactions to penicillin. What may these depend on?
    Seizures, bone marrow depression, granulocytopenia, diarrhea, nausea & vomiting, and injection site pain or inflammation.
  18. Pencillin G has ______ oral absorption, while V has _______ oral absorption.
    Poor (varied), good
  19. Do penicillins V & G have resistance to penicillinase?
  20. Pen V & G have good activity against ____________ and most _______________.
    Treponema pallidum, streptococci
  21. Pen V & G have moderate activity against ____________ and _______________.
    Streptococcus pneumoniae, enterococci
  22. Penicillin-resistant penicillins are also called what?
    Antistaphylococcal penicillins
  23. Oxacillin and dicloxacin are what type of penicillin? What are their oral absorptions?
    Antistaphylococcal penicillins, good
  24. Nafcillin is what type of penicillin? What is its oral absorption?
    Antistaphylococcal penicillin, variable
  25. Penicillin-resistant penicillins have good activity against __________ & __________.
    Methicillin-sensitive staph. Areus, streptococci
  26. Penicillin-resistant penicillins have poor activity against __________ , __________,__________, & ___________
    Gram-negative rods, enterococci, anaerobes, MRSA
  27. Penicillin-resistant penicillins are eliminated through the _________, so they are a good choice for patients with _____.
    Liver, renal insufficiency
  28. Two aminopenicillins are?
    Ampicillin & amoxicillin
  29. Do aminopenicillins have good oral absorption?
    Yes, amoxicillin has excellent oral absorption
  30. The aminopenicillin specrum includes ________ & __________
    Gram positive, gram negative
  31. Aminopenicillins have good activity against which of the following?
    a. staphylococci b. streptococci c. enterococci d.anaerobes e. B & C f. all of the above
  32. Aminopenicillins have poor activity against ________ & _________
    staphylococci, anaerobes
  33. Ticarcillin and piperacillin are ________________ penicillins.
  34. Antipseudomonal penicillins are given by which route?
  35. Piperacillin extends the spectrum of __________ to include ____________
    Pseudomonas A
  36. Activity of ticarcillin is _________ to that of __________
    inferior, piperacillin
  37. Piperacillin has activity against __________ & _________, but may encounter reistance because of __________.
    Enterobacteriacae, bacteroides, B-lactamase