Here are the short flashcard topics drawn directly from your beta-lactams PDF:
Beta-Lactam Antibiotics - Flashcard Topics
Card 1 - Classes of Beta-Lactam Drugs
Q: What are the 5 classes of beta-lactam antibiotics?
A: Penicillins, Cephalosporins, Monobactams, Carbapenems, Beta-lactamase inhibitors
Card 2 - Mechanism of Action
Q: How do beta-lactams kill bacteria?
A: They bind to Penicillin Binding Proteins (PBPs) on the cell membrane, inhibit cross-linking of peptidoglycan (transpeptidase step), and cause cell lysis via autolysins under high osmotic pressure. They are bactericidal only during active cell wall synthesis.
Card 3 - Penicillin G
Q: Key facts about Penicillin G?
A: Natural product of Penicillium notatum; potent and cheap; drug of choice for gram+/- cocci and anaerobes; acid-unstable (not oral); susceptible to beta-lactamases (penicillinases)
Card 4 - Acid-Resistant Penicillins
Q: Name acid-resistant penicillins and their limitation?
A: Penicillin V, Phenethicillin - better oral availability than Pen G but narrow spectrum and poor bioavailability
Card 5 - Penicillinase-Resistant Penicillins
Q: What are antistaphylococcal penicillins used for?
A: Infections by penicillinase-producing Staphylococci and Streptococci. Narrower spectrum than Pen G (no gram-negative cocci, no enterococci, no anaerobes). Examples: Nafcillin, Oxacillin, Dicloxacillin
Card 6 - Extended-Spectrum Penicillins
Q: Extended-spectrum penicillins: examples and uses?
A: Ampicillin/Amoxicillin - active against gram-negative rods (E. coli, H. influenzae, Salmonella, Shigella) but susceptible to beta-lactamases. Antipseudomonal: Piperacillin, Ticarcillin.
Card 7 - Cephalosporin Generations
Q: List the 4 generations of cephalosporins with examples?
A:
- 1st gen: Cephalexin, Cefazolin (gram+, E. coli, Klebsiella)
- 2nd gen: Cefuroxime, Cefoxitin (broader gram-)
- 3rd gen: Ceftriaxone, Cefotaxime, Ceftazidime (CNS penetration, antipseudomonal)
- 4th gen: Cefepime (broadest spectrum)
Card 8 - Cephalosporin Clinical Uses
Q: Key clinical advantages of cephalosporins?
A: Broad-spectrum; resistant to many beta-lactamases; 2nd/3rd gen better against gram-negative; cross-sensitivity with penicillins possible (rare anaphylaxis). 3rd gen used for CNS infections and gram-negative sepsis.
Card 9 - Carbapenems
Q: Carbapenems: mechanism, examples, and uses?
A: Broadest spectrum beta-lactams; bind PBPs; very resistant to beta-lactamases. Examples: Imipenem (given with cilastatin to prevent renal metabolism). Used for serious polymicrobial and resistant gram-negative infections. Adverse effect: seizures at high doses.
Card 10 - Aztreonam (Monobactam)
Q: What is special about aztreonam?
A: Only gram-negative aerobic coverage (no gram+ or anaerobic activity). Safe alternative to aminoglycosides for serious gram-negative infections. Eliminated unchanged in urine.
Card 11 - Beta-Lactamase Inhibitors
Q: What do beta-lactamase inhibitors do and what are examples?
A: Structurally resemble beta-lactams but have weak antibacterial activity alone. Irreversibly inhibit Class A beta-lactamases (from Staph, H. influenzae, E. coli, Salmonella). Used in combination: Amoxicillin+Clavulanate, Ampicillin+Sulbactam, Piperacillin+Tazobactam.
Card 12 - Penicillin Adverse Effects
Q: Main adverse effects of penicillins?
A: Hypersensitivity reactions (most important - from rash to anaphylaxis); IgE-mediated anaphylaxis most dangerous; ask allergy history before prescribing. CNS toxicity at very high doses.
Card 13 - Vancomycin
Q: Vancomycin: mechanism, spectrum, and uses?
A: Inhibits cell wall synthesis by blocking polymerization of linear peptidoglycan. Narrow spectrum: gram-positive only (Staph, Strep, Clostridium). Drug of choice for MRSA; also used for C. difficile pseudomembranous colitis. Key adverse effect: ototoxicity.
Card 14 - Cycloserine
Q: Cycloserine mechanism and use?
A: Suicide inhibitor of alanine racemase - blocks synthesis of D-alanine. Active against gram+/-. Second-line agent for tuberculosis. Adverse effect: dose-dependent CNS toxicity.
Card 15 - Bacitracin & Fosfomycin
Q: Bacitracin and Fosfomycin - mechanisms and uses?
A: Bacitracin: blocks Stage II of cell wall synthesis (lipid carrier dephosphorylation); restricted to topical use (nephrotoxic if systemic). Fosfomycin: inhibits first stage of cell wall synthesis (UDP-acetylmuramyl-pentapeptide formation); oral single-dose for uncomplicated UTI; appears safe in pregnancy.
