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50 Cards in this Set
- Front
- Back
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Vancomycin (Vancocin) is very rarely indicated as the drug of first choice in the initial treatment of an infection because:
Answer it frequently causes jaundice and hemolytic anemia it has a very broad spectrum it should be held in reserve to minimize development of resistance its use is accompanied by rapid and severe candidal super-infections many pathogens are resistant to vancomycin |
it should be held in reserve to minimize development of resistance
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Piperacillin (Pipracil) should be combined with a member of the following groups when used in the treatment of Pseudomonas aeruginosa infections, in order to decrease the development of resistance
Answer penicillinase resistant penicillins chloramphenicol cephalosporins sulfonamides aminoglycosides |
aminoglycosides
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Aztreonam (Azactam) is effective against:
Answer gram positive bacteria only gram negative bacteria only anaerobes only spirochetes only both gram positive and gram negative bacteria |
gram negative bacteria only
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Ethambutol (Myambutal), rifampin (Rimactane) and pyrazinamide (Aldinamide) are administered concurrently with isoniazid (INH) in the treatment of tuberculosis in order to:
Answer reduce the pain of injection facilitate penetration of the blood brain barrier minimize the development of organisms resistant to isoniazid delay excretion of isoniazid by the kidney retard absorption after intramuscular injection |
minimize the development of organisms resistant to isoniazid
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Cefaclor (Ceclor)
Answer is a second generation cephalosporin is eliminated by the kidneys has dose dependent renal toxicity is effective against Klebsiella infections all of the above |
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all of the above |
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A 65-year-old man presents to the Emergency Department with a 2-day history of fever, chest pain, chills, and rust colored sputum production. He also complains of shortness of breath. The chest x-ray and sputum staining suggests Streptococcus pneumoniae. While blood culture results are pending, therapy must be initiated immediately. What would be the best choice to commence therapy with the least potential for adverse effects?
Answer cefepime (Maxipime) aztreonam (Azactam) chloramphenicol (Chloromycetin) penicillin G (Pfizerpen) vancomycin (Vancocin) |
penicillin G (Pfizerpen)
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Which of the following antibiotics alters the function of the 50-S ribosomal subunits?
Answer vancomycin (Vancocin) doxycycline (Vibramycin) chloramphenicol (Chloromycetin) fosfomycin (Monurol) bacitracin |
chloramphenicol (Chloromycetin)
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Select the antibiotic for treatment of staphylococcal pneumonia, where the causative agent is penicillinase-producing Staphylococcus aureus.
Answer tetracycline (Actisite) nafcillin (Nafcil) penicillin G penicillin V gentamicin (Garamycin) |
nafcillin (Nafcil)
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Cefixime (Suprax) is a
Answer penicillinase resistant penicillin antipseudomonal penicillin extended spectrum penicillin first generation cephalosporin third generation cephalosporin |
third generation cephalosporin
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A 64-year-old woman with an infection due to vancomycin-resistant Enterococcus faecium (VRE) was given a bactericidal parenteral antibiotic which inhibits protein synthesis. She was most likely treated with:
Answer aztreonam (Azactam) clindamycin (Clindocin) quinupristin; dalfopristin (Synercid) linezolid (Zyvox) ceftriaxone (Rocephin) |
quinupristin; dalfopristin (Synercid)
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The most important adverse effect of imipenem-cilastatin combination (Primaxin) is:
Answer nephrotoxicity hepatotoxicity seizures hypersensitivity reactions pseudomembranous colitis |
seizures
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Which of the following are examples of mechanisms for the development of drug resistance in microorganisms?
Answer induction of penicillinase in Staphylococcus aureus increased levels of acetyltransferase in salmonella causing inactivation of chloramphenicol by acetylation decreased uptake of tetracycline by Staphylococcus aureus decreased affinity of trimethoprim for dihydrofolate reductase in enterobacteriaceae all are correct |
all are correct
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Gentamicin is sometimes used in combination with a penicillin because
Answer inhibition of cell wall synthesis facilities the uptake of gentamicin by the bacteria inhibitors of protein synthesis block the production of beta-lactamase enzymes which are induced by penicillins effects of gentamicin on the kidney slow the excretion of penicillins penicillin directly enhances aminoglycoside binding to bacterial ribosomes all of the above are correct |
inhibition of cell wall synthesis facilities the uptake of gentamicin by the bacteria
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A 58-year-old hospitalized woman develops a Pseudomonas infection. An extended spectrum antipseudomonal penicillin is prescribed, and a second drug is ordered for combination chemotherapy. The second drug, gentamicin (Garamycin), will be administered as a single daily 30-minute infusion. This dosing regimen is appropriate because the second drug:
Answer does not exhibit a post-antibiotic effect exhibits concentration-dependent killing has a half-life of over 24 hours is highly protein-bound is not tolerated if given more frequently |
exhibits concentration-dependent killing
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Which of the following drugs is a second generation cephalosporin?
Answer amoxicillin (Amoxil) cefoperazone (Cefobid) cefuroxime (Zinacef) cloxacillin (Cloxapen) cefazolin (Ancef) |
cefuroxime (Zinacef)
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Which of the following toxicities is least likely to occur with sulfonamides?
Answer nephrotoxicity ototoxicity Stevens-Johnson syndrome jaundice, hepatitis agranulocytosis |
ototoxicity
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A 78-year-old female patient in a nursing home has been treated with nitrofurantoin (Furadantin) for months because of repeated urinary tract infections. Which of the following adverse reactions may occur?
Answer adrenal suppression pulmonary fibrosis nephrotoxicity thrombocytopenia tendon rupture |
pulmonary fibrosis
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A 75-year-old man has an intra-abdominal infection caused by a beta-lactamase-producing Gram-negative organism. The patient has documented penicillin hypersensitivity resulting in an anaphylactic response. Which drug is best for this patient?
Answer aztreonam (Azactam) cefepime (Maxipime) cefoxitin (Mefoxin) ceftazidime (Fortaz) cephalexin (Keflex) |
aztreonam (Azactam)
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The least toxic of the following antibiotics is:
Answer sulfamethoxazole (Gantanol) penicillin G cefoperazone (Cefobid) amikacin (Amikin) doxycycline (Vibramycin) |
penicillin G
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In selecting an antibiotic to treat a particular infection, which of the following considerations is incorrect?
Answer the antibiotic sensitivity of the pathogen should be determined and taken into account a bactericidal agent should be selected in preference to a bacteriostatic agent an agent less toxic to the host should be selected over a more toxic agent an agent acting on protein synthesis should be selecteded over one which does not have this effect a narrow spectrum agent should be selected over a broad spectrum agent |
an agent acting on protein synthesis should be selecteded over one which does not have this effect
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Drug of choice for the treatment of syphilis
Answer spectinomycin (Trobicin) chloramphenicol (Chloromycetin) tobramycin (Nebcin) tetracycline (Actisite) Penicillin G |
Penicillin G
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Which of the following antibiotics can reasonably be expected to inhibit the bactericidal action of the penicillins?
Answer chloramphenicol (Chloromycetin) fosfomycin (Monurol) bacitracin vancomycin (Vancocin) amikacin (Amikin) |
chloramphenicol (Chloromycetin)
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Serious nephrotoxicity limits the systemic use of the following drug:
Answer chloramphenicol nafcillin (Nafcil) bacitracin tetracycline (Actisite) ceftriaxone (Rocephin) |
bacitracin
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Ampicillin (Omnipen) is a
Answer penicillinase resistant penicillin antipseudomonal penicillin extended spectrum penicillin first generation cephalosporin third generation cephalosporin |
extended spectrum penicillin
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Drug of choice for the treatment of Neisseria gonorrhoeae infections:
Answer spectinomycin (Trobicin) ceftriaxone (Rocephin) penicillin G gentamicin (Garamycin) chloramphenicol (Chloromycetin) |
ceftriaxone (Rocephin)
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Isoniazid (Niazide), given to "slow" acetylators may produce:
Answer peripheral neuropathies Stevens-Johnson syndrome thrombocytopenia apnea methemoglobinemia |
peripheral neuropathies
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Mechanism of action of tetracyclines
Answer inhibition of cell wall synthesis inhibition of DNA gyrase binding to the 30 S ribosomal subunit binding to the 50 S ribosomal subunit inhibition of the dihydrofolate reductase enzyme |
binding to the 30 S ribosomal subunit
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Inhibits the transpeptidation of the peptidoglycan chains?
Answer sulfamethoxazole + trimethoprim (Bactrim) vancomycin (Vancocin) fosfomycin (Monurol) cyloserine (Seromycin) cefepime (Maxipime) |
cefepime (Maxipime)
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Which of the following drugs is associated with the "red man" syndrome?
Answer meropenem (Merrem) fosfomycin (Monurol) vancomycin (Vancocin) aztreonam (Azactam) dicloxacillin (Dynapen) |
vancomycin (Vancocin)
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Which of the following are toxic effects of tobramycin (Nebcin)?
Answer aplastic anemia, gray baby syndrome renal damage, hallucinations crystalluria, allergic reactions renal tubular damage, ototoxicity GI irritation, superinfections, hepatotoxicity in pregnancy |
renal tubular damage, ototoxicity
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Very effective for the treatment of Legionella infections:
Answer Penicillin G cefazolin (Ancef) erythromycin (Erythrocin) methenamine (Mandelamine) vancomycin (Vancocin) |
erythromycin (Erythroci
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Which of the following drugs is considered to be a bacteriostatic agent?
Answer penicillin G cefazolin (Ancef) gentamicin (Garamycin) tetracycline (Actisite) amoxicillin + clavulanic acid (Augmentin) |
tetracycline (Actisite)
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Kernicterus may occur in neonates given
Answer penicillin G chloramphenicol cephalosporins sulfonamides aminoglycosides |
sulfonamides
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The major cause of resistance to penicillin is the emergence of bacteria that
Answer block the transport of penicillin through their cell membrane do not bind penicillin to their 30S ribosomal subunits produce penicillinase, a beta-lactamase enzyme do not contain protein in their cell membrane produce excessive amounts of the enzyme peptidoglycan transpeptidase |
produce penicillinase, a beta-lactamase enzyme
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Which of the following drugs inhibits the membrane transport of the peptidoglycan subunits?
Answer vancomycin (Vancocin) fosfomycin (Monurol) bacitracin cycloserine (Seromycin) piperacillin (Pipracil) |
bacitracin
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Which of the following statements does not apply to tetracyclines?
Answer resistance may occur through changes in bacterial cell membrane transport bind to calcium in developing bone and teeth excreted in milk of nursing mothers bactericidal activity against Pseudomonas aeruginosa undergoes enterohepatic circulation |
bactericidal activity against Pseudomonas aeruginosa
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A 42-year-old man is diagnosed with a Pseudomonas aeruginosa infection. Susceptibility tests show that the strain expresses a beta-lactamase. Which of the following drugs would be the best to administer along with gentamicin (Garamycin)?
Answer cloxacillin (Cloxapen) meropenem (Merrem) piperacillin (Pipracil) sulbactam tazobactam |
meropenem (Merrem)
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The Jarisch-Herxheimer reaction in syphilis is caused by:
Answer an overdose of penicillin G the rapid destruction of a large number of treponemas hypersensitivity to penicillin G penicillin that has not been properly refrigerated retention of the treponemas in the body |
the rapid destruction of a large number of treponemas
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Which of the following drug: rationale combinations is not correct?
Answer trimethoprim - sulfamethoxazole: inhibits two steps in synthesis of DNA topoisomerase I and II amoxicillin - clavulanate: inhibits beta-lactamase, preventing destruction of amoxicillin imipenem - cilastatin: prevents antibiotic inactivation by inhibiting dehydropeptidase in the kidney ampicillin - sulbactam: inhibits beta-lactamases, preventing inactivation of ampicillin |
trimethoprim - sulfamethoxazole: inhibits two steps in synthesis of DNA topoisomerase I and II
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Select the incorrect drug -- adverse effect pair.
Answer isoniazid (INH) -- hepatotoxicity rifampin (Rimactane) -- enzyme induction ethambutol (Myambutal) -- decreased visual acuity pyraznamide (Aldinamide) -- nephrotoxicity streptomycin -- ototoxicity |
pyraznamide (Aldinamide) -- nephrotoxicity
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Drug of choice for the treatment of septicaemia caused by methicillin resistant Staphylococcus aureus (MRSA) infections
Answer nafcillin (Nafcil) chloramphenicol (Chloromycetin) vancomycin (Vancocin) cefixime (Suprax) sulfamethoxazole + trimethoprim (Bactrim) |
vancomycin (Vancocin)
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Antibiotics which inhibit cell wall synthesis include:
Answer vancomycin (Vancocin) meropenem (Merrem) aztreonam (Azactam) cefepime (Maxipime) all of the above |
all of the above
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Relative anti-bacterial efficacy of different tetracyclines
Answer is primarily due to differences in pharmacokinetics is due to widely varying resistance to different tetracycline congeners results from differing abilities to chelate divalent metal ions is based on "fast" and "slow" acetylator phenotypes of patients results from differential induction of cytochrome P450s by different tetracyclnies |
is primarily due to differences in pharmacokinetics
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Renal excretion is not a major route of elimination:
Answer cefazolin (Ancef) amoxicillin (Amoxil) streptomycin penicillin G (Pfizerpen) cefoperazone (Cefobid) |
cefoperazone (Cefobid)
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Drug of choice for the treatment for Klebsiella or Proteus infections:
Answer penicillinase resistant penicillins chloramphenicol cephalosporins (first or second generation) cephalosporins (third generation) aminoglycosides |
cephalosporins (first or second generation)
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A 24-year-old woman is treated with sulfamethoxazole for a urinary tract infection. Which of the following results from the mechanism of action of this drug?
Answer acute hemolytic anemia in glucose-6-phosphate dehydrogenase-deficient patients concentration-dependent killing of susceptible bacteria inactivation of the drug by acetylation rapid renal clearance requirement for sustained therapeutic levels of the drug in plasma |
requirement for sustained therapeutic levels of the drug in plasma
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Main elimination route is active secretion into the proximal tubular fluid by the anion transport system:
Answer chloramphenicol (Chloromycetin) amoxicillin (Amoxil) amikacin (Amikin) linezolid (Zyvox) tobramycin (Nebcin) |
amoxicillin (Amoxil)
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Cefepime (Maxipime) is effective against:
Answer gram positive bacteria only gram negative bacteria only anaerobes only spirochetes only both gram positive and gram negative bacteria |
both gram positive and gram negative bacteria
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Mechanism of anti-TB action of isoniazid
Answer synthesizes nonfunctional protein interferes with PABA utilization by bacteria inhibits synthesis of RNA in bacteria inhibits mycolic acid synthesis inhibits peptidoglycan synthesis |
inhibits mycolic acid synthesis
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Which of the following side effects of trimethoprim-sulfamethoxazole (Bactrim) has been attributed to its interference with folate metabolism?
Answer Stevens-Johnson syndrome erythema multiforme exfoliative dermatitis thrombocytopenia hemolysis |
thrombocytopenia
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