Misc. B- lactamase

Question 1

Aztreonam

Answer 1

monobactam
active only against G-
resists most b- lactamase of G-

Question 2

Mechanism of Aztreonam

Answer 2

binds to PBP-3 creating long unstable filamentous bacteria that will lyse

Question 3

IV/ IM Aztreonam

Answer 3

Excreted unchanged in urine - adjust dose for renal failure. Crosses inflamed meninges

Question 4

What is vancomycin used for?

Answer 4

IV for MRSA or non resistant staph if allergic to B- lactamas
not absorbed orally
used for pseudomem colittis

Question 5

Side effects of Vancomycin?

Answer 5

Red man syndrome: flushing of upper body & face, hypotension, tachycardia & shock. MECHANISM: histamine release (a vasodilator)

Ototoxicity (renal failure; permanent)

Nephrotoxicity (can be reversed)

Question 6

Mechanism for vancomycin

Answer 6

binds to d-ala dala terminus and prevents removal of d-ala

Question 7

Telavancin

Answer 7

dervied from vancomysin
also binds to d-ala d-ala (inhibits crosslinking)
disrupts membrane= causes lysis
works against gram positive
SE: NVD, foamy urine, taste disturbance
CAution for preg. teratogenetic (hand or extra finger or something)

Question 8

Oritavancin

Answer 8

3 mechanisms:
- binds stem peptide of peptidoglycan (inhibits poilymerization)
- binds peptide bridging segments- inhibits corsslinking
- disrupts membrane integrity- depolatization cell death
SQ absesses
wait 48 hours befor taking heparin

Question 9

Bacitracin

Answer 9

topical cuts scrapes
nephrotixic
P-P
NAM

Question 10

FOSFOMYCIN

Answer 10

uncomplicated UTIs in women

: Inhibits enolpyruvate transferase blocking the addition of phosphoenolpyruvate to UDP-N-acetylglucosamin