beta-lactam inhibitors - others

Question 1

OTHER BETA-LACTAM DRUGS

monobactam

Answer 1

astreonam

Question 2

 Resistant to beta-lactamases produced by certain gram (-) rods
 Klebsiella
 Pseudomonas
 Serratia
 No activity against gram (+) and anaerobes

Answer 2

astreonam

Question 3

astreonam RoA

Answer 3

IV

Question 4

Elimination of astreonam

Answer 4

 Eliminated via renal tubular secretion

Question 5

w/ or w/o cross-allergenicity with penicillin?

Answer 5

none

Question 6

adverse effects of astreonam

Answer 6

	Adverse effects 
	GI upset with possible superinfection
	Vertigo
	Headache
	Rare hepatotoxicity
	Skin rash

Question 7

 An inhibitor of cell wall synthesis binding to PBP3

 Synergistic with aminoglycosides

Answer 7

astreonam

Question 8

 Chemically different from penicillins

 Retain the beta-lactam ring

Answer 8

carbapenems

Question 9

the carbapenems are (3)

Answer 9

B. IMIPENEM, MEROPENEM, and ERTAPENEM

Question 10

 Low susceptibility to beta-lactamases

Answer 10

carbapenems

Question 11

 Wide activity against
 Gram(+) cocci
 Gram (-) rods
 Anaerobes

Answer 11

carbapenems

Question 12

RoA of carbapenems

Answer 12

IV

Question 13

 Useful for infections caused by organisms resistant to other antibiotics


Answer 13

CARBAPENEMS

Question 14

Drug of choice for enterobacter

Answer 14

CARBAPENEMS

Question 15

Inactivates impinem

Answer 15

renal dehydropeptidase I

Question 16

 Administered in combination w/impinen

Answer 16

cilastatin

Question 17

 Increases the half-life of impinem

 Inhibits formation of nephrotoxic metabolites

Answer 17

cilastatin

Question 18

 Inhibitor of the renal dehydropeptidase I

Answer 18

cilastatin

Question 19

 Adverse effects of imipenem-cilastatin

Answer 19

GI distress
 Skin rash
 At very high plasma levels, CNS toxicity
 Confusion, encephalopathy, seizures

Question 20

cross-allergenicity with penicillins (C, INC, Par)

Answer 20

Partial

Question 21

 Similar to imipenem
 Not metabolized by renal dehydropeptidases
 Less likely to cause seizure

Answer 21

MEROPENEM

Question 22

 Long half-life
 Less active against pseudomonas
 IM injection causes pain and irritation

Answer 22

ERTAPENEM

Question 23

 Used in fixed combination with certain hydrolyzable penicillins
 Effective against plasmid-encoded beta-lactamases
 Gonococci
 Streptococci
 E. coli
 H. influenzae

Answer 23

beta-lactam inihibitors: CLAVULANIC ACID, SULBACTAM, and TAZOBACTAM

Question 24

Bactericidal glycoprotein

Answer 24

VANCOMYCIN

Question 25

Binds to the D-Ala-D-Ala terminal of the nascent peptidoglycan pentapeptide side chain

Answer 25

VANCOMYCIN

Question 26

Inhibits transglycosylation

Answer 26

VANCOMYCIN

Question 27

Prevents elongation of peptidoglycan chain

Answer 27

VANCOMYCIN

Question 28

Interferes with cross-linking

Answer 28

VANCOMYCIN

Question 29

spectrum of activity of vancomycin

Answer 29

Narrow spectrum of activity

Question 30

• Rapid IV infusion of this drug may cause diffuse blushing |  “Red man syndrome”

Answer 30

VANCOMYCIN

Question 31

• Eliminated unchanged in urine

Answer 31

VANCOMYCIN

Question 32

RoA of vancomycin

Answer 32

IV

Question 33

penetrates most tissues

Answer 33

VANCOMYCIN

Question 34

• Toxic effects of vancomycin

Answer 34

```  Chills  Fever  Phlebitis  Ototoxicity  Nephrotoxicity ```

Question 35

• Toxic effects of vancomycin

Answer 35

```  Chills  Fever  Phlebitis  Ototoxicity  Nephrotoxicity ```

Question 36

 Antimetabolite inhibitor of cytosolic enolpyruvate transferase

Answer 36

B. FOSFOMYCIN

Question 37

 Prevents the formation of N- acetylmuramic acid which is essential in peptidoglycan chain formation

Answer 37

B. FOSFOMYCIN

Question 38

 Resistance occurs via decreased intracellular accumulation of the drug

Answer 38

B. FOSFOMYCIN

Question 39

 Excreted in the kidney with urinary levels exceeding the minimum inhibitory concentration (MIC) for many urinary tract pathogens

Answer 39

B. FOSFOMYCIN

Question 40

 In a single dose  Drug is less effective than the 7-day course of treatment with fluoroquinolones  Multiple dosing can result to resistance rapidly

Answer 40

B. FOSFOMYCIN

Question 41

 Diarrhea is common |  Synergistic with beta-lactam and quinolones in specific infections

Answer 41

B. FOSFOMYCIN

Question 42

 Peptide antibiotic  Interferes with a late stage in cell wall synthesis in gram (+) organisms  Marked toxicity  Limited to topical use only

Answer 42

C. BACITRACIN

Question 43

RoA of bacitracin

Answer 43

Topical

Question 44

 Antimetabolite

Answer 44

D. CYLCOSERINE

Question 45

Blocks the incorporation of D-Ala into the pentapeptide side chain of the peptidoglycan

Answer 45

D. CYLCOSERINE

Question 46

Used only in TB caused by organisms resistant to first-line antituberculous drugs

Answer 46

D. CYLCOSERINE

Question 47

Potentially neurotoxic  Tremors  Seizure  Psychosis

Answer 47

D. CYLCOSERINE