Anti-microbials Flashcards
1
Q
β-lactam antibiotics
a. cloxacillin is β-lactamase sensitive
A
a. False, Cloxacillin and Flucloxacillin are β-lactamase resistant
2
Q
β-lactam antibiotics
b. ceftriaxone inhibits bacterial protein synthesis
A
b. False, Ceftriaxone (3rd gen) works by inhibiting the mucopeptide synthesis in the bacterial cell wall.
3
Q
β-lactam antibiotics
c. imipenem causes a red discolouration of the urine in children
A
c. True. Imipenem acts as an antimicrobial through the inhibition of cell wall synthesis and causes red discolouration of urine in children
4
Q
β-lactam antibiotics
d. amoxicillin decreases the efficacy of the combined oral contraceptive pill
A
d. False, has no effect on the combined oral contraceptive pill
5
Q
β-lactam antibiotics
e. aztreonam is used to treat E. coli infectionsGram neg. bacteria (E. coli, P. aeruginosa etc)
A
e. True, Good activity against aerobic
6
Q
Co-amoxiclav
a. inhibits bacterial DNA synthesis
A
a. False. Inhibits cell wall synthesis
7
Q
Co-amoxiclav
b. is used to treat urinary tract infections
A
b. True, amoxicillin is used to treat urinary tract infections
8
Q
Co-amoxiclav
c. acts synergistically with tetracycline
A
c. False, the therapeutic efficacy of Amoxicillin can be decreased when used in combination with Tetracycline.
9
Q
Co-amoxiclav
d. contains a β-lactamase inhibitor
A
d. True, Clavulanic acid binds covalently near or in the active site of the b-lactamase enzyme
10
Q
Co-amoxiclav
e. co-amoxiclav is safer than co-trimoxazole during pregnancy
A
e. True, co-trimoxazole is CI in pregnancy
11
Q
Ciprofloxacin
a. is used in the treatment of urinary tract infections
A
a. True, a ciprofloxacin extended release tablet is indicated for uncomplicated urinary tract infections, complicated urinary tract infections
12
Q
Ciprofloxacin
b. antacids increases absorption
A
b. False, fluroquinolone absorption impaired by divalent cations (incl. those in antacids)
13
Q
Ciprofloxacin
c. increases the risk of seizures
A
c. True
14
Q
Ciprofloxacin
d. can cause rupture of the Achilles tendon in young athletes
A
d. True
15
Q
Ciprofloxacin
e. inhibits bacterial cell wall synthesis
A
e. False, fluoroquinolones inhibit topoisomerase II and IV
16
Q
Metronidazole
a. is used in the treatment regimen of Helicobacter pylori eradication
A
a. True
17
Q
Metronidazole
b. causes a disulfiram-like reaction with alcohol
A
b. True, Inhibits alcohol metabolism → acetaldehyde levels ↑ → disulfiram-like effect
18
Q
Metronidazole
c. causes a metallic taste
A
c. True, dry mouth, metallic taste, CNS effects and disulfiram reaction
19
Q
Metronidazole
d. is used to treat aerobic infections
A
d. False, is used to treat anaerobic bacteria
20
Q
Metronidazole
e. erythromycin decreases the elimination T1/2 of metronidazole
A
e. False, macrolides inhibit P450 enzymes
21
Q
Co-trimoxazole
a. inhibits bacterial folic acid synthesis
A
a. True, Inhibits the bacterial dihydrofolate reductase enzyme. Preventing the formation of DNA
22
Q
Co-trimoxazole
b. is used to treat toxoplasmosis
A
b. True, Prophylaxis & treatment of Pneumocystis jirovecii pneumonia, Prophylaxis of toxoplasmosis & Isospora belli diarrhea, Treatment of choice for nocardiosis
23
Q
Co-trimoxazole
c. causes kernicterus in neonates
A
c. True, crystalluria, SJS, kernicterus, reduced efficacy COC
24
Q
Co-trimoxazole
d. increases the risk of bleeding when co-administered with warfarin
A
d. True
25
Co-trimoxazole
e. is safe to use in patients that are allergic to sulphonamides
e. False, Sulfamethoxazole is a sulphonamide.
26
Protein synthesis inhibitors
a. chloramphenicol causes bone marrow toxicity
a. True
27
Protein synthesis inhibitors
b. gentamicin is safe to use in patients with renal failure
b. False, nephrotoxic and ototoxic
28
Protein synthesis inhibitors
c. doxycycline is used in the treatment of acne
c. True, tetracyclines have good skin penetration
29
Protein synthesis inhibitors
d. erythromycin is used to treat respiratory infections
d. True
30
Protein synthesis inhibitors
e. clindamycin is used in the treatment of pseudomembranous colitis
e. False, pseudomembranous colitis is a side effect of clindamycin
31
Match the antibiotic with its adverse effect
a. vancomycin ─ ‘Red man’ syndrome
a. True
32
Match the antibiotic with its adverse effect
b. chloramphenicol ─ grey baby syndrome
b. True
33
Match the antibiotic with its adverse effect
c. streptomycin ─ ototoxicity
c. True
34
Match the antibiotic with its adverse effect
d. azithromycin ─ constipation
d. False, Diarrhoea
35
Match the antibiotic with its adverse effect
e. tetracycline ─ tooth discoloration
e. True, discoloration of teeth and nails
36
Vancomycin
a. is used orally in the treatment of pseudomembranous colitis
a. Tue
37
Vancomycin
b. is used for the treatment of cloxacillin-resistant Staphylococcus aureus infections
b. True
38
Vancomycin
c. inhibits bacterial protein synthesis
c. False, inhibits cell wall synthesis
39
Vancomycin
d. is β-lactamase sensitive
d. False,
40
Vancomycin
e. rifampicin increases the elimination T1/2 of vancomycin
e. False, vancomycin is not metabolised by CYP450 enzymes, so rifampicin has no effect
41
Antibiotics
a. penicillin V causes a rash as an adverse effect
a. True
42
Antibiotics
b. 4th generation cephalosporins are more β-lactamase sensitive than 1st generation cephalosporins
b. False, more resistance increases with generations
43
Antibiotics
c. ciprofloxacin is contraindicated in penicillin-allergic patients
c. False
44
Antibiotics
d. erythromycin increases the anticoagulant effect of warfarin
d. True
45
Antibiotics
e. doxycycline is used in the prophylaxis of malaria
e. True
46
β-lactam antibiotics
a. penicillin G is given orally
a. False, IV/IM
47
β-lactam antibiotics
b. ceftriaxone is used to treat bacterial meningitis
b. False, Gram pos. + H. influenzae, N. gonorrhoeae, Salmonella spp, P. aeruginosa
48
β-lactam antibiotics
c. imipenem increases the risk of seizures at high dosages
c. True
49
β-lactam antibiotics
d. aztreonam is contraindicated in penicillin-allergic patients
d. False, does not contain bicyclic ring structure
50
β-lactam antibiotics
e. clavulanic acid prevents the degradation of amoxicillin by β-lactamases
e. True
51
Antibiotic Drugs
a. vancomycin is administered orally to treat pseudomembranous colitis
a. True
52
Antibiotic Drugs
b. gentamicin is used as a single dose of S. aureus infections
b. False, indicated for P. aeruginosa, Proteus species (indole-positive and indole-negative), E. coli, Klebsiella-Enterobactor-Serratia species, Citrobacter species and Staphylococcus species
53
Antibiotic Drugs
c. mupirocin is administered topically for skin infections
c. True
54
Antibiotic Drugs
d. metronidazole is used as one of the antibiotics in the treatment regimen to eradicate Helicobacter pylori
d. True
55
Antibiotic Drugs
e. chloramphenicol is used as first-line treatment for tick bite fever
e. False, chloramphenicol is used for cholera. Doxycycline is used for tick bite fever
56
Match the antibiotic with its mechanism of action
a. Cephadrine- inhibition of bacterial cell wall synthesis
a. True
57
Match the antibiotic with its mechanism of action
b. co-trimoxazole - inhibition of folic acid synthesis
b. True
58
Match the antibiotic with its mechanism of action
c. streptomycin - formation of free radicals that interact with DNA
c. False, Aminoglycosides like Streptomycin "irreversibly" bind to specific 30S-subunit proteins and 16S rRNA. This is metronidazole
59
Match the antibiotic with its mechanism of action
d. metronidazole- inhibition of bacterial protein synthesis
d. False, Reactive intermediates are formed after reduction of the drug that inhibit DNA synthesis
60
Match the antibiotic with its mechanism of action
e. ciprofloxacin- inhibition of DNA gyrase
e. True, fluoroquinolones inhibit DNA gyrase (topoisomerase II)
61
Match the antibiotic with its adverse effect
a. amoxicillin – rash
a. true
62
Match the antibiotic with its adverse effect
b. gentamicin - nephrotoxicity
b. True
63
Match the antibiotic with its adverse effect
c. erythromycin – constipation
c. False, diarrhoea
64
Match the antibiotic with its adverse effect
d. tetracycline - discolouration of teeth in children
d. True
65
Match the antibiotic with its adverse effect
e. metronidazole - metallic taste
e. True
66
The antibiotic is matched with its contraindication
a. cephadrine - penicillin allergy
a. True, cephalosporin may cause penicillin hypersensitivity reactions (similar core structures)
67
The antibiotic is matched with its contraindication
b. ciprofloxacin - young children (<12 years of age)
b. True
68
The antibiotic is matched with its contraindication
c. tetracycline – neonates
c. True
69
The antibiotic is matched with its contraindication
d. erythromycin - penicillin allergy
d. False, safe for penicillin allergies
70
The antibiotic is matched with its contraindication
e. amoxicillin - pregnancy
e. False, no risk
71
Antibiotic – drug interactions
a. erythromycin and warfarin co-administration increases the risk of bleeding
a. True
72
Antibiotic – drug interactions
b. ciprofloxacin increases the level of theophylline in the blood
b. True, ciprofloxacin inhibits CYP450 enzymes. Increases levels of theophylline
73
Antibiotic – drug interactions
c. probenecid decreases the T1/2 of penicillin G
c. False, The excretion of Benzylpenicillin can be decreased when combined with Probenecid.
74
Antibiotic – drug interactions
d. co-trimoxazole decreases the levels of digoxin in the blood
d. False, increases
75
Antibiotic – drug interactions
e. there is an increased risk of ototoxicity when gentamicin is co-administered with vancomycin
e. True
76
Antibiotics
a. cefepime is less resistant to β-lactamases than cephadrine
a. False, forth generation cephalosporins are more resistant to Beta lactamases than first generation ones
77
Antibiotics
b. rapid IV infusion of vancomycin increases the risk of “red-man” syndrome
b. True
78
Antibiotics
c. metronidazole increases alcohol metabolism
c. False, Inhibits alcohol metabolism → acetaldehyde levels ↑ → disulfiram-like effect
79
Antibiotics
d. clindamycin is used to treat pseudomembranous colitis
d. False, clindamycin causes pseudomembranous colitis as an adverse effect
80
Antibiotics
e. chloramphenicol causes bone marrow toxicity
e. True
81
Co-trimoxazole
a. is used to treat urinary tract infections
a. False, Prophylaxis & treatment of Pneumocystis, jirovecii pneumonia, Prophylaxis of toxoplasmosis & Isospora belli diarrhea, Treatment of choice for nocardiosis
82
Co-trimoxazole
b. is contraindicated in neonates
b. False, is contraindicated in pregnancy, porphoria, G6PD deficiency and allergy
83
Co-trimoxazole
c. is safe to use in the third trimester of pregnancy
c. False, teratogenic
84
Co-trimoxazole
d. is used in the treatment of toxoplasmosis
d. True
85
Co-trimoxazole
e. decreases the plasma concentration of methotrexate when co-administrated
e. False, increases methotrexate levels as it inhibits p450 enzynes
86
Protein synthesis inhibitors
a. azithromycin has a shorter duration of action than erythromycin
a. False, much longer and less dosing
87
Protein synthesis inhibitors
b. antacids increase the absorption of tetracycline
b. False, antacids and milk prevent absorption
88
Protein synthesis inhibitors
c. chloramphenicol crosses the blood-brain-barrier
c. True
89
Protein synthesis inhibitors
d. doxycycline is used in the prophylaxis of malaria
d. True
90
Protein synthesis inhibitors
e. fusidic acid causes hepatotoxicity
e. True
91
1. co-trimoxazole
a. Inhibits translocation
b. Interferes with peptidoglycan synthesis
c. Inhibits topoisomerase
d. Inhibits folic acid synthesis
e. Inhibits bacterial protein synthesis (30s)
f. Inhibits peptidyltransferase
g. Inhibits translocation
h. Inhibit bacterial cell wall synthesis
d. Inhibits folic acid synthesis
92
2. amoxicillin
a. Inhibits translocation
b. Interferes with peptidoglycan synthesis
c. Inhibits topoisomerase
d. Inhibits folic acid synthesis
e. Inhibits bacterial protein synthesis (30s)
f. Inhibits peptidyltransferase
g. Inhibits translocation
h. Inhibit bacterial cell wall synthesis
h. Inhibit bacterial cell wall synthesis
93
3. vancomycin
a. Inhibits translocation
b. Interferes with peptidoglycan synthesis
c. Inhibits topoisomerase
d. Inhibits folic acid synthesis
e. Inhibits bacterial protein synthesis (30s)
f. Inhibits peptidyltransferase
g. Inhibits translocation
h. Inhibit bacterial cell wall synthesis
b. Interferes with peptidoglycan synthesis
94
4. ciprofloxacin
a. Inhibits translocation
b. Interferes with peptidoglycan synthesis
c. Inhibits topoisomerase
d. Inhibits folic acid synthesis
e. Inhibits bacterial protein synthesis (30s)
f. Inhibits peptidyltransferase
g. Inhibits translocation
h. Inhibit bacterial cell wall synthesis
c. Inhibits topoisomerase
95
5. gentamicin
a. Inhibits translocation
b. Interferes with peptidoglycan synthesis
c. Inhibits topoisomerase
d. Inhibits folic acid synthesis
e. Inhibits bacterial protein synthesis (30s)
f. Inhibits peptidyltransferase
g. Inhibits translocation
h. Inhibit bacterial cell wall synthesis
e. Inhibits bacterial protein synthesis (30s)
96
6. azithromycin
a. Inhibits translocation
b. Interferes with peptidoglycan synthesis
c. Inhibits topoisomerase
d. Inhibits folic acid synthesis
e. Inhibits bacterial protein synthesis (30s)
f. Inhibits peptidyltransferase
g. Inhibits translocation
h. Inhibit bacterial cell wall synthesis
a. Inhibits translocation
97
7. chloramphenicol
a. Inhibits translocation
b. Interferes with peptidoglycan synthesis
c. Inhibits topoisomerase
d. Inhibits folic acid synthesis
e. Inhibits bacterial protein synthesis (30s)
f. Inhibits peptidyltransferase
g. Inhibits translocation
h. Inhibit bacterial cell wall synthesis
f. Inhibits peptidyltransferase
98
8. clindamycin
a. Inhibits translocation
b. Interferes with peptidoglycan synthesis
c. Inhibits topoisomerase
d. Inhibits folic acid synthesis
e. Inhibits bacterial protein synthesis (30s)
f. Inhibits peptidyltransferase
g. Inhibits translocation
h. Inhibit bacterial cell wall synthesis
g. Inhibits translocation
99
Which of the following drugs are correctly matched with their Indication/use
1.co-trimoxazole – pneumocystis jiroveci pneumonia
True
100
Which of the following drugs are correctly matched with their Indication/use
2.clarithromycin – H. pylori in peptic ulcer regimen
True
101
Which of the following drugs are correctly matched with their Indication/use
3.Vancomycin – ‘red-man’ syndrome
False, ADR
102
Which of the following drugs are correctly matched with their Indication/use
4.Ciprofloxacin – cystitis
True
103
Which of the following drugs are correctly matched with their Indication/use
5.Metronidazole – otitis media
False
104
Which of the following drugs are correctly matched with their Indication/use
6.Doxycycline – tick-bite fever
True
105
Which of the following drugs are correctly matched with their Indication/use
7.Chloramphenicol – pseudomembranous colitis
False
106
The antibiotic is correctly matched to its mechanism of action
a. streptomycin — inhibition of bacterial protein synthesis
True, aminoglycosides such as Amikacin, gentamicin, tobramycin, netilmicin, neomycin, streptomycin, kanamycin, framycetin inhibit bacterial protein synthesis
107
The antibiotic is correctly matched to its mechanism of action
b. ciprofloxacin — inhibition of bacterial cell wall synthesis
False, fluoroquinolone inhibit topoisomerase II and IV
108
The antibiotic is correctly matched to its mechanism of action
c. amoxicillin — inhibition of folic acid synthesis
False, amoxicillin disrupts cell wall synthesis
109
The antibiotic is correctly matched to its mechanism of action
d. trimethoprim — inhibition of bacterial dihydrofolate reductase enzyme
True,
Trimethoprim is a reversible inhibitor of dihydrofolate reductase
110
The antibiotic is correctly matched to its mechanism of action
e. tetracycline — inhibition of nucleic acid synthesis
False, protein synthesis inhibitors bind the 30s unit
111
Match the antibiotic with its adverse effect
a. aztreonam — red discolouration of the urine
False, aztreonam is a monobactam antibiotic and is associated with
1. Injection site reactions
2. Rash
3. Rarely toxic epidermal necrolysis
4. Gastrointestinal side effects
5. Drug-induced eosinophilia
112
Match the antibiotic with its adverse effect
b. erythromycin — diarrheoa
True, macrolides cause diarrhoea
113
Match the antibiotic with its adverse effect
c. gentamicin — ototoxicity
True, aminoglycosides cause ototoxicity and nephrotoxicity
114
Match the antibiotic with its adverse effect
d. penicillin G — grey baby syndrome
False. Grey baby syndrome is associated with chloramphenicol.
115
Match the antibiotic with its adverse effect
e. sulphamethoxazole — kernicterus
True
116
β-lactam antibiotics
a. cephalosporins decrease the effectiveness of the combined oral contraceptive pill
True, decrease the efficacy of COC
117
β-lactam antibiotics\
b. cefuroxime potentiates the effect of warfarin
True, cefuroxime may decrease secretion of warfarin thereby increase the anticoagulant effect
118
β-lactam antibiotics
c. cilastatin stimulates the renal metabolism of imipenem
False, inhibits
119
β-lactam antibiotics
d. aztreonam is safe to use in penicillin-allergic patients
True, No cross sensitivity with penicillins or
cephalosporins (can use in penicillin allergic
patients)
120
β-lactam antibiotics
e. penicillin G is ineffective in the treatment of Haemophilus influenzae
True, ampicillin is recommended as standard therapy, with an expanded-spectrum cephalosporin, cefepime, or chloramphenicol as alternate regimens
121
Antibiotics that inhibit protein synthesis
a. gentamicin potentiates the muscle relaxant effects of vecuronium
True, aminoglycosides potentiate the muscle relaxant effects of neuromuscular blockers
122
Antibiotics that inhibit protein synthesis
b. clindamycin causes pseudomembranous colitis
True
123
Antibiotics that inhibit protein synthesis
c. azithromycin has a shorter elimination half-life than erythromycin
False, the new macrolide have a long DOA
124
Antibiotics that inhibit protein synthesis
d. doxycycline is used in the prevention of malaria
True
125
Antibiotics that inhibit protein synthesis
e. clindamycin is used to treat Clostridium difficile infections
False, used to treat Topically for serious sight-threatening eye infections, otitis media, infection of the nasal vestibuli,
