CELL WALL SYNTHESIS INHIBITORS (BETA-LACTAMS, VANCOMYCIN)

Question 1

Name 2 classes of bacterial cell wall synthesis inhibitors.

Answer 1

Beta-lactams, Vancomycin

Question 2

Name 4 types of beta lactams

Answer 2

Penicillins, cephalosporins, carbapenems, monobactam

Question 3

Name the 4 classes of penicillins and the relative antibiotics under each class

Answer 3

Natural penicillin (Pen G and Pen V), anti-staphylococcal penicillin (cloxacillin, oxacillin, flucloxacillin), aminopenicillin (ampicillin, amoxicillin), antipseudomonal penicillin (piperacillin)

Question 4

What do natural penicillins cover?

Answer 4

Gram-positive coverage only - streptococcus, enterococcus, peptostreptococcus. NO STAPH AUREUS (MSSA/MRSA)

Question 5

Syphilis caused by Treponema pallidum can be treated with which penicillin?

Answer 5

Pen G

Question 6

What do anti-staphylococcal penicillins cover?

Answer 6

Gram-positive coverage only - MSSA, streptococcus A,B,C only.

Question 7

What do aminopenicillins cover?

Answer 7

Gram-positive + hemophilus influenzae + e.coli

Question 8

What does anti-pseudomonal penicillin cover?

Answer 8

Broad spectrum activity in combination with tazobactam (pip-tazo) –> covers all gram positive except MRSA + all gram negative.

Question 9

Name 3 beta lactams-beta-lactamase inhibitor combination drugs.

Answer 9

Augmentin (Amoxicillin + clavulanic acid)
Unasyn (ampicillin + sulbactam)
Zosyn (piperacillin + tazobactam)

Question 10

Name the 5 classes of cephalosporins and the relative antibiotics under each class

Answer 10

1st gen (cephalexin PO, cefazolin IV)
2nd gen (cefuroxime)
3rd gen (ceftriaxone, ceftazidime)
4th gen (cefepime)
5th gen (ceftaroline)

Question 11

What does 1st gen cephalosporin cover?

Answer 11

Cephalexin + cefazolin. Similar to anti-staphylococcal penicillins - MSSA, streptococcus + e.coli + h. influenzae

Question 12

What does 2nd gen cephalosporin cover?

Answer 12

Cefuroxime. MSSA + streptococcus + e.coli + h. influenzae + klebsiella + proteus

Question 13

What does 3rd gen cephalosporin cover?

Answer 13

Ceftriaxone. MSSA + streptococcus + e.coli + h. influenzae + proteus + klebsiella.
Ceftazidime: no gram positive coverage BUT covers e.coli, h. influenzae, klebsiella, proteus, pseudomonas

Question 14

What does 4th gen cephalosporin cover?

Answer 14

Cefepime = ceftriaxone + ceftazidime coverage. MSSA + streptococcus + e.coli + h.influenza, proteus, klebsiella, pseudomonas + enterobacter + ESBL-producing e.coli and klebsiella

Question 15

What does 5th gen cephalosporin cover?

Answer 15

Ceftaroline. MRSA + MSSA + streptococcus + e.coli + h. influenzae, proteus, klebsiella

Question 16

Name at least 3 types of microbes against which cephalosporins are ineffective? with exceptions

Answer 16

LAME:
Listeria monocytogenes
Atypicals (Chlamydial, Legionella, Mycoplasma)
MRSA (except ceftaroline)
Enterococcus

Pseudomonas (except ceftazidime and cefepime)

Question 17

Name the antibiotics under the class of carbapenems.

Answer 17

Ertapenem, Imipenem, Meropenem

Question 18

What does ertapenem cover?

Answer 18

MSSA, streptococcus, Bacteroides, h.influenzae, e.coli, klebsiella, proteus, ESBL-producing, enterobacter

Question 19

What do imipenem and meropenem cover?

Answer 19

MSSA, streptococcus, enterococcus, bacteroides, h.influenzae, e.coli, klebsiella, proteus, ESBL-producing, enterobacter, pseudomonas

Question 20

What does Vancomycin cover?

Answer 20

All Gram positives only. MRSA, MSSA, streptococcus, enterococcus, peptostreptococcus, c. difficile

Question 21

How is vancomycin administered?

Answer 21

IV except for CDAD (use oral)