Antibiotics: Cell wall inhibitors

Question 0

MOA of beta lactam antibiotics?

Answer 0

Bind to PBP in cell wall to inhibit transpeptidation reaction that crosslinks cell wall PG

Question 1

Narrow spectrum penicillin used against Strep, pneumococcal, meningococcal infections?

Answer 1

Penicillin G - IV
Penicillin V - Oral
(Prone to inactivation by beta lactamases - degrade beta lactam ring)

Question 2

What drug prolongs action of pen by competing with renal tubular transporters?

Answer 2

Probenecid

Used in gout

Question 3

Very narrow spectrum pen used against staphylococcal infections? (Penicillinase producing)

Answer 3

Methi, Naf, Oxa, Cloxacillin
“NAF for STAPH”
Excreted in bile
Given via IV due to poor absorption when given PO

Question 4

Extended spectrum penicillin against Listeria and Enterococcus?

Answer 4

Ampicillin

Lista mo na si Ampi

Question 5

Extended spectrum penicillin used as empiric treatment for otitis media, pneumonia, sinusitis?

Answer 5

Amoxicillin - greater ORAL bioavailability

Question 6

Extended spectrum penicillin for moraxella and H. influenzae?

Answer 6

Co-amoxyclav

Question 7

Ampicillin (Listeria) common AE?

Answer 7

Pseudomembranous colitis
Clostridium difficile
Treat with metro or vanco if life threatening

Question 8

Clavulanic acid MOA?

Answer 8

Inhibits penicillinase, enhance activity of ampil and amox vs bacteria

Question 9

ESPs work synergistically with what group of drugs?

Answer 9

Aminoglycosides
Ampi prevents restoration of holes in bacteria cell wall, allow AG to enter cell
Ampi Genta

Question 10

Antimicrobial covering of ESP?

Answer 10

Ampicillin - Listeria. Enterococcus.
Coamox - Moraxella, H. influ
Proteus, E. coli, Salmonella

Question 11

Penicillin for psedomonas? For enterobacter and kleb?

Answer 11

Pseudomonas - Ticarcillin - have antiplatelet activity, prone to bleeding
Enterobacter - Piperacillin

Question 12

Antipseudomonal penicillins?

Answer 12

Takes Care of Pseudomonas
Ticarcillin
Carbenicillin
Piperacillin

Question 13

Microbes covered by first gen ceph?

Answer 13

PEK

Proteus. E. coli. Klebsiella.

Question 14

First gen ceph has same MOA as penicillins, usually used for?

Answer 14

Surgical prophylaxis
Bone infection (Cefazolin with good bone penetration)
Skin and soft tissue infections by staph and strep except MRSA

Question 15

Mnemonic for First gen ceph?

Answer 15

Fader help me faz my PHarma

Question 16

Difference of second gen ceph from first gen?

Answer 16

More resistant to beta lactamase.
Can cover more gram negative but still not effective against pseudomonas
Does not cross BBB

Question 17

Microbial coverage of second gen?

Answer 17

HEN PEKS

H. influenzae, Enterobacter, Neisseria, Proteus, E. coli, Klebsiella, Serratia

Question 18

Which second gen cause disulfiram like reaction?

Answer 18

Clara took PMT at PM
Cefamandole
Cefotetan

Question 19

Second gen used as single dose treatment for neisseria?

Answer 19

Cefuroxime

Question 20

Difference of third gen from second and first?

Answer 20

Decreased gram positive coverage. With anti-pseudomonas and anti-bacteroides activity
Synergistic with AG (first and second inc nephrotox with AG)

Question 21

Third generation cephalosporin that causes disulfiram like reaction?

Answer 21

Clara took Pmt at pm

Cefoperazone

Question 22

Mnemonic for third gen?

Answer 22

Fenge

Question 23

Fourth gen ceph with wide coverage of gram positive and negative, resistant to beta lactamase?

Answer 23

Cefepime

Question 24

Cephalosporins against Pseudomonas?

Answer 24

TAZ, FEP, FOPERA Ceftazidime (3rd) Cefepime (4th) Cefoperazone (3rd)

Question 25

Carbapenem that covers gram positive and negative bacteria, reserved for serious life threatening infections?

Answer 25

Imipenem Meropenem Ertapenem

Question 26

What inhibits renal metabolism of imipenem?

Answer 26

Cilastatin | Kill is lastin' with cilastatin

Question 27

Monobactam for infections by Klebsiella, Pseudomonas and Serratia? KlePS

Answer 27

Aztreonam | Resistant to beta lactamase

Question 28

Beta lactamase inhibitor used with penicillin against strep, ecoli, haemophilus?

Answer 28

Clavulanic acid Amoxiclav Ampi Sulbac Pip Tazo

Question 29

Glycopeptide used for MRSA?

Answer 29

Vancomycin

Question 30

Vancomycin AE?

Answer 30

Red man syndrome Due to histamine release (Prevent by slowing rate of infusion or give antiHis)

Question 31

Vancomycin MOA?

Answer 31

Bind to D-Ala D-Ala terminus of peptidoglycan, also inhibit cell wall synthesis

Question 32

What drug if resistant to vancomycin?

Answer 32

Linezolid

Question 33

Peptide antibiotic reserved for topical use against gram positive organism?

Answer 33

Bacitracin Marked nephrotox - topical only vs Aztreonam - for gram negative

Question 34

Antimetabolite used as second line drug for drug-resistant TB?

Answer 34

Cycloserine | Blocks incorporation of D-Ala to the PG