Pharm Exam 4: Antibiotics Ii

Front 1

What bacteria is now considered a superbug?

Back 1

Gonorrhea

Front 2

What does the CDC now recommend for treatment of gonorrhea?

Back 2

Ceftriaxone

Front 3

Name a drug that starts with D that is a last resort for resistant bacteria?

Back 3

Dapsone

Front 4

Name a drug that starts with I that is a last resort for resistant bacteria?

Back 4

Isoniazid

Front 5

Name a drug that starts with M that is a last resort for resistant bacteria?

Back 5

Metronidazole

Front 6

Name a drug that starts with P that is a last resort for resistant bacteria?

Back 6

Polymixin B and E

Front 7

Name a drug that starts with R that is a last resort for resistant bacteria?

Back 7

Rifamycin

Front 8

Name a drug that starts with V that is a last resort for resistant bacteria?

Back 8

Vancomycin

Front 9

What kind of infection can resistant Staphylococcus aureus cause?

Back 9

MRSA Infection

Front 10

What two drug-resistant bacteria can cause life-threatening urinary and intesting infections?

Back 10

E. coli and Klebsiella

Front 11

What drug resistant bacteria is hospital acquired and wound infection is comon in troops in Iraq and Afghan?

Back 11

Acinetobacter baumannii (MDR-AB)

Front 12

What bacteria is known for being vancomycin resistant?

Back 12

Enterococcus

Front 13

What drug resistant bacteria can cause severe pneumonia and UTI especially in cancer and AIDS patients?

Back 13

Pseudomonas aeruginosa

Front 14

What happened between 1960 and 2000 with development of antibiotics?

Back 14

Innovation gap

Front 15

What is the average bacterial growth time?

Back 15

20-30 minutes (rapid!)

Front 16

Increased PABA synthesis can cause resistance to what antibiotic?

Back 16

Sulfonamide

Front 17

What antibiotic has beta-lactamase resistance?

Back 17

Imipenum

Front 18

What antibiotic has improved uptake?

Back 18

Doxycycline

Front 19

What property increases improved uptake of doxycycline?

Back 19

Lipid solubility

Front 20

Name a new modified tetracycline?

Back 20

Tigacycline

Front 21

What drug in tetracycline class has a modified scaffold?

Back 21

Tigacycline

Front 22

What drug in tetracycline class has a new scaffold?

Back 22

Retapumulin

Front 23

For what antibiotic is the mechanism of action inhibition of cell wall synthesis by binding to D-Ala-D-Ala terminus of cell wall precursor?

Back 23

Vancomycin

Front 24

How is drug resistance to vancomycin mediated?

Back 24

Plasmid-mediated

Front 25

What is the cluster of 7 genes that produce altered cell wall precursors, giving rise to vancomycin resistance?

Back 25

VanA type gene

Front 26

D-Ala gets changed to what with Vancomycin resistance?

Back 26

D-Lactate

Front 27

What infection is used to treat with Vancomycin?

Back 27

MRSA

Front 28

What antibiotic can have additive toxicity with ototoxic or nephrotoxic drugs?

Back 28

Vancomycin

Front 29

Rapid IV infusion of Vancomycin can cause what syndrome?

Back 29

Red man syndrome - severe flushing

Front 30

Colitis resistant to metronidazole is treated with what antibiotic?

Back 30

Vancomycin

Front 31

What route of administration is contraindicated with Vancomycin?

Back 31

Intramuscular

Front 32

For what drug is the mechanism of action a combination of 2 separate steps of protein elongation?

Back 32

Streptogramin A and B

Front 33

Which streptogramin causes inactivation of peptidyl transferase?

Back 33

Streptogramin A

Front 34

Which streptogramin causes intereference with positioning of charged tRNA into ribosome?

Back 34

Streptogramin B

Front 35

Inidividual streptogramin is bacteriostatic/cidal?

Back 35

Bacteriostatic

Front 36

Combination streptogramin is called what?

Back 36

Quinupristin/Dalfopristin (B/A)

Front 37

Combination streptogramin is bactericidal/bacteriostatic?

Back 37

Bacteriocidal

Front 38

For what two drug combinations does synergism occur?

Back 38

Quinupristin/Dalfopristin

Front 39

Streptogramin group A binding induces conformation change in ribosome that increases/decreases binding of B?

Back 39

Increases (synergism)

Front 40

With streptogramin A+B, there is synergistic inhibition of protein translation T/F?

Back 40

True

Front 41

Are gram- bacteria resistant/susceptible to Vancomycin?

Back 41

Resistant because drug does not cross outer membrane

Front 42

For what bacterial group is Streptogramin most commonly used?

Back 42

Gram + cocci

Front 43

Streptogramin is active against Enterococcus faecium or Enterococcus faecalis?

Back 43

E. faecium

Front 44

What is an alternative treatment for MRSA?

Back 44

Streptogramin A+B

Front 45

Streptogramins may/may not elevate liver enzymes?

Back 45

May elevate liver enzymes

Front 46

Methylation of rRNA confers resistance to which streptogramin?

Back 46

Quinupristin

Front 47

Acetylation of which streptogramin confers resistance?

Back 47

Dalfopristin

Front 48

Efflux pumps confers resistance to which streptogramin?

Back 48

Dalfopristin

Front 49

Local irritation at injection site can cause what?

Back 49

Phlebitis

Front 50

Synercid (Quinopristin/Dalfopristin) does what to CYP3A4?

Back 50

Inhibits 3A4

Front 51

For which antibiotic is the mechanism of action inhibition of formation of translation initiation complex?

Back 51

Linezolid

Front 52

For which antibiotic is the mutation on 23S rRNA?

Back 52

Linezolid

Front 53

Linezolid is bacteriostatic against which two cocci?

Back 53

Enterococci and staphylococci

Front 54

Linezolid is bacteriocidal against which cocci?

Back 54

Streptococci

Front 55

Which antibiotic is virtually exclusive for multidrug-resistant gram+ infections?

Back 55

Linezolid

Front 56

Which antibiotic is a weak monoamine oxidase inhibitor?

Back 56

Linezolid

Front 57

Which antibiotic has additive effects with MAOI antidepressants?

Back 57

Linezolid

Front 58

Avoidance of tyramine-rich foods is recommended with which antibiotic?

Back 58

Linezolid (weak MAOI)

Front 59

Does linezolid have excellent or poor absorption?

Back 59

Excellent absorption

Front 60

How is linezolid primarily eliminated?

Back 60

Renal

Front 61

What drug is a lipopeptide that inserts into bacterial membrane and disrupts the membrane potential?

Back 61

Daptomycin

Front 62

Daptomycin is bacteriostatic or bacteriocidal?

Back 62

Bacteriocidal

Front 63

Daptomycin can have what kind of interaction with beta-lactams?

Back 63

Synergism

Front 64

Daptomycin is reserved for serious/multidrug-resistant Gram + infections T/F?

Back 64

True

Front 65

Name three serious multidrug resistance Gram + infections:

Back 65

1) VRE
2) MRSA
3) Drug resistant Streptococcus

Front 66

For what antibiotic is the mechanism of action binding to bacterial isoleucyl-tRNA synthetase?

Back 66

Mupirocin

Front 67

Which antibiotic inhibits isoleucine incorporation and protein synthesis?

Back 67

Mupirocin

Front 68

Which antibiotic is reserved for skin infections caused by drug-resistant gram+ bacteria?

Back 68

Mupirocin

Front 69

Which drug can be applied nasally to eradicate MRSA in adults?

Back 69

Mupirocin

Front 70

Nasal use of Mupirocin must be avoided in what population?

Back 70

Neonates - drug absorption may be excessive

Front 71

What antibiotics are cyclic peptides with long hydrophobic tails (like detergents)?

Back 71

Polymixin B and E

Front 72

For which antibiotic is the mechanism of action interaction and disruption of cellular membranes?

Back 72

Polymixin B and E

Front 73

Are Polymixins B and E bacteriostatic or bacteriocidal?

Back 73

Bacteriocidal

Front 74

Polymixin B and E are used against what class of bacteria?

Back 74

Gram- bacteria

Front 75

Which polymixin is used for eye, ear, topical use?

Back 75

Polymixin B

Front 76

Which polymixin is used for ear only - but as a last resort?

Back 76

Polymixin E

Front 77

What drug is known as "the nuke bomb"

Back 77

Polymixin E

Front 78

Polymixin can be highly neuro- and nephrotoxic in oral or IV forms T/F?

Back 78

True

Front 79

Reductive metabolism of what drug in anaerobes produces free radials that damage DNA and proteins?

Back 79

Metronidazole

Front 80

Baceroides is an aerobic or anaerobic bacteria?

Back 80

Anaerobic

Front 81

Which drug would be used to treat bacteroides fragilis?

Back 81

Metronidazole (anaerobic)

Front 82

Helicobacter is aerobic or anaerobic?

Back 82

Anaerobic

Front 83

Which drug is part of "Triple Therapy" to treat helicobacter infection?

Back 83

Metronidazole

Front 84

Clostridium dificile (antibiotic associated colitis) is treated with what antibiotic?

Back 84

Metronidazole

Front 85

Can protozoan infections be treated with metronidazole?

Back 85

Yes it can

Front 86

What drug binds 30S ribosome with 5x higher affinity than tetracycline?

Back 86

Tigecycline

Front 87

Tigecycline is bacteriocidal or bacteriostatic?

Back 87

Bacteriocidal

Front 88

Tigecycline is/is not expelled by efflux pumps?

Back 88

Is not expelled by efflux pumps

Front 89

Tigecycline binds to what site on the ribosome?

Back 89

Novel sites

Front 90

What drug interferes with ribosomal protection?

Back 90

Tigecycline

Front 91

Should tigecycline be given to children or pregnant women?

Back 91

Should not

Front 92

What is the causative agent of TB?

Back 92

Mycobacterium tuberculosis

Front 93

What is the division time for Mycobacterium tuberculosis?

Back 93

24 hours

Front 94

Phagocytes engulf but do/do not kill Mycobacterium tuberculosis?

Back 94

Engulf but do not kill

Front 95

XDR-TB strains are resistant to how many drugs?

Back 95

3+ drugs

Front 96

What three drugs are standard for treatment of TB?

Back 96

1. Isoniazid (INH)
2. Rifampin
3. Ethambutol (EMB)

Front 97

What does DOTS stand for?

Back 97

Direct Observation of Thearpy, Short course

Front 98

What is DOTS?

Back 98

Same drugs 3x weekly for 6 months

Front 99

For TB, combination therapy is required or recommended?

Back 99

Required - resistance will develop to monotherapy

Front 100

What drug when used alone is used for prophylaxis of TB?

Back 100

Isoniazid (INH)

Front 101

What drug is the mechanism of action inhibition of mycolic acid FA synthesis?

Back 101

Isoniazid

Front 102

Name a unique component of the mycobacterial cell wall:

Back 102

Mycolic acid

Front 103

Isoniazid is bactericidal or static for growing forms of TB?

Back 103

Bacteriacidal

Front 104

Isoniazid is bactericidal or static for "resting" forms of TB?

Back 104

Bacteriostatic

Front 105

What drug can cause hemolysis in patients deficient in G6PD?

Back 105

Isoniazid

Front 106

Isoniazid can/cannot cause peripheral neuritis?

Back 106

Yes it can

Front 107

What vitamin can be given to offset peripheral neuritis?

Back 107

Pyridoxine (Vitamine B6)

Front 108

Liver acetylases metabolize what drug?

Back 108

Isoniazid

Front 109

There are two forms of liver acetylases that metabolizes isoniazid:

Back 109

1. Rapid acetylation
2. Slow acetylation

Front 110

What drug has the mechanism of action - inhibition of DNA-dependent RNA polymerase and blocks transcription?

Back 110

Rifampin

Front 111

Mutations to drug target of Rifampin develops quickly/slowly?

Back 111

Quickly - avoid monotherapy

Front 112

Rifampin is used in combination therapy to treat what two conditions?

Back 112

TB and leprosy

Front 113

Orange-red bodily fluids may result from administration of what antibiotic?

Back 113

Rifampin

Front 114

Rifampin is widely distributed in tissues and CNS T/F?

Back 114

True

Front 115

What is the causative agent of leprosy?

Back 115

Mycobacterium leprae

Front 116

Leprosy is also known by what other name?

Back 116

Hansen's disease

Front 117

Leprosy is highly contagious T/F?

Back 117

False - very low transmission rate

Front 118

Anyone can get leprosy, T/F?

Back 118

False - 95% of us are naturally immune

Front 119

Leprosy causes flesh to rot T/F?

Back 119

False - immune response causes damage

Front 120

What drug is used to cure leprosy?

Back 120

Dapsone

Front 121

Dapsone is given daily to a patient with leprosy for how long?

Back 121

1 year

Front 122

Dapsone is given along with what drug to treat leprosy?

Back 122

Rifampin

Front 123

What mechanism of action is similar to that of dapsone?

Back 123

Sulfonamids

Front 124

Dapsone is an anti-folate, T/F?

Back 124

True

Front 125

Sulfa drugs are what kind of analogues that inhibit DHPS?

Back 125

PABA analogs

Front 126

What is a unique therapy used to shift MRSA infected tissue?

Back 126

Maggots
"Larval therapy"

Front 127

Sticking thousands of bacteria-killing viruses to wound dressing is called what kind of therapy?

Back 127

Bacteriophage therapy