P.10 BETA-LACTAM and OTHER CELL WALL AND MEMBRANE ACTIVE ANTIBIOTICS
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All of the ff. antibiotics acts directly on the cell membrane of the microorganism, except?

  • Nystatin
  • Amphotericin B
  • Polymyxin
  • Aminoglycosides (correct)
  • Among the listed antibiotics, which ones inhibit the synthesis of bacterial cell walls?

  • Penicillin, Cephalosporins, Carbapenems (correct)
  • Nystatin, Amphotericin, Polymyxin B
  • Erythromycin, Clindamycin, Tetracyclines
  • Rifampicin, Rifabutin, Quinolones
  • Which antibiotics are agents that disrupt the function of ribosomal subunits to inhibit protein synthesis?

  • Chloramphenicol, Tetracyclines, Erythromycin, Clindamycin (correct)
  • Trimethoprim, Sulfonamides
  • Rifampicin, Rifabutin, Quinolones
  • Aminoglycosides
  • Which antibiotics specifically affect bacterial nucleic acid metabolism by inhibiting RNA polymerase?

    <p>Rifampicin, Rifabutin, Quinolones</p> Signup and view all the answers

    Which mechanism of action does sulfonamide antibiotics primarily target?

    <p>Folate metabolism</p> Signup and view all the answers

    Which antibiotic class binds to the 30S ribosomal subunit to cause bacterial cell death?

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

    Which bacterial pathway is targeted by trimethoprim and sulfonamides to inhibit growth?

    <p>Folate metabolism</p> Signup and view all the answers

    Which antimicrobial agent is highly active against susceptible gram-positive cocci?

    <p>Penicillin G (IV) and V (oral)</p> Signup and view all the answers

    What do Penicillinase-resistant penicillins like Nafcillin target?

    <p>Penicillinase-producing Staphylococcus aureus</p> Signup and view all the answers

    Which antibiotic class is known for having an improved gram-negative spectrum, especially when combined with a beta-lactamase inhibitor?

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

    Which type of antibiotic has activity against Pseudomonas aeruginosa?

    <p>Extended-spectrum penicillin</p> Signup and view all the answers

    Which part of the penicillin molecule is responsible for the loss of significant antibacterial activity when chemically altered?

    <p>Thiazolidine ring connected to the beta-lactam ring</p> Signup and view all the answers

    What is the chief structural requirement for biological activity in penicillin?

    <p>The penicillin nucleus</p> Signup and view all the answers

    Which component of the penicillin molecule determines many antibacterial and pharmacological characteristics?

    <p>Side chain (R)</p> Signup and view all the answers

    What is inhibited by beta-lactam antibiotics like penicillin in bacterial cells?

    <p>Transpeptidation reaction</p> Signup and view all the answers

    All are mechanisms that cause resistance to penicillin and other beta-lactams, except?

    <p>Enhanced resistance to antibiotics</p> Signup and view all the answers

    How does amoxicillin differ from most oral penicillins in terms of absorption?

    <p>Requires an empty stomach for administration</p> Signup and view all the answers

    Which pharmacological characteristic is associated with highly protein-bound penicillin like nafcillin?

    <p>Lower free-drug concentrations in serum</p> Signup and view all the answers

    What is the effect of benzathine and procaine penicillin being formulated to delay absorption?

    <p>Prolonged blood and tissue concentrations</p> Signup and view all the answers

    Penicillin poorly distributed except in cases of meningitis, EXCEPT?

    <p>Breast milk</p> Signup and view all the answers

    How is Nafcillin primarily cleared from the body?

    <p>Biliary excretion</p> Signup and view all the answers

    Main route of elimination for Oxacillin, Dicloxacillin, and Cloxacillin, EXCEPT?

    <p>Sputum and Milk excretion</p> Signup and view all the answers

    What percentage of renal excretion of Penicillin occurs through glomerular filtration?

    <p>10%</p> Signup and view all the answers

    What type of bacteria are penicillin-resistant to, despite having greater activity against gram-negative bacteria?

    <p>Staphylococci b-lactamase producing</p> Signup and view all the answers

    Which antibiotic is DOC for infections caused by Treponema pallidum and many other spirochetes?

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

    Which oral b-lactam antibiotics are most active against penicillin-resistant pneumococci?

    <p>Ampicillin and Amoxicillin</p> Signup and view all the answers

    Which type of bacteria can extended spectrum penicillins target with the addition of a b-lactamase inhibitor?

    <p>Both gram-positive and gram-negative bacteria</p> Signup and view all the answers

    What is the role of extended spectrum penicillins in combination with ESP?

    <p>They assist in absorption into the cell wall</p> Signup and view all the answers

    Which of the following is NOT an adverse reaction associated with penicillins?

    <p>GI upset</p> Signup and view all the answers

    In what condition should creatinine levels be before administering high doses of penicillin?

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

    What adverse reaction can high doses of penicillin cause in patients with renal failure?

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

    Which bacterial genus is NOT sensitive to First Generation Cephalosporins?

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

    These bacterial species are inactive against First Generation Cephalosporins, EXCEPT?

    <p>E. coli</p> Signup and view all the answers

    Which bacterial group is specifically mentioned as NOT being active against Cephalosporins & Cephamycins?

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

    What is a characteristic of intramuscular administration of second-generation cephalosporins?

    <p>Avoided due to pain</p> Signup and view all the answers

    For patients with renal issues, what adjustment is typically required in the dosage of oral first-generation cephalosporins?

    <p>Reduce the dosage</p> Signup and view all the answers

    Which antibiotic is cited as an alternative to anti-staphylococcal penicillin for patients allergic to penicillin?

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

    What is the suggested primary use for first-generation cephalosporins?

    <p>Surgical prophylaxis</p> Signup and view all the answers

    Which second-generation cephalosporin is mentioned as the most commonly used in the text?

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

    What is the main reason why cefaclor is not popular these days according to the text?

    <p>Drug resistance</p> Signup and view all the answers

    Which type of infections should second-generation cephalosporins be used cautiously?

    <p>Penicillin resistant pneumococci</p> Signup and view all the answers

    How is excretion primarily carried out for oral first-generation cephalosporins like cephalexin, cephradine, and cefadroxil?

    <p>Through glomerular filtration and tubular secretion into urine</p> Signup and view all the answers

    What is a common route of elimination for second-generation cephalosporins?

    <p>Renal clearance</p> Signup and view all the answers

    Which bacterium type are second-generation cephalosporins primarily used to target?

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

    Which bacterial strains can oral second-generation cephalosporins primarily treat?

    <p>Beta-lactamase-producing Haemophilus influenzae</p> Signup and view all the answers

    What is the main reason for using Cefuroxime in the treatment of community-acquired pneumonia?

    <p>Effectiveness against beta-lactamase-producing Klebsiella pneumoniae</p> Signup and view all the answers

    Which 3rd generation cephalosporins have useful activity against P. aeruginosa?

    <p>Cefoperazone and Ceftazidime</p> Signup and view all the answers

    What is the primary route of excretion for ceftriaxone and cefoperazone?

    <p>Biliary tract</p> Signup and view all the answers

    Which body fluids and tissues do 3rd generation cephalosporins penetrate well?

    <p>Cerebrospinal fluid</p> Signup and view all the answers

    What is the primary characteristic of MONOBACTAMS that differentiates them from other beta-lactam antibiotics?

    <p>They have a thiazolidine ring far from the beta-lactam ring</p> Signup and view all the answers

    Which 3rd generation cephalosporins are approved treatment for meningitis?

    <p>Ceftriaxone and cefotaxime</p> Signup and view all the answers

    What is a common adverse effect associated with 4th generation Cephalosporins?

    <p>Local irritation at the injection site</p> Signup and view all the answers

    BLI are Not good inhibitors of class C b-lactamase (render less productive), produced by EXCEPT?

    <p>Bacteroides and Branhamella</p> Signup and view all the answers

    Cephalosporins that contain a methylthiotetrazole group frequently cause?

    <p>Hypoprothrombinemia and bleeding disorders</p> Signup and view all the answers

    What is the notable feature of 4th generation Cephalosporins regarding their resistance to hydrolysis by b-lactamases?

    <p>They are more resistant than 1st generation Cephalosporins</p> Signup and view all the answers

    What is a demonstrated renal toxicity associated with some 4th generation Cephalosporins?

    <p>Interstitial nephritis</p> Signup and view all the answers

    Which group of bacteria are 3rd generation cephalosporins NOT reliably active against?

    <p>Enterobacter species</p> Signup and view all the answers

    Which statement regarding the activity of MONOBACTAMS is NOT true?

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

    All bacterial strains are most affected by Ambler Class A BETA LACTAMASE INHIBITORS, EXCEPT?

    <p>N. gonorrhoeae and Serratia</p> Signup and view all the answers

    Which bacteria are 4th generation Cephalosporins highly active against?

    <p>Pseudomonas aeruginosa and Haemophilus influenzae</p> Signup and view all the answers

    In which type of infections are combinations of beta-lactam antibiotics with beta-lactamase inhibitors often indicated?

    <p>Mixed aerobic and anaerobic infections in intra-abdominal regions</p> Signup and view all the answers

    Antibiotic of choice for treatment of Enterobacter infections because it is resistant to destruction by the b-lactamase produced by these organisms?

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

    What is the primary reason for the low urinary concentrations of Imipenem?

    <p>Inactivation by renal dehydropeptidases</p> Signup and view all the answers

    Which carbapenem is resistant to most b-lactamases but not metallo-b-lactamases?

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

    What is a distinguishing feature of Meropenem compared to Imipenem?

    <p>Greater activity against gram-positive organisms</p> Signup and view all the answers

    What is the primary advantage of Meropenem over Imipenem in terms of renal clearance?

    <p>Not significantly degraded by renal dehydropeptidase</p> Signup and view all the answers

    What determines the antibacterial spectrum of the combination of a beta-lactam antibiotic with a beta-lactamase inhibitor?

    <p>The companion penicillin in the combination</p> Signup and view all the answers

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