7. Glycopeptides pharma - AI MCQs
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Questions and Answers

What is the primary mechanism of action of glycopeptides?

  • Inhibition of protein synthesis
  • Disruption of the bacterial cell membrane potential
  • Interference with DNA replication
  • Inhibition of cell wall synthesis (correct)
  • Which types of bacteria are glycopeptides effective against?

  • Gram-positive anaerobes
  • All types of bacteria
  • Gram-negative bacteria
  • Gram-positive cocci (correct)
  • What is a common indication for the use of vancomycin?

  • Meningitis caused by penicillin-sensitive bacteria
  • Treatment of viral infections
  • Fungal infections
  • Septicemia caused by MRSA (correct)
  • What is the resistance mechanism to vancomycin in enterococci?

    <p>Modification of the D-Ala-D-Ala binding site</p> Signup and view all the answers

    Which of the following bacteria is not targeted effectively by glycopeptides?

    <p>Escherichia coli</p> Signup and view all the answers

    What is the effect of glycopeptides on bacterial cell membranes?

    <p>They increase membrane permeability</p> Signup and view all the answers

    Which combination is commonly used for treating endocarditis caused by enterococci?

    <p>Vancomycin with gentamicin</p> Signup and view all the answers

    What is NOT an indication for oral administration of vancomycin?

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

    What is a significant adverse effect associated with certain antimicrobial therapies?

    <p>Phlebitis at site of injection</p> Signup and view all the answers

    Which glycopeptide is NOT mentioned as a member of the class?

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

    What mechanism does fosfomycin use to inhibit bacterial growth?

    <p>Inhibits enzyme enolpyruvate transferase</p> Signup and view all the answers

    What is the consequence of vancomycin binding affinity loss due to resistance?

    <p>Loss of activity against Gram-positive bacteria</p> Signup and view all the answers

    Which of the following is an indication for using telavancin?

    <p>Complicated skin and soft tissue infections</p> Signup and view all the answers

    What condition can be prevented by slow infusion or pretreatment with antihistamines?

    <p>Red man syndrome</p> Signup and view all the answers

    Which of the following statements is true regarding teicoplanin?

    <p>It is also effective against vancomycin-resistant strains.</p> Signup and view all the answers

    What is a limitation of fosfomycin's use in treating severe infections?

    <p>Resistance due to lack of drug transport into cells.</p> Signup and view all the answers

    Which type of organisms is fosfomycin effective against?

    <p>Broad spectrum including some Gram-negative organisms</p> Signup and view all the answers

    What is a critical monitoring aspect while using certain antimicrobials?

    <p>Monitor for nephrotoxicity</p> Signup and view all the answers

    Which bacterial strain is fosfomycin particularly effective against?

    <p>Extended spectrum β-lactamase–producing E. coli</p> Signup and view all the answers

    Which statement accurately reflects the antibacterial spectrum of teicoplanin?

    <p>It has higher activity against enterococci than vancomycin.</p> Signup and view all the answers

    Study Notes

    Glycopeptides

    • Glycopeptides are bactericidal against Gram-positive bacteria.
    • Glycopeptides do not penetrate the cell membrane of Gram-negative bacteria due to their large molecular weight and hydrophilic nature.
    • They inhibit cell wall synthesis by binding to D-Ala-D-Ala terminus of a growing peptidoglycan pentapeptide.
    • This binding inhibits the transglycosylase enzyme which stops the elongation and cross-linking of peptidoglycan.
    • They can increase membrane permeability and disrupt bacterial cell membrane potential.

    Glycopeptide Antibacterial Spectrum

    • Glycopeptides are mainly active against Gram-positive cocci like staphylococci, streptococci, and enterococci.
    • They can display synergistic activity with gentamicin and streptomycin against enterococci (E. faecium and E. faecalis).
    • They are also active against Gram-positive anaerobes, including C. difficile.
    • They are not active against Gram-negative bacteria.

    Glycopeptide Examples

    • Includes vancomycin, teicoplanin, and telavancin.

    Vancomycin

    • Mainly given intravenously.
    • Indicated for septicemia, endocarditis (caused by MRSA and enterococci), meningitis, and enterocolitis.
    • Combined with gentamicin when used for endocarditis in patients with penicillin allergy.
    • Given orally for C. difficile enterocolitis.

    Vancomycin Resistance

    • Resistance in enterococci stems from modification of the D-Ala-D-Ala binding site.
    • Terminal D-Ala is replaced by D-lactate, leading to loss of hydrogen bond that facilitates vancomycin binding.
    • This results in loss of vancomycin activity.
    • This mechanism is also present in rare vancomycin-resistant S. aureus strains.

    Vancomycin Adverse Effects

    • Phlebitis at injection site.
    • Nephrotoxicity (requires monitoring).
    • Ototoxicity (rare).
    • Red man syndrome (prevented by slow infusion or oral antihistamine pretreatment).

    Teicoplanin

    • Similar antibacterial spectrum and clinical indications to vancomycin.
    • Active against vancomycin-resistant S. aureus.
    • Shows higher activity against enterococci than vancomycin.

    Telavancin

    • Similar antibacterial spectrum to vancomycin.
    • Approved for complicated skin and soft tissue infections and hospital-acquired pneumonia.

    Fosfomycin

    • Broad-spectrum antibiotic.
    • Active against extended spectrum β-lactamase-producing (ESBL) E. coli.
    • Limited use in severe infections due to resistance related to lack of drug transport into the cell.

    Fosfomycin Antibacterial Spectrum

    • Active against both Gram-positive and Gram-negative organisms including E. coli and E. faecalis.

    Fosfomycin Mechanism of Action

    • Inhibits an early stage of bacterial cell wall synthesis.
    • Inhibits the enzyme enolpyruvate transferase by acting as an analog of phosphoenolpyruvate.
    • This enzyme is responsible for forming N-acetylmuramic acid, a key component of peptidoglycan.

    Fosfomycin Indications

    • Uncomplicated lower urinary tract infections in women (safe during pregnancy).
    • Given as a single 3-g dose tablet.

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    Description

    This quiz explores the mechanisms of action of glycopeptides, their antibacterial spectrum, and their effectiveness against Gram-positive bacteria. Learn about their role in inhibiting cell wall synthesis and their interactions with other antibiotics. Test your knowledge on glycopeptides like vancomycin and their clinical implications.

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