B-Lactams, Quinolones, Macrolides and Ketolides

Question 1

B-lactam Antibiotic Classifications

Answer 1

Penicillins, Cephalosporins, Carbapenems, Monobactams

Question 2

B-lactam Characteristics

Answer 2

mostly renally eliminated, most have short half-lives, most have poor cns penetration

Question 3

Penicillin classifications

Answer 3

natural penicillins, antistaphylococcal penicillins, aminopenicillins, carboxypenicillins, ureidopenicillins, b-lactamase inhibitor combinations

Question 4

Natural penicillins

Answer 4

penicillin g, benzathinine and vk

Question 5

antistaphylococcal penicillins

Answer 5

nafcillin, oxacilllin, methicillin (off market), doxloxacillin*

Question 6

aminopenicillins

Answer 6

ampicillin, amoxicillin

Question 7

carboxypenicillins

Answer 7

ticarcillin

Question 8

ureidopenicillins

Answer 8

pipercillin

Question 9

b-lactamase inhibitor combinations

Answer 9

amp/clav*, amp/sulb; ticar/clav; pip/tazo

Question 10

Cephalosporin characteristic

Answer 10

more stable (than b-lactams?) against b-lactamases = broader spectrum of activity
not active against most eslb's, enterococci and listeria

Question 11

1st Gen Cephalosporin

Answer 11

cefazolin, chephalexin, cefadroxil

Question 12

1st Gen Cephalosporins used for

Answer 12

skin/ skin-structure, surgical prophalaxis, uti, endocarditis

Question 13

1st Gen Cephalosprins used against

Answer 13

(gram +)

S. aureus (MSSA), Steptococci, E.Coli, Klebsiella

Question 14

2nd Gen Cephalosporin

Answer 14

cefotetan, cefoxitin, cefmetazole, cefuroxime*, cefprozil

Question 15

2nd Gen Cephalosporin used for

Answer 15

colorectal, urogenital, low/upper RTI

Question 16

2nd Gen Cephalosporin used against

Answer 16

( enhanced gram - , enhanced anaerobe, sum gram +)
H. influenza ( penicillin resistant)
M. catarralis and Neisseria sp
Bacteroides sp. ( anaerobe)( including B. frag)
Proteus, Klebsiella.
Not as active at gram + as 1st gen

Question 17

Cephalosporin that covers anaerobes below the waist

Answer 17

cefoxitin

Question 18

cefoxitin used for

Answer 18

polymicrobial infections, intra-abdominal infections, gynecologic

Question 19

3rd Gen Cephalosporin w/ activity against MSSA/ strep/ gram -

Answer 19

Ceftriaxone, cefdinir, cefixime, cefotaxime

Question 20

3rd Gen Cephalosporin w/ activity against broad spectrum gram -

Answer 20

ceftazidime ( more stability agains “space bugs”/ PSAE)

Question 21

only cephalosporin with activity agains PSAE

Answer 21

ceftazidime

Question 22

3rd generation Cephalosporin used for

Answer 22

NGPR( now DOC), meningitis (PRP), gram (-) sepsis/UTI/RTI (HAP), SSTI

Question 23

3rd generation Cephalosporin used against

Answer 23

(Enhanced gram (-), less gram (+) and anaerobic)
Serratia, Klebsiella, H. Influenza, Moraxella catarhalis, Neisseria gonorrhoeae, S. Aureus, Strep pneu and pyogenes. Pseudomonas, Acinetobacter, Citrobacter, Enterobacter - Space Bugs which have AMP-C which causes hydrolysis; drugs have variable activity to AMP-C

Question 24

B- lactam with longer half life

Answer 24

ceftriaxone

Question 25

B- lactams with good CNS penetration

Answer 25

ceftriaxone and cefotazime

Question 26

B- lactams NOT renally eliminated

Answer 26

nafcillin, oxacillin, ceftriaxone, cefoperazone

Question 27

1 Penicillin spectrum of activity

Answer 27

Streptococci, T.pallidum (syphilis)

Question 28

2 Antistaphylococcal penicillin spectrum

Answer 28

MSSA and strep

Question 29

3 Aminopenicillin spectrum

Answer 29

Strep, Enterococcus, Listeria, Salmonella sp, Shigella sp, “wimpy” gram-negative bacteria

Question 30

4 Carboxypenicillins spectrum

Answer 30

more gram ( - ) including PSAE, E.coli, Proteus sp. Enterobacter sp. less gram (+)

Question 31

5 Ureidopenicillins spectrum

Answer 31

Enhanced gram (-) bacteria (PSAE), Serratia, streptocci, gram (+) not as good

Question 32

6 b-lactamase inhibitor

Answer 32

b-lactamase prodcuing strains of E.coli, Proteus sp. MSSA, H.flu. Neisseria, Bacteroides sp.

Question 33

B-lactamase inhibitors

Answer 33

clavulanic acid, sulbactam, tazobactam, avibactam

Question 34

4th and 5th gen Cephalosporins

Answer 34

4- cefepime

5 - Ceftaroline - life cefepime but w/ MRSA

Question 35

4th and 5th gen Cephalosporins used for

Answer 35

(good gram - and gram +)
MSSA, strep, enterobacteriacecae, citrobacter, enterobacter,
NO- stenotrophomas, burkholderia

Question 36

Carbapenems

Answer 36

Imipenem, meropenem, ertapenem, doripenem

Question 37

Carbapenems used for

Answer 37

drugs of choice for esbl’s and inducible amp-c producers

polymicrobial, HAP (not dori/erta), meningitis (mero)

Question 38

Carbapenems used against

Answer 38

MSSA, strep, enterobacteriaceae, citrobacter sp. enterobacter sp., stenotrophomonas, burkholderia sp, ESLB producers

Question 39

Which carbapenem does not cover PSAE or enterococcus

Answer 39

Ertapenem

Question 40

Monobactams

Answer 40

Aztreonam

broad spectrum gram (-) onlu similarly to ceftazifime

Question 41

Monobactam used for

Answer 41

penicillin allergic patients

Question 42

Quinolones

Answer 42

Norfloxacin, ofloxacin, ciprofloxacin, levofloxacin, moxifloxacin

Question 43

Quinolones used against

Answer 43

all cover Enterobacteriaccea. Neisseria sp, moraxella, Haemophilus sp. Good gram negative

Question 44

Quinolones used against

Answer 44

MSSA, pneumococci covered by Levo, moxi, gemiflox

Question 45

Cirpofloxacin doent cover

Answer 45

S pneumonia

Question 46

Quinolones with no PSAE

Answer 46

moxi and gemi

Question 47

Quinolone good for anaerobes

Answer 47

moxi

Question 48

Aytipicals? Quinolones

Answer 48

cipro, levo, moxi, gemi

Question 49

Best quinolones for PSAE

Answer 49

cipro> levaquin