lect 14: inhib cell wall syn II

Question 1

what is the mechanism of action of cephalosporins

Answer 1

activate cell wall autolytic enzymes through blocking terminal cross-linking of peptidoglycan

Question 2

structure of cephalosporins

Answer 2

beta-lactam ring structure

Question 3

what is cephalosporins advantage over penicillins

Answer 3

cephalosporins have a R group that increases their resistance to B-Lactamase

Question 4

what is the prototype first generation cephalosporins

Answer 4

cefazolin

Question 5

what group is cefazolin in

Answer 5

first generation cephalosporins

Question 6

what group is cephalexin in

Answer 6

first generation cephalosporins

Question 7

route of administration of cefazolin

Answer 7

parenteral

Question 8

route of administration of cephalexin

Answer 8

oral

Question 9

what do first generation cephalosporins target

Answer 9

• G+; G-
• most G+ cocci are susceptible

Question 10

what group of cephalosporins can be used for MSSA

Answer 10

first generation cephalosporins

Question 11

what is the DOC for surgical prophylaxis

Answer 11

Cefazolin (first generation cephalosporin)

Question 12

what do second generation cephalosporins target

Answer 12

• G+
• increased G- activity

Question 13

what can second generation cephalosporins not work on

Answer 13

no antipseudomonal activity

Question 14

what group is cefaclor in

Answer 14

second generation cephalosporins

Question 15

what group is cefuroxime in

Answer 15

second generation cephalosporins

Question 16

what group is cefprozil in

Answer 16

second generation cephalosporins

Question 17

what is the prototype second generation cephalosporins

Answer 17

Cefaclor

Question 18

which of the second generation cephalosporins can be administered parenterally

Answer 18

Cefuroxime

*the other two are administered orally

Question 19

which of the cephalosporins are broad spectrum

Answer 19

third generation cephalosporins

Question 20

what group is ceftriaxone (Rocephin) in

Answer 20

third generation cephalosporins

Question 21

what group is Cefotaxime sodium (Claforan) in

Answer 21

third generation cephalosporins

Question 22

which group is Ceftazidime (fortaz) in

Answer 22

third generation cephalosporins

Question 23

which group is cefixime in

Answer 23

third generation cephalosporins

Question 24

what is the only third generation cephalosporin that is administered orally

Answer 24

Cefixime

Question 25

which two third generation cephalosporins are able to **penetrate the CNS**

Answer 25

* Ceftriaxone * Cefotaxime sodium

Question 26

what is the prototype third generation cephalosporins

Answer 26

Ceftriaxone

Question 27

which organism is Ceftriaxone specifically used against?

Answer 27

Neisseria

Question 28

what organism is Ceftazidime specifically used against

Answer 28

Pseudomonas Aeruginosa

Question 29

DOC of N. Gonorrhoeae? When should you not use it though?

Answer 29

Ceftriaxone \*avoid use in neonates, biliruben displacement

Question 30

what is the one fourth generation cephalosporins

Answer 30

Cefepime (Maxipime)

Question 31

what is the route of administration of Cefepime?

Answer 31

IV

Question 32

what does fourth generation cephalosporins (Cefepime) cover?

Answer 32

* antipseudomonal * better G+ coverage * Broadest coverage

Question 33

What is the only "Unnamed" "Fifth" generation cephalosporin

Answer 33

Ceftaroline Fosamil

Question 34

What is the route of administration of Ceftaroline Fosamil

Answer 34

IV

Question 35

what does "Unnamed" "Fifth" generation cephalosporin specifically NOT cover

Answer 35

No antipseudomonal activity

Question 36

what does "Unnamed" "Fifth" generation cephalosporin (Ceftaroline fosamil) cover

Answer 36

**MRSA and VRSA** \* _only beta lactame active_ against MRSA

Question 37

DOC for Moraxella catarrhalis

Answer 37

second or third generation Cephalosporins

Question 38

DOC for Neisseria Gonorrhoeae

Answer 38

Ceftriaxone

Question 39

DOC for E. coli; Klebsiella; Proteus infection

Answer 39

first or second generation Cephalosporins

Question 40

DOC for salmonella infection

Answer 40

third generation Cephalosporins

Question 41

DOC for penicillin resistant Steprococcus pneumoniae

Answer 41

Ceftriaxone

Question 42

DOC Borrelia Burgdorferi (late disease)

Answer 42

Ceftriaxone

Question 43

Toxicity of Cephalosporins

Answer 43

* superinfection * Allergy * Diarrhea * Disulfiram-like reaction * dose dependent renal tubular necrosis

Question 44

what reaction can occur when a person taking Cephalosporins drinks alcohol

Answer 44

Disulfiram-like reaction

Question 45

If a patient is allergic to PCN, would you hesitate giving a Cephalosporin

Answer 45

* yes, there is a 10% cross sensitivity with PCN

Question 46

What is the sole Monobactam drug

Answer 46

Aztreonam (Azactam)

Question 47

coverage of Aztreonam (Azactam)

Answer 47

* **only** against **aerobic G-** (pseudomonas, serratia, klebsiella, proteus) * no activity against G+ * no cross sensitivity with other B-lactams

Question 48

What group is Imipenem in

Answer 48

Carbapenems

Question 49

What group is Meropenem (Merrem) in

Answer 49

Carbapenems

Question 50

What group is Entrapenem (Invanz) in

Answer 50

Carbapenems

Question 51

Imipenem must be adminstered with what

Answer 51

Cilastatin

Question 52

route of adminstration of Imipenem and Meropenem

Answer 52

* IV

Question 53

coverage of Imipenem and Meropenem

Answer 53

* broad spectrum : anaerobes, G+, G-

Question 54

what can Imipenem cause that you should be weary of

Answer 54

seizures

Question 55

DOC for B-lactamase producing Enterobacter infections

Answer 55

Imipenem and Meropenem

Question 56

MOA of Vancomycin

Answer 56

* prevents transpeptidation of the peptidoglycan chain-binds to the terminal D-ala-D-ala \* cell wall inhibitor that is not a B-lactams \* bactericidal

Question 57

coverage of Vancomycin

Answer 57

* **MRSA** * G+ in PCN-allergic patients

Question 58

route of administration of Vancomycin when treating superinfections caused by staphylococcus and c-diff

Answer 58

orally

Question 59

Adverse effects of Vancomycin

Answer 59

* Ototoxic * Nephrotoxic * "red man" syndrome: flushing from histamine release (not a hypersensitivity reaction)

Question 60

mechanism of action of Fosfomycin (Monurol)

Answer 60

inhibits cell wall synthesis at one of the first steps in the synthesis of peptidoglycan-prevents NAG to NAM reduction

Question 61

coverage of Fosfomycin (Monurol)

Answer 61

* G+ * G-

Question 62

MOA of Bacitracin

Answer 62

interferes with final dephosphorylation step in the phospholipid carrier cycle; can't transport NAG-NAM across the inner membrane

Question 63

coverage of Bacitracin

Answer 63

* **G+** * often used in combo with neomycin and polymyxins (G- coverage) \*\*Neosporin: topical

Question 64

toxicity of Bacitracin

Answer 64

nephrotoxicity (therefore rarely used parenterally)