Mecn Pharmacology Antimicrobials

Front 1

Penicillins are _______ molecules

Back 1

Polar

Front 2

Protein binding in penicillins is
a) high
b) low

Back 2

Protein binding is high in penicillins.

Front 3

Method of route for Benzathine and Procaine penicillins

Back 3

IM injection; formulated to delay absorption

Front 4

Kidney excretion of Penicillins

Back 4

Rapid

Front 5

How are Nafcillin, oxacillin, dicloxacillin, and cloxacillin excreted?

Back 5

Biliary excretion.
Most penicillins are rapidly excreted by the kidneys, unchanged. For patients with poor kidney function, antistaphylococcal drugs are recommended.

Front 6

Penicillin G is a _____ spectrum drug
a) narrow
b) broad

Back 6

Narrow.
Drug of choice for infections caused by strep, meningococci, some pneumococci, and non B-lactamase producing staph.

Front 7

Penicillin G is a drug of choice for

Back 7

Infections caused by strep, meningococci, some pneumococci, and non B-lactamase-producing staph.
Penicillin G is a narrow spectrum penicillin.

Front 8

T or F:
Penicillin G is B-lactamase resistant

Back 8

False

Front 9

Potassium Penicillin is absorbed
a) rapidly
b) slowly

Back 9

Rapidly

Front 10

Benzathine Penicillin and procaine are absorbed
a) rapidly
b) slowly

Back 10

Slowly through IM route

Front 11

T or F:
Penicillin V is administered via IV

Back 11

False. Penicillin V is prepared in an oral form.

Front 12

Antistaphylococcal penicillins are ______ spectrum.

Back 12

Narrow.
Antistaphylococcal penicillins are DOC for staph. They are limited by MRSA.

Front 13

Methicillin, Nafcillin, Oxacillin, Cloxacillin are what kind of penicillins?

Back 13

Antistaphylococcal

Front 14

Antistaphylococcal penicillins are:
a) resistant
b) not resistant
to staph B-lactamases.

Back 14

Resistant

Front 15

What are Antistaphylococcal penicillins inactive against?

Back 15

Enterococci anerobes

Front 16

Aminopenicillins are ____ spectrum penicillins.

Back 16

Broad

Front 17

Ampicillin, amoxicillin are what category of penicillins?

Back 17

Aminopenicillins

Front 18

Aminopenicillins are ____ against B-lactamases.
a) resistant
b) not resistant

Back 18

Not resistant. Aminopenicillins are destroyed by B-lactamases.They are broad-spectrum.

Front 19

Piperacillin, ticarcilin, carbenicillin are what category of penicillins?

Back 19

Antipseudomonal

Front 20

Antipseudomonal penicillins are ____ spectrum.
a) broad
b) extended
c) narrow

Back 20

Extended spectrum. Antipseudomonal penicillins are also known as extended spectrum penicillins.

Front 21

What do Aminopenicillins and Penicillin G have in common?

Back 21

Have same spectrum. Are not resistant to B-lactamase.

Front 22

Aminopenicillins and Penicilin G have the same spectrum in common. But Aminopenicillins are also effective against:

Back 22

H. influenzae, E coli, Salmonella, Shigella. Aminopenicillins are more effective against gram-negative bacilli. This is why aminopenicillins are referred to as broad-spectrum penicillins.

Front 23

Aminopenicillins are ____ B-lactamases.
a) resistant to
b) inactivated by

Back 23

B. Aminopenicillins are inactivated by B-lactamases.

Front 24

Name two aminopenicillins.

Back 24

Ampicillin, Amoxicillin

Front 25

What kind of penicillin is prescribed for UTI's, sinusitis, otitis, and lower respiratory tract infections?

Back 25

Aminopenicillins (Ampicillin, Amoxicillin)

Front 26

What class of antimicrobials have a synergistic effect with B-lactam antibiotics?

Back 26

Aminoglycosides.
This is because cell wall synthesis inhibitors alter permeability of bacterial cells. They facilitate the entry of other antibiotics that might not ordinarily gain access to interacellular targets.

Front 27

Aminopenicillins are effective against gram ____ bacteria than Penicillin G.
a) positive
b) negative

Back 27

B. Aminopenicillins have the same spectrum as Penicillin G, but are more effective against gram negatives.

Front 28

Ampicillin and amoxicillin can cause ____ that are not allergic in nature.

Back 28

skin rashes

Front 29

Cephalosporins have the ____ mode of action as penicillins.
a) different
b) same

Back 29

Same.

Front 30

Cephalosporins are affected by the ____ resistance mechanisms as penicillins.
a) same
b) different

Back 30

Same.

Front 31

Which of the two are more resistant to B-lactamases? Penicillins or Cephalosporins?

Back 31

Cephalosporins tend to be more resistant than the penicillins.

Front 32

How many generation drugs to cephalosporins have?

Back 32

four

Front 33

The classification of cephalosporins are categorized based largely on what factors?

Back 33

1) Bacterial susceptibility patterns (gram positive to gram negative) and
2) resistance to B-lactamases.

Front 34

T or F:
Cephalosporins are effective against MRSA.

Back 34

F. Cephalosporins are NOT effective against MRSA, L. monocytogenes, C. difficile, and enterococci.

Front 35

Cefadroxil is a ____ generation cephalosporin.

Back 35

1st

Front 36

Cefazolin is a ____ generation cephalosporin.

Back 36

1st

Front 37

Cephalexin is a ____ generation cephalosporin.

Back 37

1st.

Front 38

Cefoxitin (Mefoxin) IV is a ____ generation cephalosporin.

Back 38

2nd.

Front 39

Cefotetan (Cefotan) IV is a ____ generation cephalosporin.

Back 39

2nd

Front 40

Cefuroxime (Ceftin, Zinacef) oral and Iv is a ____ generation cephalosporin.

Back 40

2nd.

Front 41

What generation cephalosporin describes the following:
1) spectrum: active against gram positive cocci (pneumococci, strep, staph)
2) Rarely DOC but used orally for UTI and minor staph lesions, cellulitis

Back 41

1st generation.
(Cefadroxil, Cefazolin, Cephalexin)

Front 42

What generation cephalosporin describes the following:
1) less active against gram positives
2) extended gram-negative and anaerobe coverage (Klebsiellae but not pseudomosas)

Back 42

2nd generation.

Front 43

What generation cephalosporin is active against B-lactamase producing h influenze?

Back 43

2nd. (3rd also)
2nd G cephalosporins display greater activity against 3 additional gram negative organisms than 1st G.
Because it is affective against h influenzae, it is used for otitis, sinusitis, and lower resp. infections.

Front 44

This generation cephalosporin is used for sinusitis, otitis, and lower respiratory infections

Back 44

2nd.
2nd G is less active against gram positive than 1st; it has extended gram negative and anaerobe coverage (Klebsiellae but not pseudomosas).

Front 45

This 2nd generation drug is used to treat CAP (community-acquired pneumonia)

Back 45

Cefuroxime. But must consider newer ESBLs (extended spectrum beta-lactamases).

Front 46

Cefipine (Maxipime), a 4th generation cephalosporin, is more resistant to ____.

Back 46

ESBL (extended-spectrum B-latcamases)

Front 47

3rd and 4th generation cephalosporins are ____ spectrum.

Back 47

Broad.

Front 48

What generation cephalosporins crosses BBB?

Back 48

3rd and 4th.

Front 49

What is used as the first line for bacterial meningitis?

Back 49

3rd & 4th cephalosporins. Ceftriaxone and Cefotaxime are agents of choice in the treatment of meningitis.

Front 50

What route is 4th generation cephalosporin administered?

Back 50

Parenteral.

Front 51

Cefotaxime is what kind of drug?

Back 51

3rd generation cephalosporin.

Front 52

ceftazidime is what kind of drug?

Back 52

3rd generation cephalosporin

Front 53

Ceftiaxone is what kind of drug?

Back 53

3rd generation cephalosporin

Front 54

Cefipime is what kind of drug?

Back 54

4th generation cephalosporin

Front 55

Describe the administration of cephalosporins

Back 55

All cephalosporins must be be administered IV or IM. They are poorly absorbed orally.

Front 56

What generation cephalosporins most penetrate into the CSF?

Back 56

3rd generation

Front 57

Carbapenems are similar structurally to ____ and ____.

Back 57

Penicillin and cephalosporins

Front 58

What type of drug is Imipenem?

Back 58

B-lactam antibiotics, Carbapenems

Front 59

Only 2 kinds of carbapenems are available. What are they?

Back 59

Imipenem and meropenem.
Newer agent: Ertapenem.

Front 60

What is the broadest-spectrum B-lactam antibiotic preparation currently available?

Back 60

Carbapenems (Imipenem and meropenem)

Front 61

Carbapenems are ____ spectrum B-lactam.

Back 61

broad

Front 62

What is Imipenem susceptible to?

Back 62

Metallo-B-lactamases

Front 63

This drug is used for highly penicillin resistant pneumococci, enterobacter, and severe mixed infections.

Back 63

Imipenem

Front 64

This drug may be the broadest spectrum of b-lactams.

Back 64

Imipenem

Front 65

Meropenem and entrapenem are more ____ than Imipenem.

Back 65

lactamase resistant

Front 66

Because of its activity against anerobes (B. fragilis), it is used in diverticulitis, peritonitis, abdominal prophylaxis.

Back 66

2nd G Cephalosporins.
Cefoxitin, Cefotetan, Cefuroxime.

Front 67

This 2nd G Cephalosporin has been used to treat CAP caused by B-lactamase producing H. influenzae and K. pneumoniae.

Back 67

Cefuroxime

Front 68

This 2nd G Cephalosporin has been used to treat CAP caused by B-lactamase producing H. influenzae and K. pneumoniae.

Back 68

Cefuroxime

Front 69

This cephalosporin is useful for pseudomonas:

Back 69

Ceftazidime, 3rd G cephalosporin

Front 70

Describe the spectrum of Monobactams

Back 70

Gram negative rods but no activity against gram positive or anaerobes.

Front 71

To what drug is Monobactam alternative to and why?

Back 71

Aminoglycosides, less toxicity.

Front 72

What kind of drug is Azetreonam (Azactam)?

Back 72

Monobactam

Front 73

This type of drug is a tricyclic glycopeptide that is highly effective against gram-positive multiple drug-resistant organisms.

Back 73

Vancomycin

Front 74

Vancomycin is effective against gram ____ organisms.

Back 74

Positive

Front 75

This drug has been lifesaving in the treatment of MRSA and methicillin resistant Staphlococcus edipermis (MRSE) infections.

Back 75

Vancomycin

Front 76

T or F:
Vancomycin is absorbed po.

Back 76

F. Vancomycin is not absorbed po,

Front 77

Clinical use for this drug are the following: sepsis or endocarditis caused by MRSA, meningitis with highly penicillin resistant pneumococcus

Back 77

Vancomycin

Front 78

This is a new treatment for vancomycin resistant enterococci.

Back 78

Linezolid

Front 79

Red man syndrome is caused by this drug

Back 79

Vancomycin

Front 80

One of the side effects of this drug is ototoxicity.

Back 80

Vancomycin

Front 81

Bacitracin is a class of ____ drugs that inhibit cell wall synthesis.

Back 81

Glycopeptides.

Front 82

Vancomycin is a class of ____ drugs that inhibit cell wall synthesis.

Back 82

Glycopeptides.

Front 83

Ototoxicity of vancomycin is
a) irreversible
b) reversible

Back 83

B Reversible.

Front 84

Linezoid is used in place of vancomycin for this resistance:

Back 84

VRE (Vancomycin resistant enterococci)

Front 85

Because of its nephrotoxicity, this drug is used only topically

Back 85

Bacitracin (a glycopeptide)

Front 86

This syndrome is caused by infusion-related flushing. It is treated by slowing infusion or increasing dosing interval.

Back 86

Red man syndrome

Front 87

Treatment with this drug is preferred for treatment of antibiotic-induced colitis due to C. difficile.

Back 87

Metronidazole (Flagyl)

Front 88

This drug is used only when the treatment of antibiotic-induced colitis due to C. difficile with metronidazole has proven ineffective.

Back 88

Vancomycin

Front 89

This drug is indicated by AHA guideline to prevent endocarditis and bacteremia for people who have mitral valve stenosis and cardiac insufficiency.

Back 89

Amoxicillin.
Vancomycin would be appropriate if patient is allergic to penicillins.

Front 90

What category of drugs do Clavulanic Acid, Sulbactam, and Tazobactam belong to?

Back 90

B-lactamase inhibitors

Front 91

What are B-lactamase inhibitors most effective against?

Back 91

Staph, H Influenzae, N Gonorrhoeae, Salmonella, E coli, K Pneumonia

Front 92

What are B-lactamase inhibitors (clauvanic acid, sulbactam, tazobactam) NOT effective against?

Back 92

enterobacter, serratia, pseudomonas

Front 93

T of F:
B-lactamase inhibitors are antibacterial.

Back 93

F. B-lactamase inhibitors have no antibacterial action but inhibit many (not all) b-lactamases.

Front 94

Name B-lactamase inhibitors.

Back 94

Clauvanic Acid, Sulbactam, Tazobactam.