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Question 1

What % of Bactrim is absorbed orally?

Answer 1

85%

Question 2

What % of Ampicillin is absorbed orally?

Answer 2

50%

Question 3

Can Ampicillin achieve therapeutic levels in CSF?

Answer 3

Yes, if meninges inflamed

Question 4

How is Bactrim excreted?

Answer 4

In the urine. Hence, this is a good drug for UTI

Question 5

Where is Bactrim metabolized?

Answer 5

Liver

Question 6

Is Bactrim available IV?

Answer 6

Yes

Question 7

In addition to Grey Baby Syndrome, what is another possible rare, but serious adverse effect to Chloramphenicol?

Answer 7

Aplastic anemia

Question 8

Which generations of cephalosporins penetrate into CSF?

Answer 8

3 and 4 (except cefoperazone and perhaps cefixime. Cefuroxime achieves CSF levels but 3rd gen agents preferred because of greater penetration and more rapid sterilization)

Question 9

Most penicillins are excreted by

Answer 9

the kidneys. Renal impairment requires adjustment

Question 10

1/2 life of PCNs in adults with normal renal function?

Answer 10

30 to 90 mins

Question 11

The beta lactam/beta lactamase inhibitors diffuse into most body tissues, with the exception of

Answer 11

brain and CSF

Question 12

Most of the oral and parenteral cephalosporins are excreted by the kidney, with the exception of

Answer 12

Ceftriaxone (eliminated by the liver)

Question 13

Cephalosporins: bactericidal or bacteriostatic?

Answer 13

time- dependent bactericidal

Question 14

Distribution of aztreonam?

Answer 14

Aztreonam distributes well into most tissues, with a volume of distr. of 0.16 L/kg. Penetration into CSF is increased in the presence of inflamed meninges

Question 15

Aztreonam is excreted____

Answer 15

primarily unchanged by glomerular filtration. Dosage adjustments are necessary in pts with renal insufficiency

Question 16

Aztreonam has activity against which gram-positive organisms?

Answer 16

None! Aztreonam has virtually no activity against GP orgs

Question 17

This drug is a reasonable substitute for the aminoglycosides in treating GN infections in pts at high risk for toxicity

Answer 17

Aztreonam

Question 18

Distribution of carbapenems?

Answer 18

They are widely distributed into most tissues, with an approx. volume of distribution of 0.25 L/kg. Penetration into the CSF varies and depends on the degree of meningeal inflammation

Question 19

Are any of the carbapenems available PO?

Answer 19

No

Question 20

Carbapenems are excreted_____

Answer 20

primarily by urinary excretion of unchanged drug

Question 21

Carbapenems: bactericidal or bacteriostatic?

Answer 21

time-dependent bactericidal (much like other beta lactams)

Question 22

Ertapenem has no activity against _________ or ______

Answer 22

Pseudomonas aeruginosa; Acinetobacter sp

Question 23

Neurotoxicity is a well known adverse event of this group of antibiotics, characterized by seizure activity

Answer 23

Carbapenems

Question 24

Which of the carbapenems is most likely to cause a seizure?

Answer 24

Imipenem

Question 25

A pt with a seizure disorder needs a carbapenem. Which one is the first one you would consider?

Answer 25

Meropenem or doripenem

Question 26

Probenecid increases the half life of the penicillins, many beta lactams, and these carbapenem drugs

Answer 26

Meropenem and doripenem (a similar interaction with imipenem occurs, but to a lesser degree)

Question 27

Fluoroquinolones: Bactericidal or bacteriostatic?

Answer 27

Bactericidal - Concentration dependent killing effect

Question 28

Distribution of the fluoroquinolones?

Answer 28

Distribute well into most tissues (approx. 1.5 to 6.1 L/kg) and fluids EXCEPT THE CNS!

Question 29

All fluoroquinolones undergo renal elimination with the exception of

Answer 29

moxifloxacin

Question 30

The macrolides are metabolized via the _____ and excreted _______

Answer 30

liver; in the urine

Question 31

Your pt has renal failure, and needs a macrolide. Which of the macrolides require dosage adjustment?

Answer 31

Clarithromycin (Biaxin) and erythromycin