Antimicrobials I

Question 1

Narrow spectrum Antibiotics (3)

Answer 1

Vancomycin, Colistin, Azteronam

Question 2

Broad spectrum Antibiotics (2)

Answer 2

Third generation Cephalosporin, Piperacillin

Question 3

Extended spectrum Antibiotics (2)

Answer 3

Carbapenem, Tigycycline

Question 4

Penicillin Group 1- (Parenteral Penicillin)

Answer 4

Benzyl Penicillin 
Procaine Penicillin (long acting)

Question 5

Penicillin Group 2- (Oral Penicillin)

Answer 5

Penicillin V

Question 6

Penicillin Group 3- (Anti-staphylococcal Penicillin)

Answer 6

Cloxacillin

Question 7

Penicillin Group 4- (Extended Spectrum Penicillin)

Answer 7

Active against Enterobacteriacea except Pseudoneumonas
Ampicillin
Amoxicillin

Question 8

Penicillin Group 5- (Penicillin against Pseudomonas aeruginosa)

Answer 8

Piperacillin

Question 9

Penicillin Group 6- (B-lactamase-resistant Penicillin)

Answer 9

Active only against Gram-negative

Temocillin

Question 10

Cephalosporins- 1st Generation

Answer 10

Cephalexin

Cephazolin

Wide range Gram-positive and Gram-negative (except Pseudomonas and Haemophilus)

Active against Streptococcus, Staphylococcus, Enterobacteriacae

Question 11

Cephalosporins- 2nd Generation

Answer 11

Cefuroxime

Cefoxitin

Wide range Gram-positive and Gram-negative including Haemophilus and Anaerobes

Cefuroxime: like Cephalexin plus active against Haemophilus and S.pneumonaie

Question 12

Cephalosporins- 3rd Generation

Answer 12

Cefotaxime

Ceftriaxone

Ceftazidime (antipseudomonal)

Wide range (but more Gram-negative than 2nd generation)

Cefotaxime: active against Enterobacteriacae, Haemophilus, and S.pneumonaie (not Pseudomonas)

Question 13

Cephalosporins- 4th Generation

Answer 13

Cephepime
Anti-Gram-negative
Cephepime: active against Enterobacteriacae and Pseudomonas

Question 14

Penicillin- Side Effects (8)

Answer 14

Hypersensitivity reaction
Anaphylactic reaction
Purities and Urticarial reaction
Maculopapular rash (commonest)
Hemolytic anemia + Thrombocytopenia
Neurotoxicity (high doses)

Question 15

Additional carbon on Cephalosporins affect what?

Answer 15

Pharmacokinetic and Antibacterial activity

Question 16

Properties of Cephalosporins (5)

Answer 16

1- More stable to enzymes
2- Broader spectrum
3- Less prone hypersensitivity 
4- Oral and parenteral
*Less active against Enterococci*

Question 17

Cephalosporins- Side Effects (7)

Answer 17

Local pain + Thrombophlebitis (at site of injection)
Hypersensitivity 
Hepatotoxicity 
GI disturbance 
Thrombocytopenia 
Pseudomembraneous Colitis

Question 18

Monobactams- Aztreonam (3)

Answer 18

1- Narrow spectrum (Anti-gram-negative)
2- Bactericidal
3- Stable to bacterial enzymes

Question 19

Carbapenem (3)

Answer 19

Isolated from Streptomyces
Broad range Gram-positive and Gram-negative
Resistant to lysis by B-lactamases

Question 20

Imipenem (Carbapenem) (4)

Answer 20

1- Not stable (combine with Cilastatin for stability)
2- Safe
3- Broad spectrum
4- Side Effects: Seizures and changes in Liver enzymes

Question 21

Meropenem (Carbapenem) (3)

Answer 21

1- Stable
2- Broad spectrum
3- Side effects similar

Question 22

Glycopeptides

Answer 22

Vancomycin and Teicoplanin

Question 23

Glycopeptides- Mode of Action (3)

Answer 23

1- Act on cell wall synthesis at stage prior to B-lactams
2- NOT act on PBP
3- NOT inactivated by B-lactamase enzymes

Question 24

Glycopeptides- Properties (4)

Answer 24

1- Gram-positive only
2- Poorly absorbed from GI
3- IM injections painful
Level of Vancomycin should be monitored in blood

Question 25

Glycopeptides- Side Effects (4)

Answer 25

Nephrotoxic (Teicoplanin less) Ototoxic Reversible Neutropenia + Thrombocytopenia

Question 26

Glycopeptides- Clinical Uses (2)

Answer 26

1- MRSA 2- Patient allergic to penicillin/cephalosporin with staphylococcal or streptococcal infections

Question 27

Sulphonamides- Properties (3)

Answer 27

Broad spectrum Well absorbed orally *Contraindicated during Pregnancy*

Question 28

Sulphonamides- Side Effects (8)

Answer 28

``` Crystalluria + Hematuria Hypersensitivity Steven-Johnson syndrome G6PD defeciency —> Hemolytic anemia Megablastic anemia Liver damage Interfere with Bilrubin transfer in fetus ```

Question 29

Trimethoprim- Properties (3)

Answer 29

Against Gram-positive aerobes + Enterobacteriacae Rapidly absorbed from GI Used for UTI (in combination with sulfonamide)

Question 30

Trimethoprim- Side Effects (1)

Answer 30

Folic acid defeciency —> Megablastic anemia

Question 31

Notrofurantonin- Properties (3)

Answer 31

Act on bacterial mRNA, ribosomal proteins Well absorbed orally Used for UTI

Question 32

Notrofurantonin- Side Effects (2)

Answer 32

Peripheral neuropathy G6PD defieciency —> Hemolysis

Question 33

Quinolone- Side Effects (4)

Answer 33

``` Pseudomembranous colitis Thrombocytopenia CNS (benign intracranial hypertension) + Psychosis ```

Question 34

Metronidazole is active against…? (3)

Answer 34

Obligate anaerobes Helicobacter Protozoa (T.vaginalis, Giardia, E.histolytica)

Question 35

Metronidazole- Side Effects

Answer 35

Metallic taste Neutropenia (reversible) Peripheral neuropathy CNS, confusion, seizures