NR566 Advanced Pharmacology For Care Of The
Family: Questions With Accurate Solutions
β-lactam antibiotic MOA Right Ans - All antibiotics in class share the same
mechanism of action: disruption of the bacterial cell wall.
Inhibition of cell wall synthesis
Empiric Therapy Right Ans - start treatment without cultures or prior to
receiving the results of a culture
immediate empiric antibiotics Right Ans - Critically ill patients receive (Fill
in the Answer) after the first set of cultures obtained; do not wait for results.
Bactericidal antibiotics Right Ans - Directly kill bacteria: Agents include
aminoglycosides, beta-lactams, fluoroquinolones, metronidazole, most
antimycobacterial agents, streptogramins, and vancomycin.
preferred for immunocompromised patients such as those with diabetes, HIV,
or cancer and for those who have overwhelming infections
Bacteriostatic agents Right Ans - inhibit bacterial proliferation while the
host's immune system does the killing. Agents include clindamycin,
macrolides, sulfonamides, and tetracyclines
β-lactam Antibiotics Right Ans - Penicillins, Cephalosporins, Carbapenems,
Monobactams
Penicillins MOA Right Ans - Weaken bacterial cell wall by two actions:
(1) inhibition of transpeptidases
(2) disinhibition (activation) of autolysins.
PBPs (Penicillin Binding Proteins) Right Ans - Transpeptidases, Autolysins,
and other bacterial enzymes are collectively named as because antibiotic class
must bind to them to produce antibacterial effects.
,gram-positive bacteria Right Ans - two layers: the cytoplasmic membrane
and a relatively thick cell wall; penicillins are generally very active against
these organisms.
gram-negative bacteria Right Ans - three layers: the cytoplasmic
membrane, a relatively thin cell wall, and an additional outer membrane; only
certain penicillins (e.g., ampicillin) are able to cross and reach penicillin
binding proteins (PBPs)
Four Major Groups of Penicillins Right Ans - (1) narrow-spectrum
penicillins that are penicillinase sensitive
(2) narrow-spectrum penicillins that are penicillinase resistant
(antistaphylococcal penicillins)
(3) broad-spectrum penicillins (aminopenicillins)
(4) extended-spectrum penicillins (antipseudomonal penicillins).
narrow-spectrum penicillins: Penicillinase sensitive penicillins Right Ans -
Penicillin G, Penicillin V
narrow-spectrum penicillinase sensitive susceptible pathogens Right Ans -
Streptococci, Neisseria, anaerobes
very narrow antimicrobial spectrum and are used only against penicillinase-
producing strains of staphylococci (S. aureus and S. epidermidis). Right Ans
- narrow-spectrum penicillins: penicillinase resistant penicillins
narrow-spectrum penicillins: penicillinase resistant penicillins Right Ans -
Nafcillin, Oxacillin, Dicloxacillin
narrow-spectrum- penicillinase resistant susceptible pathogens Right Ans -
S. Aureus, S. Epidermidis
Drugs of choice for most staphylococcal infections Right Ans -
penicillinase-resistant penicillins (Nafcillin, Oxacillin, Dicloxacillin)
,Broad spectrum Penicillin: Aminopenicillins Right Ans - Ampicillin,
Amoxicillin
Broad spectrum Aminopenicillin susceptible pathogens Right Ans -
Haemophilus influenzae, Escherichia coli, Proteus mirabilis, enterococci,
Neisseria gonorrhoeae
Extended spectrum penicillins (antipseudomonal penicillin) Right Ans -
Piperacillin
Has the same antimicrobial spectrum as penicillin G, plus increased activity
against certain gram-negative bacilli, including Haemophilus influenzae,
Escherichia coli, and Salmonella and Shigella Right Ans - Broad spectrum
Penicillin: Aminopenicillins
First line for acute otitis media and sinusitis Right Ans - Amoxicillin
Extended spectrum penicillins suceptible pathogens Right Ans -
Haemophilus influenzae, Escherichia coli, Proteus mirabilis, enterococci,
Neisseria gonorrhoeae, pseudomonas, enterobactor, klebsiella
Principle pathogenic target of Piperacillin Right Ans - Pseudomonas
aeruginosa
beta-lactamase inhibitors to broaden penicillin spectrum Right Ans -
clavulanate, sulbactam, tazobactam
Penicillin/Beta-Lactamase Combinations Right Ans - Ampicillin/sulbactam
(Unasyn)
Amoxicillin/clavulanate (Augmentin)
Piperacillin/tazobactam (Zosyn)
MRSA Drug of Choice Right Ans - Vancomycin
Most Important AE of Penicillins Right Ans - Hypersensitivity Reaction
Drug of choice when history of anaphylaxis or some other severe allergic
reaction to penicillins Right Ans - Avoid cephalosporin;
, Vancomycin, erythromycin, and clindamycin are effective and safe
alternatives for patients with penicillin allergy.
Common drug used to treat bacterial infections in children. Right Ans -
Penicillins
First line treatment for infection following animal or human bites Right
Ans - Amoxicillin/clavulanate (Augmentin)
Medication common for streptococcal pharyngitis Right Ans - Penicillin
Penicillin Risk in Pregnancy Right Ans - evidence suggests there is no
second or third trimester fetal risk
Penicillin Risk in Infants Right Ans - Used safely in infants with bacterial
infections, including syphilis, meningitis, and group A streptococcus.
Amoxicillin Right Ans - Safe use during breastfeeding
Penicillin Use in Older Adults Right Ans - Doses should be adjusted in older
adults with renal dysfunction.
Cephalosporins Right Ans - β-lactam antibiotics similar in structure and
actions to the penicillins.
Are bactericidal, often resistant to β-lactamases, and active against a broad
spectrum of pathogens.
Useful alternative with mild penicillin allergy
Cephalosporins MOA Right Ans - Bactericidal drug similar to penicillins
that bind to penicillin-binding proteins (PBPs):
(1) disrupt cell wall synthesis
(2) activate autolysins (enzymes that cleave bonds in the cell wall). The
resultant damage to the cell wall causes death by lysis. Most effective against
cells undergoing active growth and division.
Ceftriaxone (Rocephin) Right Ans - Cephalosporin eliminated largely by the
liver.
Dosage reduction is not necessary in patients with renal impairment.
Family: Questions With Accurate Solutions
β-lactam antibiotic MOA Right Ans - All antibiotics in class share the same
mechanism of action: disruption of the bacterial cell wall.
Inhibition of cell wall synthesis
Empiric Therapy Right Ans - start treatment without cultures or prior to
receiving the results of a culture
immediate empiric antibiotics Right Ans - Critically ill patients receive (Fill
in the Answer) after the first set of cultures obtained; do not wait for results.
Bactericidal antibiotics Right Ans - Directly kill bacteria: Agents include
aminoglycosides, beta-lactams, fluoroquinolones, metronidazole, most
antimycobacterial agents, streptogramins, and vancomycin.
preferred for immunocompromised patients such as those with diabetes, HIV,
or cancer and for those who have overwhelming infections
Bacteriostatic agents Right Ans - inhibit bacterial proliferation while the
host's immune system does the killing. Agents include clindamycin,
macrolides, sulfonamides, and tetracyclines
β-lactam Antibiotics Right Ans - Penicillins, Cephalosporins, Carbapenems,
Monobactams
Penicillins MOA Right Ans - Weaken bacterial cell wall by two actions:
(1) inhibition of transpeptidases
(2) disinhibition (activation) of autolysins.
PBPs (Penicillin Binding Proteins) Right Ans - Transpeptidases, Autolysins,
and other bacterial enzymes are collectively named as because antibiotic class
must bind to them to produce antibacterial effects.
,gram-positive bacteria Right Ans - two layers: the cytoplasmic membrane
and a relatively thick cell wall; penicillins are generally very active against
these organisms.
gram-negative bacteria Right Ans - three layers: the cytoplasmic
membrane, a relatively thin cell wall, and an additional outer membrane; only
certain penicillins (e.g., ampicillin) are able to cross and reach penicillin
binding proteins (PBPs)
Four Major Groups of Penicillins Right Ans - (1) narrow-spectrum
penicillins that are penicillinase sensitive
(2) narrow-spectrum penicillins that are penicillinase resistant
(antistaphylococcal penicillins)
(3) broad-spectrum penicillins (aminopenicillins)
(4) extended-spectrum penicillins (antipseudomonal penicillins).
narrow-spectrum penicillins: Penicillinase sensitive penicillins Right Ans -
Penicillin G, Penicillin V
narrow-spectrum penicillinase sensitive susceptible pathogens Right Ans -
Streptococci, Neisseria, anaerobes
very narrow antimicrobial spectrum and are used only against penicillinase-
producing strains of staphylococci (S. aureus and S. epidermidis). Right Ans
- narrow-spectrum penicillins: penicillinase resistant penicillins
narrow-spectrum penicillins: penicillinase resistant penicillins Right Ans -
Nafcillin, Oxacillin, Dicloxacillin
narrow-spectrum- penicillinase resistant susceptible pathogens Right Ans -
S. Aureus, S. Epidermidis
Drugs of choice for most staphylococcal infections Right Ans -
penicillinase-resistant penicillins (Nafcillin, Oxacillin, Dicloxacillin)
,Broad spectrum Penicillin: Aminopenicillins Right Ans - Ampicillin,
Amoxicillin
Broad spectrum Aminopenicillin susceptible pathogens Right Ans -
Haemophilus influenzae, Escherichia coli, Proteus mirabilis, enterococci,
Neisseria gonorrhoeae
Extended spectrum penicillins (antipseudomonal penicillin) Right Ans -
Piperacillin
Has the same antimicrobial spectrum as penicillin G, plus increased activity
against certain gram-negative bacilli, including Haemophilus influenzae,
Escherichia coli, and Salmonella and Shigella Right Ans - Broad spectrum
Penicillin: Aminopenicillins
First line for acute otitis media and sinusitis Right Ans - Amoxicillin
Extended spectrum penicillins suceptible pathogens Right Ans -
Haemophilus influenzae, Escherichia coli, Proteus mirabilis, enterococci,
Neisseria gonorrhoeae, pseudomonas, enterobactor, klebsiella
Principle pathogenic target of Piperacillin Right Ans - Pseudomonas
aeruginosa
beta-lactamase inhibitors to broaden penicillin spectrum Right Ans -
clavulanate, sulbactam, tazobactam
Penicillin/Beta-Lactamase Combinations Right Ans - Ampicillin/sulbactam
(Unasyn)
Amoxicillin/clavulanate (Augmentin)
Piperacillin/tazobactam (Zosyn)
MRSA Drug of Choice Right Ans - Vancomycin
Most Important AE of Penicillins Right Ans - Hypersensitivity Reaction
Drug of choice when history of anaphylaxis or some other severe allergic
reaction to penicillins Right Ans - Avoid cephalosporin;
, Vancomycin, erythromycin, and clindamycin are effective and safe
alternatives for patients with penicillin allergy.
Common drug used to treat bacterial infections in children. Right Ans -
Penicillins
First line treatment for infection following animal or human bites Right
Ans - Amoxicillin/clavulanate (Augmentin)
Medication common for streptococcal pharyngitis Right Ans - Penicillin
Penicillin Risk in Pregnancy Right Ans - evidence suggests there is no
second or third trimester fetal risk
Penicillin Risk in Infants Right Ans - Used safely in infants with bacterial
infections, including syphilis, meningitis, and group A streptococcus.
Amoxicillin Right Ans - Safe use during breastfeeding
Penicillin Use in Older Adults Right Ans - Doses should be adjusted in older
adults with renal dysfunction.
Cephalosporins Right Ans - β-lactam antibiotics similar in structure and
actions to the penicillins.
Are bactericidal, often resistant to β-lactamases, and active against a broad
spectrum of pathogens.
Useful alternative with mild penicillin allergy
Cephalosporins MOA Right Ans - Bactericidal drug similar to penicillins
that bind to penicillin-binding proteins (PBPs):
(1) disrupt cell wall synthesis
(2) activate autolysins (enzymes that cleave bonds in the cell wall). The
resultant damage to the cell wall causes death by lysis. Most effective against
cells undergoing active growth and division.
Ceftriaxone (Rocephin) Right Ans - Cephalosporin eliminated largely by the
liver.
Dosage reduction is not necessary in patients with renal impairment.
