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Questions and Answers
What is the primary function of porins in the lipopolysaccharide layer of bacteria?
What is the primary function of porins in the lipopolysaccharide layer of bacteria?
- To inactivate β-lactam antibiotics
- To produce β-lactamases
- To act as water-filled channels for transmembrane entry (correct)
- To secrete penicillinases
How do β-lactamases contribute to antibiotic resistance in bacteria?
How do β-lactamases contribute to antibiotic resistance in bacteria?
- By inactivating β-lactam antibiotics enzymatically (correct)
- By increasing the permeability of the bacterial membrane
- By reducing the concentration of β-lactam antibiotics
- By producing more β-lactam antibiotics
What is the typical location of β-lactamases in Gram-negative bacteria?
What is the typical location of β-lactamases in Gram-negative bacteria?
- In the cytoplasm
- In the inner membrane
- In the periplasmic space (correct)
- In the outer membrane
What is the role of β-lactamase inhibitors in antibiotic therapy?
What is the role of β-lactamase inhibitors in antibiotic therapy?
Which of the following β-lactamase inhibitors is combined with amoxicillin in an oral preparation?
Which of the following β-lactamase inhibitors is combined with amoxicillin in an oral preparation?
What is the characteristic of β-lactamases produced by Gram-positive bacteria?
What is the characteristic of β-lactamases produced by Gram-positive bacteria?
What is the mechanism of action of clavulanic acid as a β-lactamase inhibitor?
What is the mechanism of action of clavulanic acid as a β-lactamase inhibitor?
Which of the following is NOT a type of β-lactamase inhibitor?
Which of the following is NOT a type of β-lactamase inhibitor?
What is the purpose of coformulating β-lactams with β-lactamase inhibitors?
What is the purpose of coformulating β-lactams with β-lactamase inhibitors?
What is the characteristic of β-lactamases produced by Gram-negative bacteria?
What is the characteristic of β-lactamases produced by Gram-negative bacteria?
What is the primary mechanism of action of penicillins?
What is the primary mechanism of action of penicillins?
Which of the following is a contraindication for penicillin use?
Which of the following is a contraindication for penicillin use?
What is the primary reason why gram-negative microorganisms are less susceptible to penicillins?
What is the primary reason why gram-negative microorganisms are less susceptible to penicillins?
Which of the following is a characteristic of penicillin binding proteins?
Which of the following is a characteristic of penicillin binding proteins?
What is the main reason why penicillins are bactericidal?
What is the main reason why penicillins are bactericidal?
What determines the susceptibility of penicillin binding proteins to β-lactam antibiotics?
What determines the susceptibility of penicillin binding proteins to β-lactam antibiotics?
Which of the following is a potential adverse effect of penicillin use?
Which of the following is a potential adverse effect of penicillin use?
What is the category of penicillin use during pregnancy?
What is the category of penicillin use during pregnancy?
Which of the following is a characteristic of penicillin?
Which of the following is a characteristic of penicillin?
Which of the following antibiotics is not a type of beta-lactam antibiotic?
Which of the following antibiotics is not a type of beta-lactam antibiotic?
Beta-lactam antibiotics
Beta-lactam antibiotics
What are the targets of beta-lactam antibiotics?
What are the targets of beta-lactam antibiotics?
What is the duration of most antibiotic treatments for strep throat?
What is the duration of most antibiotic treatments for strep throat?
Which of the following antibiotics is used to treat patients who are allergic to penicillin?
Which of the following antibiotics is used to treat patients who are allergic to penicillin?
What is the result of the inhibition of transpeptidase by beta-lactam antibiotics?
What is the result of the inhibition of transpeptidase by beta-lactam antibiotics?
What is the name of the enzyme that is inhibited by beta-lactam antibiotics?
What is the name of the enzyme that is inhibited by beta-lactam antibiotics?
What is the mechanism of resistance to beta-lactam antibiotics?
What is the mechanism of resistance to beta-lactam antibiotics?
What is the role of penicillin-binding proteins in bacterial cell wall synthesis?
What is the role of penicillin-binding proteins in bacterial cell wall synthesis?
What is the primary mechanism targeted to treat strep throat?
What is the primary mechanism targeted to treat strep throat?
What type of microbial agent is NOT commonly associated with sore throat?
What type of microbial agent is NOT commonly associated with sore throat?
Which of the following medications is not an over-the-counter medication for sore throat?
Which of the following medications is not an over-the-counter medication for sore throat?
What is the purpose of a rapid throat strep test?
What is the purpose of a rapid throat strep test?
What is the primary mechanism of action of beta-lactam antibiotics?
What is the primary mechanism of action of beta-lactam antibiotics?
Which are the 2 most common adverse effect of penicillins?
Which are the 2 most common adverse effect of penicillins?
Which of the following is a common mechanism of antibiotic resistance utilized by bacterial cells?
Which of the following is a common mechanism of antibiotic resistance utilized by bacterial cells?
Which causes sore throat?
Which causes sore throat?
Children at least 6 months old can be given ibuprofen (Rx by PCP) to treat mild-moderate pain
Children at least 6 months old can be given ibuprofen (Rx by PCP) to treat mild-moderate pain
Ibuprofen is safe for children under 6 months old
Ibuprofen is safe for children under 6 months old
Acetaminophen is safe and effective for both infants and children
Acetaminophen is safe and effective for both infants and children
Study Notes
Bacteria Cell Wall Structure
- Lipopolysaccharide layer has proteins that act as water-filled channels (porins) for transmembrane entry
Beta-Lactamase
- Bacteria can inactivate β-lactam antibiotics enzymatically via β-lactamases
- Thousands of different β-lactamases have been characterized by molecular class or functional characteristics
- Substrate specificities can be narrow or extend to almost all β-lactams
- Gram-positive bacteria produce and secrete large amounts of β-lactamase, typically narrow-spectrum penicillinases
- Gram-negative bacteria have β-lactamases in lower quantities, but their location in the periplasmic space provides maximal protection
Beta-Lactamase Inhibitors
- Coformulated with β-lactams to "protect" them from β-lactamase
- Bind to β-lactamases and prevent hydrolyzing β-lactam agents
- Examples: Clavulanic Acid, Sulbactam, Tazobactam, Avibactam, Relebactam, Vaborbactam
Penicillin Mechanism of Action
- Structurally resemble the terminal portion of peptidoglycan strand
- Compete for and bind to penicillin-binding proteins (PBPs), which catalyze transpeptidase and facilitate cross-linking of the cell wall
- Result: formation of a weakened cell wall and ultimately cell death
- Regarded as bactericidal and work in a time-dependent fashion
Penicillin Drugs
- Examples: Pen G, PenV, Amoxicillin, Ampicillin
Contra-Indications and Precautions
- Contraindicated in patients with hypersensitivity to penicillin or cephalosporins
- Used cautiously in patients with renal disease, asthma, bleeding disorders, gastrointestinal disease, pregnancy, or lactation, and history of allergies
Antibiotics Used for Strep Throat
- Penicillin
- Amoxicillin
- Amoxicillin + Clavulanic acid (Augmentin)
- Alternative antibiotics for those allergic to penicillin: Azithromycin, Clarithromycin, Cephalosporins, and Clindamycin
Sore Throat Management
- Causes: allergies, bacteria, viruses
- Over-the-counter medications: pain medications, demulcents, numbing medications, antihistamines
- Consideration before taking pain medication: only by MD prescription
Therapeutic Intervention: Strep Throat
- To kill the group A Streptococcus bacteria that cause strep throat
- Antibiotics work only on bacteria and have no effect on sore throats caused by viruses
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