AM revision

Question 1

What mediates drug allergies?

Answer 1

immediate hypersensitivity - IgE mediated
Delayed Hypesensitivity - Cell or immunecomplex mediated

Question 2

Symptoms of Immediate hypersensitivity?

Answer 2

• LAryngeal Oedema
• Shock
• Itching
• Urticaria (hives)
• Voming/nausea
• Wheezing

Question 3

Symptoms of delayed hypersensitivity:

Answer 3

• Erythema Nodosum
• Drug Rash
• Drug fever
• Serum sickness

Question 4

What antivirals need constatn blood conc. monitoring?

Answer 4

Zidovudine for HIV
Ganciclovir for CMV

Question 5

What is stevens-johnson syndrome?

Answer 5

A form of Delayed hypersensitivity
Not just skin but mucous membranes

Question 6

What am is associated with stevens-johnson?

Answer 6

Sulphonamides

Question 7

What is thrush & what am causes it?

Answer 7

Oral or vaginal candidiasis
Caused by Broad spec. penicillin/cephalosporins

Question 8

What drugs commonly cause hepatotoxicity?

Answer 8

Tetracylcines
Rifampicin
Flucloxicillin
Isonizaid (TB)

Question 9

What drugs commonly cause convulsions & encephalopathy?

Answer 9

PEnicillin
Cephalosporin
Acyclovir

Question 10

What drugs commonly cause ototoxicity?

Answer 10

Aminoglycosides
Vancomycin

Question 11

What drugs cause peripheral neuropathy?

Answer 11

Isoniazid
Metronidazole
Nitrofurantoin

Question 12

How does isoniazid cause peripheral neuropathy?

Answer 12

Competetive inhibition of Vitamin B6 (pyridoxine)

Question 13

What is pancytopenia?

Answer 13

Depression of all marrow produced cell lines (unselective depression)

Question 14

What causes selective depression of platelets?

Answer 14

Linezolid

Question 15

How does co-trimoxazole produce a haematological side effect?

Answer 15

Co-trimoxazole inhibits folic acid synthesis
-> Folate deficiency
-> Megaloblastic anaemia

Question 16

What is co-trimoxazole?

Answer 16

Trimethoprim
Sulphamethoxazole

Question 17

When would you use co-trimoxazole over cephalosporins and why?

Answer 17

For chest infections as its less likely to cause a CDI

Question 18

How do glycopeptides work?

Answer 18

Glycopeptides inhibit peptidoglycan precurosor production

Question 19

How do Beta-lactams work?

Answer 19

Bind to PBP
-> Inhibits carb cross chain linkage
-> no peptidoglycan formed
-> cell killed by autolytic enzymes

Question 20

Another name for benzyl penicillin?

Answer 20

PEnicillin G

Question 21

What would you use on a gram +ve infection if someone was alleric to penicillin?

Answer 21

Macrolides particularly erythromycin & clarythromicin

Question 22

What do you use levofloxacin for?

Answer 22

A chest infection
Its much better than older quinalones for gram +ves

Question 23

Why are glycopeptides given parenterally?

Answer 23

They arnt absorbed in the gut

Question 24

What do mutagenic drugs do?

Answer 24

Mutate foetal chromosomes

Question 25

What do teratogenic drugs do?

Answer 25

Theyre associated with congenital abnormilities

Question 26

How are antimicrobials used for prophylaxis?

Answer 26

- Pre-op to prevent infection - Post-exposure to a highly communicable disese

Question 27

What antibiotics need constand monitoring?

Answer 27

Vancomycin Gentamicin

Question 28

Example of synergy with AMs?

Answer 28

Penicillin & gentamicin undergoe snergy when treating Streptococcal infections

Question 29

When would you use combination therapy?

Answer 29

- When theres a mixed infection - When the two drugs have a synergistic effect - When you want to limit resistance to any one agent

Question 30

What drug causes abnormal cartilage development in kids?

Answer 30

Ciprofloxacin

Question 31

Define inherent resistance?

Answer 31

All strains of a species are resistant Usually because the drug cant penetrate the cell wall E.g. VRE

Question 32

Define acquired resistance?

Answer 32

Sometimes by spontatnoues mutation but normally transfer of genes through plasmids or transposons. Only some of the strains are resistant E.g. 30% of E.Coli strains are resistant to Ampicillin

Question 33

How do we combat B-lactamases?

Answer 33

- None B-lactams - Modify the B-lactam R1 side chain so its not recognised - Mix it with a B-lactamase inhibitor

Question 34

What is an R1 modified penicillin?

Answer 34

Flucloxacillin

Question 35

What is a mix of a B-Lactam & a B-lactamase inhibiotr?

Answer 35

Co-Amoxiclav is amoxicillin & calvulanic acid.

Question 36

What is ESBL?

Answer 36

Exteneded spectrum B-lactamases Resistant to most if not all B-lactams

Question 37

What is CPE?

Answer 37

Carbapenemase Producing Enterobacteriacaie Immune to carbapenems and unfortunately often a lot of other antibiotics too. Endemic in some countries healthcare

Question 38

VRE?

Answer 38

Vancomycin REsistant Enterococci (enterococcus Faecium/Faecalis)

Question 39

What is MRSAs method of resistance?

Answer 39

Altered PBP binding sites, hence why its still weak to glycopeptides

Question 40

What gram +ve organism is partiall resistant to flucloxacillin?

Answer 40

Staph. Aureus Some strainds are resistant

Question 41

Why wouldnt you use amoxicillin fo blind gram-ve coliform treatment?

Answer 41

20-30% of striands are now ressistant to it

Question 42

How would we most accurately determine antibiotic sensitivty?

Answer 42

The MIC & MBC

Question 43

Do all antivirals inhibit nucleic acid synthesis?

Answer 43

NO,

Question 44

What are the 4 bi Cs broad spectru antibiotics known for leading to a rise in CDI?

Answer 44

Cephalosporin Clindamycin Co-Amoxiclav Ciprofloxacin

Question 45

Which cephalosporin generations are best for Gram -ve organisms?

Answer 45

The most recent, i.e. 3rd gen

Question 46

Which cephalosporins are best for gram +ve organisms?

Answer 46

The oldest, i.e. 1st gen

Question 47

Which generation of cephalosporin is effective against pseudomonas?

Answer 47

Third gen specifcally ceftazidime