Chemotherapy: daptomycin: practice question

A Pharmacology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Pharmacology · Chemotherapy: daptomycin

Sample item

A 62-year-old man with MRSA pneumonia is considered for daptomycin because vancomycin was not tolerated. Why is daptomycin unsuitable?

AIt is bacteriostatic and cannot kill organisms in lungBPulmonary surfactant binds and inactivates itCIt causes severe bronchospasmDIt lacks activity against MRSA

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Pulmonary surfactant binds and inactivates it

Daptomycin is a cyclic lipopeptide that inserts into the Gram-positive cell membrane and causes depolarisation. It is useful for MRSA bacteraemia and right-sided endocarditis, but surfactant in the alveoli inactivates it, so it is not used for pneumonia. It can raise creatine kinase, so levels are monitored.

Option by option

A. It is bacteriostatic and cannot kill organisms in lung
It is rapidly bactericidal, not bacteriostatic.
B. Pulmonary surfactant binds and inactivates it (correct)
Correct. Inactivation by surfactant makes it ineffective in pneumonia.
C. It causes severe bronchospasm
Bronchospasm is not a recognised major effect; myopathy is.
D. It lacks activity against MRSA
It is active against MRSA and vancomycin-resistant enterococci.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this Pharmacology question

What is the answer to this Pharmacology question?

The best answer is B, Pulmonary surfactant binds and inactivates it. Daptomycin is a cyclic lipopeptide that inserts into the Gram-positive cell membrane and causes depolarisation.

Why is "It is bacteriostatic and cannot kill organisms in lung" not the answer?

It is rapidly bactericidal, not bacteriostatic.

Why is "It causes severe bronchospasm" not the answer?

Bronchospasm is not a recognised major effect; myopathy is.

Why is "It lacks activity against MRSA" not the answer?

It is active against MRSA and vancomycin-resistant enterococci.

What concept does this question test?

It tests Chemotherapy: daptomycin in Pharmacology. It is useful for MRSA bacteraemia and right-sided endocarditis, but surfactant in the alveoli inactivates it, so it is not used for pneumonia. It can raise creatine kinase, so levels are monitored.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Chemotherapy: daptomycin?

Learn drugs as classes, then the exception in each class that an examiner would pick. Then use the flashcards and the other Pharmacology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.