Mechanisms of Action

Question 1

what inhibits cell wall synthesis (bactericidal)?

Answer 1

Penicillin, amoxicillin, cephalexin

Question 2

What inhibits protein synthesis (bacteriostatic)?

Answer 2

azithromycin

Question 3

antifungals, such as __________, inhibit a CYP450 enzyme, which prevents the production of __________

Answer 3

fluconazole

ergosterol

Question 4

Bacteria can resist antibiotics by preventing access to the _____, _____ the antibiotic, ______ the antibiotic, or rapid ______ of the antibiotic

Answer 4

antibiotic
degrading the antibiotic
altering the antibiotic
extrusion of the antibiotic

Question 5

beta-lactamases can ________ the antibiotic and has a role in antibiotic resistance

Answer 5

disable

Question 6

carbapenams are highly _______ to hydrolysis by penicilinases. often given to very ill patients

Answer 6

resistant

Question 7

target proteins can be disguised, which occurs in _________ and penicillin binding proteins

Answer 7

MRSA

Question 8

penetration of the drug is deterred only in _______ _______ species (because drug has to enter through the porins in the outer cell wall)

Answer 8

gram negative

Question 9

discharge is a form of antibiotic resistance, when a _____ _____ transports antibiotic back across the outer membrane of out of the bacteria

Answer 9

proton pump

Question 10

most beta-lactams end in -____, -____, or start with ceph-

Answer 10

• cillin

- penem

Question 11

beta-lactams bind to penicillin-binding protein at the active site and prevent _________ (peptidoglycan chains require this to be strong)

Answer 11

crosslinking

Question 12

the most prevalent mechanisms for antibiotic resistance are inactivation of antibiotic by ________ and modification of ______ (low affinity to bind to antibiotic)

Answer 12

B-lactamase

penicillin-binding proteins

Question 13

gram _______ are most susceptible to beta lacams

Answer 13

gram positive (rely on the peptidoglycan chains in their cell wall)

Question 14

mycoplasma don’t have a cell wall (no peptidoglycan to inhibit), so _______ won’t work

Answer 14

beta latams

Question 15

the three general categories of penicillin are:

Answer 15

penicillins
antistaphylococcal penicillins
extended-spectrum penicillins

Question 16

penicillins are polar, so ______cellular concentrations will be higher than _____cellular

Answer 16

extracellular

intracellular

Question 17

penicillin is rapidly excreted by the kidneys in its active form, so it’s great for _____

Answer 17

UTIs

Question 18

penicillin V have the greatest activity against ________, ______, and non-beta-lactamse anaerobes

Answer 18

gram positive

gram negative cocci

Question 19

penicillin V are not effective against gram _____ ______

Answer 19

negative rods

Question 20

resistance is high for PCNs, so seldom used as ______ treatment

Answer 20

empiric

Question 21

penicillin V (oral) treats mild to moderate infections because of its ______________.

Answer 21

poor bioavailability

Question 22

Downside of penicillin V is its dosing of ______ a day

Answer 22

4 times

Question 23

penicillin VK is combined with _______ so it is protected against _________

Answer 23

potassium

gastric acid

Question 24

penicillin should be given ______ food

Answer 24

without

Question 25

GI (nausea, vomiting) and ________

Answer 25

hypersensitivy (skin most common)

Question 26

bacteriostatic antibiotics (tetracyclines) may lead to antagonism of _______ activity of penicillin V

Answer 26

bactericidal

Question 27

OCPs are excreted by liver, estradiol is reabsorbed. With penicillin, this may _____ efficacy of OCPs

Answer 27

reduce

Question 28

antistaphococals are specific for targeting ______ (only gram positive!)

Answer 28

staph

Question 29

amoxicillin can be given 2-3 times a day, versus 4. Better _____, greater ______

Answer 29

tolerated | better bioavailability

Question 30

the most active of the beta-lactams agains strep infections are _______ (moderate against gram neg)

Answer 30

amoixicillin

Question 31

________ are poor against staph

Answer 31

amoxicillin

Question 32

absorption of _______ isn't affected by food

Answer 32

amoxicillin

Question 33

amoxicilin is excreted ______ in the ______

Answer 33

unchanged | urine

Question 34

continue treatment with penicillin if the rash is ______, which is common with amoxicillin

Answer 34

morbilliform (looks like measles)

Question 35

amoxicillin 500 mg #20 | take 2 tab PO daily x 10 days with food

Answer 35

example drug card

Question 36

_____ have synergistic activity with aminoglycosides

Answer 36

penicillin VK, amoxicillin

Question 37

beta-lactamase inhibitors can be added to amoxicillin in order to ______ the activity to include gram ____ bacteria

Answer 37

extend | gram negative

Question 38

the 3 beta-lactamase inhibitors are:

Answer 38

clavulanate sulbactam tazobactam

Question 39

amoxicillin with clavulanate is a _______ synthesis inhibitor with a _______ inhibitor

Answer 39

cell wall | beta lactamase

Question 40

clavuanic irrersibly binds ____ _____ produced by a number of gram neg and positive.

Answer 40

beta lactamases

Question 41

beta lactamases are not active against antibiotics, but they ________ the penicillins spectrum of activity

Answer 41

increase

Question 42

Amox-Clav #28 875 mg 1 tab PO BID X 14 days Cephalexin #40 250 mg 1 tab PO QID x 10 days

Answer 42

drug example

Question 43

the are ____ generations of cephalosporins. The higher the generation, the ____ the gram negative coverage improves

Answer 43

5 | higher (gram positive coverage decreases)

Question 44

cephalosporins have the greatest activity against ____ ____ and least againast gram ____

Answer 44

gram positive | gram negative

Question 45

_____ is very active against gram-positive cocci, but not against MRSA

Answer 45

cephalexin

Question 46

2nd generation cephalosporins are _____ as 1st generation, with addition of some _______ anaerobes

Answer 46

heterogeneous | added gram negative

Question 47

3rd generation has expanded gram _____ coverage, but decreased gram positive coverage

Answer 47

negative

Question 48

4 generation cephalosporins is helpful with ______ and _____, also covers staph auras, hemophilus, neisseria

Answer 48

enterobacter | pseudomonas

Question 49

5th generation cephalosporins has improved gram _____ activity (good for MRSA!)

Answer 49

positive

Question 50

all beta-lactams lack activity against _____ and ____

Answer 50

mycoplasma and chlamydia

Question 51

only ____ generation cephalosporin is anti mRSA

Answer 51

5th

Question 52

_______ have higher affinity to PBP (more potent)

Answer 52

carbapenems

Question 53

carbapenems are commonly used in ______ and the ICU

Answer 53

hospitals

Question 54

imipenem is always paired with _______, because it would otherwise be inactivated in the kidney by enzymes. Cilastatin inactivates them.

Answer 54

Cilastatin

Question 55

Monobactams have a very ______ spectrum; only bind to PBP in _____, _____

Answer 55

PBP enterobactera Pseudomonas aeruginosia

Question 56

__________ penicillin is works against pesudomonas aeurginosa. Not good against staph.

Answer 56

antipseudomonal

Question 57

_______ is commonly prescribed for otitis media, sinusitis, skin infections, pneumonia

Answer 57

amoxicillin and clavulanate (Augmentin)

Question 58

if there are no beta-lactamases, you should not prescribe a drug with ________ bc it won't be beneficial

Answer 58

clavulanic acid