ORG MED LEC
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| 🇬🇧 | 🇬🇧 |
| 1 A __ that blown in to Fleming's lab while he was on vacation in 1928 changed the course of medicine forever. 2 Fleming named the substance __ after the mould __. | 1 fungal spore 2 Penicillin, Penicillium notatum |
| __ managed to produce larger amounts of penicillin and tested it on __ | 1 E. Chain and H. Florey (1930 to 1940s) (Nobel Prize 1945) 2 Mice |
| 1 used in Chinese folk medicine to treat boils and carbuncles 2 Chinese and Ukranian - treatment for infected wounds 3 anthrax bacilli were killed when grown in culture with presence of certain bacteria 4) Vuillemin | 1 molded curd of soybean (500 to 600 BC) 2 Moldy cheese 3) 1877 - Pasteur and Joubert 4 Antibiosis (literally against life) |
| Modifying naturally occurring antibiotics and to prepare synthetic analogs necessitated the inclusion of __ in the definition | Semisynthetic, synthetic derivatives |
| A substance is classified as antibiotic if the ff. conditions are met: | 1. It is a product of metabolism 2. It is a synthetic product produced as a structural analog of a naturally occurring antibiotic. 3. It ANTAGONIZES GROWTH or survival of one or more species of microorganisms. 4. It is effective in LOW concentrations. |
| Antibiotics’ other attributes: | 1. Exhibit sufficient SELECTIVE TOXICITY to be decisively effective against pathogenic microorganism or neoplastic tissue, without causing significant toxic effects 2. Chemical is STABLE enough to be isolated, processed and stored for a reasonable length of time without deterioration of potency. 3. RATE of biotransformation and elimination of antibiotic should be SLOW enough to allow a convenient dosing schedule, yet rapid and complete enough to facilitate removal of the drug from the body soon after administration is discontinued. |
| Classification of Antibiotics | 1 Based on Mode of Action (Bacteriostatic, Bactericidal) 2 Based on spectrum of action (Broad spectrum, Narrow spectrum) |
| 1 Acts against limited group of bacteria 2 Acts against larger group of bacteria | 1 Narrow spectrum 2 Broad spectrum |
| Broad Spectrum antibiotics list | 1) Carbapenems 2) Chloramphenicol 3) 2nd, 3rd, 4th Gen Cephalosporins 4) 3rd gen fluoroquinolones 5) Broad spectrum penicillin 6) Tetracyclines |
| Narrow Spectrum antibiotics list | 1 Penicillin G and V 2 Lincosamides (Clindamycin) 3 Glycopeptides (Vanco and Teicoplanin) 4 Streptogramins 5 Rifamycins 6 Daptomycins |
| 1 Function to destroy or Kill bacteria 2 Function to stop growth or slow the growth of bacteria | 1 Bactericidal 2 Bacteriostatic |
| Cell wall synthesis inhibitors | B-lactams, Glycopeptides, Bacitracin, Fosfomycin, Alafosfalin, |
| DNA Gyrase inhibitors | 1 Quinolones 2 Coumermycin antibiotics |
| Inhibition of DNA-dependent RNA Polymerase | 1 Rifampicin |
| Cell membrane synthesis disruptors | Lipopeptides |
| Folate synthesis inhibitors | Sulfonamides |
| RNA Synthesis inhibitors | Ansamycines |
| Protein Synthesis Inhibitors | Tetracyclines, Aminoglycosides, Macrolides, Lincosamides, Amphenicols, Pleuromutilins, Oxazolidinones |
| They have a macrolide structure | 1 erythromycin 2 oleandomycin |
| Contain closely related amino sugar moieties | 1 Streptomycins 2 Kanamycins, 3 Neomycins, 4 Paromomycins, 5 Gentamicins |
| Large group of polypeptides | 1 bacitracins 2 tyrothricin 3 polymyxin BTP |
| SS-lactam ring–containing antibiotics derived from amino acids. | 1 Penicillins 2 Cephalosporins |
| First antibiotic used choice for tx of infection caused by Gram + bacteria. | Penicillin (Pen G and Pen V) |
| 1 Penicillin G other name 2 Penicillin V other name | 1 Benzylpenicillin 2 Phenoxymethyl |
| What are the methods of Bacterial Resistance in Beta lactam type of drugs? | 1 Efflux pumps 2 Beta-lactamases enzyme hydrolyze the amide bond of Beta-lactam ring (Inactivation) 3 Mutation of genes, altering the active sites and production of PBPs (penicillin binding proteins) 4 Closure of Porins 5 Impaired penetration of drug to target PBPs |
| It is in the general structure of penicillin | 6-aminopenicillanic acid (6-APA) |
| 1 No substitution in this area in the structure of penicillin 2 Required for activity in the structure of penicillin 3 Improves acid stability, but decreases the activity of the agent in the structure of penicillin 4 When changed to alcohol, activity decreases in the structure | 1 Methyl groups 2 Nitrogen 3 When the sulfur atom of thiazolidine ring is oxidized to a sulfone or sulfoxide 4 Carboxylic acid |
| Penam Nomenclature 1 CA-SYSTEM 2 USP-SYSTEM | 1) 1-thia-4-aza-bicyclo[3.2.0]-7-heptane (Assign 1 to sulfur) 2) 4-thia-1-aza bicyclo [3.2.0]-7-heptane (Assign 1 to Nitrogen, 4 is sulfur) |
| 1 Describe the ring system with substituents that are generally present 2 Distinguishes the compounds on the basis of the R group of the acyl portion of the molecule | 1 Penicillanic acid 2) 6-carbonylaminopenicillanic acid as "penicillin" |
| 1 Early commercial penicillin characteristics 2 Improved purification procedures characteristics of penicillin | 1 Yellow to brown amorphous powder 2 White crystalline |
| 1 Major degradation product 2 Second degradation product 3 Third degradation product | 1 Penicillamine 2 Penicilloaldehyde 3 Penilloic acid |
| Binds to PBPs (Transpeptidase) leading to transpeptidation reaction essential for peptidoglycan synthesis | Beta Lactams |
| . | . |
| Penicillin side effects | ABCD-SSS 1 ANAPHYLAXIS 2 BLACK TONGUE 3 DIARRHEA 4 SKIN RASH 5 STOMACH UPSET 6 SEIZURES |
| Staphcillin side effects | Interstitial nephritis |
| Imipenem-Cilastatin | Seizures, allergic rxns, Toxic metabolite cause nephrotoxicity |
| Antipseudomonal penicillin (Extended spectrum) | CAROXYPENICILLIN AND UREIDOPENICILLIN 1 Carbenicillin 2 Ticarcillin 3 Piperacillin 4 Mezlocillin CTPM |
| Antistaphylococcal penicillin (RESISTANCE TO Beta-Lactamase) | 1 Methicillin 2 Nafcillin 3 Oxacillin 4 Cloxacillin 5 Dicloxacillin |
| ACID RESISTANT PENICILLINS | VODKA Penicillin V Oxacillin Dicloxacillin Cloxacillin Amoxicillin |
| PENICILLINASE RESISTANT PENICILLINS | CONDOM Cloxacillin Oxacillin Naphcillin Dicloxacillin Oxacillin Methicillin |
| Tx of choice for gonorrhea | Ampicillin + Probenecid |
| In the repository forms of penicillin 1 Suspension of penicillin in __ 2 Suspension in __ | 1 Peanut oil or sesame oil with white beeswax 2 Vegetable oil with Aluminum monostearate or Aluminum distearate |
| Repository FORMS (IM) of penicillin | 1 Penicillin G procaine (Crysticillin, Duracillin, Wycillin) 2 Penicillin G benzathine (Permapen) |
| Acyl side chain of the penicillin can be cleaved using enzyme or chemical methods to produce 6-APA 75% of penicillin is produced is modified in this manner | Semi-synthetic penicillin |
| Penicillin with bulky side groups can block the Beta-lactamases which hydrolyze the lactam ring | Penicillinase-resistant penicillin - Antistaphylococcal |
| Beta lactamases are prevalent in what microorganisms? | S aureus S epidermidis |
| Prototype drug -off the market due to high incidence of nephrotoxicity Interstitial nephritis | (Staphcillin) 2,6-dimethoxyphenylpenicillin |
| 1 Methicillin is acid sensitive and has been improved by adding __ 2 This results to drugs such as | 1 Electron withdrawing groups 2 Oxacillin, Nafcillin |
| Can be given to patients with renal problems Stable in acid>orally relatively small amounts are excreted through kidneys, with the major portion excreted in the bile | Nafcillin (2-ethoxy-phenylpenicillin) (Unipen) |
| Better absorbed than other antistaphs | Isoxazoyl Penicillin |
| Isoxazoyl Penicillins: | Oxacillin, Cloxacillin, Dicloxacillin |
| Agent of choice against Haemophilus influenzae infections | Ampicillin, 6-(d-α-aminophenylactemidopenicillanic acid) BN: Omniphen, Amcill, Principen |
| Treatment of choice for gonorrhea | Ampicillin + Probenecid |
| P-hydroxy analog of ampicillin better GI absorption than ampicillin introduced in 1974, | Amoxicillin 6-[d-(-)-α-amino-para-hydroxyphenylacetamido]penicillanic acid BN: Amoxil |
| Most successful derivative of thienamycin primary group is converted to nonnucleophilic basic function rapid degradation by renal peptidases | Imipenem-Cilastatin (BN: Primaxin) Cilastatin - inhibitor of DHP-I> longer DOA |
| Most successful derivative of thienamycin primary group is converted to nonnucleophilic basic function rapid degradation by renal peptidases | Imipenem-Cilastatin (BN: Primaxin) Cilastatin - inhibitor of DHP-I> longer DOA |
| Most successful derivative of thienamycin primary group is converted to nonnucleophilic basic function rapid degradation by renal peptidases | Imipenem-Cilastatin (BN: Primaxin) Cilastatin - inhibitor of DHP-I> longer DOA |
| Most successful derivative of thienamycin primary group is converted to nonnucleophilic basic function rapid degradation by renal peptidases | Imipenem-Cilastatin (BN: Primaxin) Cilastatin - inhibitor of DHP-I> longer DOA |
| Most successful derivative of thienamycin primary group is converted to nonnucleophilic basic function rapid degradation by renal peptidases | Imipenem-Cilastatin (BN: Primaxin) Cilastatin - inhibitor of DHP-I> longer DOA |
| Prodrugs of ampicillin | Hetacillin, Bacampicillin, Cyclacillin HBC |
| Similar to aminopenicillins in structure but have either carboxyl group or urea group instead of the amine | Extended Spectrum Penicillin/ Antipseudomonal penicillins |
| Tx for systemic and UTI infections caused by P. aeruginosa, Proteus spp and Providencia spp, all are resistant to ampicillin. not stable in acids and inactivated by penicillinase given by IV US in 1970 | Carboxypenicillins ( Carbenicillin, Ticarcillin) α- carboxybenzylpenicillin (Geopen, Pyopen) |
| Ureidopenicillins | Piperacillin-most potent, Azlocillin, Mezlocillin |
| More active than Mezlocillin most generally useful B-lactamases producing strains are resistant rapidly destroyed by stomach acid IV and IM admin only | Piperacillin Sodium |
| Class II inhibitor has potent antibacterial activity transient inhibition of some Beta lactamases | Carbapenem derivative Imipenem |
| Possess 2-hydroxyethylidene moiety at C-2 isolated from Streptomyces clavuligeris 1-oxopenam lacking the 6-acylamono side chain of pens acid- stable | Clavulanate Potassium BN: Augmentin, Timentin |
| Potentiates the activity of Ampicillin and Carbenicllin Penicillanic acid sulfone or 1,1-dioxopenicillanic acid | Sulbactam BN: Unasyn |
| 1 Tazobactam is combined with __ | 1 Piperacillin |
| Most successful derivative of thienamycin primary group is converted to nonnucleophilic basic function rapid degradation by renal peptidases | Imipenem-Cilastatin (BN: Primaxin) Cilastatin - inhibitor of DHP-I> longer DOA |
| Inhibited growth of wide variety of gram + and gram - bacteria | C. acremonium - by 1945: Giuseppe Brotzu |
| 1 isolated three principal antibacterial activity: 2 three principal antibacterial activity: | 1 1948: Abraham and Newton 2 Cephalosporin P1, Cephalosporin N, Cephalosporin C |
| 1 steroid with minimal antibacterial act. 2 identical to synnematin N (penicillin N), C. salmosynnematum | 1 Cephalosporin P1 2 Cephalosporin N |
| 1 First gen cephalosporin | 1 Cephazolin |
| 1 Drug of choice for surgical prophylaxis 2 Active against H influenza but not Serratia or B fragilis | 1 Cefazolin 2 Cefaclor, cefamandole, cefonicid, cefuroxime, ceforanide |
| 1 Second gen cephalosporin | 1 Cefuroxime 2 Cefaclor 3 Cefoxitin |
| 1 Used to treat mixed anaerobic infections such as peritonitis or diverticulitis 2 For community acquired pneumonia 3 Active against P aureginosa | 1 Cefoxitin, cefotetan or cefmetazole 2 Cefuroxime 3 Ceftazidime & Cefoperazone |
| Thurd gen cephalosporin | Ceftriaxone Cefotaxime Ceftazidime |
| Clavulanate acid | Streptomyces clavuligerus |
| Cephalosporin N | C. salmosynnematum |
| Cephalosporins | Cephalosporium spp. |
| Thienamycin | Streptomyces cattleya |
| Monobactam | Saprophytic soil bacteria in Japan and US |