Wolverton Chapter 4: Systemic Antibacterial Agents

Front 1

Name the 4 classes of β-Lactam Antibiotics.

Back 1

1) Penicillins
2) Cephalosporins
3) Carbapenems
4) Monobactams

Front 2

β-Lactams bind to penicillin-binding proteins located where on the bacteria?

Back 2

Bacterial cell membrane

Front 3

What is the mechanism that make β-Lactams bactericidal?

Back 3

Inhibiting the bacterial cell wall peptidoglycan synthesis

Front 4

By activating bacterial autolytic enzymes what do β-Lactams achieve?

Back 4

Initate bacterial cell lysis

Front 5

Penicillium chrysogenum is a fungus known to produce which β-Lactam drug naturally?

Back 5

Penicillin G

Front 6

What pregnancy category are penicillins?

Back 6

Category B

Front 7

What are the 3 first generation penicillinase-resistant penicillins?

Back 7

1) Dicloxacillin
2) Nafcillin
3) Oxacillin

Front 8

Name the 2 Aminopenicillins.

Back 8

1) Amoxicillin
2) Ampicillin

Front 9

What is another name for Amoxicillin-Sulbactam?

Back 9

Unasyn

Front 10

What is another name for Piperacillin-Tazobactam?

Back 10

Zosyn

Front 11

Most PCN's are excreted through the kidney's with the exception of what 3 which are mostly metabolized by the liver.

Back 11

1) Nafcillin
2) Oxacillin
3) Piperacillin

Front 12

When ampicillin is given to someone with mono a typical morbilliform skin rash is seen, what other drug when given with ampicillin can cause a similar reaction?

Back 12

Allopurinol

Front 13

Which pregnancy category is Vancomycin?

Back 13

Category C

Front 14

All Macrolides are pregnancy category B except which 2 that are category C?

Back 14

Clarithromycin and Telithromycin

Front 15

Which group of antibiotics are products of Actinomycetes?

Back 15

Macrolides

Front 16

Macrolides reversibly bind to what subunit of the bacterial ribosome?

Back 16

Large 50S subunit

Front 17

By what mechanism are Macrolides bacteriostatic?

Back 17

Inhibit RNA-dependant protein synthesis

Front 18

TRUE or FALSE
Vancomycin is bacteriostatic against enterococci but bactericidal against staph and strep

Back 18

TRUE

Front 19

Red Man syndrome usually seen with Vancomycin is caused by release of what systemically?

Back 19

Histamine

Front 20

Red Man syndrome can be avoided by slowing infusion or fast infusion?

Back 20

Slowing infusion

Front 21

Macrolides are bacteriostatic or bactericidal?

Back 21

Bacteriostatic

Front 22

Which macrolide inhibits the hepatic cytochrome P-450 (CYP) pathway?

Back 22

Erythromycin

Front 23

Fluoroquinolones are bactericidal or bacteriostatic?

Back 23

Bactericidal

Front 24

Which class of abx inhibit bacterial DNA replication via inhibition of DNA gyrase (bacterial topoisomerase 2)?

Back 24

Fluoruinolones

Front 25

What pregnancy class are fluoroquinolones?

Back 25

Pregnancy class C

Front 26

Fluorquinolones cannot be taken at the same time as what drug, which can inhibit its absorption?

Back 26

Antacids containing (Ca, Mg, Al)

Front 27

Tetracyclines are bacteriostatic or bactericidal?

Back 27

Bacteriostatic

Front 28

Which class of drugs inhibit bacterial protein synthesis by binding to the 30S subunit of the bacterial ribosome?

Back 28

Tetracyclines

Front 29

In addition to being bacteriostatic, Tetracyclines also have what 2 additional properties?

Back 29

1) Anti-inflammatory
2) Anti-Collagenolytic

Front 30

What pregnancy category are Tetracyclines?

Back 30

Pregnancy category D

Front 31

This drug is the only Tetracycline acceptable for use in patients with renal failure?

Back 31

Doxycycline

Front 32

What is a relative contraindication for Tetracyclines?

Back 32

Severe Liver disease

Front 33

Which class of abx has the potential to cause Fanconi's syndrome?

Back 33

Tetracyclines

Front 34

Which tetracycline has been associated with Diabetes Inspidus?

Back 34

Demeclocycline

Front 35

Which class of abx should NOT be used in patients with Myasthenia Gravis?

Back 35

Tetracyclines

Front 36

Rifamycins are derived from the soil mold Streptomyces and are bactericidal or static?

Back 36

Bactericidal for both intracellular and extracellular organisms

Front 37

Rifampin is what pregnancy category?

Back 37

Pregnancy category C

Front 38

This abx can cause orange discoloration of the urine and permanent staining of soft contact lenses.

Back 38

Rifampin

Front 39

Sulfamethoxazole is an analog of what compound?

Back 39

PABA

Front 40

PABA is an essential component of what in our bodies?

Back 40

Essential in folic acid synthesis

Front 41

Bactrim is pregnancy class what?

Back 41

Pregnancy class C

Front 42

What drug is a combination fixed ratio of 1 part trimethoprim to 5 parts sulfamethoxazole?

Back 42

Bactrim

Front 43

Sulfanomides are bacteriostatic or cidal?

Back 43

Bacteriostatic by competitive antagonism of dihydorpteroate synthetase, blocking bacterial synthesis of reduce folic acid

Front 44

Bactrim is metabolized by the liver and excreted by what?

Back 44

the kidney

Front 45

Patients on long-term Bactrim therapy should have what lab test monitored?

Back 45

CBC since it can cause aplastic anemia, neutropenia, agranulocytosis, and thrombocytopenia

Front 46

Bactrim can cause hemolytic anemia in what set of patients?

Back 46

Those with G6PD deficiency

Front 47

Since Bactrim is a folate antagonist it is contraindicated in patients with what?

Back 47

Megaloblastic anemia

Front 48

Clindamycin is a derivative of lincomycin and is bacteriostatic or cidal?

Back 48

Bacteriostatic

Front 49

Clindamycin binds to what portion of the bacterial ribosome?

Back 49

50S portion and blocks protein synthesis

Front 50

What pregnancy class is Clindamycin in?

Back 50

Pregnancy class B

Front 51

What is the main abx used in the class of Oxazolidinones?

Back 51

Linezolid

Front 52

What class of abx is Tigecycline structurally similar to?

Back 52

Tetracycline

Front 53

Linezolid is binds to the what portion of the 50S ribosomal unit?

Back 53

23S portion of the 50S ribosomal unit

Front 54

Linezolid pregnancy class what?

Back 54

Pregnancy class C

Front 55

3 drugs can be used off label to treat children for Onychomycosis, what are they?

Back 55

1) Terbinafine
2) Itraconazole
3) Fluconazole

Front 56

Tinea Capitis is best treated with systemic antifungals in order to penetrate the hair shaft, what 4 drugs can be used?

Back 56

1) Griseofulvin
2) Terbinafine
3) Itraconazole
4) Fluconazole

Front 57

The only 2 oral antifungals that will help to treat Tinea Versicolor are...

Back 57

1) Terbinafine
2) Ketoconazole

Front 58

Griseofulvin, Terbinafine, Itraconazole, Fluconazole and Ketoconazole can all be used to treat what 3 fungal infections?

Back 58

1) Tinea Corporis
2) Tinea Cruris
3) Tinea Pedis

Front 59

Terbinafine is contraindicated in patines with what active disease?

Back 59

Chronic or Active Liver Disease

Front 60

Patients with evidence of ventricular dysfunction, such as CHF should not be given which anti fungal?

Back 60

Itraconazole

Front 61

Both Itraconazole and Fluconazole can cause what EKG abnormality in rare cases?

Back 61

QT prolongation and torsades

Front 62

This anti fungal is contraindicated in pts with porphyria or hepatocellular failure.

Back 62

Griseofulvin