Beta Lactum

Question 1

All beta lactam have in their structure?

Answer 1

a beta-lactam ring

Question 2

The antibiotics under this group consist of:

Answer 2

Penicillins.
Cephalosporins.
Carbapenems.
Monobactams

Question 3

Source

Answer 3

Natural: from molds (Fungi) only penicillin G and Penicillin V
Semisynthetic.

Question 4

Disadvantages of penicillin G

Answer 4

1- Acid-sensitive -Can’t be Taken otally
2) B-lactamase - sensitive
3) Narrow-spectrum
4- short acting

Question 5

To solve acid resistance

Answer 5

Penicillin v

Question 6

To solve B lactamase resistance

Answer 6

Methicillin

Question 7

To solve short acting

Answer 7

a. Procaine penicillin G/ 12h.
b. Fortified Procaine Penicillin G/ 24h and quick onset.
c. Benzathine Penicillin G/ month.

Question 8

To solve narrow spectrum

Answer 8

1. Ampicillin -> incomplete oral absorption ( short duration)
2. Amoxicillin-> complete oral absorption
3. Pro- ampicillin

Question 9

Short acting can be Long actin when we increase

Answer 9

Frequency

Question 10

Absorption

Answer 10

According to preparations
Penicillin V , ampicillin and amoxicillin -> absorbed orall

Question 11

Distribution

Answer 11

No pass B.B.B Pass easily inflamed meanings.
Pass placenta barrier but has no negative effects ( not teratogenic )

Question 12

Metabolism

Answer 12

Metabolized by bacterial enzymes:
Penicillinase~ Penicilloic acid ~ Inactive & Hapten causes allergic reactions.

Question 13

What hapten do ?

Answer 13

Allergic reactions

Question 14

Side effects

Answer 14

Ampicillin causes “maculopapular rash”
Jarisch-Herxheimer reaction
Diarrhea and superinfection.

Question 15

Case of maculopapular rash

Answer 15

Allergy.
b) Leukemia.
c) Infectious mononucleosis (diagnostic test).
d) Patients treated by allopurinol.

Question 16

Cause of Jarisch-Herxheimer reaction

Answer 16

Due to syphlitis

Question 17

Indication

Answer 17

1. Respiratory tract infections TB
   2) unnary tract infections
   3) G I T infections
   4) Meningitis
   5- Endocarditis.
   6-Syphilis

Question 18

Lactamase inhibitors

Answer 18

1.Ampicillin+ Sulbactam forms Unasyn
2. Amoxycillin + clavulanic acid forms Augmentin and Hibiotic.

Question 19

Mechanism of action

Answer 19

1. Bactrio static -> (prevent growth and
   Reproduction )
   2.Bactericidal: Kills the bacteria
   #Penicillins bind to specific penicillin binding proteins (PBPs) that inhibits transpeptidase enzyme leads to inhibition of cross linking between peptidoglycan layers causing inhibition of cell wall synthesis

Question 20

Cephalosporins
Source and chemistry

Answer 20

as Penicillin

Question 21

Cephalosporins
Source and chemistry

Answer 21

as Penicillin

Question 22

Lactamase producing bacteria are PEPSI

Answer 22

Proteus,
E. Coli,
Pseudomonas,
Staph
H. Influenza).

Question 23

Spectrum

Answer 23

Broad

Question 24

Spectrum

Answer 24

Broad

Question 25

excretion of Cephalosporins

Answer 25

Active Renal tubular excretion

Question 26

Distribution of

Answer 26

Cannot pass b.b.b

Question 27

Exception in execration of Cephalosporins

Answer 27

1.Cefotaxime is Partially' de-acetylated & partially excreted unchanged in urine. 2. Ceftriaxone & Cefoperazone undergo Biliary excretion.

Question 28

Adverse effects of Cephalosporins

Answer 28

1.Hypersensitivity: as penicillin. 2. Diarrhea and superinfections: as penicillin. 3.Never give ceftriaxone and Ca in same line as may form insoluble salt causing biliary stones 4. Nephrotoxicity; especially if given with aminoglycosides

Question 29

First generation members ( cannot pass 3B)

Answer 29

Cephalexin Cephradine. Cefazolin Cefapirin

Question 30

Second generation members ( cannot pass 3B) except …

Answer 30

Cefuroxime cefaclor. Cefuroxime cefamandole Cefoxitin Except (Cefuroxime)

Question 31

Third generation members ( pass3B) except

Answer 31

Except cefoperazone. 1. Cefixime 2. Cefotaxime 3. Ceftriaxone 4. Cefoperazone 5. Ceftazidime 6. Moxalactam.

Question 32

Fourth generation members

Answer 32

Cefepime

Question 33

Imipenem source and chemistry

Answer 33

Synthetic β Lactam antibiotics.

Question 34

Imipenem distribution

Answer 34

Given IV and Pass BBB during meningitis.

Question 35

Adverse effect of Imipenem

Answer 35

Allergy and partial cross-allergy with penicillin, GIT disturbances and seizures

Question 36

Indication of Imipenem

Answer 36

sserious hospital acquired (Nosocomial) infections.

Question 37

How to make imipenem safe for kidney

Answer 37

Imipenem + Cilastatin forms Tienam

Question 38

Why Imipenem nephrotoxic

Answer 38

due to dihydropeptidase enzyme

Question 39

Benefits of meropenem

Answer 39

Not nephrotoxic Rare To produce seizures

Question 40

Ertapenem benefits

Answer 40

has longer half life (given once/lay] → Doesn't produce Seizures →not nephrotoxic