OTHER BETA LACTAM ANTIBIOTICS Flashcards
It is a monobactam that is resistant to beta-lactamases produced by certain gram-negative rods, including Klebsiella, Pseudomonas, and Serratia
Aztreonam
The drug has no activity against gram- positive bacteria or anaerobes.
Aztreonam
It is an inhibitor of cell wall synthesis, preferentially binding to a specific penicillin-binding protein (PBP3), and is synergistic with aminoglycosides.
Aztreonam
Aztreonam is administered via ___?
Intravenously
Aztreonam is eliminated via _____?
Renal tubular secretion
T or F: Aztreonam has cross-allergenicity with penicillin
F, Aztreonam has no cross-allergenicity with penicillin
Which of the following are the adverse effects of Aztreonam?
a. Vertigo
b. Rare hepatotoxicity
c. GI upset with possible superinfection
d. Headache
e. All of the above
e. all of the above
These (4) drugs are CARBAPENEMS (chemically different from penicillins but RETAINING the beta-lactam ring structure) with LOW susceptibility to beta-lactamases.
Imipenem, Doripenem, Meropenem, and Ertapenem
CARBAPENEMS drugs have wide activity against ____?
- Gram-negative rods including P. aeruginosa
- Gram-positive cocci (including penicillin-resistant pneumococci)
-Anaerobes
It is useful for infections caused by organisms resistant to other antibiotics
Imipenem, Doripenem, Meropenem, and Ertapenem (Carbapenems)
Imipenem, Doripenem, Meropenem, and Ertapenem (Carbapenems) is administered via ____ ?
IV (parenterally)
For pseudomonal infections, carbapenems drugs are often used in combination with _____?
a. penicillin
b. aminogylcoside
c. cephalosporins
d. amoxicillin
b. aminoglycoside
_______ is combined with cilastatin, which inhibits
renal dehydropeptidases
Imipenem
______ is currently the co-drugs of choice for infections caused by Enterobacter, Citrobacter, and Serratia species
Carbapenems
_______ rapidly inactivated by renal dehydropeptidase I and is administered in fixed combination with cilastatin, an inhibitor of this enzyme
Imipenem
_______ increases the plasma half-life of imipenem and inhibits the formation of a potentially nephrotoxic metabolite
Cilastrin
T or F: Other carbapenems are not significantly degraded by the kidney
T
T or F: Adverse effects of imipenem-cilastatin include gastrointestinal distress and CNS toxicity (confusion, encephalopathy, seizures)
T
T or F: Carbapenems have a partial cross-allergenicity with penicillins
T
______ similar to imipenem except that it is not metabolized by renal dehydropeptidases and is less likely to cause seizures
Meropenem & Doripenem
_______ drug has slightly greater activity against gram (-) aerobes and slightly less activity against gram (+)
Meropenem & Doripenem
______ active against enterococci and Pseudomonas, and its intramuscular injection causes pain and irritation.
Ertapenem
Type of carbapenem drug which is NOT degraded by renal dehydropeptidase
Ertapenem
Type of carbapenem drug which has a long half-life
Ertapenem
Type of carbapenem drug which that penetrate in CSF well
Imipenem, Doripenem, Meropenem
______ used in fixed combinations with certain hydrolyzable penicillins
Clavulanic acid, sulbactam, and tazobactam (Beta-lactamases inhibitor)
______ is the most active against plasmid-encoded beta-lactamases such as those produced by gonococci, streptococci, E coli, and H influenzae.
Clavulanic acid, sulbactam, and tazobactam (Beta-lactamases inhibitor)
______ not good inhibitors of inducible chromosomal beta-lactamases formed by Enterobacter, Pseudomonas, and Serratia.
Clavulanic acid, sulbactam, and tazobactam (Beta-lactamases inhibitor)
Bactericidal glycoprotein
Vancomycin
_____ binds to D-Ala-D-Ala terminal of the nascent peptidoglycan pentapeptide side chain
Vancomycin
What is VRE and VRSA?
VRE - Vancomycin-resistant enterococci
VRSA - Vancomycin-resistant S. aureus
_____ inhibits transglycosylation
Vancomycin
It is isolated from the bacterium Amycolatopsis orientalis
Vancomycin
______ is a backup drug for treatment of infection caused by Clostridium difficile
Vancomycin
Given for bacterial enterocolitis
Vancomycin
T or F: Vancomycin is given orally for bacterial enterocolitis
T
Similar drugs of Vancomycin
Teicoplanin and Telavancin
______ has a narrow spectrum of activity and is used for serious infections caused by drug-resistant gram-positive cocci and anaerobes, including MRSA
Vancomycin
Vancomycin is used in combination with a third-generation cephalosporin for treating infection due to penicillin-resistant pneumococci (PRSP).
What type of third-generation drug is this?
Ceftriaxone
T or F: Dosage modification is not mandatory in patients with renal impairment
F, dosage modification is mandatory
Red man syndrome is associated with what drug?
Vancomycin
Rapid intravenous infusion may cause diffuse flushing from histamine release
The diffuse flushing is an effect called “_____” ?
Red Man Syndrome
T or F: Toxic effects of Vancomycin include
a. phlebitis
b. ototoxicity
c. nephrotoxicity
d. all of the above
d. all of the above
What is PRSP?
PRSP - Penicillin-resistant pneumococci
______ is an antimetabolite inhibitor of cytosolic enolpyruvate transferase.
Fosfomycin
______ Prevents the formation of N-acetylmuramic acid which is essential in peptidoglycan chain formation
Fosfomycin
Coverage of this drug is gram-positive and gram-negative
Fosfomycin
T or F: Resistance to fosfomycin occurs via INCREASED intracellular accumulation of the drug
F, DECREASED
Fosfomycin is excreted via ____?
kidney
In a single dose of Fosfomycin, the drug is ______ effective than 7-day course of treatment with ______?
a. more; Ceftriaxone
b. less; Cefaclor
c. more; Moxalactam
d. less; Fluoroquinolones
d. less; Fluoroquinolones
Multiple dosing of Fosfomycin can result to ______ rapidly
A. Resistance
B. Susceptibility
A. Resistance
What is the clinical use of Fosfomycin?
Uncomplicated cystitis (UTI)
_____ may be synergistic with beta-lactam and quinolone antibiotics with specific infection
Fosfomycin
lipid carrier that transfers peptidoglycan subunits to
the growing cell wall
What drug has this mechanism of action?
Bacitracin
it is a peptide antibiotic that interferes with a late stage in cell wall synthesis in gram-positive organisms.
Bacitracin
Obtained from the Tracy strain of Bacillus subtilis in 1943
Bacitracin
This drug is marked to have toxicity (nephrotoxicity)
Bacitracin
This drug is limited to topical use only
Bacitracin
______ antimetabolite that blocks the incorporation of d-Ala into the pentapeptide side chain of the peptidoglycan.
Cycloserine
_____ only used to treat tuberculosis caused by organisms resistant to first-line antituberculous drugs.
Cycloserine
Produced by Streptomyces orchidaceous
Cycloserine
inhibits incorporation of d-alanine into peptidoglycan
pentapeptide by inhibiting alanine racemase, which converts l-alanine to d-alanine, and d-alanyl-d-alanine ligase
What drug has this mechanism of action?
Cycloserine
This drug is potentially neurotoxic
cycloserine
Adverse reactions to this drug include: tremors, headaches, acute psychosis and convulsions
cycloserine
Fermentation product of Streptomyces roseosporus
daptomycin
Coverage of this drug is vancomycin-resistant strains of enterococci
and S. aureus (VRE, VRSA)
daptomycin
it is a novel cyclic lipopeptide drug with spectrum similar to vancomycin
daptomycin
it is active against vancomycin-resistant strains of enterococci and staphylococci
daptomycin
daptomycin is eliminated via ____?
kidney
Adverse reactions to this drug include: myopathy, allergic pneumonitis in patients receiving prolonged therapy (>2 weeks)
daptomycin
______ should be monitored since daptomycin may cause myopathy
a. CBC count
b. Creatine phosphokinase
c. Albumin level
d. Glucose
b. Creatine phosphokinase
T or F: Daptomycin is also used to treat pneumonia together with cycloserine
F, it should not be used to treat pneumonia since Pulmonary surfactant antagonizes daptomycin
Daptomycin is active against vancomycin-resistant strains of _______ and _______
