Pharm - Ch 43 - Beta-Lactam And Other Cell Wall Active Antibiotics

Front 1

DOC for syphilis

Back 1

penicillin G

Front 2

DOC for enterobacter

Back 2

imipenem

Front 3

DOC for endocarditis prophylaxis

Back 3

amoxicillin, vancomycin in penicillin allergies

Front 4

DOC for MRSA

Back 4

vancomycin

Front 5

DOC for gonorrhea

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3rd gen cephalosporins: cefoperazone, cefotaxime, ceftazidime, ceftriaxone

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Which is not accurate about biodisposition of penicillins and cephalosporins? A oral bioavailability affected by lability in stomach B most 3rd gen cross BBB C nafcillin and ceftriaxone eliminated by biliary D procaine penicillin G used intramuscularly E renal tubular reabsorption inhibited by probenacid

Back 6

E renal tubular reabsorption inhibited by probenacid

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primary MOA for cephalosporins involves inhibition of A beta-lactamases B cell mem synthesis C reaction involving transpeptidation D syn of N-acetylmuramic acid E transglycosylation

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C reaction involving transpeptidation

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tx for gonorrhea in pt with gram neg diplococci ID on urethral exudate: A amoxicillin B ceftriaxone C procaine penicillin G plus probenecid D tetracycline E vancomycin

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B ceftriaxone

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tx of treponemes pallidum: A vancomycin B oral tetracycline C benzathine penicillin G D fosfomycin E ceftriaxone

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C benzathine penicillin G

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which is true about imipenem: A narrow spectrum B used in fixed combo with sulbactam C susceptible to beta-lactamases of Enterobacter D dose reduction needed in renal dysfunction to avoid seizures E active against MRSA

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D dose reduction needed in renal dysfunction to avoid seizures

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elderly pt with gram pos cocci from skin ulcer needs tx with: A amoxicillin B aztreonam C cefoxitin D nafcillin E penicillin G

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D nafcillin

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which penicillins are resistant to beta lactamases?

Back 12

nafcillin, methicillin, oxacillin

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gram neg bacilli infection in penicillin allergic pt: A ampicillin plus sulbactram B aztreonam C cefazolin D imipenem plus cilastatin E ticarcillin plus clavulanic acid

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B aztreonam

Front 14

gram neg diplococci in CSF meaning purulent meningitis caused by S pneumoniae with MIC for pen G > 2 mcg/mL should be tx with: A ampicillin-sulbactam B cefoperazone C cefotaxime plus vancomycin D cefoxitin E nafcillin

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C cefotaxime plus vancomycin

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molecular basis for resistance to pen G: A beta-lactamase prod B change in PBP C decreased intracell pen G accumulation D change in building block of peptidoglycan precursor E change in porin structure

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B change in PBP

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gram pos rod diphtheroid infection tx with: A ampicillin B cefzolin C fosfomycin D ticarcillin E vancomycin

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A ampicillin

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which is true about cefotetan: A active against MRSA B drug of choice in community-aquired pneumo C decreases prothrombin time D 3rd gen E active against Bacteroides fragilis

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E active against Bacteroides fragilis

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drug that has activity against P aeruginosa, but resistance occurs with its use alone; shouldn't be used in those with penicillin allergy; active against gram neg rods if combined with tazobactam: A amoxicillin B aztreonam C imipenem D piperacillin E vancomycin

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D piperacillin

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what is true about vancomycin: A bacteriostatic B binds PBPs C not susceptible to penicillinase D advantage of oral bioavail E staph enterocolitis occurs with its use

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C not susceptible to penicillinase

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which is NOT true about ampicillin: A activity enhanced with sulbactam B causes maculopapular rashes C DOC for L monocytogenes D eradicates most MRSA E may cause pseudomem colitis

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D eradicates most MRSA

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1st gen cephalosporins:

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cefazolin, cephalexin

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2nd gen cephalosporins:

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cefotetan, cefoxitan, cefamandole, cefuroxime, cefaclor

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3rd gen cephalosporins:

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ceftazidime, cefoperazone, cefotaxime, ceftrioxone

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4th gen cephalosporins:

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cefepime

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MOA of cephalosporins:

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binds PBPs

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MOA of aztreonam

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binds PBPs

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SEs of aztreonam

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GI upset, HA, vertigo, hepatotoxicity

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SEs of carbapenems

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GI upset, rash, CNS toxicity

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beta lactamase inhibitors:

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clavulanic acid, sulbactam, tazobactam

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MOA of vancomycin

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inhibits transglycosylation

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MOA of fosfomycin

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prevents formation of NAM

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SEs of vancomycin

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chills, fever, ototoxicity, nephrotoxicity

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means of administration of bacitracin

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topical only

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cycloserine is used to tx:

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TB resistant to other drugs

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daptomycin is used to tx:

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vancomycin resistant bacteria

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Type of resistance found with vancomycin

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Point mutation

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Cheap wide spectrum antibiotic DOC of otitis media

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Amoxicillin

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PCN active against pseudomonas

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Carbenicillin, piperacillin and ticarcillin

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Antibiotic causing red-man syndrome, and prevention

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Vancomycin, infusion at a slow rate; antihistamines

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SE of imipenem

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Seizures