Beta-Lactams & Glycopeptides

Question 1

Which natural penicillin is to be administered parenterally?

Answer 1

Pen G

Question 2

Use of Penicillinase-resistant agents

Answer 2

Gram (+)

• Staph
• MSSA

Question 3

Coverage of Augmentin

Answer 3

1) Staphylococci
2) H.influenzae
3) Gonococci
4) E coli

Question 4

Coverage of Unasyn

Answer 4

1) Staph Aureus
2) GN aerobes

[Skin, Intra-ab, Gynaecologic infections]

Question 5

Coverage of Piperacillin

Answer 5

1) Klebseilla & Pseudomonas
2) Increased anaerobic coverage
3) Gram (+): S.pyrogens, Enterococcus

Question 6

Which drug can cover Pseudomonas ESBL infection?

Answer 6

Meropenem & Tienam (Imipenam + Cilastin)

Question 7

MRSA infection

Answer 7

1) 5th gen cephalosporin (Ceftaroline,Ceftobiprole)

2) Vancomycin

Question 8

MSSA infection

Answer 8

1) Penicillinase-resistant 
(Cloxacillin, Flucloxacillin)
2) 1st gen cephalosporin 
(Cefazolin, Cephalexin)
3) Augmentin (Amoxicillin + CA)
4) Vancomycin

Question 9

Which cephalosporin is cleared by the liver?

Answer 9

Ceftriaxone

Question 10

Which cephalosporins have good CNS penetration?

Answer 10

3rd & 4th gen cephalosporins

Question 11

Coverage of Aztreonam

Answer 11

B-lactamase producing G (-) bacteria

- Enterobacteriaceae, Pseudomonas aeruginosa, H.influenzae, Neisseria gonorrhoea

Question 12

Mechanisims of resistance to penicillins

Answer 12

1) PBP has reduced affinity for penicillins
2) B-lactamase hydrolyse B-lactam ring
3) Bacteria decrease porin production -> decrease in IC [drug]
4) Efflux pumps

Question 13

Pseudomonas infection?

Answer 13

1) Ceftazidime
2) Cefepime
3) Aztreonam
4) Zosyn (Piperacillin + Tazobactam)

Imipenem, Meropenem

Question 14

ADE of Penicillins

Answer 14

• Hypersensitivity
• Neuro/hepatotoxicity
• CDAD
• Anosmia
• SJS/TEN

Question 15

ADE of Cephalosporins

Answer 15

• Hepatotoxicity
• GIT
• Thrombophlebitis

Question 16

ADE of Carbepenems

Answer 16

• GIT
• Rash
• Neurotoxicity (seizures)

Question 17

ADE of Aztreonam

Answer 17

(Generally well tolerated)

• Rash
• Transaminasemia

Question 18

ADE of Vancomycin

Answer 18

• Nephrotoxicity
• Ototoxicity
• Thrombophlebitis (10%)
• Red-neck/man syndrome

Question 19

Which of the Beta-lactams can be given orally?

Answer 19

• Pen V
• Penicillinase-resistant penicillin
• Aminopenicillins (Amoxicillin/Ampicillin)
• Augmentin
• 1st & 2nd gen ceph (Cefazolin/Cephalexin/Cefuroxime)

Question 20

Which drugs can cause Thrombophlebitis?

Answer 20

• Cephalosporins
• Vancomycin
• Amphotericin B

Question 21

Which drugs can cause Hepatotoxicity?

Answer 21

• Penicillins
• Tetracyclines (& Tigecyclines)
• Macrolides
• 5-Flucytosine
• Triazoles
• Rifampicin, Isoniazid, Pyraziminade

Question 22

Which drugs can cause Nephrotoxicity?

Answer 22

• Aminoglycosides
• Vancomycin
• Amphotericin B

Question 23

Which drugs can cause Otoxicity?

Answer 23

• Aminoglycosides
• Vancomycin
• Amphotericin B
• Azithromycin

Question 24

Which drugs can cause Neurotoxicity?

Answer 24

• Penicillins
• Carbepenems (seizures)
• Voriconazole

Question 25

Which drugs can cause Peripheral neuropathy?

Answer 25

• Linezolid

- Isoniazid