beta-lactam: other drugs Flashcards Preview

► Med Misc 05 > beta-lactam: other drugs > Flashcards

Flashcards in beta-lactam: other drugs Deck (64):
1

Is vancomycin absorbed orally?

no

2

Bactericidal glycoprotein

A. VANCOMYCIN

3

Binds to the D-Ala-D-Ala terminal of the nascent peptidoglycan pentapeptide side chain

A. VANCOMYCIN

4

Inhibits transglycosylation

A. VANCOMYCIN

5

Prevents elongation of peptidoglycan chain

A. VANCOMYCIN

6

Interferes with cross-linking

A. VANCOMYCIN

7

Spectrum of activity of VANCOMYCIN

Narrow

8

what is the tissue penetration of vancomycin when given IV?

Wide:Penetrates most tissues

9

Drug that is eliminated unchanged in urine

vancomycin

10

• Rapid IV infusion of vancomycin may cause diffuse blushing called

“Red man syndrome”

11

Cause of “Red man syndrome”

Rapid IV infusion of vancomycin

12

Toxic effects of vancomycin

 Chills
 Fever
 Phlebitis
 Ototoxicity
 Nephrotoxicity

13

 Antimetabolite inhibitor of cytosolic enolpyruvate transferase

fosfomycin

14

Prevents the formation of N- acetylmuramic acid which is essential in peptidoglycan chain formation

fosfomycin

15

fosfomycin Prevents the formation of -------------- which is essential in peptidoglycan chain formation

N- acetylmuramic acid

16

essential in peptidoglycan chain formation

N- acetylmuramic acid

17

In a single dose, drug is less effective than the 7-day course of treatment with fluoroquinolones

fosfomycin

18

Multiple dosing of this drug can result to resistance rapidly

fosfomycin

19

Diarrhea is common with this drug

fosfomycin

20

common toxicity of fosfomycin

diarrhea

21

fosfomycin is synergistic with (2) drugs in specific infections

beta-lactam and quinolones

22

Excreted in the kidney with urinary levels exceeding the minimum inhibitory concentration (MIC) for many urinary tract pathogens

fosfomycin

23

mode of excretion for fosfomycin

kidney

24

Resistance to this drug occurs via decreased intracellular accumulation of the drug

fosfomycin

25

Peptide antibiotic

C. BACITRACIN

26

Interferes with a late stage in cell wall synthesis in gram (+) organisms

C. BACITRACIN

27

Limited to topical use only

C. BACITRACIN

28

toxicity of bacitracin

nephrotoxicity

29

 Antimetabolite

cycloserine

30

Blocks the incorporation of D-Ala into the pentapeptide side chain of the peptidoglycan

cycloserine

31

Used only in TB caused by organisms resistant to first-line antituberculous drugs

cycloserine

32

2nd line anti-TB drugs

cycloserine

33

Potentially neurotoxic
 Tremors
 Seizure
 Psychosis

cycloserine

34

Used in fixed combination with certain hydrolyzable penicillins
Effective against plasmid-encoded beta-lactamases

CLAVULANIC ACID, SULBACTAM, and TAZOBACTAM

35

carbapenem with
 Long half-life
 Less active against pseudomonas
 IM injection causes pain and irritation

ERTAPENEM

36


 Similar to imipenem
 Not metabolized by renal dehydropeptidases
 Less likely to cause seizure

MEROPENEM

37

advantage of meropenem to imipenem

 Not metabolized by renal dehydropeptidases
 Less likely to cause seizure

38

 Rapidly inactivated by renal dehydropeptidases I

imipenem

39

enzyme that inactivates imipenem

renal dehydropeptidases I

40


 Administered in combination imipenem
 Inhibits formation of nephrotoxic metabolites

 Cilastatin

41

Inhibitor of the enzyme renal dehydropeptidases I

cilastatin

42

Increases the half-life of imipenem

 Cilastatin

43

 Adverse effects of imipenem-cilastatin

 GI distress
 Skin rash
 At very high plasma levels, CNS toxicity
 Confusion, encephalopathy, seizures

44

drug of choice for enterobacter

imipenem

45

 Chemically different from penicillins
 Retain the beta-lactam ring

carbapenems

46

 Low susceptibility to beta-lactamases

carbapenems

47

 Wide activity against
 Gram(+) cocci
 Gram (-) rods
 Anaerobes

carbapenems

48

 For pseudomonal infections
 Combined with aminoglycosides

carbapenems

49

 Useful for infections caused by organisms resistant to other antibiotics

carbapenems

50

RoA of carbapenems

IV

51

Monobactam

ASTREONAM

52

Resistant to beta-lactamases produced by certain gram (-) rods

ASTREONAM

53

 No activity against gram (+) and anaerobes

ASTREONAM

54

 An inhibitor of cell wall synthesis binding to PBP3

ASTREONAM

55

Synergistic with aminoglycosides

ASTREONAM

56

 Adverse effects of astreonam

 GI upset with possible superinfection
 Vertigo
 Headache
 Rare hepatotoxicity
 Skin rash

57

is astreonam bactericidal or bacteriostatic

?

58

is astreonam synergistic with aminoglycosides

yes

59

is astreonam nephrotoxic

no

60

RoA of astreonam

IV

61

Does astreonam have cross-allergenicity with penicillin?

none

62

Does imipenem have cross-allergenicity with penicillin?

yes but PARTIAL only

63

elimination of astreonam

renal tubular secretion

64

half-life of astreonam is prolonged when

if person has renal failure

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