Cell Wall Synthesis Inhibitors

Question 1

Name 4 Anti-staphylococcal Penicillin

Answer 1

M.O.N.D.
- Methicillin
- Oxacillin
- Nafcillin
- Dicloxacillin

*O & D = isoxazoyl

A.K.A. Methicillin group of antibiotics

Question 2

First anti-staphylococcal penicillin

Answer 2

Methicillin

Question 3

A relatively acid-stable isoxazolyl penicillin that is suitable for mild to moderate localized staphylococcal infections

Answer 3

Dicloxacillin

Question 4

Considered drugs of choice for serious staphylococcal
infections such as endocarditis.

Answer 4

Oxacillin and Nafcillin

Question 5

Anti-staphylococcal penicillin with dual elimination routes

Answer 5

Oxacillin: kidney and biliary

Question 6

Nafcillin is primarily cleared by _______ excretion

Answer 6

biliary

Question 7

Nafcillin and Oxacillin route of administration

Answer 7

IV

Question 8

Drug of choice for shigellosis

Answer 8

Ampicillin

Question 9

Extended spectrum antibiotic that may be taken orally with food

Answer 9

Amoxicillin

Question 10

Extended spectrum penicillin cannot be stand alone and must be given in combination with:

Answer 10

Aminoglycosides

Question 11

DOC for Listeria monocytogenes

Answer 11

Ampicillin

Question 12

Aminopenicillin given orally to treat bacterial sinusitis, otitis, LRT infections

Answer 12

Amoxicillin

Question 13

Piperacillin is available only as co-formulation with the beta-lactamase inhibitor:

Answer 13

Tazobactam

Question 14

Beta-lactamase inhibitor that do not have a beta-lactam ring

Answer 14

Avibactam

Question 15

A non-suicidal, non-covalently binding boronic acid beta-lactamase inhibitor that is used in combination with Meropenem to prevent KPCs from hydrolyzing the carbapenem

Answer 15

Vaborbactam

Question 16

This prevents beta-lactamase including Ambler Class A and C, helping to prevent degradation of Imipenem

Answer 16

Relebactam

Question 17

Most common mechanism of resistance to penicillins and other β-lactams

Answer 17

Beta-lactamase production

Question 18

Extended-spectrum penicillin active against gram-negative bacilli such as K. pneumoniae and P. aeruginosa

Answer 18

Piperacillin or Ureidopenicillin

Question 19

________ salts and _______ salts of penicillin G
provide repository forms for intramuscular injection, formulated to delay absorption, resulting in prolonged blood and tissue concentrations.

Answer 19

Benzathine and Procaine salts

Question 20

An analog of phosphoenolpyruvate, it is structurally unrelated to any other antimicrobial agent. It inhibits the cytoplasmic enzyme enolpyruvate transferase by covalently binding to the cysteine residue of the active site and blocking the addition of phosphoenolpyruvate to UDP-N-acetylglucosamine. This reaction is the first step in the formation of UDP-N-acetylmuramic acid, the precursor of N-acetylmuramic acid, which is found only in bacterial cell walls.

Answer 20

Fosfomycin trometamol

Question 21

Phosphonomycin that inhibits a very early stage of bacterial cell wall synthesis for treatment of uncomplicated lower UTI in women

Answer 21

Fosfomycin trometamol

Question 22

A novel cyclic lipopeptide fermentation product of
Streptomyces roseosporus that may be active against vancomycin-resistant strains of enterococci and S aureus.

Answer 22

Daptomycin

Question 23

This is known to bind to the cell membrane via calcium dependent insertion of its lipid tail. This results in depolarization of the cell membrane with potassium efflux and rapid cell death

Answer 23

Daptomycin

Question 24

Daptomycin can cause an __________ in patients receiving prolonged therapy (>2 weeks).

Answer 24

allergic pneumonitis

Question 25

__________________ antagonizes daptomycin; hence, it should not be used to treat pneumonia.

Answer 25

Pulmonary surfactant

Question 26

A highly nephrotoxic agent that interfere with dephosphorylation in cycling of the lipid carrier that transfers peptidoglycan subunits to the growing cell wall; hence, it is only used topically

Answer 26

Bacitracin

Question 27

A water-soluble antibiotic that inhibits alanine racemase and ligase of many Gram-positive and Gram-negative organisms, but it is used almost exclusively to treat tuberculosis caused by strains of Mycobacterium tuberculosis resistant to first-line agents.

Answer 27

Cycloserine

produced by Streptomyces orchidaceous

Question 28

This is the infusion-related flushing caused by release of histamine, a common reaction with vancomycin

Answer 28

Red man syndrome

Question 29

Vancomycin is poorly absorbed from the intestinal tract and is administered orally only for the treatment of colitis caused by:

Answer 29

Clostridium difficile

Question 29

This is the only first-generation parenteral cephalosporin still in general use

Answer 29

Cefazolin

Question 29

This a drug of choice for surgical prophylaxis for many strep and staph infections requiring IV therapy

Answer 29

Cefazolin

Question 30

Ceftriaxone primary route of elimination

Answer 30

biliary tract

Question 31

Hematologic side effects of cephalosporins containing methylthiotetrazole group

Answer 31

Hypoprothrombinemia
Bleeding disorders

Question 32

The only available fourth-generation cephalosporin.

Answer 32

Cefepime

but we now have cefpirome

Question 33

Third gen cephalosporins approved for treatment of meningitis, including meningitis caused by pneumococci, meningococci, H. influenzae, and susceptible enteric Gram-negative rods, but not by L monocytogenes.

Answer 33

Ceftriaxone and cefotaxime