Antibiotics Lecture 29

Question 1

Cephalosporin 
MOA
cidal or static
Toxicity 
MOR

Answer 1

-beta lactam drug that inhibits cell wall
synthesis but are less susceptible to penicillinases

time dependent cidal

Toxicity

1. Hypersensitivity reactions
2. Autoimmune hemolytic anemia
3. Disulfiram-like reaction
4. Vitamin K deficiency
5. cross reactivity with penicillins
6. increase nephrotoxicity of aminoglycosides

Question 2

1st generation

Answer 2

1. Gram Positive
   - surgical prophylaxis against MSSA
2. Gram Negative
   - PEK

Question 3

2nd generation

Answer 3

1. More Gram Negative
   - HENPECKS
2. Anaerobes

Question 4

3rd generation

Answer 4

ceftriaxone–>CSF, biliary clearance, longer lasting

1. serious gram negative reactions
   - pseudomonas aeruginosa(some)
2. PRSP
3. HENPECKSSS

Question 5

4th generation

Answer 5

pseudomonal activity

Question 6

5th generation

Answer 6

No pseudo

1. MRSA

Question 7

What diseases are not covered by cephalosporins?

Answer 7

LAME
Listeria
Atypical
MRSA(except 5)
Enterococci

Question 8

Carbapenams
MOA
Drugs
Clinical Use 
Toxicity

Answer 8

B-lactamase resistant, always administered with cilastatin

Time dependent cidal

Imipenem
Meropenem
Doripenem
Ertapenem(no pseudo)

Broad Spectrum+Anaerobes 
Empiric therapy for hospital acquired infections 
1. Bacteroides spp
2. MSSA
3. Pseudomonas 
4. Beta lactamase producing strains 

Toxicity

1. GI distress
2. skin rash
3. seizures**

Question 9

Monobactams 
MOA
Drugs 
Clinical Use
Toxicity

Answer 9

Less susceptible to beta lactamases

• synergistic with aminoglycosides
• no cross allergenicity with penicillin
• renal insufficiency can tolerate

Aztreonam

1. Gram NEGATIVE ONLY
   - Pseudomonas

Usually non toxic, some GI