B-Lactams

Question 1

Which sub-classes fall under B-Lactams?

Answer 1

Penicillins
Cephalosporins
Monobactam
Carbapenems

Question 2

How to B-Lactams work?

Answer 2

Bind to penicillin binding protein and prevent cross-bridge formation in cell wall

Question 3

What is the purpose of B-Lactamase inhibitors

Answer 3

Given with B-Lactams to bind to B-Lactamase and prevent inactivation of B-Lactam by B-Lactamase

Question 4

Natural Penicillin spectrum

Answer 4

Decent Gram+ (limited staph)

Poor Gram -

Question 5

Anti-staph Penicillin spectrum

Answer 5

Gram+ only. Does not work for MRSA

Question 6

What is special about Ceftaroline?

Answer 6

A 5th gen cephalosporin that actually works against MRSA

Question 7

Aminopenicillin spectrum

Answer 7

Good Gram+ Strep and Entero (Staph with inhibitor)

Better Gram- than penicillin, but still limited

Question 8

Carboxypenicillin spectrum

Answer 8

Gram+ same as penicillin

Gram- Better than aminopenicillin

Question 9

Ureidopenicillin spectrum

Answer 9

Gram+: Same as aminopenicillin

Gram-: Best of penicillins

Question 10

B-Lactam PK parameters

Answer 10

Wide distribution, CNS w/ inflammation
Take Penicillin, dicloxacillin and ampicillin on empty stomach.
All but staph-resistant penicillins are renaly eliminated.

Question 11

B-Lactam ADRs

Answer 11

Hypersensitivity
Rash
GI upset
C. diff
Nephritis

Question 12

1st gen cephalosporins

Answer 12

Gram+: Good

Gram-: Very limited

Question 13

2nd Gen Cephalosporins

Answer 13

Gram+: Slightly less than 1st

Gram-: Slightly improved over 1st

Question 14

3rd Gen Cephalosporins

Answer 14

Gram+: Some strep, limited staph

Gram-: Broad (only ceftazidime covers psudomonas)

Question 15

4th Gen Cephalosporins

Answer 15

Gram+ : Good staph and strep

Gram- : Enhanced, including pseudomonas

Question 16

5th Gen Cephalosporins

Answer 16

Gram+ : Good (covers MRSA)

Gram- : Limited

Question 17

Cephalosporin PK

Answer 17

Well absorbed
Take w/o regard to food
CNS distribution with inflammation in 3rd, 4th and 5th gen
Renal excretion

Question 18

Cephalosporin ADRs

Answer 18

Similar to Penicillin

Question 19

Carbapenems Spectrum

Answer 19

Gram+ : Good
Gram-: Excellent
Anaerobes: Excellent

Question 20

Carbapenem PK

Answer 20

All IV
All Renal
CNS penetration w/inflammation

Question 21

Carbapenem ADRs

Answer 21

Similar to penicillin

Seizures (especially with imipenem)

Question 22

Monobactam spectrum

Answer 22

Only Gram-

Question 23

Monobactam PK and ADR

Answer 23

Renal
Ok to give to penicillin allergic patient
ADR: Same as penicillin