Antibiotics 2

Question 1

Name all 4 B-Lactam compounds

Answer 1

1. Penicillins
2. Cephalosporins
3. Monobactams
4. Carbapenems

Question 2

B-Lactam products are bacteriostatic or bactericidal?

Answer 2

Bactericidal

Question 3

Penicillin G, Penicillin V, and Amoxicillin…which are natural and which are synthetic? What is special about methicillin?

Answer 3

Penicillin G and V are natural. Amoxicillin is synthetic.

Methicillin is B-lactamase resistant

Question 4

How to B-lactams work?

Answer 4

Bind to and inhibit the Penicllin-Binding-Proteins (PBPs)…they play an important role in synthesis and maintenance of bacterial cell wall peptidoglycan

Question 5

Key adverse effect of B-lactams?

Answer 5

Hypersensitivity…perhaps anaphylaxis.

Question 6

What is expected if a patient has an allergic reaction to penicillin or B-lactam antibiotic?

Answer 6

If a patient has a severe reaction to penicillin, expect there to be a cross-reaction to other B-lactam antibiotics such as cephalosporins, monobactams, and carbapenems

Question 7

Which 3 drugs are very-narrow spectrum and B-lactamase resistant

Answer 7

Methicillin
Nafcillin
Oxacillin

Question 8

Which two drugs are narrow spectrum and B-lactamase sensitive?

Answer 8

Penicllin G

Penicillin V

Question 9

Which two drugs are broad spectrum and B-lactamase sensitive?

Answer 9

Ampicillin

Amoxicillin

Question 10

Which three drugs are extended spectrum and B-lactamase sensitive?

Piper had a tick in her ass

Answer 10

Piperacillin
Ticarcillin
Azlocillin

Question 11

What drug is a B-lactamase inhibitor and is typically given with B-lactams?

Answer 11

Clavulanic acid

Question 12

What is amoxicillin and calvulanic acid combination?

Answer 12

Augmentin

Question 13

When are cephalosporins typically given?

What are cephalosporin resistance to B-lactamases compared to penicillins?

Answer 13

a. Agent used frequently if penicillins are not well tolerated.
b. In general, these agents are more resistant to β-lactamase as compared to penicillins.

Question 14

MOA of cephalosporins?

Answer 14

Bind and inhibit the PBPs

Question 15

Key adverse effect with cephalorsporins?

Answer 15

Hypersensitivity

Question 16

1st generation cephalosporins (2)
B-Lactamase sensitivity
CNS penetration

Answer 16

Cefazolin
Cephalexin
B-lactamase sensitive
Do NOT enter CNS

Question 17

2nd generation cephalosporins (3)
B-Lactamase sensitivity
CNS penetration

Answer 17

Cefotetan
Cefaclor
Cefuroxime
B-lactamase sensitive
Some enter CNS...not cefuroxime

Question 18

3rd generation cephalosporins (4)
B-Lactamase sensitivity
CNS penetration

Answer 18

Ceftriaxone
Cefotaxime
Cefdinir
Cefixime
B-lactamase sensitive
Most enter CNS

Question 19

4th generation cephalosporins (1)
B-Lactamase sensitivity
CNS penetration

Answer 19

Cefepime
B-lactamase RESISTANT
ENTER CNS

Question 20

Cephalosporins broaden out from gram positive

Answer 20

All handle gram positives.
1st generation only does gram positives
4th generation has the broadest spectrum of gram positive and gram negative bacteria

Question 21

Monobactam compound

Answer 21

Aztreonam

Question 22

Spectrum of activity for Aztreonam
CNS penetration
Treats
B-lactamase sensitivity

Answer 22

Limited to gram negative rods
Penetrates CNS well
Treats very serious infections (pneumonia, meningitis, and sepsis)
B-lactamase resistant

Question 23

MOA of Aztreonam

Answer 23

Binds and inhibits PBP

Question 24

Spectrum of activity of Aztreonam is limited to doing battle with

Answer 24

Gram negative rods only

Question 25

Name 4 carbapenem compounds | Me and Dora Explored IMDB

Answer 25

1. Doripenem 2. Imipenem 3. Ertapenem 4. Meropenem

Question 26

Spectrum of activity for carbapenems

Answer 26

Broad...covers gram negative and gram positive

Question 27

Bacterial resistance to carbapenems

Answer 27

Due to bacteria expressing 'carbamenemase'. Not sensitive to B-lacatamse

Question 28

Which carbapenem is inactivated by the kidney? How to combat this?

Answer 28

Imipenem is inactivated by the kidney and is co-administered with CILASTATIN

Question 29

Primary use of carbapenems

Answer 29

Penetrate tissues and CSF so used for EMPIRIC treatment of LIFE-THREATENING infections

Question 30

MOA of carbapenems

Answer 30

Bind and inhibit PBP

Question 31

Key adverse effect of carbapenems

Answer 31

GI disturbances: N/V/D

Question 32

Name the only glycopeptide antibiotic

Answer 32

Vancomycin

Question 33

Spectrum of activity of vancomycin | Used to combat which infections (3)

Answer 33

1. Activity against GRAM POSITIVE bacteria and SOME gram negative bacteria 2. Entercocci, MRSA, and C. Diff

Question 34

MOA of vancomycin

Answer 34

Prevents elongation of the peptidoglycan cell wall structure by BINDING TO THE D-ALA-D-ALA PENTAPEPTIDE AND ACTING AS A STERIC INHIBITOR *Masks the substrate like a boss

Question 35

Key adverse effect of vancomycin

Answer 35

FLUSHING (RED MAN SYNDROME)

Question 36

Name the only polypeptide cell wall inhibitor

Answer 36

Bacitracin

Question 37

Spectrum of activity of Bacitracin

Answer 37

GRAM NEGATIVE and GRAM POSITIVE bacteria

Question 38

Bacitracin use

Answer 38

Restricted to topical and ophthalmic ointments...it makes nice, moist, ointments

Question 39

MOA of Bacitracin

Answer 39

Blocks INCORPORATION OF AMINO ACIDS AND NUCLEIC ACIDS into the cell wall *Has nothing to do with PBPs

Question 40

Name the only phosphoenolpyruvate cell wall inhibitors

Answer 40

Fosfomycin

Question 41

Spectrum of activity of fosfomycin

Answer 41

Broad spectrum of activity against GRAM + AND GRAM _

Question 42

MOA of fosfomycin

Answer 42

BLOCKS EARLY STEP in cell wall synthesis by preventing synthesis of UDP-N-acetylmuramic acid *May or may not be important but fosfomycin is the only one that does anything even remotely close to that