Intro to Antibiotics II

Question 1

carbapenems

Answer 1

same MOA as PCNs

resistant to hydrolysis until emergence of KPC carbepenemase

Question 2

carbapenem coverage

Answer 2

aerobic and anaerobic, gram positive, excellent against enterobacter, pseudomonas, acinetobacter

Question 3

stenotrophomonas maltophilia

Answer 3

resistant to carbapenams

Question 4

carbapenems

Answer 4

ertapenem
imipenem
meropenem
ertapenem

Question 5

lower resp tract infection tx

Answer 5

carbapenems

Question 6

monobactam mechanism

Answer 6

same as PCNs

Question 7

monobactam spectrum

Answer 7

gram negative

NO activity against gram positive cocci or anaerobes

Question 8

glycopeptide mechanism

Answer 8

inhibit cell wall synthesis
-binds high afinity D-ala-Dala terminal of cell wall precursor units

-unable to penetrate outer membrane of gram negatives

Question 9

glycopeptide coverage

Answer 9

gram positive

-staph aureus (MRSA), staph epidermidis (MRSE), streptococci, bacillus, corynbacterium, actinomyces, clostridium

Question 10

all gram negative and mycobacterium

Answer 10

resistant to glycopeotides

Question 11

vancomycin

Answer 11

glycopeptide

give IV**

Question 12

MRSA tx

Answer 12

vancomycin

Question 13

clostridium dificile tx

Answer 13

vancomycin (orally)

Question 14

important for vancomycin

Answer 14

monitor serum drug concentrations

Question 15

red-man syndrome

Answer 15

side effect of rapid vancomycin infusion
-flushing, tachycardia, hypotension

mast cells - histamine release

Question 16

fluoroquinolones mechanism

Answer 16

concentration dependent killing

target bacterial DNA gyrase and topoisomerase

DNA gyrase - introduces negative supercoils

Question 17

fluoroquinolone spectrum

Answer 17

E. coli, salmonella, shigella, enterobacter, campylobacter, neisseria, pseudomonas, s. aureus

Question 18

respiratory fluoroquniolones

Answer 18

levofloxacin
gatifloxacin
moxifloxacin

cover streptococcus species

Question 19

ciprofloxacin

Answer 19

fluoroquinolone

-covers pseudomonas

Question 20

adverse with FQs

Answer 20

GI sx, CNS, rash, photosensitive, achilles rupture

Question 21

aminoglycoside mechanism

Answer 21

concentration dependent killing

bind 30S ribosome - interfere with protein synthesis

alters permeability

diffusion through outer pore proteins in gram negatives

Question 22

aminoglycoside spectrum

Answer 22

aerobic gram negatives, limited gram positive

Question 23

synergistic bactericidal activity against gram positive

Answer 23

aminoglycoside PLUS

beta-lactam or vancomycin

Question 24

gentamicin

Answer 24

aminoglycoside

active against serratia

Question 25

hospital acquired pneumonia tx

Answer 25

gentamicin

Question 26

tetracycline and glycylcyclines mechanism

Answer 26

bacteriostatic -inhibits protein synthesis by binding 30S ribosome prevents receptor of aminoacyl tRNA acceptor site

Question 27

spectrum for tetracyclines and glycylcyclines

Answer 27

aerobic and anaerobic gram positive and gram negative also - rickettsia, coxiella burnetii, mycoplasma pneumonia, chlamydia species, legionella, burrelia burdorferi, treponema pallidum

Question 28

all strains of pseudomonas

Answer 28

resistant to tetracyclines and glycylcyclines

Question 29

community acquire pneumonia

Answer 29

doxycycline

Question 30

rock mountain spotted fever tx

Answer 30

rickettsial infection tetracyclines and glycylcyclines

Question 31

anthrax tx

Answer 31

tetracyclines and glycylcyclines

Question 32

Q fever tx

Answer 32

tetracyclines and glycylcyclines

Question 33

macrolides mechanism

Answer 33

bacteriostatic | -reversibly binds 50S subunit

Question 34

macrolides

Answer 34

clarithromycin | azithromycin

Question 35

macrolide spectrum

Answer 35

aerobic gram positive cocci and bacilli inactive against most gram negatives

Question 36

azithromycin tx

Answer 36

respiratory tract infetion | -coverage of strep pneumonia, h. influenza and atypicals - mycoplasma, chlamydophilia, legionella

Question 37

macrolide drug interaction

Answer 37

CYP3A4 inhibition

Question 38

lincosamide mechanism

Answer 38

bind to 50S suppress protein synthesis

Question 39

spectrum of lincosamides

Answer 39

pneumococci, s. pyogenes, viridans streptococci, MSSA, b. fragilis

Question 40

lung abscess tx

Answer 40

clindamycin lincosamide

Question 41

clindamycin

Answer 41

lincosamide

Question 42

anaerobic lung and pleural space infetcion

Answer 42

clindamycin

Question 43

oxazolidinones mechanism

Answer 43

inhibit protein synthesis binding 50S subunit prevent larger fmet-tRNA complex formation

Question 44

oxazolidinones specdtrum

Answer 44

gram positive staph (MSSA, MRSA, VRSA), streptococcus, enterococci, gram positive anaerobic cocci, gram positive rods

Question 45

linezolid

Answer 45

oxazolidinone absorbed well orally reserve for multi-drug resistant organisms**

Question 46

hospital acquired pneumonia by MSSA and MRSA

Answer 46

linezolid

Question 47

adverse of oxazolidones

Answer 47

myelosuppression -anemia, leukopenia, thrombocytopeina GI sx, HA, rash