Lecture 62 - Cephalosporins/Vancomycin/Streptogramin

Question 1

Remember that Celphalosporin is a ___-______, just like Streptomycin. So which protein does it act on to inhibit cell wall synthesis?

Answer 1

Beta-lactam

PBP (penicillin binding protein)

Question 2

First gen Cephalosporins are good substitutes for Pen G, so they work well agains Gram ____ bacteria. Trending toward second and third gens moves more and more toward effectiveness against Gram _____. In general, third generation are more resistant to ____-______.

Answer 2

Gram +

Gram -

Beta-Lactamases

Question 3

Cephalosporins, like disulfiram, should not be taken with alcohol, as this can lead to headache, nausea, and ______ (kind of like a bad hangover.)

Answer 3

Vomitting

Question 4

First gen Cephalosporins can be given both ____ and ____. The same is true for Second gen, which have enhanced efficacy against Gram ____ bacteria.

Answer 4

Orally and IV

Gram -

Question 5

If a third gen Cephalosporin that can be given ORALLY is needed, ______ is the go to. If it does not need to be oral, ______ is the one. Which one can cross the BBB to achieve significant levels in the CNS? Keep in mind this means it would be the drug of choice for bacterial ______ (caused by S. pneumoniae and/or N. meningitidis.)

Answer 5

Cefdinir

Ceftriaxone

Ceftriaxone can cross the BBB

Meningitis

Question 6

______ is a fourth gen Cephalosporin that is good against BOTH Gram + and Gram -. It is administered IV, and has enhanced resistance to ___-_______ over third gen. It is a very common for treatment of febrile _______.

Answer 6

Cefepime

Beta-lactamases

Neutropenia

Question 7

_______ is a fifth gen Cephalosporin that covers both methicilin sensitive and resistant Staph aureus.

Answer 7

Ceftaroline

Question 8

Cefiderocol is a new cephalosporin prescribed to patients over ____ years old as a last line defense against Gram ____ UTIs.

Answer 8

18 years old

Gram -

Question 9

How is vancomycin typically administered? It does not cross the _____, and is effective again Gram _____ only. For patients with enterococcal endocarditis who are allergic to Penicillin, Vancmycin + ______ should be administered. For patients with highly penicillin-resistant pneumococcal meningitis, Vancomycin + _______ should be administered.

Answer 9

IV

BBB

Gram +

Gentamycin

Ceftriaxone

Question 10

____ man syndrome is a possible adverse event of Vancomycin. It causes the release of histamine, causing hypotension and erythema of the face and upper trunk.

Answer 10

Red man syndrome

Question 11

_______ is a combination of quinupristin and dalfopristin. The act by binding the ____S subunit of the bacterial Ribosome and inhibit protein synth. Individually, these drugs are bacterio_____, but together they are bacterio____. This combo drug MUST be given ____, and it is given for multi-drug resistant infections, particularly vancomycin resistant E. faecium and MRSA.

Answer 11

Streptogramin

50S

BacterioSTATIC

BacterioCIDAL

IV