inhibitors of cell wall synthesis

Question 1

the broadest spectrum beta lactam antibiotic preparation

Answer 1

imipenem/cilastatin combination

Question 2

what class of drug is used in empiric therapy against penicillinase producing G+ and G- aerobic and anaerobic bacteria and Pseudomonas aeruginosa

Answer 2

carbapenems

Question 3

does imipenem penetrate into the CSF when meninges are inflamed

Answer 3

yes

Question 4

imipenem is combined with cilastatin. why?

Answer 4

Imipenem is metabolized by an enzyme produced by the kidney to give an inactive toxic metabolite, when combined with cilastatin it inhibits the renal enzyme to reduce toxicity and maintain activity

Question 5

why is imipenem not recommended for meningitis intrathecally or renal failure?

Answer 5

might cause convulsions

Question 6

which of the following is an adverse reaction of imipenem

a. abdominal cramps
b. constipation
c. hypokalemia
d. neurotoxicity

Answer 6

neurotoxicity : seizures in high doses

Question 7

what is the structural difference between carbapenems and aztreonam

Answer 7

the beta lactam ring is not fused to another ring in aztreonams structure unlike carbapenems

Question 8

name the route of excretion for imipenem

Answer 8

glomerular filtration

Question 9

name the route of excretion for aztreonam

Answer 9

urinary excretion

Question 10

which drug is the safe alternate to patients who cannot tolerate penicillins or cephalosporins

Answer 10

aztreonam

Question 11

aztreonam has cross sensitivity with?

Answer 11

ceftazidime 3rd gen cephalosporin

Question 12

vancomycin has an activity as
a. broad spectrum
b. narrow spectrum
which organisms is it effective against?

Answer 12

b. narrow spectrum

active against G+ organisms only

Question 13

what are the indications for vancomycin? name 2

Answer 13

main use in MRSA

used orally for life threatening colitis due to clostridium difficile and staphylococci (not absorbed orally)

Question 14

the use of vancomycin should be restricted to?

Answer 14

the use of vancomycin should be restricted to serious infections caused by beta lactamase producing G+ bacteria or patients with G+ infections who are allergic to beta lactams

Question 15

oral vancomycin is only for?

Answer 15

clostridium difficile

Question 16

an example of a drug that can be given to tackle G+ organisms that are methicillin resistant

Answer 16

vancomycin or metronidazole

Question 17

can vancomycin be given orally?

Answer 17

no, but only for the treatment of clostridium difficile (enterocolitis)

Question 18

is vancomycin absorbed orally?

Answer 18

no, given as a slow IV infusion

Question 19

vancomycin leads to shock and flushing? why does this happen? what is it called?

Answer 19

it happens due to rapid adminstration. it is called Red man syndrome.

Question 20

what are the 5 adverse reactions of vancomycin?

Answer 20

Fever, Chills, Phlebitis at injection site
Shock and flushing due to rapid administration leading to “Red Man Syndrome”
Dose related hearing loss in renal failure and drug accumulation

Question 21

2 drugs used in the management of MRSA

Answer 21

vancomycin and metronidazole

Question 22

bacitracin causes :

a. pheblitis
b. neurotoxicity
c. nephrotoxicity

Answer 22

c. nephrotoxicity

Question 23

route of adminstration for bacitracin

a. oral
b. oral and IV
c. topical and IV
d. topical

Answer 23

d. topical

Question 24

cephalosporins were naturally obtained from?

Answer 24

cephalosporium acremonium

Question 25

name the first generation cephalosporins

Answer 25

1. cefalexin (keflex) 2. cefazolin (ancef) 3. cefadroxil (duricef)

Question 26

name the drug used in orthopedic surgery

Answer 26

cefazolin (ancef)

Question 27

what is the antibacterial spectrum for 1st gen cephalosporins?

Answer 27

active against staphylococcal penicillinase. Active against PEcK

Question 28

name the second gen cephalosporins?

Answer 28

1. cefaclor (ceclor) 2. cefprozil (cefzil) 3. cefuroxime (zinnat oral and zinacef inj)

Question 29

the drug useful in gonorrhoea is a. cefaprozil b. cefaclor c. ceftriaxone d. cefuroxime

Answer 29

cefuroxime :)

Question 30

second generation cephalosporins are stronger against gram + organisms? true or false

Answer 30

false bro they are weak but they are stronger to 3 additional gram - organisms try naming them ;)

Question 31

name the 3 additional gram - organisms that 2nd gen cephalosporins are active against

Answer 31

1. haemophilus influenzae 2. enterobacter aerogenes 3. neisseria spp basically - HENPEcK

Question 32

name the 3rd gen cephalosporins

Answer 32

1. cefexime (suprax) 2. ceftazidime ( fortum) 3. cefpodoxime ( oreolax) 4. ceftriaxone ( rocephin)

Question 33

name the drug used in septicemia

Answer 33

ceftazidime

Question 34

name the drug that is active against pseudomonas aeruginosa and used in bone and joint infections a. cefprozil b. ceftazidime c. ceftriaxone d. cefalexin

Answer 34

ceftazidime

Question 35

DOC in meningitis is a. ceftazidime b. ceftriaxone c. cefprozil d. cefepime

Answer 35

ceftriaxone

Question 36

a patient has to undergo a hip surgery that may impose contamination. which drug is an ideal prophylactic for this patient?

Answer 36

ceftriaxone.

Question 37

Mr. adam needs to undergo a coronary bypass surgery. What would be his prophylactic drug?

Answer 37

ceftriaxone to avoid risks of infection

Question 38

name the fourth generation cephalosporin

Answer 38

cefepime (maxipime)

Question 39

which drug is applied for febrile neutropenic patients a. cefprozil b. cefepime c. ceftriaxone d. cefaclor

Answer 39

b. cefepime (maxipime)

Question 40

what are the adverse reactions of cephalosporins a. nephrotoxicity b. neurotoxicity c. diarrhoea d. convulsions

Answer 40

c. diarrhoea