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Questions and Answers
What is the reason for using Cefazolin in surgical prophylaxis?
What is the reason for using Cefazolin in surgical prophylaxis?
- Bile excretion
- Good tissue and fluid penetration (correct)
- Broad spectrum activity
- Minimal allergic reactions
How is Ceftriaxone primarily excreted from the body?
How is Ceftriaxone primarily excreted from the body?
- Metabolism in the liver
- Glomerular filtration
- Bile excretion (correct)
- Tubular secretion
What is the primary adverse reaction profile of cephalosporins compared to penicillins?
What is the primary adverse reaction profile of cephalosporins compared to penicillins?
- Neurotoxicity
- Hepatotoxicity
- Well-tolerated (correct)
- High incidence of diarrhea
What is the cross-reactivity rate between penicillin and cephalosporins?
What is the cross-reactivity rate between penicillin and cephalosporins?
Which organisms are covered by carbapenems?
Which organisms are covered by carbapenems?
Which carbapenem has coverage different from the others?
Which carbapenem has coverage different from the others?
What factors affect the selection of antimicrobial agents?
What factors affect the selection of antimicrobial agents?
What are the properties influencing the frequency of dosing of antimicrobial agents?
What are the properties influencing the frequency of dosing of antimicrobial agents?
What are the chemotherapeutic spectra of antimicrobial drugs?
What are the chemotherapeutic spectra of antimicrobial drugs?
What are the mechanisms of acquired resistance in drug-resistant organisms?
What are the mechanisms of acquired resistance in drug-resistant organisms?
What can combinations of antimicrobial drugs lead to?
What can combinations of antimicrobial drugs lead to?
What can capillaries in certain tissues act as, impacting penetration and concentration of antimicrobial agents?
What can capillaries in certain tissues act as, impacting penetration and concentration of antimicrobial agents?
What is the primary mechanism of action of penicillins?
What is the primary mechanism of action of penicillins?
Which type of penicillin is effective against Pseudomonas aeruginosa when combined with a β-lactamase inhibitor?
Which type of penicillin is effective against Pseudomonas aeruginosa when combined with a β-lactamase inhibitor?
What is a common cause of resistance to penicillins?
What is a common cause of resistance to penicillins?
Which type of penicillin is used for treating infections caused by penicillinase-producing staphylococci?
Which type of penicillin is used for treating infections caused by penicillinase-producing staphylococci?
What is the primary function of cell wall inhibitors as antimicrobial drugs?
What is the primary function of cell wall inhibitors as antimicrobial drugs?
What is the main advantage of semisynthetic penicillins like ampicillin and amoxicillin?
What is the main advantage of semisynthetic penicillins like ampicillin and amoxicillin?
Which adverse reaction is associated with penicillins?
Which adverse reaction is associated with penicillins?
Which cephalosporin can cross the blood-brain barrier?
Which cephalosporin can cross the blood-brain barrier?
Which penicillin shows poor oral bioavailability?
Which penicillin shows poor oral bioavailability?
Which generation of cephalosporins is effective against Pseudomonas aeruginosa?
Which generation of cephalosporins is effective against Pseudomonas aeruginosa?
Which cephalosporin is used for treating meningitis and has good penetration into bone?
Which cephalosporin is used for treating meningitis and has good penetration into bone?
Which body organ does penicillin have insufficient penetration into?
Which body organ does penicillin have insufficient penetration into?
What are the topics covered in Pharmacology (3)?
What are the topics covered in Pharmacology (3)?
What is the principle behind antimicrobial therapy?
What is the principle behind antimicrobial therapy?
What factors are considered for selecting the most appropriate antimicrobial agent?
What factors are considered for selecting the most appropriate antimicrobial agent?
What is the purpose of Gram stain and sample culture in antimicrobial therapy?
What is the purpose of Gram stain and sample culture in antimicrobial therapy?
What does MIC stand for in the context of antimicrobial therapy?
What does MIC stand for in the context of antimicrobial therapy?
What is the significance of selective toxicity in antimicrobial therapy?
What is the significance of selective toxicity in antimicrobial therapy?
What is the primary route of excretion for Ceftriaxone?
What is the primary route of excretion for Ceftriaxone?
What is the main reason for avoiding or using caution with 1st generation cephalosporins in individuals with penicillin allergy?
What is the main reason for avoiding or using caution with 1st generation cephalosporins in individuals with penicillin allergy?
Which cephalosporin is preferred for surgical prophylaxis due to its good tissue and fluid penetration and activity against penicillinase-producing S. aureus?
Which cephalosporin is preferred for surgical prophylaxis due to its good tissue and fluid penetration and activity against penicillinase-producing S. aureus?
What is the primary mechanism of action of carbapenems?
What is the primary mechanism of action of carbapenems?
What is the primary adverse reaction profile of cephalosporins compared to penicillins?
What is the primary adverse reaction profile of cephalosporins compared to penicillins?
How are carbapenems primarily eliminated from the body?
How are carbapenems primarily eliminated from the body?
Which penicillin has poor oral bioavailability?
Which penicillin has poor oral bioavailability?
Which cephalosporin has the longest half-life?
Which cephalosporin has the longest half-life?
Which cephalosporin is active against MRSA?
Which cephalosporin is active against MRSA?
Which cephalosporin has greater stability against beta-lactamases?
Which cephalosporin has greater stability against beta-lactamases?
Which cephalosporin is effective in treating meningitis and has good penetration into bone?
Which cephalosporin is effective in treating meningitis and has good penetration into bone?
Which penicillin is primarily excreted through the kidneys?
Which penicillin is primarily excreted through the kidneys?
What influences the selection of the most appropriate antimicrobial agent?
What influences the selection of the most appropriate antimicrobial agent?
What is the primary factor considered when selecting the most appropriate antimicrobial agent?
What is the primary factor considered when selecting the most appropriate antimicrobial agent?
What is the significance of selective toxicity in antimicrobial therapy?
What is the significance of selective toxicity in antimicrobial therapy?
What does MIC stand for in the context of antimicrobial therapy?
What does MIC stand for in the context of antimicrobial therapy?
What is the primary function of cell wall inhibitors as antimicrobial drugs?
What is the primary function of cell wall inhibitors as antimicrobial drugs?
What can capillaries in certain tissues act as, impacting penetration and concentration of antimicrobial agents?
What can capillaries in certain tissues act as, impacting penetration and concentration of antimicrobial agents?
Which type of penicillin has extended Gram-negative antimicrobial activity and is commonly used for respiratory infections?
Which type of penicillin has extended Gram-negative antimicrobial activity and is commonly used for respiratory infections?
What is the primary reason for the increasing resistance of natural penicillins like penicillin G and penicillin V?
What is the primary reason for the increasing resistance of natural penicillins like penicillin G and penicillin V?
Which mechanism can lead to resistance to penicillins?
Which mechanism can lead to resistance to penicillins?
What is the primary mode of administration for penicillins?
What is the primary mode of administration for penicillins?
Which type of penicillin is used to treat infections caused by penicillinase-producing staphylococci?
Which type of penicillin is used to treat infections caused by penicillinase-producing staphylococci?
What is the primary target of cell wall inhibitors as antimicrobial drugs?
What is the primary target of cell wall inhibitors as antimicrobial drugs?
What factors affect the selection of antimicrobial agents?
What factors affect the selection of antimicrobial agents?
What are the mechanisms of acquired resistance in drug-resistant organisms?
What are the mechanisms of acquired resistance in drug-resistant organisms?
What is the primary function of cell wall inhibitors as antimicrobial drugs?
What is the primary function of cell wall inhibitors as antimicrobial drugs?
What can combinations of antimicrobial drugs lead to?
What can combinations of antimicrobial drugs lead to?
What is the significance of selective toxicity in antimicrobial therapy?
What is the significance of selective toxicity in antimicrobial therapy?
What is the reason for using Cefazolin in surgical prophylaxis?
What is the reason for using Cefazolin in surgical prophylaxis?
What is the primary factor considered when selecting the most appropriate antimicrobial agent?
What is the primary factor considered when selecting the most appropriate antimicrobial agent?
What is the significance of selective toxicity in antimicrobial therapy?
What is the significance of selective toxicity in antimicrobial therapy?
What is the primary route of excretion for Ceftriaxone?
What is the primary route of excretion for Ceftriaxone?
What can capillaries in certain tissues act as, impacting penetration and concentration of antimicrobial agents?
What can capillaries in certain tissues act as, impacting penetration and concentration of antimicrobial agents?
What is the reason for using Cefazolin in surgical prophylaxis?
What is the reason for using Cefazolin in surgical prophylaxis?
What are the topics covered in Pharmacology (3)?
What are the topics covered in Pharmacology (3)?
What is the primary reason for the increasing resistance of natural penicillins like penicillin G and penicillin V?
What is the primary reason for the increasing resistance of natural penicillins like penicillin G and penicillin V?
Which penicillin shows poor oral bioavailability?
Which penicillin shows poor oral bioavailability?
What is the primary route of excretion for Ceftriaxone?
What is the primary route of excretion for Ceftriaxone?
Which body organ does penicillin have insufficient penetration into?
Which body organ does penicillin have insufficient penetration into?
What can capillaries in certain tissues act as, impacting penetration and concentration of antimicrobial agents?
What can capillaries in certain tissues act as, impacting penetration and concentration of antimicrobial agents?
What is the primary mechanism of action of carbapenems?
What is the primary mechanism of action of carbapenems?
What are the two properties influencing the frequency of dosing of antimicrobial agents?
What are the two properties influencing the frequency of dosing of antimicrobial agents?
What are the mechanisms of acquired resistance in drug-resistant organisms?
What are the mechanisms of acquired resistance in drug-resistant organisms?
What are the chemotherapeutic spectra of antimicrobial drugs?
What are the chemotherapeutic spectra of antimicrobial drugs?
What can combinations of antimicrobial drugs lead to?
What can combinations of antimicrobial drugs lead to?
What can capillaries in certain tissues act as, impacting penetration and concentration of antimicrobial agents?
What can capillaries in certain tissues act as, impacting penetration and concentration of antimicrobial agents?
What is the primary cause of drug resistance in antimicrobial therapy?
What is the primary cause of drug resistance in antimicrobial therapy?
Which adverse reactions are associated with penicillins?
Which adverse reactions are associated with penicillins?
Which cephalosporin is primarily used for treating complicated skin infections and community-acquired pneumonia?
Which cephalosporin is primarily used for treating complicated skin infections and community-acquired pneumonia?
What is the primary route of excretion for penicillins?
What is the primary route of excretion for penicillins?
Which cephalosporin has the longest half-life among all cephalosporins?
Which cephalosporin has the longest half-life among all cephalosporins?
What is the main reason for avoiding or using caution with 1st generation cephalosporins in individuals with penicillin allergy?
What is the main reason for avoiding or using caution with 1st generation cephalosporins in individuals with penicillin allergy?
What is the primary mechanism of action shared by cephalosporins and penicillins?
What is the primary mechanism of action shared by cephalosporins and penicillins?
What is the primary route of excretion for Ceftriaxone?
What is the primary route of excretion for Ceftriaxone?
What is the highest rate of allergic cross-sensitivity between penicillin and 1st generation cephalosporins?
What is the highest rate of allergic cross-sensitivity between penicillin and 1st generation cephalosporins?
What is the primary mechanism of action of carbapenems?
What is the primary mechanism of action of carbapenems?
What is the primary adverse reaction profile of cephalosporins compared to penicillins?
What is the primary adverse reaction profile of cephalosporins compared to penicillins?
Which cephalosporin is preferred for surgical prophylaxis due to its good tissue and fluid penetration and activity against penicillinase-producing S. aureus?
Which cephalosporin is preferred for surgical prophylaxis due to its good tissue and fluid penetration and activity against penicillinase-producing S. aureus?
Which carbapenem has coverage different from the others?
Which carbapenem has coverage different from the others?
Antimicrobial therapy takes advantage of the biochemical differences that exist between microorganisms and human beings resulting in absolute toxicity.
Antimicrobial therapy takes advantage of the biochemical differences that exist between microorganisms and human beings resulting in absolute toxicity.
The selection of the most appropriate antimicrobial agent considers the identity of the organism, the susceptibility of the organism to a particular agent, and the site of infection.
The selection of the most appropriate antimicrobial agent considers the identity of the organism, the susceptibility of the organism to a particular agent, and the site of infection.
Cefazolin is primarily used for treating complicated skin infections and community-acquired pneumonia.
Cefazolin is primarily used for treating complicated skin infections and community-acquired pneumonia.
Natural penicillins like penicillin G and penicillin V show increasing resistance.
Natural penicillins like penicillin G and penicillin V show increasing resistance.
Cell wall inhibitors are primarily targeting the ribosomes of microorganisms.
Cell wall inhibitors are primarily targeting the ribosomes of microorganisms.
Ceftriaxone is primarily excreted through the kidneys.
Ceftriaxone is primarily excreted through the kidneys.
Is Cefazolin preferred for surgical prophylaxis due to its good tissue and fluid penetration and activity against penicillinase-producing S. aureus?
Is Cefazolin preferred for surgical prophylaxis due to its good tissue and fluid penetration and activity against penicillinase-producing S. aureus?
Ceftriaxone is primarily excreted through the urine
Ceftriaxone is primarily excreted through the urine
The cross-reactivity rate between penicillin and cephalosporins is around 3% to 5%
The cross-reactivity rate between penicillin and cephalosporins is around 3% to 5%
Carbapenems have the same mechanism of action as penicillins
Carbapenems have the same mechanism of action as penicillins
Carbapenems have a narrow spectrum of activity
Carbapenems have a narrow spectrum of activity
Cephalosporins have a higher rate of allergic cross-sensitivity with 1st generation cephalosporins than with penicillin
Cephalosporins have a higher rate of allergic cross-sensitivity with 1st generation cephalosporins than with penicillin
Penicillins are primarily excreted through the liver.
Penicillins are primarily excreted through the liver.
Cephalosporins share the same mechanism of action as penicillins.
Cephalosporins share the same mechanism of action as penicillins.
First-generation cephalosporins act on Gram-positive and some Gram-negative bacteria.
First-generation cephalosporins act on Gram-positive and some Gram-negative bacteria.
Third-generation cephalosporins like ceftriaxone have the longest half-life.
Third-generation cephalosporins like ceftriaxone have the longest half-life.
Ceftaroline is the only beta-lactam active against MRSA.
Ceftaroline is the only beta-lactam active against MRSA.
Cephalosporins are not effective in treating meningitis.
Cephalosporins are not effective in treating meningitis.
Capillaries in certain tissues act as natural barriers to drug delivery, impacting penetration and concentration of antimicrobial agents
Capillaries in certain tissues act as natural barriers to drug delivery, impacting penetration and concentration of antimicrobial agents
Factors affecting selection of antimicrobial agents include patient factors, safety and efficacy, and cost of therapy
Factors affecting selection of antimicrobial agents include patient factors, safety and efficacy, and cost of therapy
Concentration-dependent killing and time-dependent killing are properties influencing the frequency of dosing
Concentration-dependent killing and time-dependent killing are properties influencing the frequency of dosing
Combinations of antimicrobial drugs have advantages such as synergism, but also disadvantages like risk of antibiotic resistance
Combinations of antimicrobial drugs have advantages such as synergism, but also disadvantages like risk of antibiotic resistance
Drug resistance can be caused by naturally inherent resistance or acquired resistance through genetic alterations
Drug resistance can be caused by naturally inherent resistance or acquired resistance through genetic alterations
Altered expression of proteins in drug-resistant organisms cannot lead to drug resistance
Altered expression of proteins in drug-resistant organisms cannot lead to drug resistance
Prophylactic use of antibiotics is necessary in all clinical situations to prevent infections.
Prophylactic use of antibiotics is necessary in all clinical situations to prevent infections.
Penicillins weaken the bacterial cell wall by interfering with the transpeptidation process, leading to cell death.
Penicillins weaken the bacterial cell wall by interfering with the transpeptidation process, leading to cell death.
Resistance to penicillins can occur through β-lactamase production, decreased drug permeability, and altered penicillin-binding proteins.
Resistance to penicillins can occur through β-lactamase production, decreased drug permeability, and altered penicillin-binding proteins.
Natural penicillins like penicillin G and penicillin V have a narrow spectrum and are not facing increasing resistance.
Natural penicillins like penicillin G and penicillin V have a narrow spectrum and are not facing increasing resistance.
Semisynthetic penicillins such as ampicillin and amoxicillin have extended Gram-negative antimicrobial activity.
Semisynthetic penicillins such as ampicillin and amoxicillin have extended Gram-negative antimicrobial activity.
Antistaphylococcal penicillins like methicillin and nafcillin are used to treat infections caused by penicillinase-producing staphylococci.
Antistaphylococcal penicillins like methicillin and nafcillin are used to treat infections caused by penicillinase-producing staphylococci.
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Study Notes
Cell Wall Inhibitors: Penicillins and Cephalosporins
- Oral absorption of some penicillins is hindered by stomach acids, with penicillin V showing poor oral bioavailability and amoxicillin being readily absorbed from the GI tract.
- Penicillins are distributed well throughout the body, but have insufficient penetration of bone, CSF, and the prostate, and no teratogenic effects when crossing the placental barrier.
- Penicillins are primarily excreted through the kidneys, and nafcillin and oxacillin are metabolized in the liver.
- Adverse reactions to penicillins include hypersensitivity, diarrhea, nephritis, neurotoxicity, and hematologic toxicities.
- Cephalosporins share the same mechanism of action as penicillins and face resistance due to the hydrolysis of the beta-lactam ring by beta-lactamases.
- The antibacterial spectrum of cephalosporins varies across different generations, with first-generation cephalosporins acting on Gram-positive and some Gram-negative bacteria, and showing resistance to staphylococcal penicillinase.
- Second-generation cephalosporins like cefuroxime sodium have a longer half-life and can cross the blood-brain barrier, with cefoxitin showing greater activity on Gram-negative bacteria.
- Third-generation cephalosporins like cefotaxime and ceftriaxone are effective in treating meningitis and have good penetration into bone, with ceftriaxone having the longest half-life of all cephalosporins.
- Fourth-generation cephalosporins like cefepime are active against Pseudomonas aeruginosa and show greater stability against beta-lactamases.
- Advanced generation cephalosporins like ceftaroline are the only beta-lactams active against MRSA and are used for treating complicated skin infections and community-acquired pneumonia.
- Cephalosporins can be administered orally or parenterally and distribute well into body fluids, with ceftriaxone and cefotaxime being used for CSF infections and childhood meningitis.
- Overall, both penicillins and cephalosporins have unique characteristics and varying antibacterial spectra, making them important in the treatment of bacterial infections.
Principles of Antimicrobial Therapy by Dr. Osama Abusara
- Capillaries in certain tissues act as natural barriers to drug delivery, impacting penetration and concentration of antimicrobial agents
- Factors affecting selection of antimicrobial agents include patient factors, safety and efficacy, and cost of therapy
- Route of drug administration and rational dosing are determined based on pharmacodynamics and pharmacokinetics of antimicrobial agents
- Concentration-dependent killing and time-dependent killing are properties influencing the frequency of dosing
- Properties affecting dosing frequency include concentration-dependent killing, time-dependent killing, and postantibiotic effect
- Chemotherapeutic spectra include narrow-spectrum and extended/broad-spectrum antimicrobial drugs
- Combinations of antimicrobial drugs have advantages such as synergism, but also disadvantages like risk of antibiotic resistance
- Drug resistance can be caused by naturally inherent resistance or acquired resistance through genetic alterations
- Acquired resistance can result from altered expression of proteins, modification of target sites, decreased accumulation, and enzymatic inactivation
- Altered expression of proteins in drug-resistant organisms can lead to drug resistance
- Modification of target sites, decreased accumulation, and enzymatic inactivation are mechanisms of acquired resistance
- Drug resistance can be caused by genetic alterations and altered expression of proteins in drug-resistant organisms
Cell Wall Inhibitors: Penicillins and Cephalosporins
- Oral absorption of some penicillins is hindered by stomach acids, with penicillin V showing poor oral bioavailability and amoxicillin being readily absorbed from the GI tract.
- Penicillins are distributed well throughout the body, but have insufficient penetration of bone, CSF, and the prostate, and no teratogenic effects when crossing the placental barrier.
- Penicillins are primarily excreted through the kidneys, and nafcillin and oxacillin are metabolized in the liver.
- Adverse reactions to penicillins include hypersensitivity, diarrhea, nephritis, neurotoxicity, and hematologic toxicities.
- Cephalosporins share the same mechanism of action as penicillins and face resistance due to the hydrolysis of the beta-lactam ring by beta-lactamases.
- The antibacterial spectrum of cephalosporins varies across different generations, with first-generation cephalosporins acting on Gram-positive and some Gram-negative bacteria, and showing resistance to staphylococcal penicillinase.
- Second-generation cephalosporins like cefuroxime sodium have a longer half-life and can cross the blood-brain barrier, with cefoxitin showing greater activity on Gram-negative bacteria.
- Third-generation cephalosporins like cefotaxime and ceftriaxone are effective in treating meningitis and have good penetration into bone, with ceftriaxone having the longest half-life of all cephalosporins.
- Fourth-generation cephalosporins like cefepime are active against Pseudomonas aeruginosa and show greater stability against beta-lactamases.
- Advanced generation cephalosporins like ceftaroline are the only beta-lactams active against MRSA and are used for treating complicated skin infections and community-acquired pneumonia.
- Cephalosporins can be administered orally or parenterally and distribute well into body fluids, with ceftriaxone and cefotaxime being used for CSF infections and childhood meningitis.
- Overall, both penicillins and cephalosporins have unique characteristics and varying antibacterial spectra, making them important in the treatment of bacterial infections.
Principles of Antimicrobial Therapy and Cell Wall Inhibitors
- Prophylactic use of antibiotics is necessary in certain clinical situations to prevent infections when benefits outweigh potential risks.
- Cell wall inhibitors are antimicrobial drugs that interfere with bacterial cell wall synthesis.
- Penicillins, cephalosporins, carbapenems, monobactams, and β-lactam antibiotics are examples of cell wall inhibitors.
- Penicillins weaken the cell wall by interfering with the transpeptidation process, leading to cell death.
- Natural penicillins like penicillin G and penicillin V have a broad spectrum but are facing increasing resistance due to β-lactamases production in many bacteria.
- Semisynthetic penicillins such as ampicillin and amoxicillin have extended Gram-negative antimicrobial activity and are used for respiratory infections.
- Antistaphylococcal penicillins like methicillin and nafcillin are used to treat infections caused by penicillinase-producing staphylococci.
- Antipseudomonal penicillins like piperacillin are effective against Pseudomonas aeruginosa when combined with a β-lactamase inhibitor.
- Resistance to penicillins can occur through β-lactamase production, decreased drug permeability, and altered penicillin-binding proteins.
- Penicillins can be administered orally or parenterally, with some forms having a long period of absorption.
- Resistance to penicillins can also occur through decreased permeability to the drug and altered penicillin-binding proteins.
- Penicillins are administered orally or parenterally, with some forms having a long period of absorption.
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