MIC 541-Exam 4- Antimicrobials IV-3

  1. Aminopenicillins were very active against Neisseria, etc, most are not resistance b/c of b-lactamase
    only treat those with Aminopenicillins if you have alab test showing

    • What do you need prior to using Aminopenicillins to treat Neisseria, H. influenzae, E. coli, Salmonell and Shigella (+ other aerobic Gram - bacteria)?
    • Lab test showing susceptibility
  2. What bacteria require a lab test prior to treatment with Aminopenicillins?
    • Neisseria
    • H. influenzae
    • E. coli
    • Salmonella
    • Shigella
  3. Why do you need a lab test for Neisseria prior to Aminopenicillin use?
    To verify susceptibility (due to the reduced susceptibilty inferred from B-lactamases)
  4. Aminopenicillins are very active against Gram - species (T/F)?
    • False
    • Previously very active
    • Currently many gram - bacteria have B-lactamase activity
  5. Are Aerobically growing gram - bacteria susceptible to Aminopenicillins?
    Most are resistant
  6. Is b. fragilis susceptible to aminopenicillins?
    Yes, it is resistant
  7. Is Prevotella resistant to Aminopenicillins?
    Yes, usually
  8. What is the metabolism and Gram stain of Prevotella?
    • Anaerobic
    • Gram -
  9. What is the metabolism and gram stain of B. fragilis?
    • Anaerobic
    • Gram -
  10. Neisseria, H. influenzae, E. coli, Salmonella and Shigella all have what gram stain and metabolism?
    • Gram negative
    • Aerobic
  11. Why are Gram negative aerobes developing resistance to Aminopenicillins?
    B-lactamase activity
  12. What are the two expanded spectrum penicillins?
    • Ticarcillin
    • Piperacillin
  13. What category of antibiotics are Ticarcillin and Piperacillin?
    Expanded spectrum penicillins
  14. Gram negative spectrum of Expanded Spectrum penicillins includes what Genus (as emphasized in class)?
  15. Pseudomonas can be treated with what Penicillins?
    Ticarcillin and Piperacillin (Expanded spectrum penicillins)
  16. Expanded spectrum penciillin is less or more effective (pound for pound) than aminopenicillin and Pen G/V?
    Less potent pound per pound
  17. Can expanded spectrum penicillins be inactivated by B-lactimases?
  18. What is relative cost of Expanded spectrum antibiotics compared to others?
    much More costly
  19. Under what conditions are Expanded spectrum penicillins usually used?
    • Hospitals
    • Serious infections
    • With an aminoglycoside
  20. What group of penicillins are used mainly in hospitals for serious infections along with an aminoglycoside?
    Expanded Spectrum Penicillins (Ticarcillin and Piperacillin)
  21. What situation would you not use an Expanded Spectrum Penicillin?
    If the pathogen is not susceptible to older penicillins or 1st generation cephalosporins
  22. What routes of administration are available for Expanded Spectrum Penicillins (Ticardillin and Piperacillin)?
  23. B-lactamase resistant penicillins include:
    • Methicillin
    • Nafcillin
    • Oxacillin
    • Cloxacillin
    • Dicloxacillin
  24. What type of Penicillins have a bulky side chain that prevents B-lactamase inactivation?
    • B-lactamse-resistant Pencicillins:
    • Methicillin, nafcillin, oxacillin, cloxacillin and dicloxacillin
  25. Methacillin, nafcillin, oxacillin, cloxacillin and dicloxacillin are all of what group of Penicillins?
    B-lactamase-resistant Penicillins
  26. What is the spectrum for B-lactamase resistant penicillins?
    • Gram + cocci or bacilli
    • Except: Listeria, enterococcus, MRSA
  27. What group of bacteria are active against gram + cocci and bacilli except listeria, MRSA and enterococcus?
    B-lactamase resistant Penicillins
  28. Why are B-lactamase resistant Penicillins not active against gram negatives?
    They are too big and bulky to get through the Gram - outer membrane
  29. What B-lactamase resistant penicillin is no longer used?
  30. What type of Penicillin is to bulky to get through the gram - outer membrane?
    B-lactamase resistant Pencillins
  31. What is the main cause of bacterial resistance to B-lactam antibiotics?
    B-lactamase production
  32. What drug combinations are used to combat B-lactamase producing bacteria?
    Penicillin/B-lactamase inhibitor combinations
  33. Name the four Penicillin/b-lactamase inhibitor Combinations currently available:
    • Augmentin
    • Timentin
    • Unasyn
    • Zosyn
  34. What Penicillin/b-lactamase inhibitor Combination is used heavily in pediatrics?
  35. What is augmentin composed of?
  36. How many B-lactamase inhibitors are available?
    • 3
    • What are the three B-lactamse inhibitors?
    • clavulanate
    • sulbactam
    • tazobactam
  37. Clavulanate, sulbactam and tazoactam are what type of drugs?
    B-lactamase inhibitors
  38. What is Amoxicillin/Clavulanate combination called?
  39. What is Ticarcillin clavulanate combination called?
  40. What is Timentin composed of?
    • Ticarcillin
    • Clavulanate
  41. What is Unasyn composed of?
  42. What is the drug name for Ampicillin/sulbactam?
  43. What is the composition of Zosyn?
  44. What is the name of the drug containing Tazobactam and Piperacillin?
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MIC 541-Exam 4- Antimicrobials IV-3
MIC 541-Exam 4- Antimicrobials IV-3