Antibiotics III

Question 1

Penicillin mechanism of action:

Answer 1

Bactericidal; covalently binds and inactivated PCN-binding proteins

Question 2

Penicillin side effects:

Answer 2

Allergy/anaphylaxis
Renal failure at high doses
Grand mal seizures

Question 3

Antibiotic drugs that can penetrate the CNS:

Answer 3

Penicillins
Cephalosporins
Monobactam
Vancomycin
Chloramphenicol 
Antifolates

Question 4

How does clavulanic acid work?

Answer 4

Suicide inhibitor of beta lactamases

Use with penicillinase sensitive penicillins

Question 5

Clavulanic acid side effects:

Answer 5

Allergies

Cholestatic jaundice

Question 6

Vancomycin mechanism of action:

Answer 6

Binds to D-ala-D-ala end peptide to prevent cross linking

Question 7

What mutation can cause a bacterium to become immune to Vancomycin?

Answer 7

Mutation of D-ala-D-ala to D-ala-D-lactate

Question 8

Cephalosporin adverse effects?

Answer 8

Anaphylaxis (allergies)
Do not give to patients with penicillin sensitivity
Renal toxicity with large dosages
Vitamin K antagonist so increased bleeding risk
Inhibits ethanol dehydrogenase

Question 9

Characteristics of monobactams:

Answer 9

Wide spectrum
Tissue and CSF penetration
Low allergy

Question 10

Adverse effects of monobactams:

Answer 10

Skin rashes

Elevated serum aminotransferases

Question 11

Carbapenem characteristics:

Answer 11

Wide spectrum
Good tissue and CSF penetration
Renal dehydropeptidases

Question 12

Carbapenem adverse effects:

Answer 12

N/V/D

Skin rashes

Question 13

Glycopeptide adverse effects:

Answer 13

Phlebitis
Histamine release/flush
Chills
Fever
Ototoxicity

Question 14

Sulfa mechanism of action:

Answer 14

Mimic PABA to inhibit folic acid synthesis

Question 15

Sulfa bacterial resistance mechanism:

Answer 15

Overproduction of PABA
Decreased uptake of sulfas
Folic acid synthase with lower sulfa affinity

Question 16

Sulfa adverse effects:

Answer 16

Crystallization in the kidneys

Stevens-Johnson Syndrome

Question 17

A.D.M.E. of sulfas:

Answer 17

Oral
CSF
Acetylated or glucuronide conjugates and renally excreted

Question 18

Trimethoprim mechanism of action:

Answer 18

Dihydrofolate reductase inhibitor

Question 19

TMP resistance:

Answer 19

Overproduction of DHF reductase

Question 20

TMP adverse effects:

Answer 20

Megaloblastic anemia due to folate deficiency

Question 21

Fluroquinolones mechanism of action:

Answer 21

DNA gyrase inhibition preventing DNA relaxation for transcription
Topoisomerase IV interfering with separation of replicated DNA into daughter cells

Question 22

Fluroquinolones excretion:

Answer 22

Renal excretion for UTI