Antibacterials

Question 1

What class are Beta Lactams, and what subgroups come within it

Answer 1

Beta Lactams are cell wall active agents, and they include Penicillins, Cephalosporins, Monobactams and Carbapenems

Question 2

examples of Penicillins

Answer 2

benzyl penicillin, amoxicillin (co-amoxiclav), flucloxacillin, piperacillin (tazocin)

Question 3

pharmacokinetics of penicillins

Answer 3

oral absorption variable
widely distributed in body fluids
renal excretion
short half life

Question 4

mode of action of beta-lactams

Answer 4

intefere with the synthesis of the bacterial cell wall peptidoglycan
attach to penicillin binding protein on bacteria and inhibit transpeptidase enzyme activity
inactivates inhibitor of autolytic anzymes leading to bacteria cell lysis (she gon die)

Question 5

use of benzyl penicillin

Answer 5

bacterial meningitis

Question 6

use of amoxicillin

Answer 6

resp infections
UTI
otitis media

Question 7

use of flucloxacillin

Answer 7

cellulitis

Question 8

use of piperacillin

Answer 8

severe infetions

pseudonomonas

Question 9

ade of penicillins

Answer 9

very few

• hypersensitivoty fever/rash
• anaphylaxis
• oral - antibiotic associated diarrhoea

Question 10

examples of cephalosporins

Answer 10

cefuroxime
cefotaxime
geftazidime
ceftriaxone

Question 11

pharmacokinteics of cephalosporins

Answer 11

given parenterally
renal excretion
increased resistance in gram negative bacilli

Question 12

use of cephalosporins

Answer 12

decreasing use
cefotaxim/ceftriaxone - meningitis
ceftazidime - some bronchiectasis infections

Question 13

ade of cephalosporins

Answer 13

cross sensitivity with penicillins

nephrotoxicity/alcohol intolerance

Question 14

monobactam examples

Answer 14

azetreonam - IV only

Question 15

use of monobactams

Answer 15

only effctive against gram -ve rods

Question 16

ade of monobactams

Answer 16

GI upset

cross sensitivity rare

Question 17

example of carbapenems

Answer 17

meropenem
doripenem
ertapenem
imipenem

Question 18

use of carbapenems

Answer 18

broad spectrum against aerobic and anaerobic, gram positive and negative
severe resistant infection under ID guidance

Question 19

ade of carbapenems

Answer 19

GI upset

cross sensitivity

Question 20

vancomycin - what class? and mode of action?

Answer 20

a glycopeptide
bactericidal antibiotic
inhibits cell wall synthesis by acting on terminal moieties of NAMA and NAG peptides (same ones beta lactams act on)

Question 21

examples of vancomycin

Answer 21

vancomycin and teicoplanin

Question 22

uses of vancomycin and teicoplanin

Answer 22

gram positive, anaerobic and aerobic
c. dificile colitis
MRSA
endocarditis

Question 23

ade of vancomycin and teicoplanin

Answer 23

rash
ototoxicity
nephrotoxicity

Question 24

pharmacokinetics of vancomycin and teicoplanin

Answer 24

cannot cross gut wall
oral - severe c.diff colitis
IV- MRSA

Question 25

trimethoprim - mode of action

Answer 25

action on nucleotide precursors
bacterial dihydrofolate reductase inhibitor
bacteriostatic

Question 26

trimethorprim with what is co-trimoxazole?

Answer 26

sulphamethoxazole

Question 27

uses of trimethoprim

Answer 27

simple uti
p. carinii
toxoplasmosis
nocardiasis