Antibiotics - Chloramphenicol Flashcards
What is transcription?
1 - copying of specific part of DNA to create mRNA
2 - converting mRNA into proteins using the ribosome
3 - adding molecules to proteins
4 - packaging proteins into vesicles
1 - copying of specific part of DNA to create mRNA
What is translation (also called protein synthesis)?
1 - copying of specific part of DNA to create mRNA
2 - converting mRNA into proteins using the ribosome
3 - adding molecules to proteins
4 - packaging proteins into vesicles
2 - converting mRNA into proteins using the ribosome
Ribosomes in prokaryotes (bacteria) is smaller in eukaryotes (human cells). Why is this important for drug development?
1 - means bacteria are limited to how they replicate
2 - drugs can inhibit mRNA
3 - drugs can be targeted against prokaryotes ribosome specifically
4 - bacterial wall production can be inhibited
3 - drugs can be targeted against prokaryotes ribosome specifically
- prokaryotes - 50 and 30S = 70S
- eukaryotes - 60 and 40S = 80S
Which of the following is NOT a step in translation (protein synthesis)?
1 - elongation
2 - transcription
3 - initiation
4 - termination
2 - transcription
Which of the following described initiation?
1 - codon signalling termination is recognised by P site
2 - 1st tRNA binds to P site and begins adding further tRNA
3 - 50S and 30S subunits bind to mRNA forming ribosome-mRNA complex
4 - tRNA bind to the A, P and E binding sites of ribosome
3 - 50S and 30S subunits bind to mRNA forming ribosome-mRNA complex
- mRNA is the blueprint for protein synthesis
- composed of 3 nucleotide sequences called codons
- tRNA binds to codons with matching anti-codon sequence
The ribosome complex has 3 specific sites where the mRNA can bind. Which of the following is NOT one of these sites?
1 - A site (aminoacyl site)
2 - B site (binding site)
3 - P site (peptidyl site)
4 - E site (exit site)
2 - B site (binding site)
- correct codons are added at sites A and P, building a protein, once finished a stop codon is recognised and the mRNA is then detached and a protein is formed.
The ribosome complex has 3 specific sites where the mRNA can bind, A site (aminoacyl site), P site (peptidyl site) and E site (exit site). Once the correct codons have been added at site A and P, the mRNA is then detached and a protein is formed.
Which of the following described elongation?
1 - codon signalling termination is recognised by P site
2 - 1st tRNA binds to P site and begins adding further tRNA at site A
3 - 50S and 30S subunits bind to mRNA forming ribosome-mRNA complex
4 - tRNA bind to the A, P and E binding sites of ribosome
2 - 1st tRNA binds to P site and begins adding further tRNA at site A
- this repeats until protein is finished
Which of the following described elongation?
1 - codon signalling termination is recognised by P site
2 - 1st tRNA binds to P site and begins adding further tRNA at site A
3 - 50S and 30S subunits bind to mRNA forming ribosome-mRNA complex
4 - tRNA bind to the A, P and E binding sites of ribosome
2 - 1st tRNA binds to P site and begins adding further tRNA at site A
- this repeats until protein is finished
Which of the following described termination?
1 - codon signalling termination is recognised by P site
2 - 1st tRNA binds to P site and begins adding further tRNA at site A
3 - 50S and 30S subunits bind to mRNA forming ribosome-mRNA complex
4 - tRNA bind to the A, P and E binding sites of ribosome
1 - codon signalling termination is recognised by P site
What is the mechanism of action of Chloramphenicol?
1 - binds to penicillin binding protein
2 - interfere with NAG and NAMs
3 - bind to 50S ribosome
4 - irreversibly binds the 50S ribosome subunit and inhibits protein synthesis
4 - irreversibly binds the 50S ribosome subunit and inhibits protein synthesis
Is Chloramphenicol bactericidal or bacteriostatic?
- bacteriostatic
- BUT can be bactericidal at high doses
Chloramphenicol is bacteriostatic in its action, but kills which of the following?
1 - E.coli
2 - H. influenzae
3 - Klebsiella
4 - Staphylococcus aureus
2 - H. influenzae
Is Chloramphenicol a broad or narrow spectrum antibiotic?
- broad spectrum
- acts of Gram +, Gram - and aerobic and anaerobic organisms
Which of the following is Chloramphenicol indicated for use in?
1 - bacterial conjunctivitis
2 - otitis externa
3 - COPD exacerbation
4 - pneumonia
1 - bacterial conjunctivitis
2 - otitis externa
- generally last choice if other medications have failed
All of the following are adverse events caused by Chloramphenicol. Which of these is the most common?
1 - bone marrow suppression
2 - aplastic anaemia
3 - transient stinging/burning/itching
4 - grey baby syndrome
5 - optic and peripheral neuritis
3 - transient stinging/burning/itching
- bone marrow suppression = occurs using high doses, but rare
- grey baby syndrome = circulatory collapse in neonates unable to excrete and metabolise the drug
Chloramphenicol is contraindicated in all of the following EXCEPT which one?
1 - history of hypersensitivity reactions
2 - hepatic impairment
3 - bone marrow disorder
4 - 3rd trimester of pregnancy
5 - breastfeeding mums
6 - children <2 y/o
2 - hepatic impairment
- not contraindicated
- BUT dosage and monitoring needs to be altered
Which enzymes does Chloramphenicol inhibit and thus prevents the metabolism of other drugs?
1 - cytochrome P450 (variations CYP3A4 and CYP2C19)
2 - pancreatic lipase
3 - glutathione
4 - HMG-CoA reductase
1 - cytochrome P450 (variations CYP3A4 and CYP2C19)
How is Chloramphenicol administered for superficial eye infections?
1 - orally
2 - IV
3 - topical administration
4 - sublingual
3 - topical administration
- typically every 2h as drug is removed by tears and blinking
- medication is presented as a %
- e.g. 0.5g in 100ml = 0.5% solution
Chloramphenicol is indicated in bacterial conjunctivitis and otitis externa. Can the drug be used interchangeably?
- no
- ear and eye drops made differently and could cause adverse events
When prescribing any antibiotics, in accordance with antibiotic stewardship, which of the following must be document on the prescription and in the patients notes?
1 - indication
2 - review date
3 - treatment duration
4 - all of the above
4 - all of the above
If prescribed as IV, how long should it be before the antibiotics are switched to oral where appropriate?
1 - 12h
2 - 24h
3 - 48h
4 - 72h
3 - 48h
Broad spectrum antibiotics are prescribed empirically, when we do not know the specific cause of the infection. However, what is the main driver to switch antibiotics to a narrow spectrum antibiotic?
1 - cost
2 - patients request
3 - microbiology results
4 - allergies
3 - microbiology results
