beta lactams

Question 1

MOA penicillins

Answer 1

interfere with bacterial cell wall synthesis by binding PBPs

Question 2

bacteriostatic or bactericidal

Answer 2

bactericidal

Question 3

exception to bactericidal activity of penicillins?

Answer 3

enterococcus

Question 4

exception to bactericidal activity of aminoglycosides?

Answer 4

enterococcus

Question 5

3 MOR penicillins

Answer 5

destruction of penicillin by beta lactamases
alteration in PBP penicillin binding site
decreased membrane permeability (G-)

Question 6

the natural penicillins…

Answer 6

aqueous pen G
benzathine pen G
procaine pen G
pen VK

Question 7

spectrum of activity of natural penicillins in G+

Answer 7

group streptococci
viridans streptococci
some enterococcus
some streptococcus pneumoniae

Question 8

very little natural penicillin against this G+ due to penicillinase production

Answer 8

staphylococcus

Question 9

spectrum of activity of natural penicillins in G-

Answer 9

only against some G- cocci

pasteurella

Question 10

spectrum of activity of natural penicillins in anaerobes

Answer 10

good activity against G+ anaerobes
mouth and above the belt anaerobes
peptococcus
peptostreptococcus
actinomyces
clostridium with the exception of C. difficile

Question 11

antibiotic given for syphilis infections

Answer 11

single dose of benzathine pen G

Question 12

penicillin is drug of choice for 8 infections, name them.

Answer 12

syphilis
meningitis
diptheria
anthrax
C. perfringens
C. tetani
viridians
group streptococci

Question 13

drugs in the penicillinase resistant penicillins

Answer 13

nafcillin
oxacillin
dicloxacillin
methicillin

Question 14

spectrum of activity penicillinase resistant penicillins in G+

Answer 14

MSSA (NOT MRSA)

group and viridans strep

Question 15

penicillinase resistant penicillins NOT active against

Answer 15

MRSA
enterococcus
S. pneumo
G-s
anaerobes

Question 16

why were aminopenicillins developed?

Answer 16

to extend the activity of penicillins against G- aerobes

Question 17

difference between the two aminopenicillins

Answer 17

amoxacillin is better absorbed orally than ampicillin

Question 18

aminopenicillins are the drug of choice for ___________ and __________ infections

Answer 18

Listeria monocytogenes

Enterococcus

Question 19

why were carboxypenicillins developed?

Answer 19

to address the emergence of more resistant G- bacteria and P. aeruginosa as a nosocomial infection

Question 20

name the carboxypenicillin

Answer 20

ticarcillin

Question 21

spectrum of activity carboxypenicillin

Answer 21

very weak against the G+s

enhanced G- activity, including pseudomonas

Question 22

carboxypenicillins NOT active against

Answer 22

klebsiella
serratia
actinobacter

Question 23

reason for developing ureidopenicillins

Answer 23

enhance activity against G- bacteria

Question 24

name the ureidopenicillin

Answer 24

piperacillin

Question 25

the only ureidopenicillin that is still available on the market is in the form of a combination drug with tazobactam called...

Answer 25

zosyn

Question 26

piperacillin is the most active penicillin against...

Answer 26

pesudomonas infections

Question 27

composition of beta lactamase inhibitor combination: augmentin

Answer 27

amoxicillin and clavulanate

Question 28

composition of beta lactamase inhibitor combination: unasyn

Answer 28

ampicillin and sulabactam

Question 29

composition of beta lactamase inhibitor combination: zosyn

Answer 29

piperacillin and tazobactam

Question 30

beta lactamase inhibitor combinations DO NOT work against

Answer 30

``` the SPICE bacteria (have inducible beta lactamases) Serratia marsecens Pseudomonas aeruginosa Indole positive proteus Citrobacter Enterobacter ```

Question 31

organism of note susceptible to ticarcillin/clavulanate

Answer 31

stenotrophomonas maltophilia

Question 32

anaerobic activity of beta lactamase inhibitor combination

Answer 32

B. fragilis

Question 33

penicillins are not bactericidal for...

Answer 33

enterococcus

Question 34

adding a _________ makes penicillin active against _______

Answer 34

aminoglycoside and enterococcus

Question 35

penicillin penetration into CNS?

Answer 35

only in the presence of inflamed meninges and high doses

Question 36

most penicillins eliminated...

Answer 36

renally

Question 37

exception: these penicillin eliminated hepatically

Answer 37

nafcillin | oxacillin

Question 38

given to inhibit the renal excretion of penicillins

Answer 38

probenecid

Question 39

these penicillins are the only ones not eliminated by hemodialysis

Answer 39

nafcillin | oxacillin

Question 40

this penicillin given with A TON of salt when administered parenterally

Answer 40

ticarcillin

Question 41

for N. meningitidis, give

Answer 41

natural penicillin

Question 42

for MSSA, give

Answer 42

penicillinase resistant penicillin

Question 43

for pseudomonas aeruginosa infections, give

Answer 43

piperacillin (a ureidopenicillin)

Question 44

for enterococcal infections, give

Answer 44

ampicillin

Question 45

for s. pneumoniae (penicillin susceptible or intermediate strains)

Answer 45

natural penicillin

Question 46

for polymicrobial infections involved nosocomial G- infections, give

Answer 46

piperacillin-tazobactam (zosyn)

Question 47

for treponema palladium, give

Answer 47

natural penicillin (benzathine pen G)

Question 48

for clostridium infections (excluding C. difficile), give

Answer 48

natural penicillin

Question 49

for salmonella infections, give

Answer 49

aminopenicillin

Question 50

for actinomycosis, give

Answer 50

natural penicillin

Question 51

for shigella infections, give

Answer 51

aminopenicillin

Question 52

important neurological side effect penicillins

Answer 52

seizures

Question 53

penicillins with transient increases in liver enzymes

Answer 53

oxacillin and nafcillin

Question 54

associated with adverse effect interstitial nephritis

Answer 54

nafcillin