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 (D)</p> Signup and view all the answers

Which mechanism of action does sulfonamide antibiotics primarily target?

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

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

<p>Aminoglycosides (D)</p> Signup and view all the answers

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

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

What do Penicillinase-resistant penicillins like Nafcillin target?

<p>Penicillinase-producing Staphylococcus aureus (C)</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 (A)</p> Signup and view all the answers

Which type of antibiotic has activity against Pseudomonas aeruginosa?

<p>Extended-spectrum penicillin (C)</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 (A)</p> Signup and view all the answers

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

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

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

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

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

<p>Transpeptidation reaction (A)</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 (A)</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 (A)</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 (D)</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 (D)</p> Signup and view all the answers

Penicillin poorly distributed except in cases of meningitis, EXCEPT?

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

How is Nafcillin primarily cleared from the body?

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

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

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

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

<p>10% (B)</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 (A)</p> Signup and view all the answers

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

<p>Penicillin (A)</p> Signup and view all the answers

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

<p>Ampicillin and Amoxicillin (C)</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 (D)</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 (C)</p> Signup and view all the answers

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

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

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

<p>Normal (A)</p> Signup and view all the answers

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

<p>Seizures (B)</p> Signup and view all the answers

Which bacterial genus is NOT sensitive to First Generation Cephalosporins?

<p>Bacteroides (D)</p> Signup and view all the answers

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

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

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

<p>Enterococci (C)</p> Signup and view all the answers

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

<p>Avoided due to pain (C)</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 (D)</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 (C)</p> Signup and view all the answers

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

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

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

<p>Cefuroxime (C)</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 (B)</p> Signup and view all the answers

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

<p>Penicillin resistant pneumococci (A)</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 (B)</p> Signup and view all the answers

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

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

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

<p>Anaerobes (C)</p> Signup and view all the answers

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

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

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

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

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

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

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

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

Which 3rd generation cephalosporins are approved treatment for meningitis?

<p>Ceftriaxone and cefotaxime (C)</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 (C)</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 (D)</p> Signup and view all the answers

Cephalosporins that contain a methylthiotetrazole group frequently cause?

<p>Hypoprothrombinemia and bleeding disorders (D)</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 (C)</p> Signup and view all the answers

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

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

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

<p>Enterobacter species (D)</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 (A)</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 (B)</p> Signup and view all the answers

Which bacteria are 4th generation Cephalosporins highly active against?

<p>Pseudomonas aeruginosa and Haemophilus influenzae (C)</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 (B)</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 (D)</p> Signup and view all the answers

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

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

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

<p>Imipenem (B)</p> Signup and view all the answers

What is a distinguishing feature of Meropenem compared to Imipenem?

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

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