NAPLEX Question of the Week: Antibiotic MOA

Some studies have found as many as 1 in 2 prescriptions written in the United States are for antimicrobials, often inappropriately. Today's question of the week involves mechanisms of action.
NAPLEX Question of the Week: Antibiotic MOA
Like

Share this post

Choose a social network to share with, or copy the shortened URL to share elsewhere

This is a representation of how your post may appear on social media. The actual post will vary between social networks

A 68 year old female is admitted to the medical intensive care unit from the nursing home for septic shock likely due to pneumonia. The patient has NKDA and is written for vancomycin, piperacillin/tazobactam, and tobramycin for empiric therapy. Which of the following antibiotics that  she is receiving exerts its mechanism of action by inhibiting cell wall synthesis? 

A. Vancomycin and piperacillin/tazobactam

B. Piperacillin/tazobactam and tobramycin

C. Vancomycin and tobramycin

D. Vancomycin

E. Tobramycin



Answer with rationale:

The correct answer is A. All beta-lactams, carbapenems, and monobactams (remember aztreonam?) decrease cell wall synthesis leading to cell death in the bacteria targeted. Remember that beta-lactams include penicillins and cephalosporins. Vancomycin works by binding to the D-alanyl-D-alanine terminal of the growing peptide chain during cell wall synthesis, resulting in inhibition of transpeptidase, which prevents further elongation and cross-linking of the peptidoglycan matrix. Aminoglycosides such as tobramycin work to inhibit protein synthesis by irreversible binding to the 30S ribosomal subunit making answers B, C, and E incorrect. 

Mechanisms of action are crucial to foundational knowledge to understand clinical pharmacotherapy. By understanding mechanism of action, you further solidify pathophysiology by understanding drug targets for disease and don't "memorize" material. Knowledge of mechanisms of action falls into NAPLEX competency statement 1.2.5. 

Have a great week!

Dr. B

Create a Free MyAccess Profile

AccessMedicine Network is the place to keep up on new releases for the Access products, get short form didactic content, read up on practice impacting highlights, and watch video featuring authors of your favorite books in medicine. Create a MyAccess profile and follow our contributors to stay informed via email updates.