Carbapenems, Monobactams, Peptide Antibiotics, Cycloserine, Daptomycin, Polymyxin

Question 1

Carbapenems

WIDEST COVERAGE among cell wall synthesis inhibitor

Answer 1

Imipenem - Cilastatin
Ertapenem
Meropenem
Doripenem

Question 2

Inhibits renal metabolism (hydrolysis) of Imipenem by dihydropeptidase

Answer 2

Cilastatin

Question 3

Coverage of Carbapenems

Answer 3

gram (+)
gram (-)
ANAEROBES
Pseudomonas EXCEPT Ertapenem
NO ATYPICAL coverage

Question 4

The most important mechanism of carbapenem resistance

Answer 4

Production of carbapenemases

Question 5

Monobactam

NO CROSS ALLERGINICITY with Penicillins

RESISTANT to beta lactamases

Answer 5

Aztreonam

Question 6

Coverage of Monobactam

Answer 6

gram (-)

PSEUDOMONAS, Klebsiella, Serratia

Question 7

Peptide Antibiotics

Interferes with LATE STAGE IN CELL WALL SYNTHESIS in gram (+) organisms

Answer 7

Bacitracin

gram (+)
topical

Question 8

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

Answer 8

Cycloserine

for drug resistant TB

Question 9

Binds to cell membrane – depolarization and cell death

More rapidly bactericidal than Vancomycin

Inactivated by pulmonary surfactants – CANNOT be used against pneumonia

Answer 9

Daptomycin

gram (+) – sepsis an endocarditis

SE: MYOPATHY
*monitor creatine phosphokinase weekly to check for severity of myopathy

Question 10

Cationic detergents

Attach to and disrupt bacterial cell membrane, bind and inactivate endotoxin

Answer 10

Polymyxin B, Polymyxin E

gram (-)
for salvage therapy of Acinetobacter, Enterobacteriaceae, Pseudomonas aeruginosa

Question 11

Inhibitor of the MurA enzyme, UDP-N-acetylglucosamine-enolpyruvyltransferase, that catalyzes the first committed step in peptidoglycan synthesis

Prevents formation of N-acetylmuramic acid

for uncomplicated UTI
safe for pregnant patients

synergistic with beta lactam and quinolones

Answer 11

Fosfomycin