Bacterial Cell Wall Synthesis Inhibitors

Question 1

ADR of Penicillins

Answer 1

1. Hypersensitivity reaction (Anaphylaxis, SJS, TEN)
2. Hepatotoxicity
3. Anosmia
4. Seizures in Renal impaired patients
5. Neurotoxicity
6. CDAD

Question 2

4 Mechanisms of Penicillin resistance

Answer 2

1. MRSA PBP2a with reduced penicillin affinity
2. Beta lactamase production - Hydrolysis of beta lactams
3. Porin production reduced
4. Efflux pumps

Question 3

3 Cephalosporin ADRs

Answer 3

1. Hypersensitivity
2. GIT diarrhea (CDAD)
3. Thrombophlebitis (Give slow and diluted form, rotating infusion sites)

Question 4

4 Carbapenem ADRs

Answer 4

1. Cross-hypersensitivity with penicillin
2. GIT-related symptoms (N/V/D) - More with Imipenem
3. Rashes
4. Neurotoxicity (Seizures)

Question 5

Aztreonam ADR

Answer 5

Well tolerated with no cross-reactivity with penicillin

Occasional skin rash and transaminasemia

Question 6

3 Vancomycin ADRs

Answer 6

1. Red man syndrome
2. Thrombophlebitis with fever, chills
3. Nephrotoxicity, ototoxicity