Antimicrobials - Inhibitors of Cell Wall Synthesis

Question 1

Beta lactam antibiotics

Answer 1

Carbapenems, Penicillins, Cephalosporins, Monobactams

Question 2

MOA of Cell Wall Synthesis Inhibitors

Answer 2

bind PBPs to inhibit last step of peptidoglycan synthesis

Question 3

Autolysin

Answer 3

bacterial enzyme that mediates cell lysis; activated by Penicillins

Question 4

target site for Beta lactam antibiotics

Answer 4

Penicillin Binding Proteins, including Transpeptidases

Question 5

major antigenic determinant for Hypersensitivity

Answer 5

Penicilloic Acid

Question 6

Known to cause Interstitial Nephritis

Answer 6

Methicillin

Question 7

Maculopapular rash when given for viral infection

Answer 7

Ampicllin or Amoxicillin

Question 8

Known to cause Pseudomembranous colitis

Answer 8

Ampicillin

Question 9

Found in high levels in bile

Answer 9

Nafcillin, ampicillin, and pipericillin

Question 10

highest oral bioavailability

Answer 10

Amoxicillin

Question 11

Post-antibiotic effect

Answer 11

killing action continues even when drug plasma levels are below measurable level

Question 12

Bactericidal

Answer 12

irreversible inhibition of growth

Question 13

Bacteriostatic

Answer 13

reversible inhibition of growth

Question 14

lowest concentration of antibiotic that prevents visible growth

Answer 14

Minimal Inhibitory Concentration

Question 15

lowest concentration that results in 99.9% decline in colony count

Answer 15

Minimal Bactericidal Concentration

Question 16

Synergism: Sequential blockade

Answer 16

Trimethoprim + Sulfamethoxazole

Question 17

Synergism: Enhanced drug uptake

Answer 17

Beta lactams increase permeability to Aminoglycosides

Question 18

Synergism: Blocakade of drug inactivating enzymes

Answer 18

Clavulanic Acid + Amoxicillin

Question 19

Cause Hypoprothrombinemia due to Vitamin K deficiency

Answer 19

Cefamandole, Cefoperazone, and Cefotetan

Question 20

Cause Disulfiram rxn (contain methyl-thiotetrazole)

Answer 20

Cefamandole, Cefoperazone, and Cefotetan

Question 21

Time dependent killing

Answer 21

Penicillins and Cephalosporins

Question 22

Which generation of Cephalosporins is best for Meningitis prophylaxis and treatment?

Answer 22

3rd Generation; reach adequate levels in CSF; Ceftriaxone, Cefixime, Cefotaxime, Ceftazidime , Cefoperazone

Question 23

Cephalosporin with activity against MRSA

Answer 23

Ceftaroline - 5th generation

Question 24

Cephalosporin that causes Kernicterus

Answer 24

Ceftriaxone; note, Cephalosporins are contraindicated in pregnancy unless benefits outweigh the risks

Question 25

Redman Syndrome

Answer 25

Vancomycin

Question 26

Active against Gram -ve bacteria only

Answer 26

Aztreonam (Monobactam)

Question 27

DOC for enterobacter infections and Beta lactamase-producing Gram -ve bacteria

Answer 27

Meropenem and Imipenem (Carbapenems)

Question 28

Partial cross-reactivity with Penicillins ==> allergic rxns

Answer 28

Carbapenems

Question 29

Inhalation for CF patients

Answer 29

Aztreonam

Question 30

Can also be used against P.aeruginosa

Answer 30

Cefaperazone + Ceftazidine OR Aztreonam OR Carbapenems

Question 31

Active against Gram +ve bacteria, including MRSA

Answer 31

Vancomycin

Question 32

Combined with aminoglycoside to treat infective endocarditis

Answer 32

Vancomycin

Question 33

Resistance due to replacing Ala with lactate at binding site

Answer 33

Vancomycin

Question 34

MOA Vancomycin

Answer 34

binds D-Ala D-Ala on peptidoglycan to decrease polymerization

Question 35

Calcium-dependent insertion of lipid tail causes depolarization, K+ efflux, and cell death

Answer 35

Daptomycin

Question 36

inactivated by surfactant so not effective against Pneumonia

Answer 36

Daptomycin

Question 37

Antibiotic cream that interferes with late stage cell wall synthesis of Gram +ves only

Answer 37

Bacitracin

Question 38

Inhibits cytoplasmic enol-pyruvate transferase in early cell wall synthesis

Answer 38

Fosfamycin

Question 39

AE: myopathy, which causes an increase in serum creatinine kinase

Answer 39

Daptomycin

Question 40

Cell wall synthesis inhibitor effective against ORSA, MRSA, VRE, VRSA but not against pneumonia or Gram -ve

Answer 40

Daptomycin

Question 41

DOC for Ampicillin-resistant Meningitis caused by H.influenzae

Answer 41

Ceftriaxone

Question 42

DOC for Gonorrhea

Answer 42

Ceftriaxone

Question 43

DOC for Meningitis prophylaxis

Answer 43

Ceftriaxone

Question 44

DOC for Lyme Disease with CNS and joint involvement

Answer 44

Ceftriaxone

Question 45

4th Generation Cephalosporin

Answer 45

Cefepime

Question 46

Cephalosporins excreted in bile

Answer 46

Ceftriaxone and Cefoperazone

Question 47

Combined with Cilastatin to prevent formation of its nephrotoxic metabolite

Answer 47

Imipenem

Question 48

Cephalosporin combination used for pneumococcal infections

Answer 48

Cefotaxime + Ceftriaxone