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Pharm Final > Anti-microbials > Flashcards

Anti-microbials Flashcards

1
Q

β-lactam antibiotics
a. cloxacillin is β-lactamase sensitive

A

a. False, Cloxacillin and Flucloxacillin are β-lactamase resistant

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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.

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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

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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

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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

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6
Q

Co-amoxiclav
a. inhibits bacterial DNA synthesis

A

a. False. Inhibits cell wall synthesis

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7
Q

Co-amoxiclav
b. is used to treat urinary tract infections

A

b. True, amoxicillin is used to treat urinary tract infections

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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.

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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

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10
Q

Co-amoxiclav
e. co-amoxiclav is safer than co-trimoxazole during pregnancy

A

e. True, co-trimoxazole is CI in pregnancy

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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

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12
Q

Ciprofloxacin
b. antacids increases absorption

A

b. False, fluroquinolone absorption impaired by divalent cations (incl. those in antacids)

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13
Q

Ciprofloxacin
c. increases the risk of seizures

A

c. True

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14
Q

Ciprofloxacin
d. can cause rupture of the Achilles tendon in young athletes

A

d. True

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15
Q

Ciprofloxacin
e. inhibits bacterial cell wall synthesis

A

e. False, fluoroquinolones inhibit topoisomerase II and IV

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16
Q

Metronidazole
a. is used in the treatment regimen of Helicobacter pylori eradication

A

a. True

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17
Q

Metronidazole
b. causes a disulfiram-like reaction with alcohol

A

b. True, Inhibits alcohol metabolism → acetaldehyde levels ↑ → disulfiram-like effect

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18
Q

Metronidazole
c. causes a metallic taste

A

c. True, dry mouth, metallic taste, CNS effects and disulfiram reaction

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19
Q

Metronidazole
d. is used to treat aerobic infections

A

d. False, is used to treat anaerobic bacteria

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20
Q

Metronidazole
e. erythromycin decreases the elimination T1/2 of metronidazole

A

e. False, macrolides inhibit P450 enzymes

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21
Q

Co-trimoxazole
a. inhibits bacterial folic acid synthesis

A

a. True, Inhibits the bacterial dihydrofolate reductase enzyme. Preventing the formation of DNA

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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

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23
Q

Co-trimoxazole
c. causes kernicterus in neonates

A

c. True, crystalluria, SJS, kernicterus, reduced efficacy COC

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24
Q

Co-trimoxazole
d. increases the risk of bleeding when co-administered with warfarin

A

d. True

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25
Q

Co-trimoxazole
e. is safe to use in patients that are allergic to sulphonamides

A

e. False, Sulfamethoxazole is a sulphonamide.

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26
Q

Protein synthesis inhibitors
a. chloramphenicol causes bone marrow toxicity

A

a. True

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27
Q

Protein synthesis inhibitors
b. gentamicin is safe to use in patients with renal failure

A

b. False, nephrotoxic and ototoxic

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28
Q

Protein synthesis inhibitors
c. doxycycline is used in the treatment of acne

A

c. True, tetracyclines have good skin penetration

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29
Q

Protein synthesis inhibitors
d. erythromycin is used to treat respiratory infections

A

d. True

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30
Q

Protein synthesis inhibitors
e. clindamycin is used in the treatment of pseudomembranous colitis

A

e. False, pseudomembranous colitis is a side effect of clindamycin

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31
Q

Match the antibiotic with its adverse effect
a. vancomycin ─ ‘Red man’ syndrome

A

a. True

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32
Q

Match the antibiotic with its adverse effect
b. chloramphenicol ─ grey baby syndrome

A

b. True

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33
Q

Match the antibiotic with its adverse effect
c. streptomycin ─ ototoxicity

A

c. True

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34
Q

Match the antibiotic with its adverse effect
d. azithromycin ─ constipation

A

d. False, Diarrhoea

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35
Q

Match the antibiotic with its adverse effect
e. tetracycline ─ tooth discoloration

A

e. True, discoloration of teeth and nails

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36
Q

Vancomycin
a. is used orally in the treatment of pseudomembranous colitis

A

a. Tue

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37
Q

Vancomycin
b. is used for the treatment of cloxacillin-resistant Staphylococcus aureus infections

A

b. True

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38
Q

Vancomycin
c. inhibits bacterial protein synthesis

A

c. False, inhibits cell wall synthesis

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39
Q

Vancomycin
d. is β-lactamase sensitive

A

d. False,

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40
Q

Vancomycin
e. rifampicin increases the elimination T1/2 of vancomycin

A

e. False, vancomycin is not metabolised by CYP450 enzymes, so rifampicin has no effect

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41
Q

Antibiotics
a. penicillin V causes a rash as an adverse effect

A

a. True

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42
Q

Antibiotics
b. 4th generation cephalosporins are more β-lactamase sensitive than 1st generation cephalosporins

A

b. False, more resistance increases with generations

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43
Q

Antibiotics
c. ciprofloxacin is contraindicated in penicillin-allergic patients

A

c. False

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44
Q

Antibiotics
d. erythromycin increases the anticoagulant effect of warfarin

A

d. True

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45
Q

Antibiotics
e. doxycycline is used in the prophylaxis of malaria

A

e. True

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46
Q

β-lactam antibiotics
a. penicillin G is given orally

A

a. False, IV/IM

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47
Q

β-lactam antibiotics
b. ceftriaxone is used to treat bacterial meningitis

A

b. False, Gram pos. + H. influenzae, N. gonorrhoeae, Salmonella spp, P. aeruginosa

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48
Q

β-lactam antibiotics
c. imipenem increases the risk of seizures at high dosages

A

c. True

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49
Q

β-lactam antibiotics
d. aztreonam is contraindicated in penicillin-allergic patients

A

d. False, does not contain bicyclic ring structure

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50
Q

β-lactam antibiotics
e. clavulanic acid prevents the degradation of amoxicillin by β-lactamases

A

e. True

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51
Q

Antibiotic Drugs
a. vancomycin is administered orally to treat pseudomembranous colitis

52
Q

Antibiotic Drugs
b. gentamicin is used as a single dose of S. aureus infections

A

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
Q

Antibiotic Drugs
c. mupirocin is administered topically for skin infections

54
Q

Antibiotic Drugs
d. metronidazole is used as one of the antibiotics in the treatment regimen to eradicate Helicobacter pylori

55
Q

Antibiotic Drugs
e. chloramphenicol is used as first-line treatment for tick bite fever

A

e. False, chloramphenicol is used for cholera. Doxycycline is used for tick bite fever

56
Q

Match the antibiotic with its mechanism of action
a. Cephadrine- inhibition of bacterial cell wall synthesis

57
Q

Match the antibiotic with its mechanism of action
b. co-trimoxazole - inhibition of folic acid synthesis

58
Q

Match the antibiotic with its mechanism of action
c. streptomycin - formation of free radicals that interact with DNA

A

c. False, Aminoglycosides like Streptomycin “irreversibly” bind to specific 30S-subunit proteins and 16S rRNA. This is metronidazole

59
Q

Match the antibiotic with its mechanism of action
d. metronidazole- inhibition of bacterial protein synthesis

A

d. False, Reactive intermediates are formed after reduction of the drug that inhibit DNA synthesis

60
Q

Match the antibiotic with its mechanism of action
e. ciprofloxacin- inhibition of DNA gyrase

A

e. True, fluoroquinolones inhibit DNA gyrase (topoisomerase II)

61
Q

Match the antibiotic with its adverse effect
a. amoxicillin – rash

62
Q

Match the antibiotic with its adverse effect
b. gentamicin - nephrotoxicity

63
Q

Match the antibiotic with its adverse effect
c. erythromycin – constipation

A

c. False, diarrhoea

64
Q

Match the antibiotic with its adverse effect
d. tetracycline - discolouration of teeth in children

65
Q

Match the antibiotic with its adverse effect
e. metronidazole - metallic taste

66
Q

The antibiotic is matched with its contraindication
a. cephadrine - penicillin allergy

A

a. True, cephalosporin may cause penicillin hypersensitivity reactions (similar core structures)

67
Q

The antibiotic is matched with its contraindication
b. ciprofloxacin - young children (<12 years of age)

68
Q

The antibiotic is matched with its contraindication
c. tetracycline – neonates

69
Q

The antibiotic is matched with its contraindication
d. erythromycin - penicillin allergy

A

d. False, safe for penicillin allergies

70
Q

The antibiotic is matched with its contraindication
e. amoxicillin - pregnancy

A

e. False, no risk

71
Q

Antibiotic – drug interactions
a. erythromycin and warfarin co-administration increases the risk of bleeding

72
Q

Antibiotic – drug interactions
b. ciprofloxacin increases the level of theophylline in the blood

A

b. True, ciprofloxacin inhibits CYP450 enzymes. Increases levels of theophylline

73
Q

Antibiotic – drug interactions
c. probenecid decreases the T1/2 of penicillin G

A

c. False, The excretion of Benzylpenicillin can be decreased when combined with Probenecid.

74
Q

Antibiotic – drug interactions
d. co-trimoxazole decreases the levels of digoxin in the blood

A

d. False, increases

75
Q

Antibiotic – drug interactions
e. there is an increased risk of ototoxicity when gentamicin is co-administered with vancomycin

76
Q

Antibiotics
a. cefepime is less resistant to β-lactamases than cephadrine

A

a. False, forth generation cephalosporins are more resistant to Beta lactamases than first generation ones

77
Q

Antibiotics
b. rapid IV infusion of vancomycin increases the risk of “red-man” syndrome

78
Q

Antibiotics
c. metronidazole increases alcohol metabolism

A

c. False, Inhibits alcohol metabolism → acetaldehyde levels ↑ → disulfiram-like effect

79
Q

Antibiotics
d. clindamycin is used to treat pseudomembranous colitis

A

d. False, clindamycin causes pseudomembranous colitis as an adverse effect

80
Q

Antibiotics
e. chloramphenicol causes bone marrow toxicity

81
Q

Co-trimoxazole
a. is used to treat urinary tract infections

A

a. False, Prophylaxis & treatment of Pneumocystis, jirovecii pneumonia, Prophylaxis of toxoplasmosis & Isospora belli diarrhea, Treatment of choice for nocardiosis

82
Q

Co-trimoxazole
b. is contraindicated in neonates

A

b. False, is contraindicated in pregnancy, porphoria, G6PD deficiency and allergy

83
Q

Co-trimoxazole
c. is safe to use in the third trimester of pregnancy

A

c. False, teratogenic

84
Q

Co-trimoxazole
d. is used in the treatment of toxoplasmosis

85
Q

Co-trimoxazole
e. decreases the plasma concentration of methotrexate when co-administrated

A

e. False, increases methotrexate levels as it inhibits p450 enzynes

86
Q

Protein synthesis inhibitors
a. azithromycin has a shorter duration of action than erythromycin

A

a. False, much longer and less dosing

87
Q

Protein synthesis inhibitors
b. antacids increase the absorption of tetracycline

A

b. False, antacids and milk prevent absorption

88
Q

Protein synthesis inhibitors
c. chloramphenicol crosses the blood-brain-barrier

89
Q

Protein synthesis inhibitors
d. doxycycline is used in the prophylaxis of malaria

90
Q

Protein synthesis inhibitors
e. fusidic acid causes hepatotoxicity

91
Q
  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

A

d. Inhibits folic acid synthesis

92
Q
  1. 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

A

h. Inhibit bacterial cell wall synthesis

93
Q
  1. 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

A

b. Interferes with peptidoglycan synthesis

94
Q
  1. 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

A

c. Inhibits topoisomerase

95
Q
  1. 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

A

e. Inhibits bacterial protein synthesis (30s)

96
Q
  1. 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

a. Inhibits translocation

97
Q
  1. 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

A

f. Inhibits peptidyltransferase

98
Q
  1. 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

A

g. Inhibits translocation

99
Q

Which of the following drugs are correctly matched with their Indication/use
1.co-trimoxazole – pneumocystis jiroveci pneumonia

100
Q

Which of the following drugs are correctly matched with their Indication/use
2.clarithromycin – H. pylori in peptic ulcer regimen

101
Q

Which of the following drugs are correctly matched with their Indication/use
3.Vancomycin – ‘red-man’ syndrome

A

False, ADR

102
Q

Which of the following drugs are correctly matched with their Indication/use
4.Ciprofloxacin – cystitis

103
Q

Which of the following drugs are correctly matched with their Indication/use
5.Metronidazole – otitis media

104
Q

Which of the following drugs are correctly matched with their Indication/use
6.Doxycycline – tick-bite fever

105
Q

Which of the following drugs are correctly matched with their Indication/use
7.Chloramphenicol – pseudomembranous colitis

106
Q

The antibiotic is correctly matched to its mechanism of action
a. streptomycin — inhibition of bacterial protein synthesis

A

True, aminoglycosides such as Amikacin, gentamicin, tobramycin, netilmicin, neomycin, streptomycin, kanamycin, framycetin inhibit bacterial protein synthesis

107
Q

The antibiotic is correctly matched to its mechanism of action
b. ciprofloxacin — inhibition of bacterial cell wall synthesis

A

False, fluoroquinolone inhibit topoisomerase II and IV

108
Q

The antibiotic is correctly matched to its mechanism of action
c. amoxicillin — inhibition of folic acid synthesis

A

False, amoxicillin disrupts cell wall synthesis

109
Q

The antibiotic is correctly matched to its mechanism of action
d. trimethoprim — inhibition of bacterial dihydrofolate reductase enzyme

A

True,
Trimethoprim is a reversible inhibitor of dihydrofolate reductase

110
Q

The antibiotic is correctly matched to its mechanism of action
e. tetracycline — inhibition of nucleic acid synthesis

A

False, protein synthesis inhibitors bind the 30s unit

111
Q

Match the antibiotic with its adverse effect
a. aztreonam — red discolouration of the urine

A

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
Q

Match the antibiotic with its adverse effect
b. erythromycin — diarrheoa

A

True, macrolides cause diarrhoea

113
Q

Match the antibiotic with its adverse effect
c. gentamicin — ototoxicity

A

True, aminoglycosides cause ototoxicity and nephrotoxicity

114
Q

Match the antibiotic with its adverse effect
d. penicillin G — grey baby syndrome

A

False. Grey baby syndrome is associated with chloramphenicol.

115
Q

Match the antibiotic with its adverse effect
e. sulphamethoxazole — kernicterus

116
Q

β-lactam antibiotics
a. cephalosporins decrease the effectiveness of the combined oral contraceptive pill

A

True, decrease the efficacy of COC

117
Q

β-lactam antibiotics\
b. cefuroxime potentiates the effect of warfarin

A

True, cefuroxime may decrease secretion of warfarin thereby increase the anticoagulant effect

118
Q

β-lactam antibiotics
c. cilastatin stimulates the renal metabolism of imipenem

A

False, inhibits

119
Q

β-lactam antibiotics
d. aztreonam is safe to use in penicillin-allergic patients

A

True, No cross sensitivity with penicillins or
cephalosporins (can use in penicillin allergic
patients)

120
Q

β-lactam antibiotics
e. penicillin G is ineffective in the treatment of Haemophilus influenzae

A

True, ampicillin is recommended as standard therapy, with an expanded-spectrum cephalosporin, cefepime, or chloramphenicol as alternate regimens

121
Q

Antibiotics that inhibit protein synthesis
a. gentamicin potentiates the muscle relaxant effects of vecuronium

A

True, aminoglycosides potentiate the muscle relaxant effects of neuromuscular blockers

122
Q

Antibiotics that inhibit protein synthesis
b. clindamycin causes pseudomembranous colitis

123
Q

Antibiotics that inhibit protein synthesis
c. azithromycin has a shorter elimination half-life than erythromycin

A

False, the new macrolide have a long DOA

124
Q

Antibiotics that inhibit protein synthesis
d. doxycycline is used in the prevention of malaria

125
Q

Antibiotics that inhibit protein synthesis
e. clindamycin is used to treat Clostridium difficile infections

A

False, used to treat Topically for serious sight-threatening eye infections, otitis media, infection of the nasal vestibuli,

Pharm Final (25 decks)

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