Inhibitors of Cell Wall Synthesis

Question 1

Penicillin G and V

Answer 1

Narrow Spectrum
Beta-lactamase sensitive
Targets: streptocooci, pneumoncocci, meningococci, and Treponema pallidum

Question 2

Nafcillin, methicillin, oxacillin

Answer 2

Very Narrow Spectrum
Beta-lactamase resistant
Target: Staphylococci (not MRSA)

Question 3

Ampicillin, amoxicillin

Answer 3

Broad Spectrum
Beta Lactamase sensitive
Targets: gram + cocci (not staph), E. coli, H. influenzae, Listeria Monocytogenes, Borrelia burgdorfei, H. Pylori

Question 4

Ticarcillin, piperacillin, azlocillin, Carbacillin

Answer 4

Extended Spectrum
Beta-Lactamase sensitive
targets: gram - rods, pseudomonas aeruginosa

Question 5

Clavulanic acid, sulbactam, tazobactam

Answer 5

Beta Lactamase inhibitors

Question 6

Mechanism of Resistance

Answer 6

beta-lactamases, changes in penicillin binding proteins, change in porins (unable to reach cell)

Question 7

Penicillin Side Effect

Answer 7

Hypersensitivity, interstitial nephritis with methicillin, GI distress, Jarisch-Herxheimer reaction

Question 8

Cefazolin, cephalexin

Answer 8

1st Generation

Targets: gram + cocci (not MRSA), E. coli, Klebsiella, Proteus

Question 9

Cefotetan, cefaclor, cefuroxime

Answer 9

2nd Generation
Targets: gram -, some anaerobic bugs
Cannot enter CNS except cefuroxime

Question 10

Ceftiaxone, cefotaxime, cefdinir, and cefixime

Answer 10

3rd Generation
gram + and - cocci, gram - rods
used for empiric management of meningitis and sepsis
Can enter CNS except cefoperazone

Question 11

Cefepime

Answer 11

4th generation

Wide activity on Pseudomonas and gram + organisms

Question 12

Ceftaroline

Answer 12

5th Generation

broad gram + and - organism, MRSA does not cover pseudomonas

Question 13

Cephalosporin Side Effect

Answer 13

Hypersensitive reaction, Vit K deficiency, inc. nephrotoxicity of aminoglycosides

Question 14

Imipenem and Meropenem

Answer 14

Carbapenems class
Resistant of Beta lactamases
Targets: Gram + cocci, gram - rods, and anaerobes

Question 15

Cilastatin

Answer 15

a renal dehydropeptidase inhibitor which inhibits imipenem’s metabolism to a nephrotoxic metabolite

Question 16

Carbapenems Side Effects

Answer 16

GI distress, skin rash, CNS effects (seizures), fever

Question 17

Aztronam

Answer 17

Resistant to beta lactamases

Target: gram - rods

Question 18

Vancomycin

Answer 18

Mechanism: Inhibits cell wall peptidoglycan formation by binding D-ala D-ala portion of cell wall precursors.
Bactericidal
Targets: Gram + only, MRSA, enterococci, Clostridium difficile
Resistance: change in D-ala D-ala to D-ala D-lac

Question 19

Vancomycin Side Effect

Answer 19

Red man syndrome: histamine release leads to flushing

Ototoxicity, Nephrotoxicity `

Question 20

1st generation cephalosporins

Answer 20

cefazoliln, cephalexin

Question 21

2nd generation cephalosporins

Answer 21

Cefotetan, cefaclor, cefuroxime, cefoxitin

Question 22

3rd generation cephalosporins

Answer 22

Ceftiaxone, cefotaxime, cefdinir, and cefixime

Question 23

4th generation cephalosporins

Answer 23

Cefepime

Question 24

5th generation cephalosporins

Answer 24

Ceftaroline