Beta-Lactams II Miscellaneous Peptide Antibiotics Lecture Objectives
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Which 2nd generation cephalosporin is commonly used for surgical prophylaxis and endocarditis?

  • Cefotaxime
  • Ceftriaxone
  • Cefuroxime axetil (Ceftin) (correct)
  • Cefixime

    • Which subclass of 2nd generation cephalosporins is effective against Neisseria gonorrhoeae, Bacteroides fragilis, and Clostridium perfringens?

  • Cefprozil
  • Cefoxitin (Mefoxin) (correct)
  • Cefotaxime
  • Cefdinir

    • Which cephalosporin is associated with extended gram-negative activity in addition to its 1st generation spectrum?

  • Ceftriaxone (correct)
  • Cefotetan
  • Cefuroxime axetil (Ceftin)
  • Cefprozil

    • For which condition is Cefixime (Suprax) particularly effective among the listed cephalosporins?

    <p>Gonorrhea</p> Signup and view all the answers

    Which cephalosporin is classified as 5th generation and is effective against MRSA, VISA, and VRSA?

    <p>Ceftaroline fosamil (Teflaro)</p> Signup and view all the answers

    What adverse effect is commonly associated with cephalosporins as a class of antibiotics?

    <p>Hypersensitivity reactions</p> Signup and view all the answers

    What is the route of administration for Benzathine penicillin G (Bicillin L-A)?

    <p>Intramuscular (i.m.)</p> Signup and view all the answers

    Which type of penicillin is specifically used against Pseudomonas infections?

    <p>Antipseudomonal penicillin</p> Signup and view all the answers

    What is the primary mechanism of physiological action of beta-lactam antibiotics?

    <p>Disruption of cell wall synthesis</p> Signup and view all the answers

    Which type of penicillin is effective against methicillin-resistant Staphylococcus aureus (MRSA)?

    <p>Antistaphylococcal penicillins</p> Signup and view all the answers

    What is the common route of administration for Penicillin V?

    <p>Oral (p.o.)</p> Signup and view all the answers

    Which bacterial species is NOT included in the list of organisms mentioned in the text?

    <p>Neisseria gonorrhoeae</p> Signup and view all the answers

    Which class of antibiotics is described as having the 'broadest spectrum' in the text?

    <p>Penicillins</p> Signup and view all the answers

    Which of the following is NOT a mechanism of action of $eta$-lactam antibiotics described in the text?

    <p>Inducing cell lysis</p> Signup and view all the answers

    Which of the following infections is NOT listed as a common indication for the use of piperacillin/tazobactam sodium (Zosyn)?

    <p>Endocarditis</p> Signup and view all the answers

    Which characteristic of first-generation cephalosporins, such as cephalexin (Keflex) and cefazolin, is described in the text?

    <p>Activity against Staphylococci, streptococci, and pneumococci</p> Signup and view all the answers

    Which bacterial enzyme is responsible for inactivation by b-lactam antibiotics?

    <p>Penicillinase</p> Signup and view all the answers

    What is the contraindication for using most b-lactam antibiotics?

    <p>Previous b-lactam allergy</p> Signup and view all the answers

    Which antibiotic is not cross-allergenic with other b-lactams?

    <p>Aztreonam</p> Signup and view all the answers

    What is the mechanism of action of vancomycin?

    <p>Inhibits peptidoglycan polymerization</p> Signup and view all the answers

    What is a common side effect of carbapenems?

    <p>Seizures</p> Signup and view all the answers

    How does probenecid affect the renal excretion of penicillins and cephalosporins?

    <p>Inhibits renal tubular secretion</p> Signup and view all the answers

    Which of the following is the primary spectrum of activity for penicillin G (Pen G)?

    <p>Non-penicillinase producing gram-positive bacteria, spirochetes, and meningococci</p> Signup and view all the answers

    Which of the following penicillins is specifically designed for activity against staphylococci and streptococci?

    <p>Nafcillin</p> Signup and view all the answers

    Which of the following penicillin combinations is effective against both gram-positive and gram-negative bacteria?

    <p>Ampicillin/sulbactam sodium (Unasyn)</p> Signup and view all the answers

    Which of the following infections can be treated with penicillin G (Pen G)?

    <p>Syphilis and endocarditis</p> Signup and view all the answers

    Which of the following penicillins has increased activity against gram-negative bacteria compared to penicillin G?

    <p>Amoxicillin/potassium clavulanate (Augmentin, Augmentin XR)</p> Signup and view all the answers

    What is the primary target site for beta-lactam antibiotics like penicillins and cephalosporins?

    <p>Penicillin-binding proteins (PBPs)</p> Signup and view all the answers

    Which of the following penicillin derivatives has the broadest spectrum of activity against gram-negative bacteria?

    <p>Piperacillin</p> Signup and view all the answers

    Which of the following is a common side effect associated with the use of beta-lactam antibiotics like penicillins and cephalosporins?

    <p>Hypersensitivity reactions</p> Signup and view all the answers

    What is the primary mechanism of action of beta-lactam antibiotics like penicillins and cephalosporins?

    <p>Inhibition of peptidoglycan cell wall synthesis</p> Signup and view all the answers

    Which of the following penicillins is specifically used for the treatment of oral and pharyngeal infections?

    <p>Penicillin V</p> Signup and view all the answers

    Which of the following is a key characteristic of the bactericidal activity of beta-lactam antibiotics?

    <p>Time-dependent bactericidal activity</p> Signup and view all the answers

    Which factor is NOT considered when selecting the most appropriate antibiotic for a given infection?

    <p>Effect on natural flora</p> Signup and view all the answers

    Which natural barrier limits the penetration of antibiotics to the site of infection?

    <p>Lipid solubility</p> Signup and view all the answers

    Which category of antimicrobial agents treats a wide variety of microbial species?

    <p>Broad Spectrum</p> Signup and view all the answers

    What can lead to superinfection by altering the nature of natural flora?

    <p>Broad-spectrum antibiotics</p> Signup and view all the answers

    Which host factor can cause an antibiotic to accumulate to toxic levels in the body?

    <p>Hepatic dysfunction</p> Signup and view all the answers

    Which microorganism group does isoniazid specifically act against?

    <p>Mycobacteria</p> Signup and view all the answers

    Which of the following statements about extended-spectrum penicillins (aminopenicillins) is correct?

    <p>They have an amino group added to the penicillin structure, increasing activity against Gram-negative bacteria.</p> Signup and view all the answers

    Which of the following bacterial infections would NOT be effectively treated by benzathine penicillin G (Bicillin L-A)?

    <p>Endocarditis caused by Staphylococcus aureus</p> Signup and view all the answers

    Which of the following statements about penicillin V is INCORRECT?

    <p>It is effective against Staphylococcus aureus infections.</p> Signup and view all the answers

    Which of the following statements regarding antistaphylococcal penicillins is correct?

    <p>They are the drugs of choice for skin and soft tissue infections due to their activity against staphylococci and streptococci.</p> Signup and view all the answers

    Which of the following statements about the spectrum of activity of penicillin G is INCORRECT?

    <p>It has activity against Gram-negative bacteria like Proteus mirabilis and Escherichia coli.</p> Signup and view all the answers

    Which of the following statements regarding the administration of benzathine penicillin G (Bicillin L-A) is correct?

    <p>It is a depot formulation that releases the drug slowly over time after intramuscular injection.</p> Signup and view all the answers

    What is the primary mechanism that confers resistance to vancomycin in VRSA strains?

    <p>Modification of the vancomycin binding site</p> Signup and view all the answers

    Which antibiotic class is known to concentrate in breast milk and is therefore contraindicated during nursing?

    <p>Tetracyclines</p> Signup and view all the answers

    Which of the following is a mechanism of resistance to macrolides in gram-positive bacteria?

    <p>Altered target site (50S subunit)</p> Signup and view all the answers

    What is the primary reason for the synergistic activity observed when aminoglycosides are combined with cell wall inhibitors?

    <p>The combined effect disrupts both protein synthesis and cell wall synthesis simultaneously</p> Signup and view all the answers

    Which of the following tetracycline antibiotics is most suitable for use in patients with renal impairment?

    <p>Doxycycline</p> Signup and view all the answers

    Which antibiotic class is known to cause ototoxicity and nephrotoxicity as its most serious side effects?

    <p>Aminoglycosides</p> Signup and view all the answers

    Which of the following statements about the pharmacokinetics of tetracyclines is correct?

    <p>They form non-absorbable chelates with multivalent cations and bind to tissues undergoing calcification</p> Signup and view all the answers

    Which of the following antibiotics is specifically designed to be resistant to enzymatic inactivation, a common mechanism of resistance to aminoglycosides?

    <p>Amikacin</p> Signup and view all the answers

    Which of the following statements best explains why aminoglycosides are considered concentration-dependent bactericidal agents?

    <p>Higher concentrations are required to exhibit a prolonged post-antibiotic effect</p> Signup and view all the answers

    Which of the following statements accurately describes the spectrum of activity of macrolides?

    <p>Macrolides have a broad spectrum of activity against both gram-positive and gram-negative bacteria</p> Signup and view all the answers

    What is the primary difference between bacteriostatic and bactericidal agents?

    <p>Bacteriostatic agents block the bacteria from dividing, while bactericidal agents kill bacteria.</p> Signup and view all the answers

    Why is it important to use bactericidal drugs for immunocompromised patients?

    <p>Immunocompromised patients need the bacteria to be killed directly rather than just inhibited.</p> Signup and view all the answers

    Which drug combination is synergistic with any cell wall inhibitors?

    <p>Beta-lactams and aminoglycosides</p> Signup and view all the answers

    What is a common disadvantage of combination therapy with antibiotics?

    <p>Antagonistic effects between antibiotics</p> Signup and view all the answers

    In antibiotic resistance, what mechanism involves genetic alterations that may persist, be corrected, or be lethal?

    <p>Spontaneous mutations of DNA</p> Signup and view all the answers

    Which alteration leads to resistance to certain antibiotics by altering target sites?

    <p>Altered protein expression</p> Signup and view all the answers

    How does decreased accumulation of antibiotics contribute to antibiotic resistance?

    <p>Decreases penetration of antibiotics to their target sites</p> Signup and view all the answers

    What enzyme inactivates beta-lactam antibiotics by destroying or rendering them inactive?

    <p>$Beta$-lactamase</p> Signup and view all the answers

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