Advanced Pharmacology test 1
Beta lactamase inhibitors - Answer Clavulanic acid, sublactam, taxobactam
Unasyn - Answer Ampicillin and sulbactam
Augmentin - Answer Amoxicillin clavulanic acid
Hapten - Answer Drug +plasma protein severe allergic reaction
Mechanisms resistance to beta lactamase - Answer Inactivation by beta lactamase,
mutation trans peptidase target, impaired penetration of drug into organism, drug
effluent pumps
MRSA - Answer Resistant organisms produce PBPs with decreased affinity for binding
beta lactam antibiotics
Impaired penetration of drug into organosm - Answer Absence of porins or down
regulation of porins or porins smaller
Drug efflux pumps - Answer Nonspecific, spit out whatever bacteria doesn't need, major
mechanism MDR
Prevention of resistance steains - Answer Testing, choose right antibiotic, complete
course therapy, don't use antibiotic when not indicated
Mutidrug resistant organisms - Answer Organisms that are resistant to 1 or more class
of organisms. Drug efflux pumps
Penicillin - Answer Bactericidal
Penicillin adverse effects - Answer GI distress, oral/vaginal candidiasis, rash,
anaphylaxis
Cephalosporins - Answer More stable against beta lactamases, increased range activity
1st generation cephalosporin - Answer Cefazolin, cephalexin
G+, susceptible beta lactamase
2,3 generations cephalosporins - Answer Broader spectrum,
Increase resistance beta lactamase, increase half life, some cross BBB
4,5 generations cephalosporins - Answer Cefepine, excellent resistance most beta
lactamase, excellent CNS penetration, ceftaroline against MRSA
Adverse reactions cephalosporins - Answer Hypersensitivity, fever, skin rashes,
nephritis, granulocytopenia, hemolytic anemia, anorexia
, Advanced Pharmacology test 1
Cefotetan - Answer Avoid ETOH! Disulfiram like reaction with this cephalosporins
Treatment for C diff from broad spectrum cephalosporin - Answer Vancomycin,
metrondiszole
Example monobactam - Answer Aztreonam
IV or IM
Active against G neg only
Tolerated by PCN allergic patiemts
Example carbapenem - Answer Imipenem, IV or IM only
Widest spectrum of any beta lactam, must prescribe with cilastin to inhibit first pass
elimination by renal enzyme dehydropeptidase, low crossreactivity for PCNs. Good for
meningitis, peritonitis in really sick patients
Vancomycin - Answer Cell wall inhibitor but not beta lactam, glycopeptide structure,
best treatment for MRSA and G+. Only use Italy to treat antibiotic induced colitis, C.
difficile and staph entericolitis
Must monitor peak and trough, poorly absorbed po
Vancomyicin - Answer Bacterocidal for G +
Vancomycin - Answer Poor oral bioavailability, 90% GFR eliminated, if renal
impairments can have accumulation.
Vancomycin Adverse Effect - Answer Ototoxicity if given with aminoglycoside!!
Tissue irritation at injection site, chill and fever
Red man syndrome - Answer Vancomycin if Tate of infusion too fast. Histamine release,
hypotension, flush, skin rash. Prevent by 1-2 hr infusion or pretreat with antihistamine
Advantages vancomycin - Answer Not susceptible to beta lactamase, no PCN allergy
Classes of protein synthesis inhibitors - Answer Tetracycline, macrolides,
oxazolidinones and aminoglycosides
Inhibitors bacterial translation - Answer Interfere with bacterial ribosome, may affect
protein synthesis in human cells, complete inhibition of protein synthesis may not be
enough to kill bacteria. Antibiotics bind to bacterial ribosome to block bacterial protein
synthesis
Examples of Tetracyclines - Answer Tetracycline, oxytetracycline, doxycycline,
demeclocycline
Tetracycline uses - Answer H pylori, cholera, acne, tick fever
Beta lactamase inhibitors - Answer Clavulanic acid, sublactam, taxobactam
Unasyn - Answer Ampicillin and sulbactam
Augmentin - Answer Amoxicillin clavulanic acid
Hapten - Answer Drug +plasma protein severe allergic reaction
Mechanisms resistance to beta lactamase - Answer Inactivation by beta lactamase,
mutation trans peptidase target, impaired penetration of drug into organism, drug
effluent pumps
MRSA - Answer Resistant organisms produce PBPs with decreased affinity for binding
beta lactam antibiotics
Impaired penetration of drug into organosm - Answer Absence of porins or down
regulation of porins or porins smaller
Drug efflux pumps - Answer Nonspecific, spit out whatever bacteria doesn't need, major
mechanism MDR
Prevention of resistance steains - Answer Testing, choose right antibiotic, complete
course therapy, don't use antibiotic when not indicated
Mutidrug resistant organisms - Answer Organisms that are resistant to 1 or more class
of organisms. Drug efflux pumps
Penicillin - Answer Bactericidal
Penicillin adverse effects - Answer GI distress, oral/vaginal candidiasis, rash,
anaphylaxis
Cephalosporins - Answer More stable against beta lactamases, increased range activity
1st generation cephalosporin - Answer Cefazolin, cephalexin
G+, susceptible beta lactamase
2,3 generations cephalosporins - Answer Broader spectrum,
Increase resistance beta lactamase, increase half life, some cross BBB
4,5 generations cephalosporins - Answer Cefepine, excellent resistance most beta
lactamase, excellent CNS penetration, ceftaroline against MRSA
Adverse reactions cephalosporins - Answer Hypersensitivity, fever, skin rashes,
nephritis, granulocytopenia, hemolytic anemia, anorexia
, Advanced Pharmacology test 1
Cefotetan - Answer Avoid ETOH! Disulfiram like reaction with this cephalosporins
Treatment for C diff from broad spectrum cephalosporin - Answer Vancomycin,
metrondiszole
Example monobactam - Answer Aztreonam
IV or IM
Active against G neg only
Tolerated by PCN allergic patiemts
Example carbapenem - Answer Imipenem, IV or IM only
Widest spectrum of any beta lactam, must prescribe with cilastin to inhibit first pass
elimination by renal enzyme dehydropeptidase, low crossreactivity for PCNs. Good for
meningitis, peritonitis in really sick patients
Vancomycin - Answer Cell wall inhibitor but not beta lactam, glycopeptide structure,
best treatment for MRSA and G+. Only use Italy to treat antibiotic induced colitis, C.
difficile and staph entericolitis
Must monitor peak and trough, poorly absorbed po
Vancomyicin - Answer Bacterocidal for G +
Vancomycin - Answer Poor oral bioavailability, 90% GFR eliminated, if renal
impairments can have accumulation.
Vancomycin Adverse Effect - Answer Ototoxicity if given with aminoglycoside!!
Tissue irritation at injection site, chill and fever
Red man syndrome - Answer Vancomycin if Tate of infusion too fast. Histamine release,
hypotension, flush, skin rash. Prevent by 1-2 hr infusion or pretreat with antihistamine
Advantages vancomycin - Answer Not susceptible to beta lactamase, no PCN allergy
Classes of protein synthesis inhibitors - Answer Tetracycline, macrolides,
oxazolidinones and aminoglycosides
Inhibitors bacterial translation - Answer Interfere with bacterial ribosome, may affect
protein synthesis in human cells, complete inhibition of protein synthesis may not be
enough to kill bacteria. Antibiotics bind to bacterial ribosome to block bacterial protein
synthesis
Examples of Tetracyclines - Answer Tetracycline, oxytetracycline, doxycycline,
demeclocycline
Tetracycline uses - Answer H pylori, cholera, acne, tick fever
