Week 9: Prin of Antimicrobial Tx, Cell Wall Inhibitors

The Antibiotic AUGMENTIN is combination of what 2 drugs?

a. Amoxicillin + Clavulanic Acid

b. Ampicillin + Cephalexin

c. Cephalexin + Clavulanic Acid

d. Penicillin + Clavulanic Acid

a. Amoxicillin + Clavulanic Acid

True or False: An example of a microorganism that produces penicillinase is staphylococcus aureus.

true

All of the following are Beta-Lactam antibiotic drug categories, except:

a. Cephalosporins

b. Penicillins

c. Carbapenems

d. Beta-Lactamase Inhibitors

d. Beta-Lactamase Inhibitors

All of the following statements about the carbapenems are TRUE.....EXCEPT: 

a. They are synthetic INJECTABLE beta-lactam antibiotics

b. they have a structure that renders them highly resistant to MOST beta-lactamases

c. Are one of the 'Antibiotics of last resort' for many bacterial infections.

d. they have a narrow spectrum of activity, being effective against only gram negative bacteria

d. they have a narrow spectrum of activity, being effective against only gram negative bacteria

This organism has these characteristics: have a plasma membrane, possess a peptidoglycan cell wall that is located immediately outside of the plasma membrane, lack a cell nucleus.

a. eukaryotic organism

b. prokaryotic organism

b. prokaryotic organism

This organism has these characteristics: have a plasma membrane, possess a cell nucleus, lack a peptidoglycan cell wall

a. eukaryotic organism

b. prokaryotic organism

a. eukaryotic organism

True or False: Beta-Lactamse Inhibitors, alone, possess antibacterial activity.

false

All of the following are mechanisms by which bacterial microorganisms confer resistance.......EXCEPT: 

a. Bacteria can produce bacterial enzymes that have the ability to destroy or or inactivate the antibiotic

b. Bacteria can decrease the uptake of antibiotic into the cell, rejecting it at the membrane, thereby limiting the concentration of the antibiotic to insufficient concentrations.

c. Bacteria can pump out the antibiotic via efflux pumps, limiting the concentration of antibiotic to insufficient concentrations.

d. Bacteria can modify or alter target sites for antibiotic via mutations. 

e. All of the above are mechanisms by which bacteria confer resistance to antibiotics.

e. All of the above are mechanisms by which bacteria confer resistance to antibiotics.

These cell wall inhibitors are classified as a Beta-lactamase (penicillinase)-resistant penicillins

a. Penicillin (both G and VK)

b. Methicillin

c. Nafcillin

d. Dicloxacillin

e. Ampicillin

f. Amoxicillin

g. Cephalexin

h. Cefaclor

i. Doripenem (Doribax)

j. Ertrapenem (Ivanz)

k. Clavulanate Potassium

b. Methicillin; c. Nafcillin; d. Dicloxacillin

This cell wall inhibitor is classified as a second generation cephalosporin

a. Penicillin (both G and VK)

b. Methicillin

c. Nafcillin

d. Dicloxacillin

e. Ampicillin

f. Amoxicillin

g. Cephalexin

h. Cefaclor

i. Doripenem (Doribax)

j. Ertrapenem (Ivanz)

k. Clavulanate Potassium

h. Cefaclor

This cell wall inhibitor is a beta-lactamase inhibitor

a. Penicillin (both G and VK)

b. Methicillin

c. Nafcillin

d. Dicloxacillin

e. Ampicillin

f. Amoxicillin

g. Cephalexin

h. Cefaclor

i. Doripenem (Doribax)

j. Ertrapenem (Ivanz)

k. Clavulanate Potassium

k. Clavulanate Potassium

This cell wall inhibitor is a First Generation Cephalosporin

a. Penicillin (both G and VK)

b. Methicillin

c. Nafcillin

d. Dicloxacillin

e. Ampicillin

f. Amoxicillin

g. Cephalexin

h. Cefaclor

i. Doripenem (Doribax)

j. Ertrapenem (Ivanz)

k. Clavulanate Potassium

g. Cephalexin

This cell wall inhibitor is a penicillin class of cell wall inhibitors

a. Penicillin (both G and VK)

b. Methicillin

c. Nafcillin

d. Dicloxacillin

e. Ampicillin

f. Amoxicillin

g. Cephalexin

h. Cefaclor

i. Doripenem (Doribax)

j. Ertrapenem (Ivanz)

k. Clavulanate Potassium

a. Penicillin (both G and VK)

These cell wall inhibitors are a parenteral carbapenem

a. Penicillin (both G and VK)

b. Methicillin

c. Nafcillin

d. Dicloxacillin

e. Ampicillin

f. Amoxicillin

g. Cephalexin

h. Cefaclor

i. Doripenem (Doribax)

j. Ertrapenem (Ivanz)

k. Clavulanate Potassium

i. Doripenem (Doribax); j. Ertrapenem (Ivanz)

These cell wall inhibitors are extended spectrum penicillins (aminopenicillins)

a. Penicillin (both G and VK)

b. Methicillin

c. Nafcillin

d. Dicloxacillin

e. Ampicillin

f. Amoxicillin

g. Cephalexin

h. Cefaclor

i. Doripenem (Doribax)

j. Ertrapenem (Ivanz)

k. Clavulanate Potassium

e. Ampicillin; f. Amoxicillin

True or False: Gram-Negative Bacteria are particularly susceptible to Penicillins.

false

Administration of an Antimicrobial Agent based on clinical experience is termed _____________________ therapy

a. Empiric

b. Definitive

a. Empiric

True or False: PLLR (Pregnancy and Lactation Labeling Rule) prescribing  information for all drugs can be found in the "Full Prescribing Information" (FPI) on the package insert, or  on the FDA website that lists Full Prescribing Information (FPI) for specific drugs.

true

True or False: The mechansim for Penicillinase resistant penicillins is to physically hinder/block the pencillinase enzyme via a bulky acyl side chain on the antiobiotic's chemical structure.

true

The chemical attachment of different R groups to the 6-aminopenicillanic acid nucleus (6-APA) of penicillin _____________________the antimicrobial activity of aminopenicillins to gram negative bacteria.

a. limits

b. extends

b. extends

Selection of an antimicrobial drug takes into consideration all of the following, except:

a. nature of the microrganism ( gram positive, gram negative)

b. organism suseptibility

c. site of the infection

d. patient age

e. is the patient pregnant

f. renal/liver function

g. toxicity of the antimicrobial

h. cost off the antimicrobial

i. All of the above

i. All of the above

1. The Cephalosporins are related both structurally and functionally to the penicillins, have the same mode of action,  and tend to be more resistant than the penicillins to certain beta-lactamases. 

2. First Generation Cephalosporins have greater activity against Gram Negative Bacteria than do the Third Generation Cephalosporins.

a. first statement is false, second statement is true

b. first statement is true, the second statement is false

c. both statements are true

d. both statements are false

b. first statement is true, the second statement is false

True or False: Antibiotic resistance occurs when bacteria evolve to evade the effect of antibiotics through multiple different mechanisms.

true

True or False: Penicillin Beta-Lactam Antibiotics interfere with the last stage of peptidoglycan cell wall synthesis by inhibiting the bacterial enzyme beta-lactamase.

false

True or False: Penicillinase is a specific type of beta-lactamase produced by bacteria, showing specificity for cephalosprin antibiotics by hydrolyzing the beta lactam ring in the beta-lactam antibiotic

false

1. MRSA is a any strain of Staphylococcus that has developed resistance to the Beta-Lactam Antibiotics, including the Penicillinase Resistant Antibiotics.

2. HA-MRSA is more susceptible to antimicrobial therapy than is CA-MRSA. 

a. Both Statements are false

b. First statement is false, and the second statement is True. 

c. First statement is true, and the second statement is false

d. Both Statements are true

c. First statement is true, and the second statement is false

The Spectrum of Activity for Penicillin is:

a. Narrow Spectrum

b. Extended Spectrum

c. Broad Spectrum

a. Narrow Spectrum

The Spectrum of Activity for Ampicillin is:

a. Narrow Spectrum

b. Extended Spectrum

c. Broad Spectrum

b. Extended Spectrum

True or False: When peptidoglycan synthesis of the bacterial cell wall is inhibited, this gives an osmotically less stable plasma cell membrane, which then results in bacterial cell lysis through osmotic pressure. ( cell swells and bursts)

true

Which antibiotic spectrum classification is: antibiotic drugs acting only on a single or limited group of microorganisms.

a. narrow spectrum

b. broad spectrum

c. extended spectrum

a. narrow spectrum

Which antibiotic spectrum classification is: antibiotics drugs  that are effective against gram positive organisms and also effective against a specific number of gram-negative organisms.

a. narrow spectrum

b. broad spectrum

c. extended spectrum

c. extended spectrum

Which antibiotic spectrum classification is: antibiotic drugs that affect a wide variety of microbial species. (not just gram + and gram -)

a. narrow spectrum

b. broad spectrum

c. extended spectrum

b. broad spectrum

Vancomycin is Indicated for the treatment of serious, life-threatening infections caused by __________________ bacteria that are unresponsive to other antibiotics.

a. Gram-Positive

b. Gram- Negative

a. Gram-Positive

have a thick layer of peptidoglycan that retains crystal violet dye in gram staining, stains purple-blue color, in general, however , easier to cross by antibiotics and treat --> is this:

a. gram negative bacteria

b. gram positive bacteria

b. gram positive bacteria

have a thin layer of peptidoglycan which does not retain dyeà stains pink in color, have an Outer Lipopolysaccharide ( lipid) Envelope, which makes it more difficult for antibiotics to cross and gain access to bacterial cell --> is this:

a. gram negative bacteria

b. gram positive bacteria

a. gram negative bacteria

True or False: The beta-lactam ring is defined as a four-membered cyclic structure that is a core component of beta-lactam antibiotics, such as penicillns and cephalosporins

true

True or False: A foundational mechanism of action for most antimicrobials is the taking advantage of selective toxicity.

true

True or False: Bacteriocidal Antimicrobial Drugs that kill bacteria are always preferable over Bacteriostatic drugs, that only arrest the growth and replication of bacteria.

false

All of the following are examples of antimicrobial drugs, except:

a. Antibacterials

b. Antivirals

c. Antifungals

d. Antiemetics

e. Antiparasitics

f. Antihistamines

g. 2 of the above are not antimicrobials

h. All of the above are antimicrobials

g. 2 of the above are not antimicrobials

True or False: Beta-Lactamases are enzymes produced by bacteria that hydrolize that characteristic Beta-Lactam ring that is common to all Beta Lactam Antibiotics, ultimately providing resistance to the Beta Lactam Antibiotic.

true

True or False: In general, Gram negative cell walls are less difficult for antibiotics to cross than are Gram Positive cell walls.

false