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3rd year drugs > Antibiotics > Flashcards

Antibiotics Flashcards

1
Q

Gentamicin is from which class of antibiotics?

A. Glycopeptides
B. Aminoglycosides
C. Penicillins
D. Tetracyclines

A

B.

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2
Q

Which of these are not an aminoglycoside?

A. Gentamicin
B. Amikacin
C. Clarithromycin
D. Neomycin
E. Vancomycin
A

C - macrolide

E - glycopeptide

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3
Q

What is the mechanism of action of aminoglycosides?

A

Binds to 30s ribosome irreversibly
Interrupts protein synthesis
*enters microbe via O2 dependent transport system
STREPS + ANAEROBE = innate resistance

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4
Q

Which of these are aminoglycosides ineffective on?

A. Streptococci
B. E.coli
C. Clostridium
D. Pseudomonas

A

A. spectrum of activity limited to gram-neg aerobes

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5
Q

What are the main adverse effects of aminoglycoside? Explain the mechanism behind this

A

Ototoxic, nephrotoxic

AGs accumulate in renal tubular epithelial cells and cochlear/vestibular hair cells. Causes apoptosis + cell death.

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6
Q

Aminoglycosides interacts with which other drugs to increase likelihood of ototoxicity?

A

Vancomycin and loop diuretics

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7
Q

Which of these DON’T interact with aminoglycosides to increase likelihood of nephrotoxicity?

A. NSAIDs
B. Cephalosporins 
C. Vancomycin
D. Ciclosporin
E. Platinum chemotherapy
A

A.

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8
Q

Which of these are aminoglycosides NOT indicated for?

A. Severe infections by gram-neg aerobes
B. Severe sepsis with unidentified source
C. Complicated UTI
D. Biliary associated and intra-abdominal sepsis
E. Endocarditis
F. Bacterial skin, eye, external ear infections
G. Community acquire pneumonia

A

G.

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9
Q

What is gentamicin’s route of administration?

A

Topical, IV or IM

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10
Q

What are 4 contraindications for aminoglycoside administration?

A

Myaesthenia Gravis
Neonates (ototoxic/nephrotoxic)
Renal impairment
Elderly patients

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11
Q

What class of antibiotics is Tazocin in?

A. Penicillins (antipseudomonal)
B. Penicillins
C. Glycopeptide
D. Carbapenems

A

A.

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12
Q

What is Tazocin’s mechanism of action?

A

Beta-lactam inhibits enzyme responsible for cross-linking peptidoglycans – bacterial cell walls. Leads to swelling, lysis, death.

Piperacillin - side chain attached to Beta lactam ring that gets converted to a form of urea, increasing it’s spectrum of activity.

Tazobactam = beta-lactamase inhibitor = confers activity against b-lactamase producing bugs like s.aureus

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13
Q

Which of these are Tazocin’s spectrum of activity

A. gram positives only
B. gram negatives only
C. gram pos + negs
D. pseudomonas spp.

A

C and D

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14
Q

Tazocin is indicated in which of these cases?

A. simple infection with known bacteria
B. low-severity community acquired pneumonia
C. hospital acquired pneumonia
D. uncomplicated UTI

A

C.

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15
Q

When can Tazocin be used?

A. Patient has a known penicillin allergy
B. Patient has severe renal impairment
C. Patient has a known carbapenem allergy
D. Pt NKDA and kidneys are fine

A

D.

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16
Q

How can tazocin increase warfarin’s anticoagulation effect?

A

Kills commensals that synthesise vit K

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17
Q

What class of antibiotic is cefalexin from?

A) penicillins
B) aminoglycosides
C) carbapenems
D) cephalosporins

A

D.

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18
Q

What class of antibiotic is meropenem from?

A) penicillins
B) aminoglycosides
C) carbapenems
D) cephalosporins

A

C.

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19
Q

What is a cephalsporins mechanism of action?

A

beta-lactam ring like penicillins. inhibits peptidoglycan cross-links = swelling = lysis = death.

more resistant to beta-lactamases via dihydrothiazine ring.

Cephalosporins have added activity against pseudomonas aeruginosa (gram -ve).

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20
Q

What is a carbapenems mechanism of action?

A

beta-lactam ring like penicillins. inhibits peptidoglycan cross links ultimately leads to cell death.

more resistant to beta-lactamases via hydroxyethyl side chain.

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21
Q

Which of these are a route of administration for meropenem?

A) PO
B) IM
C) IV
D) Subcut

A

C. carbapenems are only IV

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22
Q

When are parenteral carbapenems or cephalosporins indicated?

A

Severe, complicated or abx-resistant infections

23
Q

Which of these are a contraindication for cefotaxime?

A) Pregnant women
B) Known penicillin allergy
C) Pt on phenytoin
D) Alcohol consumption

A

B. cefotaxime is a cephalosporin which is a beta lactam

24
Q

Which of these are not a side-effect of meropenem?

A) Neurological toxicity - seizures
B) D+V
C) Abx associated pseudomembranous colitis
D) Dizziness

A

D.

25
Q

Is the statement below true?

Cephalosporins decrease the nephrotoxic effects of aminoglycosides.

A

False.

26
Q

Is the statement below true?

Carbapenems decrease the plasma concentration and therefore efficacy of valproate

A

True.

27
Q

What is the spectrum of activity of Benzylpenicillin?

A) broad spectrum - most gram positives
B) broad spectrum - most gram positives and negatives
C) narrow spectrum - some gram positives
D) narrow spectrum - some gram positives and negatives

A

D.

28
Q

Which of these is resistant to benzylpenicillin?

A) streptococcus
B) bacillus
C) clostridius
D) neisseria meningitidis 
E) e.coli
F) neisseria gonorrhoea
A

E.

29
Q

Which of these should not be taken with Benzylpenicillin? Why?

A) phenytoin
B) methotrexate
C) OCP
D) doxycycline

A

B. leads to higher risk of toxicity as reduces renal excretion.

30
Q

Which of these are not an appropriate route of administration for benzylpenicillin?

A) IV
B) PO
C) IM

A

B. Gastric acid prevents GI absorption of benzylpenicillin.

31
Q

Which of these are a side effect of benzylpenicillin?

A) GI upset
B) Postural hypotension
C) Neurological toxicity
D) Insomnia

A

C.

32
Q

Which of these are not an indication for benzylpenicillin?

A) Streptococcal tonsilitis
B) Meningococcal infection
C) Clostridial myonecrosis
D) MRSA endocarditis

A

D. MRSA is resistant to benpen

Meningococcal simply means an infection caused by neisseria meningitidis.

33
Q

Co-trimoxazole is in which class of antibiotics?

A) Carbapenems
B) Cephalosporins
C) Trimethoprim
D) Penicillins

A

C. Co-trimoxazole is sulfamethoxazole and trimethoprim

34
Q

What is the mechanism of action of trimethoprim?

A

Inhibits bacterial folate synthesis - bacteriostatic

35
Q

Which of these is co-trimoxazole active against?

A) pneumocystis jirovecii
B) candida albicans
C) cryptococcus
D) aspergillus fumigatus

A

A.

36
Q

Which of these is co-trimoxazole not indicated for?

A) pneumocystis jirovecii infections
B) hospital-acquired pneumonia
C) lower UTIs
D) skin and soft tissue infections

A

D.

37
Q

Which of these are not a contraindication for trimethoprim?

A) renal impairment
B) 1st trimester of pregnancy
C) rheumatic heart disease
D) neonates

A

C.

38
Q

Which of these are a side effect of trimethoprim? how does this happen?

A) haematological disorders
B) insomnia
C) neurological toxicity
D) dry mouth

A

A. folate antagonists can impair haematopoiesis.

39
Q

Which of these are side effects of trimethoprim?

A) N+V
B) Skin rash
C) sore mouth
D) SJS
E) hyperkalaemia
A

All.

40
Q

Why musn’t trimethoprim be given with methotrexate or phenytoin?

A

Methotrexate is a folate antagonist
Phenytoin increases folate metabolism (i.e. breakdown)

Giving more than one drug that decreases folate can lead to haematological problems

41
Q

Which of these is nitrofurantoin not indicated in?

A) Acute uncomplicated lower UTIs
B) Acute uncomplicated upper UTIs
C) Prophylaxis of UTI in pts with recurrent infections

A

B

42
Q

What is nitrofurantoin’s mechanism of action?

A) Bactericidal: active metabolite damages bacterial DNA
B) Bacteriostatic: inhibits bacterial folate synthesis
C) Bacteriostatic: inhibits bacterial protein synthesis by binding to the 30s subunit
D) Bactericidal: inhibits cross-linking of peptidoglycan ultimately leading to cell lysis and death

A

A.

43
Q

Which of these is NOT sensitive to nitrofurantoin?

A) e.coli
B) staph saprophyticus
C) klebsiella
D) proteus

A

C and D. Innately resistant to nitrofurantoin as they have low activity of nitrofuran reductase (metabolises nitrofurantoin to its active metabolite)

44
Q

Which of these are NOT a contraindication for nitrofurantoin?

A) renal impairment
B) pregnant women towards term
C) babies in their first 3 months of life
D) 1st trimester of pregnancy

A

D.

45
Q

Which of these are NOT a side-effect of nitrofurantoin

A) peripheral neuropathy
B) haemolytic anaemic in neonates
C) GI upset
D) hyperkalaemia

A

D.

46
Q

Why is nitrofurantoin contra-indicated in near term pregnancy and infants in their first 3 months of life?

A

Immature RBCs unable to mop up nitrofurantoin-stimulated superoxides which damages RBCs

47
Q

What class of antibiotics does doxycycline belong to?

A) Penicillins
B) Carbapenems
C) Tetracycline
D) aminoglycosides

A

C.

48
Q

The following describes the mechanism of action of which antibiotic class?

Inhibition of bacterial protein synthesis by binding to the 30s subunit, which prevents the binding of tRNA onto mRNA

A) macrolides
B) aminoglycosides
C) tetracyclines
D) trimethoprim

A

C.

49
Q

Which of these are used to treat acne vulgaris and chlamydial infection?

A) tetracyclines
B) penicillins
C) nitrofurantoin
D) cephalosporins

A

A.

50
Q

Which of these are tetracyclines not used to treat?

A) Infective exacerbations of COPD
B) Pneumonia
C) Atypical pneumonia
D) Upper RTIs

A

D.

51
Q

Are tetracyclines contra-indicated in pregnant and breast-feeding women and children under 12?

A

yes. they bind to teeth in foetal development, infancy and early childhood

52
Q

The following describe drugs interactions of which antibiotic?

Binds to divalent cations and so shouldn’t be given within 2h of calcium, antacids or ions as it prevents abx absorption.

A) macrolides
B) aminoglycosides
C) tetracyclines
D) trimethoprim

A

C.

53
Q

Which of these do NOT enhance the anticoagulant effect of warfarin?

A) tetracyclines
B) penicillins
C) trimethoprim
D) nitrofurantoin

A

D.

54
Q

Which of these are a side-effect of tetracyclines

A) higher risk of c.diff infection than other abx
B) photosensitivity
C) oesophageal irritation
D) Discolouration and/or hyperplasia of tooth enamel in children

A

A. risk is lower than other abx

3rd year drugs (1 decks)

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