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Pharmacology > Beta Lactam > Flashcards

Beta Lactam Flashcards

1
Q

What are the 4 beta lactam antibiotics

A

Penicillin
Cephalosporin
Monobactam
Carbapenems

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2
Q

MOA of bacte. growth inhibition by beta lactam

A

Interfere with transpeptidation rxn of bacterial cell wall synthesis

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3
Q

Absorption of all oral penicillins are impaired by food EXCEPT

A

Amoxicillin

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4
Q

_ and _ penicillins are formulated to delay absorption resulting to prolonged blood and tissue con’c

A

Benzathine

Procaine

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5
Q

Excretion of penicillin (time)

A

Normal renal: 30mins

Renal failure: 10 hours

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6
Q

Classification of penicillin

A

Penicillin G

Penicillin V

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7
Q

What are the antistaphylococcal penicillins

A

Oxacillin
Cloxacillin
Dicloxacillin
Nafcillin

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8
Q

What are the extended spectrum penicillin

A

Aminopenicillin: amoxicillin, ampicillin

Carboxypenicillin: carbenicillin, ticarcillin

Ureidocillin: pipercillin, mezlocillin, azlocillin

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9
Q

Antistaph penicillin cleared by biliary excretion

A

Nafcillin

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10
Q

Antistaph penicillin cleared by biliary and urinary excretion

A

Oxacillin
Cloxacillin
Dicloxacillin

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11
Q

Indicated for strep pharyngitis, syphilis, leptospirosis

A

Penicillin G

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12
Q

Penicillin for MILD to MODERATE LOCALIZED staph infxn

A

(Oral)

Isoxazolyl penicillin: cloxacillin, dicloxacillin

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13
Q

Penicillin for SERIOUS SYSTEMIC staph infxn

A

Oxacillin
Nafcillin
(IV)

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14
Q

Penicillin indicated for shigellosis and listerosis

A

Ampicillin

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15
Q

Penicillin with less enterococcal activity

A

Carboxypenicillin:
Carbepenicillin
Ticarpenicillin

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16
Q

Extended spectrum penicillin indicated for SERIOUS INFECTIONS

A

Carboxypenicillin: ticarcillin

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17
Q

Antipsuedomonal penicillins

A

Ticarcillin
Piperacillin
Mezlocillin
Azlocillin

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18
Q

2 drugs given in combi with antipseudomonal penicillin

A

Aminoglycoside

Fluoroquinolone

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19
Q

Serious adverse effects of penicillin

A

Hypersensitivity

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20
Q

Penicillin: AE is neutropenia

A

Nafcillin

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21
Q

Penicillin: AE is hepatitis

A

Oxacillin

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22
Q

Penicillin: AE is interstitial nephritis

A

Methicillin (no longer used)

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23
Q

Only 1st gen cephalosporin administered IV route?

A

Cefazolin

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24
Q

Indicated for UTI, cellulitis, soft tissue abscess

A

Oral 1st gen cephalosporin

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25
Q

Advantage of cephalosporin over penicillin

A

More stable and broader spectrum

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26
Q

Drug of choice for surgical prophylaxis, history of penicillin allergy and serious staph infxns

A

Cefazoli

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27
Q

2nd gen cephalosporin against anaerobes

A

Cefoxitin
Cefmetazole
Cefotetan

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28
Q

What gen of cepha is indicated for sinusitis, otitis, and LRTI

A

2nd gen

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29
Q

2G cepha for community acquired pneumonia

A

Cefuroxime

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30
Q

2G cepha for peritonitis, diverticulitis and pelvic inflammatory disease

A

Cefoxitin
Cefmetazole
Cefotetan

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31
Q

Dosage of ceftriaxone (3G) for: most serious infections and meningitis

A

1g per day

2g every 12 hrs

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32
Q

All 3rd gen cephalosporin can penetrate body fluids and tissues. True or False

A

False.

Except cefoperazone and oral cephalo

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33
Q

All 3G cephalo need dosage adjustment Px with renal insufficiency. True or False

A

False.

Not need: cefoperazone & ceftriaxone - billiary excretion

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34
Q

3G cephalo for bacterial meningitis (2)

A

Ceftriaxone

Cefotaxime

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35
Q

3G cephalo bacte coverage: B fragilis

A

Ceftizoxime

Moxalactam

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36
Q

3G cephalo active against pseudomonas

A

Ceftazidime

Cefoperazone

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37
Q

3G cephalo indicated for febrile neutropenia

A

Ceftazidime

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38
Q

Excretion of 1G cephalo

A

Glomerular filtration

Tubular secretion

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39
Q

Excretion of 1G cephalo is blocked by what drug

A

Probenecid

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40
Q

3G cephalo is avoided in treatment of which organisms which can cause drug resistance

A 
ESCHAPPM
Enterobacter
Serratia
Citrobacter
Hafnia
Aeromonas
Proteus
Providencia
Morganella
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41
Q

Which gen of cephalo penetrates well the csf and cleared by the kidney

A

4G Cefepime

42
Q

1st beta lactam against MRSA

A

Ceftaroline (5G)

43
Q

What increases the risk of cross reactivity rxn among cephalosporin

A

R1 side chains

44
Q

Cephalosporin that contains METHYLTHIOTETRAZOLE GROUP

A

CefaMANDOLE (2G)
CefMETAZOLE (2G)
CefoTETAN (2G)
CefoPERAZONE (3G)

45
Q

AE of methylthiotetrazole group

A

Hypoprotothrombinemia and bleeding disorders

46
Q

Tx for AE of methylthiotetrazole group containing cephalosporin

A

Vit K1 (10mg twice weekly)

47
Q

Monobactam: Aztreonam is structurally similar to which drug?

A

CeftaziDIME

48
Q

Gram (-) spectrum of Aztreonam is similar to which gen of cephalosporin?

A

3rd

49
Q

Aztreonam bacterial coverage is limited to?

A

Aerobic gram (-) rods including P. aeruginosa

50
Q

AE include skin rashes and elevation of serum aminotransferase during its administration

A

Aztreonam

51
Q

Available only in combi with specific penicillin.

A

B-lactamase inhibitor

52
Q

B-LI are potent inhibitors of all B-lactamase. True or False

A

False. Not good against CLASS C B-lactamase

53
Q

Which class is B-LI most active against?

A

Class A beta lactamase

54
Q

3 pairs of penicillin-beta lactamase inhibitor

A

Amoxicillin-Clavulinic acid
Ampicillin-Sulbactam
Pipercillin-Tazobactam

55
Q

Indicated for empirical therapy, mixed aerobic and anaerobic infxn such as intra abdominal infxn

A

Beta lactamase inhibitors

56
Q

Carabapenem with longest half life

A

Ertapenem (4 hours)

1g IV or IM once a day

57
Q

MOA of Carbapenems

A

Inhibit cell wall synthesis

58
Q

Which carbapenem do NOT inhibit pseudomonas, enterococcus, and actinobacter

A

Ertapenem

59
Q

Carbapenem with AE as seizure

A

Imipinem-cilastatin

60
Q

AE of most carbapenem

A

Low platelets, fever

61
Q

Carba used for meningitis

A

Meropenem

62
Q

Carba used for intra abdominal

A

Ertapenem

63
Q

Carbe used for nocardia

A

Imipenem

64
Q

It inactivates imipinem in renal tubules resulting to low urinary conventrations

A

Dehydropeptidase

65
Q

An inhibitor of renal dehydropeptidase which is administerd together with imipenem

A

Cilastatin

66
Q 
Indicated for:
Mixed aerobic and anaerobic infections
Enterobacter infxns
ESBL gram (-) 
Febrile neutropenia
A

Carbapenem

67
Q

Carbapenems are indicated for febrile neutropenia EXCEPT

A

Ertapenem

68
Q

Carbapenem LESS ACTIVE against P. aeruginosa and actinobacter

A

Ertapenem

69
Q

Carbapenem with GREATER activity against gram (-) aerobes and LESS activity against garm (+)

A

Doripenem

Meropenem

70
Q

Excessive amount of this carbapenem can cause seizure

A

Imipenem

71
Q

Inhibits cell wall synthesis by binding firmly to d-Ala-d-Ala terminus of nascent peptidoglycan pentapeptide

A

Vancomycin

72
Q

Inhibits the transglycosylase preventing further elongation of peptidoglycan and cross-linking

A

Vancomycin

73
Q

Resistance to vancomycin in enterococci is due to replacement of terminal d-Ala by

A

D-lactate

74
Q

90% of vancomycin is excreted by

A

Glomerular filtration

75
Q

Vancomycin con’c for cellulitis

A

10-15mcg/ml (mild to moderate infection)

76
Q

Vancomycin con’c for endocarditis, meningitis, necrotizing pneumonia

A

15-20 mcg/ml (serious infections)

77
Q

First line of treatment for severe cases of C. difficile infection or cases that fail to respond to metimazole

A

Vancomycin

78
Q

Indicated for bloodstream infxn and endocarditis caused by MRSA

A

Vancomycin

79
Q

Vancomycin is used in combination with what drug for Tx of enterococcal ndocarditis with serious penicillin allergy

A

Gentamycin

80
Q

Can cause phlebitis at site of injection

A

Vancomycin

81
Q

When used with vancomycin, it can increase the risk of oto- and nephrotoxicity

A

Aminoglycosides

82
Q

AE of vancomycin: infusion related flushing due to release of histamine

A

Red man syndrome

83
Q

Red man syndrome can be prevented by?

A
  1. Prolonging the infusion period to 1-2 hours

2. Pretreatment with antihistamine (diphenhydramine)

84
Q

Glycopeptode very similar to vancomycin

A

Teicoplanin (once daily IV or IM)

85
Q

Semisynthetic lipoglycopeptide derived from vancomycin

A

Telavancin

86
Q

Tx for complicated skin and soft tissue infections and hosp-acquired pneumonia

A

Telavancin

87
Q

Monitoring of serum telavancin is required. True or False.

A

False

88
Q

Derived from Teicoplanin

A

Dalbavancin (once weekly IV)

89
Q

Improved activity agains gram (+) bacte and MRSA and VISA

A

Dalbavancin

90
Q

Novel cyclic lipopetide

A

Daptomycin

91
Q

Bacterial coverage: Vanco-resistant enterococci and S. aureus

A

Daptomycin

92
Q

MOA: bind to cell membrane via calcium dependent insertion of its lipid tail

A

Daptomycin

93
Q

Tx for skin and soft tissue infxns, bacteremia, and endocarditis

A

Daptomycin

94
Q

What antagonized by pulmonary surfactant and therefor not be used in treating pneumonia

A

Daptomycin

95
Q

AE include myopathy and allergic pneumonitis

A

Daptomycin

Phosphokinase levels should be monitored weekly

96
Q

Inhibits the addition of phosphoenolpyruvate to UDP-N-acetylglucosamine

A

Fosfomycin

97
Q

Tx of uncomplicated lower urinary tract infections in women

A

Fosfomycin (single 3g dose)

98
Q

Used topically

A

Bacitracin

99
Q

Causes suppression of mixed bacterial flora in surface lesions of skin or mucous membranes

A

Bacitracin

100
Q

Inhibits alanine racemase

A

Cycloserine

101
Q

Tx for tuberculosis caused by Mycobacterium tuberculosis resistant to 1st line agents

A

Cycloserine

Pharmacology (3 decks)

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