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1

Name 2 classes of bacterial cell wall synthesis inhibitors.

Beta-lactams, Glycopeptide

2

Beta lactams bind to the active side of which enzyme?

Transpeptidase (penicillin binding protein)

3

Name 4 types of beta lactams

Penicillins, cephalosporins, carbapenems, monobactam

4

Name the 4 classes of penicillins

  1. natural penicillins (Pen G and Pen V),
  2. penicillinase resistant penicillins (cloxacillin, flucloxacillin),
  3. aminopenicillins (amoxicillin, ampicillin),
  4. antipseudomonal penicillins (piperacillin) 

5

Which natural penicillin is administered parenterally?

Penicillin G

6

Syphilis caused by Treponema pallidum can be treated with which penicillin?

Penicillin G

7

Are natural penicillins commonly used against Staphylococcus aureus?

No

8

Which class of penicillin is commonly used against methicillin sensitive Staphylococcus aureus?

Penicillinase resistant penicillins

9

How does methicillin sensitive Staphylococcus aureus acquire resistance against the natural penicillins?

They produce penicillinases

10

Which bacteria is cloxacillin effective against?

Methicillin Sensitive Staphylococcus aureus (MSSA)

11

How are the penicillins mainly cleared?

Renal clearance

12

Name the 2 aminopenicillins

Ampicillin, amoxicillin

13

Are aminopenicillins effective against beta lactamase producing strains of bacteria?

No

14

Which of the aminopenicillins (amoxicillin or ampicillin) has better oral absorption?

Amoxicillin

15

Does aminopenicillins sufficiently cover Pseudomonas and Klebsiella?

No

16

How are aminopenicillins cleared?

Renal excretion

17

How is piperacillin administered?

Intravenously

18

Which class of penicillins has coverage against Pseudomonas, Proteus and Klebsiella?

Anti-pseudomonal penicillins (piperacillin)

19

Name 3 beta lactams-beta-lactamase inhibitor combination drugs.

  1. Augmentin (Amoxicillin + clavulanic acid)
  2. Unasyn (ampicillin + sulbactam)
  3. Zosyn (piperacillin + tazobactam)

20

How do beta-lactamase inhibitors work?

They either covalently bind at or near the active site of the β-lactamase and restructures it, permanently inactivating. In doing so, they protects other beta-lactam antibiotics from beta-lactamase catalysis.

21

Name a microbe that commonly causes nosocomial infections and is resistant to all penicillins.

MRSA (methicillin resistant Staphylococcus aureus)

22

Name at least 2 penicillins related life-threatening allergic reactions.

  1. Anaphylaxis
  2. Stevens Johnson syndrome
  3. Toxic epidermal necrolysis

23

Which generation of cephalosporins does cefazolin and cephalexin belong to?

First generation

24

Which generation of cephalosporins are primarily administered orally?

First and second generation cehalosporins. Cefazolin (first generation) is an exception.

25

How are the 3rd, 4th and 5th generation cephalosporins administered?

Parenterally

26

Name at least 3 types of microbes against which first and second generation cephalosporins are ineffective?

  1. Pseudomonas aeruginosa and

(LAME species)

  1. Listeria monocytogenes,
  2. Atypicals (Mycoplasma, Chlamydia, Legionella spp.),
  3. MRSA, and 
  4. Enterococcus species

27

Ceftriaxone belongs to which generation of cephalosporins?

Third generation

28

Name one cephalosporin from the third and fourth generation each which is effective against Pseudomonas aeruginosa.

Third generation – Ceftazidime

Fourth generation - Cefepime

29

Which generation of cephalosporins has coverage against MRSA?

Fifth generation (ceftobiprole, ceftaroline)

30

How are most cephalosporins cleared?

Renal clearance