Cell Wall Inhibitors

Question 1

What is the major AE of penicillins?

Answer 1

hypersensitivity

Question 2

What differentiates the different penicillins?

Answer 2

R substituent

Question 3

MOA of penicillins

Answer 3

interferes w/last step of cell wall synthesis
(transpeptidation or cross linkage)
(PBPs, inhibition of transpeptidase and autolysins)

Question 4

The success of an antibiotic depends on the ____________, ___________ and ___________

Answer 4

size
charge
hydrophobicity

Question 5

Spectrum of penicillins is determined by the ability of the drug to enter the _______________ and _______________

Answer 5

enter the periplasmic space

bind PBPs

Question 6

Beta-lactam enty into gram (-) bacteria depend on what three things?

Answer 6

size
charge
hydrophobicity

Question 7

_____________ covers gram (-) and gram (+) cocci, gram (+) bacilli and spirochetes

Answer 7

penicillin G

Question 8

______________ has a high minimum lethal concentration (MLC)

Answer 8

penicillin V

Question 9

Penicillin V is indicated for ____________ infections

Answer 9

anaerobic

Question 10

__________ is the DOC for gas gangrene and syphilis

Answer 10

penicillin

Question 11

_____________ is susceptible to vancomycin, but rarely to ciprofloxacin

Answer 11

vancomycin

Question 12

Methicillin, Nafcillin, Oxacillin, Cloxacillin, Dicloxacillin

Answer 12

antistaphylococcal penicillins

Question 13

The antistaphylococcal penicillins are only active against __________________________

Answer 13

penicillinase-producing staph infections

MSSA- S. aureus

Question 14

What is the role of sulbactam and clavunic acid?

Answer 14

beta-lactamase inhibitors

Question 15

__________ is the DOC for listeria and respiratory infections

Answer 15

ampicillin

Question 16

____________ is used for ENT infections and as phrophylaxis for dental work

Answer 16

amoxicillin

Question 17

What are the extended spectrum penicillins?

Answer 17

Ampicillin

Amoxicillin

Question 18

Carbenicillin, Ticarcillin, Mezlocillin, Azlocillin

Answer 18

antipseudomonal penicillins

Question 19

____________ is most effective against pseudomonas

Answer 19

pipercillin

Question 20

Pipercillin + _____________

Answer 20

tazobactam

Question 21

Ticarcillin + ___________

Answer 21

clavulanic acid

Question 22

What is a mode of natural resistance to penicillins?

Answer 22

lack of peptidoglycan in cell wall

Question 23

What are three methods of acquired resistance to penicillins?

Answer 23

1. aquire beta-lactamases/penicillinase
2. decrease permeability
3. Altered PBPs

Question 24

Antipseudomona/antistaphylococcal antibiotics are usually only given _____ or _____

Answer 24

IV or IM

Question 25

Penicillin V, Amoxicillin and Amoxicillin w/calvulanic acid are only available in what form?

Answer 25

orally

Question 26

Do penicillins cross the placental barrier?

Answer 26

yes

Question 27

How are most penicillins metabolized?

Answer 27

excreted in urine

Question 28

How is nafcillin eliminated?

Answer 28

biliary route

Question 29

____________ inhibits the secretion of penicillins

Answer 29

probenecid

Question 30

What category of drugs are penicillins?

Answer 30

cell wall inhibitor

Question 31

What category of drugs are cephalosporins?

Answer 31

cell wall inhibitor

Question 32

PEcK

Answer 32

1st gen cephalosporins

Question 33

HENPEcK

Answer 33

2nd gen cephalosporins

Question 34

Ceftriazone and cefotaxime are the DOC for what condition?

Answer 34

meningitis

Question 35

What is the spectrum of cefepime?

Answer 35

staph strep gram (-)

Question 36

What is a good substitute for bacteria resistant to penicillin G?

Answer 36

1st generation cephalosporins

Question 37

Cephalosporins are usually administered in what form?

Answer 37

IV

Question 38

Ceftriazone, cefamandol and cefoperazone are the only three cephalosporins to be excreted through ______________

Answer 38

bile

Question 39

How are most cephalosporins excreted?

Answer 39

urine

Question 40

Do cephalosporins have cross-sensitivity to penicillins?

Answer 40

yes

Question 41

Which two cephalosporins can cause a disulfiram-like reaction?

Answer 41

cefamandole | cefoperazone

Question 42

Which two cephalosporins have an anti-vit K effect?

Answer 42

cefamandole | cefoperaone

Question 43

What is the broadest spectrum antibiotic?

Answer 43

impenem/cilastatin

Question 44

What category of drug is imipenem?

Answer 44

carbapenem | cell wall inhibitor

Question 45

What enzyme is responsible for the metabolism of imipenem?

Answer 45

dehydropeptidase in the kidneys

Question 46

What category of drug is aztreonam?

Answer 46

monobactam | cell wall inhibitor

Question 47

Atreonam is effective against what type of bug?

Answer 47

gram (-) rods | *no activity against anaerobes and gram (+)

Question 48

What category of drug is a good substitute for someone with an allergy to penicillin/cephalosporins?

Answer 48

aztreonam (monobactam)

Question 49

What category of drug is vancomycin?

Answer 49

cell wall inhibitor

Question 50

MOA of vancomycin

Answer 50

inhibits bacterial cell wall phospholipids

Question 51

What is the DOC for C. diff?

Answer 51

vancomycin

Question 52

What drug can cause the "red man syndrome"

Answer 52

vancomycin

Question 53

What category of drug is bacitracin?

Answer 53

cell wall inhibitor