Kaplan- Antibacterial Agents

Question 1

Which organism is treated with the synergistic regimen of penicillins + amino glycosides

Answer 1

Enterococci or Pseudomonas aeruginosa

Question 2

Example of antagonistic effect = Penicillins + ______ to treat _____.

Answer 2

tetracyclines ; pneumococcal meningitis

Question 3

Penicillins are ________ of cell wall synthesis.

Answer 3

bactericidal inhibitors

Question 4

mechanism of resistance w. penicillin

Answer 4

Penicillinase (beta-lactamases) break lactam ring structure
Structural cahngs in PBPs
Change in porin structure

Question 5

Penicillin Resistance to this organism? is caused by penicillinases (beta-lactamases) breaking lactam ring structure

Answer 5

Staphylococci

Question 6

Penicilin Resistance to this organism? is caused by structural change in PBPs

Answer 6

methicillin-resistance Staphylococcus aureus [MRSA] , penicillin-resistant pneumococci

Question 7

Penicillin REsistance to this organism? is caused by change in porin structure

Answer 7

Pseudomonas

Question 8

Penicillin G active verses

Answer 8

1. Streptococci
2. Pneumococci (increased resistance)
3. Meningococci
4. Treponema pallidum

Question 9

Penicillin V active verses

Answer 9

Steptococci

oral pathogens

Question 10

oral, or IV extended spectrum penicillin

Answer 10

Ampicillin

Question 11

oral extended spectrum penicillin

Answer 11

Amoxicillin

Question 12

What are the extended spectrum penicillin antibiotics formulated w.

Answer 12

(ampicillin or amoxicillin) with clavulanic acid or sulbactam

Question 13

Ampicillin and Amoxicillin active verses

Answer 13

Gram + cocci (except MRSA)
E. Coli
H. influenzae

Question 14

What is Ampicillin active against that amoxicillin is not

Answer 14

Listeria monocytogense

Question 15

Amoxicillin is also used for back up drug in _____ and to eradicate ______

Answer 15

Lyme disease

H. pylori in GI ulcers

Question 16

increased activity verses gram negative rods compared to the other pencillins

Answer 16

Ticarcillin (Ticar)

Question 17

Ticarcillin (Ticar) is active verses

Answer 17

Psudomonas aeruginosa and other gram - rods

Question 18

How is activity of Ticarcillin enhanced

Answer 18

penicillinase inhibiors clavulanic acid or tazobactam

Question 19

Timentin is what combo

Answer 19

Ticarcillin + clavulanate potassium

Question 20

penicillin + aminogycosides is active verses

Answer 20

enterococci and psudomonal species

Question 21

how are most penicillins secreted? half life?

Answer 21

active tubular secretion w. half life < 60 min

Question 22

Which penicillins are largely eliminated in bile?

Answer 22

Nafcillin and oxacillin

Question 23

Which penicillin undergoes enterohepatic cycling, but is excreted by kidneys?

Answer 23

Ampicillin

Question 24

which penicillin is a repository form w. a half life of 2 wks?

Answer 24

Benzathine penicillin G

Question 25

When is dose reduction needed w. penicillins?

Answer 25

major renal dysfunction

Question 26

Common adverse effects of penicillins

Answer 26

Urticarial skin rash | severe anaphylaxis is possible

Question 27

Common side effete of methicillin

Answer 27

Interstitial Nephritis

Question 28

T/F Assume complete cross-allergenicity between individual penicillins

Answer 28

true

Question 29

GI distress (NVD) is especially assoc with what penicillin

Answer 29

ampicillin

Question 30

What is a common reaction in treatment of syphilis

Answer 30

Jarish-Herxheimer reaction

Question 31

What is common adverse effect of ampicillin

Answer 31

maculopapular rash

Question 32

common adverse effect of methicillin

Answer 32

interstitial nephritis

Question 33

Name 3 first generation Cephalosporins

Answer 33

Cefadroxil (Duricef) Cefazolin (Ancef, Kefzol) Cephalexin (Keflex)

Question 34

What do first generation cephalosporins protect against

Answer 34

Gram + Cocci (except MRSA) E. coli Klebsiella pneumoniae some proteus species

Question 35

common use of cephalosporins is

Answer 35

surgicla prophylaxis

Question 36

which cephalosporins enter the CNS

Answer 36

NONE

Question 37

Second generation cephalosporins active verses

Answer 37

increased gram - coverage including some anaerobes

Question 38

Bacteroidesfragilis is covered w. which cephalosporin

Answer 38

Cefotetan (Cefotan)

Question 39

H. influenzae & Moraxella entarrhalis is covered by which cephalosporin

Answer 39

Cefaclor

Question 40

Third generation cephalosporins active verses

Answer 40

gram + & gram - cocci, plus many gram - rods

Question 41

Which third generation cepaholsporin does NOT enter the CNS?

Answer 41

cefoperazone

Question 42

What are 3rd generation cephalosporins important in empire management of

Answer 42

meningitis and sepsis

Question 43

treatment of gonorrhea

Answer 43

ceftriaxone (Rocephin) (IM) and cefixime (Suprax) (PO) used in single dose

Question 44

cephalosporin active against most most bacteria causing meningitis

Answer 44

cefotaxime (Claforan)

Question 45

3rd generation Cephalosporin active agianst B. fragilis

Answer 45

Ceftizoxime (Cefizox)

Question 46

name what most Fourth gerneation cephalosporins active against also name a specific antibiotic in this class

Answer 46

resistant to most beta-lactamases - Cefepime (IV)

Question 47

Cephalosporins renal clearance similar to penicillins, with active tubular secretion blocked by ______.

Answer 47

probenecid

Question 48

Dose modification in renal dysfunction, except _____ & _____, which is largely eliminated in the bile.

Answer 48

Cefoperazone & Ceftriaxone

Question 49

Most authorities recommend avoiding cephalosporins in patients allergic to penicillins. For gram + organisms recommend _____. For gram - rod organisms recommend _____.

Answer 49

+ macrolide | - rods aztreonam

Question 50

Cefotetan, Cefoperazone, Cefamandole, Moxalactam cause

Answer 50

Hypoprothrombinema | & disulfiram-like-interactions w. ethanol

Question 51

Adverse effect of IV injection of cephalosporins

Answer 51

phlebitis

Question 52

IM adverse effect of cephalosporins

Answer 52

pain