OTHER BETA LACTAM ANTIBIOTICS Flashcards

1
Q

It is a monobactam that is resistant to beta-lactamases produced by certain gram-negative rods, including Klebsiella, Pseudomonas, and Serratia

A

Aztreonam

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2
Q

The drug has no activity against gram- positive bacteria or anaerobes.

A

Aztreonam

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3
Q

It is an inhibitor of cell wall synthesis, preferentially binding to a specific penicillin-binding protein (PBP3), and is synergistic with aminoglycosides.

A

Aztreonam

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4
Q

Aztreonam is administered via ___?

A

Intravenously

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5
Q

Aztreonam is eliminated via _____?

A

Renal tubular secretion

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6
Q

T or F: Aztreonam has cross-allergenicity with penicillin

A

F, Aztreonam has no cross-allergenicity with penicillin

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7
Q

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

A

e. all of the above

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8
Q

These (4) drugs are CARBAPENEMS (chemically different from penicillins but RETAINING the beta-lactam ring structure) with LOW susceptibility to beta-lactamases.

A

Imipenem, Doripenem, Meropenem, and Ertapenem

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9
Q

CARBAPENEMS drugs have wide activity against ____?

A
  • Gram-negative rods including P. aeruginosa
  • Gram-positive cocci (including penicillin-resistant pneumococci)
    -Anaerobes
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10
Q

It is useful for infections caused by organisms resistant to other antibiotics

A

Imipenem, Doripenem, Meropenem, and Ertapenem (Carbapenems)

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11
Q

Imipenem, Doripenem, Meropenem, and Ertapenem (Carbapenems) is administered via ____ ?

A

IV (parenterally)

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12
Q

For pseudomonal infections, carbapenems drugs are often used in combination with _____?

a. penicillin
b. aminogylcoside
c. cephalosporins
d. amoxicillin

A

b. aminoglycoside

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13
Q

_______ is combined with cilastatin, which inhibits
renal dehydropeptidases

A

Imipenem

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14
Q

______ is currently the co-drugs of choice for infections caused by Enterobacter, Citrobacter, and Serratia species

A

Carbapenems

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15
Q

_______ rapidly inactivated by renal dehydropeptidase I and is administered in fixed combination with cilastatin, an inhibitor of this enzyme

A

Imipenem

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16
Q

_______ increases the plasma half-life of imipenem and inhibits the formation of a potentially nephrotoxic metabolite

A

Cilastrin

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17
Q

T or F: Other carbapenems are not significantly degraded by the kidney

A

T

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18
Q

T or F: Adverse effects of imipenem-cilastatin include gastrointestinal distress and CNS toxicity (confusion, encephalopathy, seizures)

A

T

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19
Q

T or F: Carbapenems have a partial cross-allergenicity with penicillins

A

T

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20
Q

______ similar to imipenem except that it is not metabolized by renal dehydropeptidases and is less likely to cause seizures

A

Meropenem & Doripenem

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21
Q

_______ drug has slightly greater activity against gram (-) aerobes and slightly less activity against gram (+)

A

Meropenem & Doripenem

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22
Q

______ active against enterococci and Pseudomonas, and its intramuscular injection causes pain and irritation.

A

Ertapenem

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23
Q

Type of carbapenem drug which is NOT degraded by renal dehydropeptidase

A

Ertapenem

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24
Q

Type of carbapenem drug which has a long half-life

A

Ertapenem

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25
Type of carbapenem drug which that penetrate in CSF well
Imipenem, Doripenem, Meropenem
26
______ used in fixed combinations with certain hydrolyzable penicillins
Clavulanic acid, sulbactam, and tazobactam (Beta-lactamases inhibitor)
27
______ 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)
28
______ not good inhibitors of inducible chromosomal beta-lactamases formed by Enterobacter, Pseudomonas, and Serratia.
Clavulanic acid, sulbactam, and tazobactam (Beta-lactamases inhibitor)
29
Bactericidal glycoprotein
Vancomycin
30
_____ binds to D-Ala-D-Ala terminal of the nascent peptidoglycan pentapeptide side chain
Vancomycin
31
What is VRE and VRSA?
VRE - Vancomycin-resistant enterococci VRSA - Vancomycin-resistant S. aureus
32
_____ inhibits transglycosylation
Vancomycin
33
It is isolated from the bacterium Amycolatopsis orientalis
Vancomycin
34
______ is a backup drug for treatment of infection caused by Clostridium difficile
Vancomycin
35
Given for bacterial enterocolitis
Vancomycin
36
T or F: Vancomycin is given orally for bacterial enterocolitis
T
37
Similar drugs of Vancomycin
Teicoplanin and Telavancin
38
______ has a narrow spectrum of activity and is used for serious infections caused by drug-resistant gram-positive cocci and anaerobes, including MRSA
Vancomycin
39
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
40
T or F: Dosage modification is not mandatory in patients with renal impairment
F, dosage modification is mandatory
41
Red man syndrome is associated with what drug?
Vancomycin
42
Rapid intravenous infusion may cause diffuse flushing from histamine release The diffuse flushing is an effect called "_____" ?
Red Man Syndrome
43
T or F: Toxic effects of Vancomycin include a. phlebitis b. ototoxicity c. nephrotoxicity d. all of the above
d. all of the above
44
What is PRSP?
PRSP - Penicillin-resistant pneumococci
45
______ is an antimetabolite inhibitor of cytosolic enolpyruvate transferase.
Fosfomycin
46
______ Prevents the formation of N-acetylmuramic acid which is essential in peptidoglycan chain formation
Fosfomycin
47
Coverage of this drug is gram-positive and gram-negative
Fosfomycin
48
T or F: Resistance to fosfomycin occurs via INCREASED intracellular accumulation of the drug
F, DECREASED
49
Fosfomycin is excreted via ____?
kidney
50
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
51
Multiple dosing of Fosfomycin can result to ______ rapidly A. Resistance B. Susceptibility
A. Resistance
52
What is the clinical use of Fosfomycin?
Uncomplicated cystitis (UTI)
53
_____ may be synergistic with beta-lactam and quinolone antibiotics with specific infection
Fosfomycin
54
lipid carrier that transfers peptidoglycan subunits to the growing cell wall What drug has this mechanism of action?
Bacitracin
55
it is a peptide antibiotic that interferes with a late stage in cell wall synthesis in gram-positive organisms.
Bacitracin
56
Obtained from the Tracy strain of Bacillus subtilis in 1943
Bacitracin
57
This drug is marked to have toxicity (nephrotoxicity)
Bacitracin
58
This drug is limited to topical use only
Bacitracin
59
______ antimetabolite that blocks the incorporation of d-Ala into the pentapeptide side chain of the peptidoglycan.
Cycloserine
60
_____ only used to treat tuberculosis caused by organisms resistant to first-line antituberculous drugs.
Cycloserine
61
Produced by Streptomyces orchidaceous
Cycloserine
62
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
63
This drug is potentially neurotoxic
cycloserine
64
Adverse reactions to this drug include: tremors, headaches, acute psychosis and convulsions
cycloserine
65
Fermentation product of Streptomyces roseosporus
daptomycin
66
Coverage of this drug is vancomycin-resistant strains of enterococci and S. aureus (VRE, VRSA)
daptomycin
67
it is a novel cyclic lipopeptide drug with spectrum similar to vancomycin
daptomycin
68
it is active against vancomycin-resistant strains of enterococci and staphylococci
daptomycin
69
daptomycin is eliminated via ____?
kidney
70
Adverse reactions to this drug include: myopathy, allergic pneumonitis in patients receiving prolonged therapy (>2 weeks)
daptomycin
71
______ should be monitored since daptomycin may cause myopathy a. CBC count b. Creatine phosphokinase c. Albumin level d. Glucose
b. Creatine phosphokinase
72
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
73
Daptomycin is active against vancomycin-resistant strains of _______ and _______