MOA

Question 1

Natural Penicillins (PCNs)

Answer 1

Inhibit cell wall synthesis by binding to penicillin binding protein

Question 2

Aminopenicillins

Ampicillin/Principen
Amoxicillin/Amoxil, Trimox, Moxilin

Answer 2

Inhibit cell wall synthesis by binfing to penicillin binding protein

Question 3

Amidinopenicillin

Pevecillinam/Pivya

Answer 3

Pivmecillinam is a prodrug that is hydrolyzed by a nonspecific esterase to the active drug mecillinam, that inhibits cell wall synthesis by binding to penicillin binding protein

Question 4

B-lactam/B-lactamase inhibitor combinations (BL/BLI)

Amoxicillin/Clavulanic - Augmentin
Ampicillin/Sulbactam - Unasyn
Piperacillin/tazobactam - zosyn
Sulbactam/durlobactam - Xacduro

Answer 4

B-lactamase inhibitor binds to B-lactamase to prevent breakdown of the antibiotic

Question 5

Cephalosporins (1st-4th gens)

Answer 5

Inhibit cell wall synthesis by binding to penicillin binding protein

Question 6

5th Gen (Anti-MRSA) Cephalosporins

Ceftaroline/Teflaro

Answer 6

Prodrugs rapidly transformed in plasma; bactericidal activity is mediated through inhibiting cell wall synthesis by binding to penicillin binding protein

Question 7

Cephalosporin/B-lactamase inhibitor (BLI) combination

Ceftazidime/avibactam - Avycaz
Ceftolozane/tazobactam - Zerbaxa
Cefepime/enmetazobactam - Exblifep

Answer 7

Cephalosporins inhibit cell wall synthesis by binding to PBP & the BLI inactivates some B-lactamases & protects cephalosporin from degradation by certain B-lactamases

Question 8

Sidophere

Cifederocol/Fetroja

Answer 8

Passive diffusion via porin channels; siderophore moiety sequesters environmental iron, then the complex is actively transported across the outer cell membrane of bacteria - this is referred to as a “Trojan Horse” - will extert antibacterial activity by inhibiting cell wall synthesis by binding to PBPs

Question 9

Carbapenems

Answer 9

Inhibit cell wall synthesis by binding to penicillin binding protein

Question 10

Carbapenem + BLI Combination

Meropenem/Vaborbactam - Vabomere
Imipenem/cilastatin/relebactam - Recarbrio

Answer 10

Carbapenem inhibits cell wall synthesis by binding to PBP & the BLI inactivates some B-lactamases & protects the cephalosporin from degradation by certain B-lactamases

Question 11

Monobactam

Aztreonam/Azactam

Answer 11

Inhibit cell wall synthesis by binding to penicillin binding protein

Question 12

Aminoglycosides

Gentamicin/Garamicin
Tobramycin/Nebcin,TOBI,Tobrex
Amikacin/Amikin
Plazomicin/Zemdri

Answer 12

Irreversibly bind to bacteria 30s ribosomal unit leading to disruption in protein synthesis

Question 13

Macrolides

Erythromycin/EES,Ery-tab,Eryc,Erycette
Clarithromycin/Biaxin
Azithromycin/Zithromax, Zpak
Fidaxomicin/Dificid

Answer 13

E,C,A: reversibly bind to bacteria 50S ribosomal unit leading to disruption of protein synthesis
F: inhibits RNA synthesis by binding to RNA polymerases

Question 14

Fluoroquinolone’s

Ciprofoloxacin/Cipro
Levofloxacin/Levaquin
Moxifloxacin/Avelox
Delafloxacin/Baxdela

Answer 14

Inhibits bacteria DNA synthesis by interfacing with DNA gyrase (topoisomerase II & IV)

Question 15

Tetracyclines

Tetracycline/Sumycin
Doxycycline/Vibramycin
Minocycline/Minocin
Eravacycline/Xerava
Omadacycline/Nurzyra

Answer 15

Bind reversibly to 30S bacteria ribosomal unit leading to inhibition of protein synthesis

Question 16

Glycylcyclines

Tigecycline/Tygacil

Answer 16

Bind reversibly to the 30S bacteria ribosomal unit leading to inhibition of protien synthesis

Question 17

Polymixins

Polymixin B/Polytrim
Colistimethate sodium + polymixin E/colostin

Answer 17

Colistimethate is a prodrug that is hydrolyzd to colsitin; penetrates & disrupts lipopolysaccharides & phospholipids in the outer cell membrane of gram negative bacteria

Question 18

Nitrofurantoin/Macrobid

Answer 18

Reduced by bacteria (nitroreductase) enzymes to nitrofurans, the highly reduced, reactive intermediate binds to ribosomal proteins inhibiting protien synthesis, inhibits several bacterial enzymes, and may cause damage to bacteria DNA

Question 19

Sulfonamide

Answer 19

Synergistically inhibit bacterial growth by interfering with folic acid synthesis; TMP dihydrofolate reductase; SMX inhibits dihydropteroate synthetase & dihydrofolate reductase

Question 20

Glycopeptides & Lipoglycopeptides

Vancomycin/Vancocin
Telavancin/Vibativ
Dalbavancin/Dalvance
Oritavancin/Orbactiv

Answer 20

Inhibits bacteria cell wall synthesis by irreversibly binding to D-alanyl D-alanine residues

Question 21

Oxazolidinone

Linezolid/Zyvox
Tedizolid/Sivestro

Answer 21

Reversibly binds to 50S ribosome at interface with the 30S unit, prevents the formation of 70S initiation complex

Question 22

Lipopeptides

Daptomycin/Cubicin

Answer 22

Disrupts & irreversibly binds to the bacteria cell membrane forming with the lipophilic tail leading to rapid cell death

Question 23

Pleuromutilin

Lefamulin/Xenleta

Answer 23

Inhibits bacterial protein synthesis through interactions (hydrogen bonds, hydrophobic interactions & Van der Waals forces) with the A & P sites of the peptidyl transferase center on the 23s rRNA of the 50S ribosomal subunit. Novel MOA & class

Question 24

Clindamycin/Cleocin

Answer 24

Reversibly bind to 50S subunit of the bacteria ribosomal unit leading to inhibition of protein synthesis

Question 25

5-nitroimidazoles Metronidazole/Flagyl Tinidazole/Tindamax Secnidazole/Solosec

Answer 25

Inactive prodrug diffuses across cell membrane & the nitro group is reduced by bacterial enzymes to radical anions that may interfere with bacterial DNA synthesis

Question 26

Fosfomycin/Monurol

Answer 26

Interferes with bacterial cell wall synthesis by inhibiting enzyme enolpyruvyl transferase

Question 27

Rifamycins

Answer 27

Prevents RNA synthesis by binding to B-subunit of bacteria DNA-dependent RNA polymerase