Antimicrobials: Cell wall synthesis inhibitors

Question 1

Bactericidal drugs

Answer 1

All cell wall synthesis inhibitors, aminoglycosides, Ketolides, quinolones, nitrofurantoin, sulfonamides + DHF reductase inhibitors, Metrondiazole

Question 2

Bacteriostatic drugs

Answer 2

all protein synthesis inhibitors

Sulfonamides alone

Question 3

Beta lactams

Answer 3

Penicillins
Cephalosporins
Monobactams
Carbapenems
B lactamase inhibitors

Question 4

Other cell wall synthesis inhibitors

Answer 4

Glycopeptides (Vanco), lipopeptides, bacitracin and cycloserine

Question 5

MOA of penicillin

Answer 5

Bind to penicillin binding proteins, prevent transpeptidation, inhibits cross linking of bacterial cell wall

Question 6

Excretion of penicillin

Answer 6

Excreted unmetabolized by kidney

Question 7

Resistant mechanisms of bacteria to penicillin

Answer 7

Beta lactamases, mutation of penicilin binding protein to decrease binding, upregulation of efflux channels

Question 8

Adverse effects of penicillin

Answer 8

Hypersensitivity, GI upset

Question 9

DOC for C. Dif

Answer 9

Metronidazole

Question 10

What can help prevent resistance to penicillin

Answer 10

Beta lactamase inhibitors: clavulanic acid, sulbactam, tazobactam

Question 11

Probenecid

Answer 11

blocks secretion of penicillin into urine and increases half life

Question 12

Main drug for syphilis

Answer 12

Penicilin G

Question 13

Methicilin

Answer 13

Beta lactamase resistant penicillin

Not used clinically due to risk of interstitial nephritis

Question 14

Aminopenicillins

Answer 14

Beta lactamase sensitive– pair with beta lactamases inhibitors
Broad spectrum

Question 15

Ampicillin

Answer 15

Active against G+ and G-
Poor absorption orally so given IV
Used for suspected listeria meningitis and aspiration pneumonia

Question 16

Amoxicillin

Answer 16

Good oral absorption

Used for otitis media, community acquired pneumonia, sinusitis, GI/GU infections, H Pylori

Question 17

Drug used in prophylaxis of dog, cat and human bite

Answer 17

Augmentin

Amoxicillin + Clavulanic Acid

Question 18

Combine aminopenicillins with what to increase synergy and decrease resistance

Answer 18

Amingoglycosides (Ex. gentamicin)

Question 19

Extended spectrum penicillins

Answer 19

Beta lactamase sensitive

Primarily used for severe nosocomial infections

Question 20

Tx/prophylaxis of group B strep in pregnancy

Answer 20

Penicillin

Question 21

Route of admin for Penicillin G

Answer 21

IV

Question 22

Route of admin for Penicilin V

Answer 22

Oral

Question 23

Piperacilin and ticarcillin

Answer 23

Against anaerobe bacteria such as pseudomonas

Question 24

Cephalosporins

Answer 24

Similar MOA as penicillin

Question 25

1st generation cephalosporin

Answer 25

Used primarily for surgical prophylaxis G+ mostly and some G- bugs for UTI Have "ph" in the name Cefazolin + Cephalexin

Question 26

2nd generation cephalosporin

Answer 26

More G- and still G+ Cefuroxime Used mostly for respiratory bugs Hardly ever used as first line treatment

Question 27

3rd generation cephalosporin

Answer 27

Systemic and CSF entry--good for tx of meningitis Treatment of community and hospital acquired pneumonia First line treatment for gonorrhea

Question 28

First line tx for ghonorrhea

Answer 28

IM ceftriaxone: 3rd generation cephalosporin

Question 29

4th generation cephalosporin

Answer 29

``` Cefepime Resistant to most Beta lactamases Penetrates CSF and good against pseudomonas Broad spectrum Can enter CNS--can tx meningitis ```

Question 30

5th generation cephalosporin

Answer 30

Can treat MRSA | ceftaroline

Question 31

Adverse effects of cephalosporins

Answer 31

Hypersensitivity

Question 32

Monobactams

Answer 32

Active against G- rods only including pseudomonas No cross allergy from penicillin or cephalosporins Aztreonam Can penetrate CSF--can tx meningitis

Question 33

Carbapenems

Answer 33

-penem Active against anaerobes, G+ and G- rods Broad spectrum Can penetrate CSF Big gun antibiotics--can treat serious infections, meningitis, sepsis

Question 34

Imipenem

Answer 34

Must be co-administered with cilastatin to decrease renal toxicity Can cause seizures

Question 35

Vancomycin

Answer 35

Glycoprotein antibiotic active only against G+ bacteria Resistant to beta lactamases IV only

Question 36

Main indication for vancomycin

Answer 36

Blood stream infection due to MRSA

Question 37

Other indications for vancomycin

Answer 37

Meningitis, MRSA osteomyelitis, endocarditis

Question 38

Adverse effects of vancomycin

Answer 38

red man syndrome, thrombophlebitis at admin site

Question 39

Bacitracin

Answer 39

Prevents dephosphorylation of lipid carrier Used predominantly as topical agent due to severe nephrotoxicity when given IV Used primarily for skin infections

Question 40

Deptomycin

Answer 40

Active against G+ cell wall Active against vanco resistant strains MRSA coverage especially bacteremia

Question 41

Do not use deptomycin for

Answer 41

Pneumonia--antagonized by surfactant

Question 42

Major SE of deptomycin

Answer 42

Myopathy