Table 1a: Summary of Antibacterial Agents

Question 1

What is the mechanism of action of penicllins?

Answer 1

cell wall synthesis inhibition (stage 3)

Question 2

Are penicillins bacteriostatic or bactericidal?

Answer 2

bactericidal

Question 3

Penicillin G and Penicillin V covers what spectrum of bacteria?

Answer 3

Gram + cocci (staph, strep, entero)
Gram - cocci (M. catarrhalis)
Gram + rods
Most anerobes (not Bacteriodes)

Question 4

What drugs would you consider using on a penicillinase producing MSSA infection?

Answer 4

Penicillinase-resistant class (oxacillin, dicloxacillin, nafcillin)
Beta-lactamase inhibitors (Amox/clav, pip/tazo)

Question 5

What are the extended spectrum penicillins?

Answer 5

Amoxicillin, ampicillin

Question 6

Extended spectrum penicllins cover what bacteria?

Answer 6

Gram - rods (H. flu, E. coli, Proteus)

Gram + cocci (but not as well as Pen G/ Pen V)

Question 7

What Penicillin covers pseudomonas?

Answer 7

Pip/tazo

Question 8

How are most penicllins excreted?

Answer 8

Renal excretion

Question 9

What are the adverse reactions to penicillins?

Answer 9

Anaphylaxis (rare)
Rash (common)
Convulsions at very high doses

Question 10

What is the mechanism of action of cephalosporins?

Answer 10

Cell wall synthesis inhibition (stage 3)

Question 11

Are cephalosporins bacteriostatic or bactericidal?

Answer 11

bactericidal

Question 12

What are the 1st generation cephalosporins?

Answer 12

Cephalexin, cephradine, cefazolin

Question 13

What are the 2nd generation cephalosporins?

Answer 13

Cefaclor, cefuroxime, cefoxitin

Question 14

What are the 3rd generation cephalosporins?

Answer 14

Cefdinir, cefotaxime, ceftriaxone

Question 15

What is a 4th generation cephalosporin?

Answer 15

Cefepime

Question 16

1st generation cephalosporins cover what bacteria?

Answer 16

Gram + cocci, gram - rods

most anaerobes

Question 17

2nd generation cephalosporins cover what bacteria?

Answer 17

Gram - rods (better than 1st gen coverage of gram - rods)

Most anaerobes

Question 18

3rd generation cephalosporins cover what bacteria?

Answer 18

Gram - rods, moderate pseudomonas activity

most anaerobes

Question 19

What gen of cephalosporins has good CNS penetration?

Answer 19

3rd generation

Question 20

Which generation of cephalosporins has the best gram + cocci coverage

Answer 20

1st>2nd>3rd

Question 21

Which generation of cephalosporins has the best gram - rod coverage?

Answer 21

3rd>2nd>1st

Question 22

What cephalosporin covers for N. gonorrheoeae?

Answer 22

ceftriaxone

Question 23

Which 3rd generation cephalosporin covers pseudomonas?

Answer 23

Ceftazidime

Question 24

What is the mechanism of action of vancomycin?

Answer 24

Cell wall synthesis inhibition (stage 2)

Question 25

Is vancomycin bacteriostatic or bactericidal?

Answer 25

bactericidal

Question 26

Vancomycin covers what bacteria?

Answer 26

Narrow spectrum gram + cocci (MRSA, enterococci) | Anaerobes including C. diff

Question 27

How are most cephalosporins excreted?

Answer 27

Renal excretion

Question 28

How is vancomycin excreted?

Answer 28

Renal excretion

Question 29

What is the mechanism of action for the carbapenems?

Answer 29

Cell wall synthesis inhibition (stage 3)

Question 30

What type of bacteria would be appropriate to treat with carbapenems?

Answer 30

Multidrug resistant organisms

Question 31

How are carbapenems excreted?

Answer 31

renal excretion

Question 32

Are carbapenems bacteriostatic or bactericidal?

Answer 32

Bactericidal

Question 33

Which drugs are macrolides?

Answer 33

Azithromycin, erythromycin, clarithromycin

Question 34

Mechanism of action of macrolides?

Answer 34

Protein synthesis inhibition (50S)

Question 35

Are macrolides bacteriostatic or bactericidal?

Answer 35

Bacteriostatic

Question 36

Macrolides cover for what bacteria?

Answer 36

Gram + cocci Gram + rods Some gram - rods Atypical bacteria: mycoplasma, chlamydia pneumonia

Question 37

Macrolides concentrate in what part of the body?

Answer 37

Lungs

Question 38

pharmacokinetics of azithromycin, erythromycin, and clarithromycin?

Answer 38

azithromycin: biliary Erythromycin: liver metabolism Clarithromycin: active metabolite

Question 39

Which macrolides have a lot of drug drug interactions and why?

Answer 39

Erythromycin and clarithromycin because they are inhibitors of P450 metabolism

Question 40

What drugs are the tetracylines?

Answer 40

Tetracycline, doxycycline, minocycline

Question 41

Mechanism of action of tetracyclines?

Answer 41

Protein synthesis inhibition of 30S ribosomes

Question 42

Tetracyclines bacteriostatic or bactericidal?

Answer 42

bacteriostatic

Question 43

Tetracyclines cover for what bacteria?

Answer 43

MRSA atypical: chlamydia, mycoplasma Broad spectrum gram +/- but resistance is common

Question 44

contraindications to tetracylcines?

Answer 44

Pregnancy or age <8y.o.

Question 45

Why are tetracyclines contraindicated in pregnant patients and children <8y.o.

Answer 45

Causes abnormal bone/tooth development

Question 46

Excretion of tetracycline, doxycycline, minocycline?

Answer 46

tetracycline: renal | Doxy/minocycline: non-renal

Question 47

Tetracyclines have drug drug interactions with what?

Answer 47

metal cations in stomach such as antacids, iron

Question 48

Mechanism of action of clindamycin?

Answer 48

Protein synthesis inhibition of 50S ribosomes.

Question 49

Is clindamycin bacteriostatic or bactericidal?

Answer 49

bacteriostatic

Question 50

Clindamycin covers for what bacteria?

Answer 50

Gram + cocci, MRSA | Anaerobes, but not C. diff

Question 51

What are the aminoglycosides?

Answer 51

Tobramycin, gentamycin, neomycin, streptomycin.

Question 52

Mechanism of action of aminoglycosides?

Answer 52

Protein synthesis inhibition of 30S ribosomes

Question 53

Are aminoglycosides bacteriostatic or bactericidal?

Answer 53

Bactericidal

Question 54

Aminoglycosides cover what bacteria?

Answer 54

Gram - aerobes (E. coli, pseudomonas)

Question 55

Linezolid is what class of antibacterial?

Answer 55

Oxazolidinone

Question 56

Mechanism of action for Linezolid

Answer 56

Protein synthesis inhibition of 50S ribosomes

Question 57

Is linezolid bacteriostatic or bactericidal?

Answer 57

Bacteriostatic (except strep, its bactericidal for strep)

Question 58

Linezolid covers for what organisms?

Answer 58

Excellent gram + coverage (staph, strep, entero, MRSA, anaerobes, rods)

Question 59

When is use of linezolid acceptable?

Answer 59

Multi drug resistant organisms

Question 60

What 4 abx are renally exreted?

Answer 60

``` Penicillins Cephalosporins Vancomycin Aminoglycoside Tetracycline (not doxy or mino) ```

Question 61

What are the DCRIMES abx that are non-renal excretion?

Answer 61

``` Doxycycline Clindamycin Rifampin Isoniazid Metronidazole Erythomycin-like (not azithro) Sulfa ```