beta-lactam: other drugs

Question 1

Is vancomycin absorbed orally?

Answer 1

no

Question 2

Bactericidal glycoprotein

Answer 2

A. VANCOMYCIN

Question 3

Binds to the D-Ala-D-Ala terminal of the nascent peptidoglycan pentapeptide side chain

Answer 3

A. VANCOMYCIN

Question 4

Inhibits transglycosylation

Answer 4

A. VANCOMYCIN

Question 5

Prevents elongation of peptidoglycan chain

Answer 5

A. VANCOMYCIN

Question 6

Interferes with cross-linking

Answer 6

A. VANCOMYCIN

Question 7

Spectrum of activity of VANCOMYCIN

Answer 7

Narrow

Question 8

what is the tissue penetration of vancomycin when given IV?

Answer 8

Wide:Penetrates most tissues

Question 9

Drug that is eliminated unchanged in urine

Answer 9

vancomycin

Question 10

• Rapid IV infusion of vancomycin may cause diffuse blushing called


Answer 10

“Red man syndrome”

Question 11

Cause of “Red man syndrome”

Answer 11

Rapid IV infusion of vancomycin

Question 12

Toxic effects of vancomycin

Answer 12

	Chills
	Fever
	Phlebitis
	Ototoxicity
	Nephrotoxicity

Question 13

 Antimetabolite inhibitor of cytosolic enolpyruvate transferase

Answer 13

fosfomycin

Question 14

Prevents the formation of N- acetylmuramic acid which is essential in peptidoglycan chain formation

Answer 14

fosfomycin

Question 15

fosfomycin Prevents the formation of ————– which is essential in peptidoglycan chain formation

Answer 15

N- acetylmuramic acid

Question 16

essential in peptidoglycan chain formation

Answer 16

N- acetylmuramic acid

Question 17

In a single dose, drug is less effective than the 7-day course of treatment with fluoroquinolones

Answer 17

fosfomycin

Question 18

Multiple dosing of this drug can result to resistance rapidly

Answer 18

fosfomycin

Question 19

Diarrhea is common with this drug

Answer 19

fosfomycin

Question 20

common toxicity of fosfomycin

Answer 20

diarrhea

Question 21

fosfomycin is synergistic with (2) drugs in specific infections

Answer 21

beta-lactam and quinolones

Question 22

Excreted in the kidney with urinary levels exceeding the minimum inhibitory concentration (MIC) for many urinary tract pathogens

Answer 22

fosfomycin

Question 23

mode of excretion for fosfomycin

Answer 23

kidney

Question 24

Resistance to this drug occurs via decreased intracellular accumulation of the drug

Answer 24

fosfomycin

Question 25

Peptide antibiotic

Answer 25

C. BACITRACIN

Question 26

Interferes with a late stage in cell wall synthesis in gram (+) organisms

Answer 26

C. BACITRACIN

Question 27

Limited to topical use only

Answer 27

C. BACITRACIN

Question 28

toxicity of bacitracin

Answer 28

nephrotoxicity

Question 29

 Antimetabolite

Answer 29

cycloserine

Question 30

Blocks the incorporation of D-Ala into the pentapeptide side chain of the peptidoglycan

Answer 30

cycloserine

Question 31

Used only in TB caused by organisms resistant to first-line antituberculous drugs

Answer 31

cycloserine

Question 32

2nd line anti-TB drugs

Answer 32

cycloserine

Question 33

Potentially neurotoxic  Tremors  Seizure  Psychosis

Answer 33

cycloserine

Question 34

Used in fixed combination with certain hydrolyzable penicillins Effective against plasmid-encoded beta-lactamases

Answer 34

CLAVULANIC ACID, SULBACTAM, and TAZOBACTAM

Question 35

carbapenem with  Long half-life  Less active against pseudomonas  IM injection causes pain and irritation

Answer 35

ERTAPENEM

Question 36

 Similar to imipenem  Not metabolized by renal dehydropeptidases  Less likely to cause seizure

Answer 36

MEROPENEM

Question 37

advantage of meropenem to imipenem

Answer 37

 Not metabolized by renal dehydropeptidases |  Less likely to cause seizure

Question 38

 Rapidly inactivated by renal dehydropeptidases I

Answer 38

imipenem

Question 39

enzyme that inactivates imipenem

Answer 39

renal dehydropeptidases I

Question 40

 Administered in combination imipenem |  Inhibits formation of nephrotoxic metabolites

Answer 40

 Cilastatin

Question 41

Inhibitor of the enzyme renal dehydropeptidases I

Answer 41

cilastatin

Question 42

Increases the half-life of imipenem

Answer 42

 Cilastatin

Question 43

 Adverse effects of imipenem-cilastatin

Answer 43

 GI distress  Skin rash  At very high plasma levels, CNS toxicity  Confusion, encephalopathy, seizures

Question 44

drug of choice for enterobacter

Answer 44

imipenem

Question 45

 Chemically different from penicillins |  Retain the beta-lactam ring

Answer 45

carbapenems

Question 46

 Low susceptibility to beta-lactamases

Answer 46

carbapenems

Question 47

 Wide activity against  Gram(+) cocci  Gram (-) rods  Anaerobes

Answer 47

carbapenems

Question 48

 For pseudomonal infections |  Combined with aminoglycosides

Answer 48

carbapenems

Question 49

 Useful for infections caused by organisms resistant to other antibiotics

Answer 49

carbapenems

Question 50

RoA of carbapenems

Answer 50

IV

Question 51

Monobactam

Answer 51

ASTREONAM

Question 52

Resistant to beta-lactamases produced by certain gram (-) rods

Answer 52

ASTREONAM

Question 53

 No activity against gram (+) and anaerobes

Answer 53

ASTREONAM

Question 54

 An inhibitor of cell wall synthesis binding to PBP3

Answer 54

ASTREONAM

Question 55

Synergistic with aminoglycosides

Answer 55

ASTREONAM

Question 56

 Adverse effects of astreonam

Answer 56

```  GI upset with possible superinfection  Vertigo  Headache  Rare hepatotoxicity  Skin rash ```

Question 57

is astreonam bactericidal or bacteriostatic

Answer 57

?

Question 58

is astreonam synergistic with aminoglycosides

Answer 58

yes

Question 59

is astreonam nephrotoxic

Answer 59

no

Question 60

RoA of astreonam

Answer 60

IV

Question 61

Does astreonam have cross-allergenicity with penicillin?

Answer 61

none

Question 62

Does imipenem have cross-allergenicity with penicillin?

Answer 62

yes but PARTIAL only

Question 63

elimination of astreonam

Answer 63

renal tubular secretion

Question 64

half-life of astreonam is prolonged when

Answer 64

if person has renal failure