Cell Wall Synthesis II

Question 1

Ceftriaxone

Admin
Metabolism
Probenecid

Answer 1

1. Admin:
   Not admin with
   Ca2+ containing
   solutions
2. Metabolism:
   40% hepatic
   metabolism
3. Probenecid:
   Not affected by
   Probenecid

Question 2

Cephalosporins 3rd generation CI?

Answer 2

CI in hyperbilirubinemia neonates
(Premature infants)
Jaundice

Question 3

Cephalosporins 4th generation resistance?

Answer 3

B-lactamase resistant

Question 4

Cephalosporins DI-3?

Answer 4

-Cephalosporins & aminoglycosides in the same container may chemically inactivate each other

-Ceftriaxone not admin at same time as Ca2+-containng solutions(48hrs)

-Alcohol-Cefamandole

-Warfarin

-Combined oral contraceptives

-Probenecid

Question 5

Cephalosporins S/E-6?

Answer 5

1. Nephrotoxicity (Aminoglycosides or vancomycin)
2. Neurotoxicty
3. Cross Hypersensitivity
4. Alcohol Intolerance’s
5. ↓ Oral contraceptives efficacy
6. Phlebitis (IV)

Question 6

Which cephalosporins causes nephrotoxicity?

Answer 6

minoglycosides or vancomycin

Question 7

Carbapenems drugs?

Answer 7

I-MED

Imipenem
Meropenem
Ertapenem
Doripenem

Question 8

Meropem BBB?

Answer 8

Cross BBB ∴ Treats bacterial meningitis (CSF)

Question 9

Ertapenem

1. Admin:
2. Spectrum
3. DOA

Answer 9

1. Admin:
   IM/IV
2. Spectrum:
   Narrow Spectrum
3. DOA
   Long-acting(1
   daily dose)

Question 10

Carbapenems Caution/CI?

Answer 10

1. Allergy
2. CNS Disorders/seizures
3. Renal impairement

Question 11

Monobactams

1. Drug
2. B-lactamases
3. Cross sensitivity/penicillin
4. Admin

Answer 11

1. Drug:
   Aztreonam
2. B-lactamases:
   Stability to many B-lactamases
3. Cross sensitivity/penicillin:
   No cross sensitivity with penicillins or cephalosporins thus can be used in penicillin allergic patients
4. Admin:
   IM/IV

Question 12

Monobactams S/E?

Answer 12

1. Drug induced eosinophilia ( ↑ eosinophils)
2. Rarely toxic epidermal necrolysis
3. Injection site reactions
4. Rash
5. GIT S/E

Question 13

Glycopeptides

1. Drug
2. Admin & exceptions
3. Indications
4. MOA

Answer 13

1. Drug:
   Vancomycin & Teicoplanin
2. Admin:
   IV except for pseudomembranous oolitic-orally
3. Indications:
   Reserved for life-threatening infections-methicillin-resistant Staph. Aureus(MRSA)
4. MOA
   Inhibits transglycosylation between side chains-peptidoglycan cross-linkages do not form ∴ weakens bacterial cell wall

Question 14

Glycopeptides S/E?

Answer 14

1. Red-man syndrome-Rapid transfusion-Histamine release
2. Ototoxicty & Nephrotoxicity
3. Fever & skin rashes

Question 15

Glycopeptides DI?

Answer 15

1. Aminoglycosides
   Ototoxic &
   nephrotoxic
   drugs

Question 16

Glycopeptides Cautions & CI?

Answer 16

1. Renal impairment
2. Elderly & neonates
3. Hearing abnormalities
4. Pregnancy

Question 17

Teicoplanin MOA

Answer 17

Inhibits transglycosylation between side chains

Peptidoglycan cross-linkages do not form ∴ weakens bacterial cell wall

Question 18

Teicoplanin difference with vancomycin?

Answer 18

Decreases incidence of red-man syndrome

Question 19

Teicoplanin S/E?

Answer 19

-Allergy
-Cross sensitivity with vancomycin

Question 20

Fosfomycin MOA?

Answer 20

Inhibits early stage in bacterial cell wall synthesis

Interferes with formation of building blocks

Question 21

Fosfomycin admission time?

Answer 21

Empty stomach or 2-3hrs after meal

Question 22

Fosfomycin I?

Answer 22

Treats lower UTIs in women and girls>5yrs

Question 23

Fosfomycin resistance?

Answer 23

-Limited
-Inadequate transport of drug into cell

Question 24

Fosfomycin S/E?

Answer 24

-GIT disturbances
-Skin rashes

Question 25

Imipenem -Adjunct medication? -S/E

Answer 25

-Adjunct medication: Imipenem + Cilastatin (enzyme inhibitor that blocks renal metabolism) -S/E: -Red Urine in children -Seizures(

Question 26

Fosfomycin DI?

Answer 26

Metoclopramide (↑ gut motility ∴ not enough time for fosfomycin absorption)

Question 27

Amoxicillins drug choice for?

Answer 27

Otitis media Sinusitis lower RTI

Question 28

Amoxicillins prophylaxis?

Answer 28

Prophylaxis to prevent infective endocarditis

Question 29

Which bacteria is resistant to all cephalosporins?

Answer 29

Enterococci

Question 30

Ceftaroline prodrug

Answer 30

Ceftaroline prodrug metabolised by plasma phosphatase

Question 31

Imipenem I?

Answer 31

Severe nosocomial infections

Question 32

Which penicillin was most active against Pseudomonas aeruginosama?

Answer 32

Antipseudomonal penicillin Pipercillin + Tazobactam

Question 33

Ceftaroline prodrug

Answer 33

Ceftaroline prodrug metabolised by plasma phosphatase

Question 34

Ceftaroline prodrug

Answer 34

Ceftaroline prodrug metabolised by plasma phosphatase

Question 35

Imipenem I?

Answer 35

Severe nosocomial infections