2nd Shifting Exam [Lessons 5-8] Flashcards by Judienne Angelique Pilpil

An antimicrobial drug that can eradicate an infection in the absence of host defense mechanisms.

Bactericidal

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True or False

Bactericidal drugs need the participation of the immune system to eradicate bacteria.

False

BacterioSTATIC drugs requires the host defense mechanisms

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Which of the following is not an bactericidal drug?

A. Rifampin
B. Metronidazole
C. Erythromycin
D. Quinolones

C. Erythromycin

Explanation: Erythromycin is a macrolide therefore, it is bacteriostatic. Macrolides are protein synthesis inhibitors, thus making it bacteriostatic.

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Which of the following antimicrobial drugs does NOT kill bacteria, but eradicates infections

A. Bactericidal
B. Bacteriostatic

B. Bacteriostatic

Bactericidal drugs kills the bacteria

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Which of the following is an bacteriostatic drug?

A. Chloramphenicol
B. Clindamycin
C. Trimethoprim
D. Vancomycin

D. Vancomycin

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This type of antibiotics include penicillin, cephalosporins, and carbapenems.

Beta-lactam antibiotics

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True or False

This ring must be intact for antimicrobial action.

Beta-lactam ring

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These are bacterial enzymes that hydrolyze the beta-lactam rings of certain penicillins, and chelosporins.

Beta-lactamases

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True or False

Beta-lactamases are responsible for bacterial resistance.

True

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Potent inhibitors of some bacterial beta-lactamases used in combination to protect hydrolyzable penicillin from inactivation.

Beta-lactam inhibitors

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Lowest concentration of antimicrobial drug capable of inhibiting growth of an organism in a defined growth medium.

Minimal Inhibitory Concentration (MIC)

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It is a bacterial cytoplasmic membrane proteins that act as the initial receptors for penicillins and other beta-lactam antibiotics.

A. Penicillin Binding Proteins
B. Penicillin Inhibitors

A. Penicillin Binding Proteins

execute its antibacterial effect.

This is where penicillin binds to perform its antimicrobial effects

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Chains of polysaccharides and polypeptides that are cross-linked to form the bacterial cell wall.

Peptidoglycan

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True or False

Peptidoglycan are present among gram (-) bacteria.

False

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True or False

Selective toxicity is when antimicrobial drugs are less toxic to the invader (bacteria) than to the host;

False

It is when drugs are MORE toxic to the bacteria than the host

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Bacterial enzymes involved in the cross-linking of linear peptidoglycan chains, the final step in cell wall synthesis

Transpeptidase

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It is a method of testing where each test tube contains varying concentrations of the antibiotic.

Kirby Bauer Method

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This is one way to measure bacterial growth.

Turbidity

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This is a method where you put in the cultureand note if there’s bacterial growth by determining its turbidity.

Turbidimetric Method

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True or False

The higher the concentration, the faster the turbidity disappears

True

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True or False

To determine the MIC of the antibiotic, the medium used to test must be clear from any turbidity.

True

Explanation: Let’s say at 300 mcg concentration of the antibiotic there is the clear medium. So that means that is the concentration which inhibited the growth of that bacteria. You will now say that 300 mcg is the MIC of that antibiotic

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Which of the following does not happen during microbial resistance?

A. Production of antibiotic-inactivating enzymes (B-lactamase)
B. Changes in the structure of target receptors
C. Decreased efflux via drug transporters
D. Decreases in the permeability of microbes’ cellular membrane to antibiotics

C. Decreased efflux via drug transporters

Increased efflux via drug transporters

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It is when antibiotic is transported outside the bacteria

Efflux

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What happens when antibiotic cannot penetrate the cell membrane

Drug cannot take effect therefore developing resistance

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It is when you add another agent to somehow prevent the development of resistance.

Adjunctive agent

Which of the following are strategis to avoid microbial resistance? A. Use of adjunctive agents that can protect against antibiotic inactivation B. Use of antibiotic combinations. C. Introduction of old chemical derivatives of established antibiotics D. Efforts to avoid indiscriminate use or misuse of antibiotics

C. Introduction of old chemical derivatives of established antibiotics

# True or False Misuse of antibiotics could lead to microbial resistance

True

It is a set of standards wherein you have a disease and you have a specific drug of choice for that disease.

Clinical practice guidelines

What is the first line of choice for URTI caused by *S. Pneumoniae*

Penicillin

# True or False When there is a big zone of inhibition, the bacteria is susceptible to that antibiotic thus this is the antibiotic to be used for that specific causative agent

True

Which of the following is not an example of cephalosporin? A. ceftriaxone B. cefuroxide C. cephalexin D. vancomycin

D. Vancomycin

Which of the following is not an aminoglycoside A. gentamicin B. clarithromycin C. kanamycin

B.Clarithromycin | Clarithromycin is a macrolide.

Which of the following is not a protein synthesis inhibitor? A. tetracyclines B. gentamicin C. clarithromycin D. clindamycin E. Vancomycin

E. Vancomycin | Vancomycin is a cell wall synthesis inhibitor

Which of the following is not a fluoroquinolones? A. ciprofloxacin B. ofloxacin, C. trimethoprim D. gatifloxacin

C. trimethoprim | Trimethoprim and sulfonamides are Folic Acid Synthesis Inhibitor.

What is the Mechanism of Action of fluoroquinolones?

DNA Synthesis Inhibitors

What are the 2 major antibiotics that inhibit cell wall synthesis?

Penicillin and Cephalosporins

# True or False Penicillins are recommended to be taken orally.

False Explanation: Penicillin are not recommended orally destroyed by the gastric acid. Penicillins are destabilized by gastric acid.

What drug inhibits penicillin to be excreted via Tubular excretion?

Probenecid Explanation: There is drug interaction between penicillin and probenecid, which is an anti-gout drug. Probenecid's mechanism of action is the inhibition of a renal tubular transporter, thereby facilitating the excretion of the disease causative uric acid by blocking reuptake

Which subclass of penicillin is partly excreted in bile

Ampicillin and Nafcillin

What subclass of penicillin is given intramuscularly, has long half-lives because the drug is released slowly and crosses the blood-brain barrier when meninges are inflamed

Procaine and Benzathine Penicillin G

These enzymes act to cross-link linear peptidoglycan chains

Transpeptidase enzymes

# True or False Penicillins can bind to inflamed meninges

True Explanation: Example during meningitis, there are usually drugs for bacterial infection in the brain, if they are inflamed or have meningitis

# True or False staphylococci can be killed by penicillin

False Explanation: staphylococci can’t be killed by penicillin because they are producers of beta-lactamases

These beta-lactamases is formed by most staphylococci (found in the skin; especially in acne) and gram (-) organisms.

Penicillinases

This drug is usually combined with piperacillin

Tazobactam

This drug is usually combined with amoxicillin

Clavulanic Acid

This drug is usually combined with ampicillin

Sulbactam

MRSA stands for?

Methicillin resistance in staphylococci

What bacteria is resistant to Penicillin G

pneumococci

# True or False Changes in the porin structure in the outer membrane contribute to resistance by impeding access of penicillin to PBPs

True

Which of the following is Penicilin G susceptible to? A. Streptococci B. Meningococci C. Gram (+) bacilli except *S. aureus* D. Spirochetes E. AOTA

E. All of the Above

This is the drug of choice for infections caused by *Treponema pallidum*

Penicillin G

This enhances the activity of Pen G against enterococci

Aminoglycoside

This is the Prototype/Parenteral subclass of penicillin

Penicillin G

This is the only oral penicillin

Penicillin V

Which of the following is not part of the narrow spectrum of penicillins A. Pen G B. Pen V C. Floxacillin

C. Floxacillin Explanation: Floxacillin is one of the penicillins that is part of the very narrow spectrum.

Which of the following are beta-lactamase suscpetible drugs? A. Pen V B. Methicillin C. Nafcillin D. Oxacillin, E. Cloxacillin

A. Pen V Explanation: The rest of the drugs are part of the very narrow spectrum of penicillin. Those in the very narrow spectrum of penicillins were developed for such staphylococcus infections because such infections are resistant to penicillin. They are resistant because they contain penicillinases, thus making them able to produce their own beta-lactamase

MRSE stands for?

Methicillin Resistant Staphylococcus epidermidis

This causes any infection of any gadget implanted on the body.

S. epidermidis

When there is acne, these drugs might not work because of development of resistanc

MRSA

What is the choice of drug for any upper respiratory tract infections e.g. tonsillitis, ear infections.

Amoxicillin

What is the alternative choice of drug for any upper respiratory tract infections e.g. tonsillitis, ear infections.

Ampicillin

What are the 3 bacteria that causes CAP?

streptococcus pneumoniae, haemophilus influenzae, and moraxella catarrhalis

# True or False Ampicillin, and Amoxicillin are synergistic (1+1=3) with aminoglycosides in enterococcal and listerial infections

True

These are causative agent of gas gangrene or complicated pneumonia

Pseudomonas

These are the common causative agents of hospital acquired pneumonia

Klebsiella, M. catarrhalis, P. aeruginosa

Ticarcillin has coverage against gram negative bacteria

True

Piperacillin has coverage against gram negative bacteria

True

Causative agents in upper respiratory tract infections

H.influenzae

Causative agents of throat infection adn Community Acquired Pneumonia

Streptococci

Causative agents of Gonorrhea/Tulo

Gonococci

Causative agents of diarrhea and UTI

E. coli

Develop itchiness from allergy

Urticaria

What happens when immune response is already destroyed in RBC

Hemolytic anemia

Worst kind as to when immune cells attack kidneys

Nephritis

Characterized by itchiness

Severe pruritus

# True or False Nafcillin can cause neutropenia

True

# True or False Ampicillin causes maculopapular rashes

True

# True or False Methicillin causes interstitial nephritis more than other penicillins

True

This is the prototype drug of narrow penicillinase resistant antibiotic

Methicillin

How many generations does cephalosporins have?

Which of the following is a 1st generation cephalosporin? A. cephalexin B. cefazolin, C. cefamandole, D. cefadroxil,

C. cefamandole Explanation: cefamandole is a 2nd generation drug

# True or False All 3rd generation cephalosporins are excreted in the bile

False Explanation: Only Cefoperazone and ceftriaxone are excreted via bile, the rest are excreted via renal tubular excretion

# True or False 1st and 2nd generations of cephalosporins could pass the BBB

False Explanation: 1st and 2nd gen could not pass the BBB, however most of the 3rd gen could.

Which of the 3rd generation cephalosporin drugs cannot cross the BBB?

cefoperazone, cefotaxime

MRSAs are resistant to Cephalosporins

True

# True or False First generation cephalosporins, most of them cover the gram positive and less of gram negative

True

# True or False Cefazolin are given orally, and Cephalexin is given via IV

False Explanation: Cefazolin = IV, Cephalexin = Oral

Employed as a prophylactic use by dentists in high risk patients for the prevention of bacterial endocarditis

Amoxicillin

# True or False 2nd generations Cephalosporins have more activity against gram (-), and Extended coverage for gram (+)

False Explanation: Less activity against gram (+); Extended coverage for gram (-)

2nd Gen Cephalosporins that works against B. fragilis

Cefotetan, Cefoxitin

2nd Gen Cephalosporins that works against H. influenzae or M. catarrhalis

Cefamandole, cefuroxime, cefaclor

Choice of drug for Neisseria (causative agent for gonorrhea)

ceftriaxone (inj) and cefixime | Pero mas madalas na gamit ang ceftriaxone

Choice of drug for Pseudomonas (causes gas gangrene)

Cefoperazone, ceftazidime

3rd Gen Cephalosporins that works against B. fragilis

Ceftizoxime

Single injection for acute otitis media

Ceftriaxone

This drug is as effective as 10 days of amoxicillin

Ceftriaxone

# True or False Cefepime combines the gram (+) activity of 1st gen and wider gram (-) spectrum of 3rd gen

True

# True or False Cephalosporins increase nephrotoxicity of aminoglycosides

True

# True or False Drug containing a methylthiotetrazole group may cause hypoprothrombinemia

True

# True or False Disulfiram is given to patients who are alcoholic

True Explanation: Disulfiram inhibits aldehyde dehydrogenase. So if the enzyme is inhibited, accumulation of acetaldehyde occurs which results in redness and itching of the skin

# True or False Cephalosporins Inhibit transpeptidase enzymes similar to penicillin

True

Cephalosporins + warfarin

enhance or lead to bleeding

Cephalosporins + ethanol

will have disulfiram like side-effects

# True or False Monobactams are resistant to beta-lactamases produced by certain gram (+) rods

False Explanation: Monobactams are resistant to beta-lactamases produced by certain gram (-) rods

bacteria that can thrive without oxygen

Anaerobes

How is aztreonam eliminated

Eliminated via renal tubular secretion

# True or False Aztreonam has no activity against gram (+) and anaerobes

True

It is an inhibitor of cell wall synthesis binding to PBP3

Aztreonam

# True or False Aztreonam half-life is prolonged in renal failure

True

It is the decrease excretion or elimination of drug, prolonging the stay of your drug in the bloodstream

Renal failure

# True or False Aztreonam has cross-allergenicity with penicillin

False Aztreonam has NO cross-allergenicity with penicillin

It is used as an alternative cell wall synthesis inhibitor when a patient is allergic to penicillin

Aztreonam

Which of the following is not an adverse effect of aztreonam A. Vertigo B. Headache C. GI Tract Superinfection D. Rare hepatotoxicity E. Swelling

E.Swelling Adverse effects of aztreonam are vertigo, headache, GI Tract Superinfection, rare hepatotoxicity, skin rashes

This drug has low susceptibility to beta-lactamases

Carbapenem

# True or False Carbapenem is chemically different from penicillins

True

# True or False One should be careful with giving antibiotics, it should be rational because once penicillinase and beta-lactamase are developed, we resort to using these different groups like aztreonam( monobactam group) and carbapenem but the problem is they are more expensive.

True

These are the drug of choice for Enterobacter

IMIPENEM, MEROPENEM, and ERTAPENEM

Which of the following is not useful for infections caused by organisms resistant to other antibiotics A. Imipenem B. Meropenem C. Ertapenem D. Enteropenem

D. Enteropenem

# True or False Imipenem is rapidly inactivated by renal dehydropeptidase I

True

This is drug is administered in combination with imipenem.

Cilastatin Explanation: Cilastatin is an renal dehydropetidase I inhibitor. Since inhibitor siya ng RD I, iniinhibit nya na madeactivate nung enzyme si imipinem, kaya nag-iincrease yung half-life ni imipinem

# True or False Meropenem is not metabolized by renal dehydropeptidases

True

# True or False meropenem can be given alone bc it’s not deactivated

True Explanation:Meropenem can be given alone because it is not deactivated by renal dehydropeptidase I. Contrarily, Imipenem can be deactivated by renal dehydropeptidase. Worst case scenario, you could have the accumulation of its nephrotoxic metabolites; that’s why imipenem is combined with cilastatin.

Half-life: 1. Imipenem 2. Ertapenem a. greater than b. less than c. equal to d. does not affect

B. Less than Explanation: Ertapenem has the longest half life between the three (imipenem, meropenem, ertapenem)

The drug that obtains the widest spectrum among fluoroquinolones A. Gemifloxacin B. Moxifloxacin C. Norfloxacin D. Ciprofloxacin

B. Moxifloxacin

It is a bactericidal glycoprotein

Vancomycin

This drug binds to the D-Ala-DAla terminal of the nascent peptidoglycan pentapeptide side chain → inhibiting cell wall synthesis

Vancomycin

VRE stands for?

Vancomycin-resistant enterococci

VRSA stands for?

Vancomycin-resistant S. aureus

# True or False Vancomycin prevents elongation of peptidoglycan chain

True

# True or False Vancomycin has a wide spectrum of activity

False

What does vancomycin inhibit

transglycosylation

Why are their VRE and VRSA?

Due to decreased affinity of the drug to the binding site

Drug of choice for MRSA

Vancomycin

What is the order of drugs for S. aureus resistance

Penicillin then methicillin, and lastly vancomycin Explanation: Penicillin cannot destroy S. aureus because S. aureus is developing B-lactamases. When penicillin does not work, the next resort is methicillin (antistaphylococcal antibiotic). However, S. aureus has already developed resistance against methicillin, and it is now termed as MRSA. Subsequently, the next line of drug given is vancomycin.

Vancomycin is the DOC for C. difficile (Clostridium difficile) which causes pseudomembranous colitis

True

# True or False Vancomycin, when given intravenously penetrates most tissues

True

# True or False Dosage modification in patients with renal impairment are considered when giving vancomycin

True explanation: Dosage modification in patients with renal impairment because one can have kidney dysfunction

Rapid IV infusion of vancomycin may cause diffuse blushing a syndrome known as...

Red Man Syndrome

Antimetabolite inhibitor of cytosolic enolpyruvate transferase

Fosfomycin

This prevents the formation of N-acetylmuramic acid which is essential in peptidoglycan chain formation

Fosfomycin

Resistance occurs via increased intracellular accumulation of the drug

False explanation: Resistance occurs via decreased intracellular accumulation of the drug

Effectiveness in a single dose: 1. Fosfomycin 2. Fluoroquinolones A. greater than B. less than C. Equal to D. Not affected

B. Less Than

# True or False Multiple dosing of fosfomycin can result to resistance rapidly

True

It is a common side effect of fosfomycin

Diarrhea

# True or False Fosfomycin are Synergistic with beta-lactam and quinolones in specific infections

True

It is a Peptide antibiotic that interferes with a late stage in cell wall synthesis in gram (+) organisms

Bacitracin

This is the ony route of administration of Bacitracin

Topical Explanation: If given systemically, it prone to toxicity. It is usually given to patients with skin infections

It is an antimetabolite that Blocks the incorporation of D-Ala into the pentapeptide side chain of the peptidoglycan

Cycloserine

# True or False Cycloserine is used only in TB caused by organisms resistant to first line anti tuberculous drugs

True

Cycloserin is in what line of drugs used in TB

2nd line

# True or False Cycloserine could be potentially neurotoxic, causing tremors, seizures, and psychosis

True

# True or False Penicillin is impaired by food, meaning it should be taken 4 hours apart.

False Explanation: It should be taken 2 hours apart. If there is food - gastric emptying rate is delayed , triggers acid secretion.

Which of the following is acid-stable? A. Penicillin V B. Dicloxacillin, C. Amoxicillin D. Ampicillin E. Penicillin G

E. Penicillin G (no oral form)

Which penicillins has delayed absorption + prolonged action

benzathine penicillin and procaine penicillin

Which penicillins are excreted in both bile and kidneys

oxacillin, cloxacillin, dicloxacillin

Which penicillins are excreted in bile

nafcillin

DOC for syphilis

Penicillin G

DOC for staphylococcal skin infections (except MRSA)

oxacillin and nafcillin

DOC for gram negative

broad spectrum penicillins

Penicillin w/ low conc. prolonged effect

benzathine penicillin and procaine penicillin

DOC for pneumococci

amoxicillin and ampicillin

# True or False Is ampicillin effective against klebsiella, indolepositive proteus, enterobacteriaceae, gram (-) aerobes

False

DOC for Shigella

ampicillin

Type A (augmented) ADR

dose related ~ lower dose to prevent ADR

Type B (bizarre) ADR

discontinue (for penicillins) Explanation: for syphilis where penicillin is the only drug available desensitization is done which is giving low doses of penicillin until patient can tolerate the reaction

# Drug Interaction vancomycin + piperacillin-tazobactam

Acute kidney injury

Food + Penicillin (except amoxicillin)

If there is food - gastric emptying rate is delayed , triggers acid secretion.

aminoglycosides + penicillin

increase antibiotic effect due to synergism

probenecid + penicillin

pharmacokinetic (excretion delay ~ penicillin has longer duration of action)

Which generation of cephalosporin has some activity of gram (+) and wider gram (-)

4th

Which generation of cephalosporin has wider gram (-) activity

3rd

Which generation of cephalosporin has less activity for gram (+), more gram (-)

2nd

Which generation of cephalosporin has greater activity for gram (+), less for gram (-)

1st

Resistance to beta-lactamase: 1. 3rd Gen 2. 4th Gen A. greater than B. less than C. Equal to D. not related

B. less than

Which generation of cephalosporin is Effective against gram (+) and MRSA

5th

DOC for B. fragilis & Anaerobes

cefotoxin, cefotetan (2nd Gen)

DOC for H. influenzae (not B. fragilis)

cefuroxime, cefaclor

DOC for Community acquired pneumonia - (H. influenzae, pneumococci)

cefuroxime

Not active w/ enterococci & Pseudomonas

1st & 2nd gen

It is stable in ESBL (Extended Spectrum Beta-Lactamase producing) Klebsiella & E. coli

Cefoxitin

DOC for meningitis

ceftriaxone, cefotaxime (3rd Gen)

coverage for Pseudomonas sp.

Ceftazidime (3rd Gen)

DOC for gonorrhea

ceftriaxone

DOC for UTI but not gonococcal urethritis

cefixime

DOC for P. aeruginosa, MRSA, S. pneumoniae & Enterobacteriaceae

Cefepime (everything lacking from (1-3 Gen), 4th Gen will cover it

If patient has history of anaphylactic shock, should you give (a) 1st and 2nd generation cepheloporins? (b) 3rd and 4th generation cephelosporins?

A. No B. Yes but with caution

If patient has history of anaphylactic shock, should you give (a) 1st and 2nd generation cepheloporins? (b) 3rd and 4th generation cephelosporins?

A. No B. Yes but with caution

Cephalosporins + Warfarin

worsen the bleeding

Cephalosporin + Ethanol

Disulfiram

Doripinem: 1. gram (-) 2. gram (+) A. greater than B. less than C. equal to D. NOTA

A. greater than

Meropenem: 1. gram (-) 2. gram (+) A. greater than B. less than C. equal to D. NOTA

A. greater than

# ADE Nausea, Vomiting, Skin Rashes, Seizures w/ renal failure

Imipenem

Carbapenem that may have cross- allergenicity w/ penicillins

Imipenem

Monobactam has cross-allergenicity with this drug

ceftazidime

This binds to cell membrane via calciumdependent insertion of its lipid tail

Daptomycin

This drug is nect in line after vancomycin resistance

Daptomycin

This drug is nect in line after vancomycin resistance

Daptomycin

Pulmonary surfactant antagonizes its action. thus not used as a drug against pneumonia

Daptomycin

Anaphylactic shock is a serious adverse effect of this drug

Penicillin

Quantitative Comparison: Drug plasmaconcentration after taking the capsule form with meals: 1. amoxicillin vs. 2. ampicillin A. greater than B. Less than C. Equal to D. NOTA

A. greater than

Desensitization can be performed on patients with a history of anaphylactic shock from penicillin use

False

Quantitative Comparison: Acid-stability: 1. penicillin G vs. 2. penicillin V A. greater than B. Less than C. Equal to D. NOTA

B. Less Than

It inhibits enolpyruvate transferase by covalently binding to the cysteine residue of the active site and blocking the addition of phosphoenolpyruvate to UDP-Nacetylglucosamine

Fosfomycin

Quantitative Comparison: Coverage for gramnegative bacteria: 1. cefamandole vs. 2. Cefalexin A. greater than B. Less than C. Equal to D. NOTA

A. greater than

Efficacy against MRSA: 1. ceftriaxone vs. 2. Ceftaroline A. greater than B. Less than C. Equal to D. NOTA

B. Less than

Chloramphenicol has coverage on the following bacteria. 1. Haemophilus influenzae 2. Neisseria meningitidis 3. Chlamydia trachomatis

1 and 2

It is used as prophylaxis for endocarditis in patients with valvular heart disease who will undergo dental procedures

Clindamycin

Teratogenic, phototoxic, osteomalacia, are its side effects

tetracycline

Nausea, diarrhea, and gastrointestinal tolerance is a common side effect of this antibiotic

eryhtromycin

Warfarin when administered with chloramphenicol can lead to massive bleeding

True

Chloramphenicol has adverse effects such as aplastic anemia, gray baby syndrome

True

Forms a chelate with divalent cations

Tetracyclines

Clinical uses of chloramphenicol

eye infections, chlamydial infections, bacterial meningitis

This antibiotic when administered w/ an SSRI can lead to serotonin syndrome

Linezolid

When given with erythromycin this drug could result to increased risk of toxicity.

Theophylline

Doxycycline is used for...

leptospirosis, chlamydia, atypical pneumonia and malaria

extent of absorption: 1. erythromycin base vs. 2. erythromycin stearate A. greater than B. Less than C. Equal to D. NOTA

B. Less Than

tetracycline + aluminum & magnesium hydroxide

reduced antibacterial effect of tetracycline

Quinupristin-dalfopristin + cyclosporine

prolonged half life of cyclosporine

Acid stability: 1. erythromycin vs. 2. clarithromycin A. greater than B. Less than C. Equal to D. NOTA

B. less than

DOC for chlamydia, leptospirosis, cholera, syphilis and malaria.

tetracycline

. At high doses, this antibiotic can produce respiratory paralysis when given with pancuronium

tobramycin

gentamycin + vancomycin

enhanced antibacterial effect of gentamycin and increased risk of nephrotoxicity of vancomycin

This antibiotic can prolong the QT interval that can lead to torsades de pointes arrhythmia

clarithromycin

This antibiotic inhibits 50S ribosomal subunit and peptide bond formation

chloramphenicol

These antibiotics inhibits 30S ribosomal subunit

tigecycline & gentamycin

2nd Shifting Exam [Lessons 5-8] Flashcards

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