Cell wall inhibitors

Question 0

Penicillin V

Answer 0

Oral stable

Question 1

Penicillin G

Answer 1

Natural penicillin. Potassium- IV, IM. Benzathine- IM depot. Procaine- IM.

Question 2

Nafcillin

Answer 2

Penicillinase resistant, antistaph

Question 3

Oxacillin

Answer 3

Penicillinase resistant, antistaph

Question 4

Dicloxacillin

Answer 4

Penicillinase resistant, antistaph

Question 5

Methicillin

Answer 5

Penicillinase resistant, antistaph. Reserved

Question 6

Ampicillin

Answer 6

Extended spectrum penicillin

Question 7

Amoxicillin

Answer 7

Extended spectrum penicillin

Question 8

Piperacillin

Answer 8

Antipseudomonal penicillin

Question 9

Ticarcillin

Answer 9

Antipseudomonal penicillin

Question 10

Aztreonam

Answer 10

Monobactam - For G- rods (Pseudomonas, Serratia), No G+ or anaerobe effect.
Parenteral, no cross-sensitivity w/ penicillin derivatives
B-lactamase resistant

Question 11

Imipenem

Answer 11

Carbapenem. IV. Broad spec: G+, G- rods, anaerobes
Given w/ Cilastatin-dehydropeptidase inhibitor (inactivation in tubules)
Risk of seizures
Pseudomonal resistance risk, give w/ aminoglycosides

Question 12

Cilastatin

Answer 12

Dehydropeptidase inhibitor. Give w/ Imipenem

Question 13

Meropenem

Answer 13

Carbapenem. IV. Broad spec: G+, G- rods, anaerobes
Pseudomonal resistance risk, give w/ aminoglycoside
Less seizure risk than Iminepem

Question 14

Ertapenem

Answer 14

Carbapenem. IV, IM. Very B-lactamase stable

Broad spec: G+, G-, anaerobes (esp Enterobacteriae)

Question 15

Doripenem

Answer 15

Carbapenem

Question 16

Clavunic acid

Answer 16

B-lactamase inhibitor (many not all)
Most active vs plasmid encoded
Weak bactericidal

Question 17

Sulbactam

Answer 17

B-lactamase inhibitor (many not all)
Most active vs plasmid encoded
Weak bactericidal

Question 18

Tazobactam

Answer 18

B-lactamase inhibitor (many not all)
Most active vs plasmid encoded
Weak bactericidal

Question 19

Vancomycin

Answer 19

Bactericidal - inhibits elongation and transpep of peptidoglycan chain
DOC: MRSA, PCN-resistant staph
only G+ spectrum, poor CNS penetration, for PCN allergic pt
Tox: red man syndrome, nephro-, oto-tox w/ aminodlycosides
Usually IV, oral: fo pseudomembranous colitis and super infx

Question 20

Telavancin

Answer 20

Bactericidal - inc cell membrane permeability
G+, MRSA, complicated skin infx, last line: nosocomial staph aureus
CI: pregnancy, renal failure

Question 21

Fosfomycin

Answer 21

Inhibits - first step in peptidoglycan synth= inhibit CW synth
For uncomplicated UTI (4th/5th line)
Can be combined w/ B-lactams

Question 22

Bacitracin

Answer 22

Interferes w/ phospholipid carriers - inhibits CW synth
G+, topical use in combo
Tox: IV -> serious nephrotoxicity

Question 23

Cycloserine

Answer 23

Inhibits incorporation of D-alanine in CW (inhibits synth)

Not used anymore b/c CNS tox

Question 24

Daptomycin

Answer 24

Liptopeptide, bactericidal, binds to bacterial membrane -> rapid depol Excreted by kidney, IV G+ mild tox