Antibiotics 2 - Other Beta-lactams (Cephalosporins, Monobactams, Carbapenems)

Question 1

Cephalosporins?

Answer 1

Beta-lactams like Penicillin so block cell wall synthesis, but are less susceptible to beta-lactamase resistance;
(4 generations).

Question 2

4 generations of cephalosporins?

Answer 2

1st generation Cephalosporins (Gram Pos).
2nd generation Cephalosporins (Gram Pos & some Neg).
3rd generation Cephalosporins (serious Gram Neg).
4th generation Cephalosporins (both Gram Pos & Neg).

Question 3

cef-________

or ceph-________?

Answer 3

cephalosporin drug (one of the four generations).

Question 4

Cefazolin, Cephalexin?

Answer 4

1st generation Cephalosporins;

Cephalexin = Oral / “Cephalic”

Question 5

Cefuroxime, Cefaclor,

Cefoxitin, Cefotetan?

Answer 5

2nd generation Cephalosporins;

first two orally, second two IV

Question 6

Cefotaxime, Ceftriaxone,

Ceftazidime, Cefixime?

Answer 6

3rd generation Cephalosporins;

Cefixime = Oral

Question 7

Cefepime?

Answer 7

4th generation Cephalosporin

“cefe = cephalosporin” + “pime = prime example of better coverage”

Question 8

Concerns with Cephalosporins?

Answer 8

(“MuTanT spores cause alcohol trip with bleeding.”)
MTT side chain causes disulfiram-like sickness with alcohol and cause increase blood-clotting time.
+ Also don’t give to babies, esp not with calcium!

Question 9

Carbapenems?

Answer 9

(“the big guns of beta-lactams!”)
very effective and very broad spectrum,
save for fighting most-resistant strains.

Question 10

Imipenem, Meropenem,

Ertapenem, Doripenem?

Answer 10

Carbapenems (big guns).

Question 11

______-penem?

Answer 11

Carbapenems (big guns).

Question 12

Aztreonam?

Answer 12

Monobactam = beta-lactam but no cross-allergenicity with penicillins –> so use Aztreonam if allergic to penicillin.

Question 13

Strength of Membrane-Disruptor antibiotics?

Answer 13

can even kill slow-growing or quiescent bacteria.

Question 14

Daptomycin?

Answer 14

(“Dap!”)
Punches holes in membranes,
of Gram Pos bacteria inlcuding MRSA.

Question 15

Concern with daptomycin?

Answer 15

Rhabdomyolysis (muscle pain/damage/weakness and brown urine with myoglobin which damages kidneys).

Question 16

Polymixin?

Answer 16

membrane-disruptor for Gram Negs,

mostly used topically in ointments.

Question 17

Uses of membrane disruptors?

Answer 17

Daptomycin for Gram Positives,

Polymixins for Gram Negatives.

Question 18

Televancin?

Answer 18

(“televangelist comes in and disrupts…the membrane”),

blocks cell wall and inserts into and disrupts membrane.