Chapter 20: Antimicrobial Medications Flashcards

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1
Q

Resistantance that develops due to genetic changes, including mutations and horizontal transfers.

A

Acquired resistance

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2
Q

A compound naturally produced by molds and bacteria that inhibits growth or kills other organisms

A

Antibiotic

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3
Q

An antibiotic or other chemical that is used to treat an infectious disease and acts by inhibiting or killing microbes; aka antimicrobial drug

A

Antimicrobial medication

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4
Q

A chemical that is used to treat a viral infection and acts by interfering with the infection cycle of the virus; also called an antiviral drug

A

Antiviral medication

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5
Q

Describes a chemical that kills a bacteria

A

Bactericidal

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6
Q

Describes a chemical that inhibits grow of bacteria

A

Bacteriostatic

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7
Q

An antibiotic that is effective against a wide range of bacteria, generally including both gram-negative and gram-positive

A

Broad-spectrum antibiotic

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8
Q

A chemical used to treat disease

A

Chemotherapeutic agent

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9
Q

Resistantance due to inherent characteristics of the organism

A

Intrinsic (innate) resistance

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10
Q

An antibiotic that is effective against a limited range of bacteria

A

Narrow-spectrum antibiotic

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11
Q

A plasmid that encodes resistance to one or more antimicrobial medications

A

R plasmid

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12
Q

Medication used to treat syphilis a long time ago

A

Salvarsan (arsenic)

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13
Q

Salvarsan and Prontosil are examples of these kinds of drugs

A

Chemotherapeutic agents

Chemicals that treat disease

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14
Q

Who discovered that Penicillium contained substances that killed bacteria

A

Alexander Fleming

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15
Q

Most antibiotics come from microorganisms that live where?

A

In soil

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16
Q

Penicillin G is mainly active against

A

Gram-positive

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17
Q

Ampicillin kills

A

Gram-positive & Gram-negative

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18
Q

Causing greater harm to a pathogen than to its host

A

Selective toxicity

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19
Q

The measure of the relative toxicity of a medication, defined as a ratio of minimum toxic dose to minimum effective dose

A

Therapeutic index

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20
Q

Antimicrobial that have a (high or low) therapeutic index are safer for humans.

A

High

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21
Q

The range between the dose used therapeutically and the dose that is toxic

A

Therapeutic window

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22
Q

A medication that has a high therapeutic index has a (narrow or wide) therapeutic window

A

Wide

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23
Q

Medications with a low therapeutic index are most used how in humans

A

Topically

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24
Q

Sulfa drugs prescribed for urinary tract infections don’t kill bacteria but stop them from multiplying, hence they have this kind of antimicrobial action

A

Bacteriostatic

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25
Q

A disadvantage of broad spectrum antibiotics

A

They disrupt the natural biome of microflora leaving the paitent at risk for new infections

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26
Q

Combinations of antimicrobials that are neither synergistic nor antagonistic are called

A

Additive

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27
Q

The rate of elimation of a drug is called

A

Half life

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28
Q

The time it takes serum concentration of a chemical to reach 50% is called

A

Half life

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29
Q

___ species lack a cell wall and cannot be treated with penicillin

A

Mycoplasma

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30
Q

Therapeutic index
Antimicrobial action
Spectrum of activities
Combination effects
Tissue distribution
Half life
Adverse effects

Are all what factors

A

What one must consider when prescribing an antimicrobial

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31
Q

Cell wall peptidoglycan synthesis
Nucleic acid synthesis
Cell membrane integrity
Metabolic pathways
Protein synthesis

Are all what

A

Targets of antibacterial medications

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32
Q

B-lactam, glycopeptide, and bacitracin all attack bacteria how

A

The peptidoglycan during reproduction

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33
Q

A group of antimicrobial medications that inhibit peptidoglycan synthesis have a shared structure called a ______ ring

They group shares the name with this ring also

A

B-lactam

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34
Q

Penicillin, cephalosporins, carbapenems, and monobactams are this group that interfer with the peptidoglycan synthesis

High therapeutic index

A

B-lactam

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35
Q

This type of narrow spectrum penicillins are affective against ____ and Penicillin V is more stable in Acid than Penicillin G thus is better taken orally

A

Natural penicillin

Gram-positive and a few gram-negative

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36
Q

The chemical structure of these antimicrobial drugs protects them from destruction by certain B-lactamases.

Generally more effective against gram-negative

Examples include: CEPHALEXIN & CEFAZOLIN(first generation)

A

Cephalosporins

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37
Q

Effective against a wide variety of gram bacteria.

Not inactivated by Extended Spectrum B-lactamases

Last resort due to toxicity

B-lactam

Includes: IMIPENEM, ERTAPENEM, MEROPENEM, DORIPENEM

A

Carbapenems

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38
Q

Vancomycin is this type of antibiotic?
Meaning it affects what

A

B lactam
Peptidoglycan synthesis

Also, it is a glycopeptide

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39
Q

____ inhibits cell wall synthesis with transport of peptidoglycan precursors across the cytoplasm membrane.

Class of B lactam

A

Bacitracin

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40
Q

Bactin, glycopeptide antibiotics, monobactam, carbapenems, cephalosporins.

All disrubt bacteria how

A

The peptidoglycan cell wall

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41
Q

Bacterial ribosome is made of subunits 30S and 50S and is called

A

70S

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42
Q

Macrolides, Chloramphenicol,

All interfer with bacteria how

Tetracycline , Aminoglycosides

Interfer how

A

Top: Disruption of 50S of Ribosome

Bottle: Disruption of 30S Ribosome

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43
Q

Streptomycin, gentamicin, neomycin all are examples of a microbial drug that interfere with the 30S Ribosome subunit

Name this group

A

Aminoglycosides

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44
Q

Bacteriostatic against some Gram-positive and Gram-negative bacteria

bind to the 30S Ribosome, blocking attachments of tRNA, prevents translation.

A

Tetracyclines

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45
Q

These are used against walking pneumonia and bind the to 50S Ribosome

Preventing transition from occurring

ERYTHROMYCIN, AZITHROMYCIN

A

Macrolides

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46
Q

Paitents with kidney disease must take medications (more or less) frequently

A

Less

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47
Q

Chloramphenicol may cause _____ loss of ability to produce blood cells

A

Aplastic anemia

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48
Q

How is horizontal gene transfer made possible, which action

A

Conjugation

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49
Q

Penicillins and derivatives
Cephalosporins and derivatives
Carbapenems and derivatives
Glycopeptide antibiotics
Bacitracin

$$$$ total list $$$$

Are all this type of antibiotic that interfere with the peptidoglycan layer

A

B-lactamas

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50
Q

Aminoglycosides (streptomycin and -mycin derivatives

Tetracycline

Macrolides (erythromycin and -mycin derivatives)

Chloramphenicol

Antibiotics with this function

A

Interfer with protien synthesis

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51
Q

Fluoroquinolones
(Ciprofloxacin and -floxcin drugs)
Rifamycins
(Rifampin)
Fidaxomicin
Metronidazole

All affect bacteria how

A

Nucleic acid synthesis

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52
Q

Daptomycin
Polymyxins

All affect bacteria how

A

Cell membrane integrity

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53
Q

Ethambutol
Isoniazid
Pyrazinamide

Affect which type of bacteria

A

Mycobacterium tuberculosis

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54
Q

Penicillinase- Resistant Penicillins developed in response to penicillinase from _____ strains

A

S. Aureus

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55
Q

B-lactam antibiotics completely inhibit ________ enzymes needed to form peptide bridge between adjacent glycine strands

Disrupt cell wall synthesis in reproducing cells

Only effective against actively growing cells

A

Penicillin-binding proteins

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56
Q

Penicillinase (B-lactamase enzyme) inactive members of the Penicillin family.

_______ produced by more resistant bacteria offer wider variety of resistance of B-lactam medications

A

Extended-spectrum B-lactamases
(ESBLs)

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57
Q

Gram _____ produce more extensive array of B-lactamases

A

Negative

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58
Q

Natural penicillins are from Penicillium chrysogenum aka Penicillin __

(Narrow or broad) spectrum
Act against gram-positive and few gram-negative

A

G
Narrow

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59
Q

MRSA comes from this bacteria

A

S. aureus

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60
Q

Ampicillin & amoxicillin are (broad or narrow) spectrum

That are inactivated by many B-lactamases

A

Broad

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61
Q

______ Penicillins have greater activity against Enterobacter & Pseudomonas

But reduced activity against Gram-positive

Destroyed by B-lactamases

A

Extended-spectrum

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62
Q

This B-lactam antibiotic

Structure makes it resistant to some B-lactamases

Some have low affinity for PBPs of gram positive

5th generation is effective against MRSA

A

Cephalosporins

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63
Q

B-lactam antibiotics harm bacteria how

A

Inhibit the cell wall synthesis

64
Q

B-lactam antibiotic

Effective against a wide rage of Gram-negative and gram-positive

Not inactivated by extended spectrum B-lactamases

Last resort for ESBL-producing organisms

A

Carbapenems

65
Q

This type of B-lactam

Bind to the amino acid side chain of NAM molecules and prevents peptidoglycan synthesis

Gram-positive only

Low in therapeutic index

A

glycopeptide antibiotic
Vancomycin

66
Q

_____ is the most widely used Glycopeptide usually administered via IV except in intestinal infections

Last resort to treat gram-positive resistant to B-lacam

Used against MRSA

A

Vancomycin

67
Q

This B-lactam

Toxicity limits to topical applications

A

Bacitracin

68
Q

This group of antibiotics is used against a wide variety of bacteria

Interfer with peptidoglycan synthesis by inhibiting _________ that help form cross links between glycine chains

A

B-lactam

Penicillin-binding proteins

69
Q

The later generations of this class of antibiotics are usually more effective against Gram-negative bacteria

Less susceptible to destruction from certain B-lactamases

A

Cephalosporins

70
Q

Ampicillin & amoxicillin are examples of (broad or narrow) spectrum B-lactam antibiotics

A

Broad

71
Q

Narrow spectrum
1st penicillinase-resistant penicillin
Used to treat gram-positive S. Aureus

A

Methicillin

72
Q

Inhibition of protein synthesis is generally (bacteriostatic or bacterialcide)

A

Static

73
Q

____ are a ribosome binding; generally the 1st choice for penicillin alergic people

A

Macrolides

74
Q

Average RN salary in MI is

A

80,000$ per year

75
Q

Streptomycin, gentamicin, and neomycin are represented in this group

A

Aminoglycosides

76
Q

Bacterialcidal against aerobic and facultative Bacteria

Bind to 30S blocks translation and misreading of mRNA

A

Aminoglycosides

77
Q

This Aminoglycosides is toxic and used only topically

A

Neomycin

78
Q

Bacterialstatic against some Gram-positive and negative

Bind to 30S and stops tRNA

A

Tetracycline

79
Q

Bacteriostatic against many Gram-positive & Atypical Pneumonia

Prevents the continuation of protein synthesis

A

Macrolides
Erythromycin & azithromycin

80
Q

Erythromycin & azithromycin are represented in this group

Where they bind to the 50S Ribosome Preventing continuation of protein synthesis

Used against pneumonia

A

Macrolides

81
Q

Clindamycin is a 50S Ribosome bacteriostatic

From this group

A

Lincosamides

82
Q

Clindamycin a (lincosamide-binds to 50S) used to treat lungs, skin, blood, female reproductive

It is a bacterial (static or cide)

A

Static

83
Q

Fluoroquinolones (ciprofloxacin)
Rifamycins(Rifampim)
Fidaxomicin

All attack this part of the bacterial cell

A

Nucleic acid

84
Q

_____ belongs to a class called Fluoroquinolones ( which target Nucleic Acid) and inhibits topoisomerases

A

Ciprofloxacin

85
Q

____ belongs to a class called Rifamycins ( nucleic acid targeting)
Bacterialcidal both grams
Bind RNA polymerase stopping RNA synthesis

A

Rifampin

86
Q

Sulfonamides and trimethoprim affect bacteria how

A

Folate biosynthsis

87
Q

Polymixin B (toxic internally) g-nega
Daptomycin gram-positive

Damage bacteria how

A

Cell membrane integrity

88
Q

Ethambutol
Isoniazid
Pyrazinmide

Affect this type of bacteria

A

Mycobacterium tuberculosis

89
Q

_____ is routinely used to determine susceptibility of bacteria to antibiotics

A

Kirby-bauer disc diffusion test

90
Q

____ is the lowest concentration that prevents growth in vitro

A

Minimum Inhibitory Concentration
(MIC)

91
Q

Minimum Inhibition Concentration
Microbes that are susceptible (treatable/ untreatable)
Microbes that are resistant (treatable/ untreatable)

A

Susceptible = treatable
Resistant = untreatable

92
Q

____ is the lowest concentration that kills 99.9% of cells in vitro

A

Minimum Bacterial Concentration

93
Q

Antibiotic-inacvating enzymes

(Penicillanse, extended spectrum B-lactamases, chloramphenicol acetylase)
Alteration in target molecule

PBPs (B-lactam antibiotics)
Ribosomal RNA (macrolides, lincosamides, streptogramins)

Decreased uptake in medicine
(Change in Porin Protiens Gram-negative)

Increased elimination of medicine
(Efflux pumps)

Are all examples of ….

A

Acquired Resistance

94
Q

Spontaneous mutation & Conjugation (gene transfer of R plasmid)

Are examples of…

A

Acquisition of resistance

95
Q

Enterococci
Enterobacter
Mycobacterium tuberculosis
Neisseria gonorrhea
Staphylococcus aurus
Staphylococcus pneumonia

A

Examples of emerging resistance

96
Q

This emerging resistance strain
Large number of cells
Combination therapy
6 months of treatment

A

Mycobacterium tuberculosis

97
Q

This strain makes MRSA

A

S. aureus

98
Q

Why are viruses hard to target

A

Because they use the host cells to multiply

Lack cell wall & ribosomes

99
Q

Prevent viral entry
Interfer with viral uncoating
Interfer with Nucleic Acid Synthesis
(Nucleoside & Nucleotide analogs)
Prevent Genome Entry
Protease Inhibition
Neuramindiase Inhibition

Are all what

A

Methods to prevent viral infections

100
Q

Funsion inhibition

Prevent viral particles from fusing with the host

Used in HIV

Is this type of target for stopping viral disease

A

Viral entry

101
Q

Prevent the release of viral nucleic acid from the protein coat.

Used in the past to reduce severity and duration of influenza A

Is this type of target for stopping viral disease

A

Vital uncoating

102
Q

Incorporate error-prone virally encoded polymerase, resulting in defective viral nucleic acid.

Treats shingles, chickenpox, cold scores, herpes
HCV
HIV & hep B

Is this type of target for stopping viral disease

A

Nucleic Acid Synthesis

103
Q

Inhibit the activity of viral polymerase by binding to a site other than the nucleotide-binding site.

Is this type of target for stopping viral disease

A

Nucleic Acid synthesis

Non-nucleoside polymerase inhibition

104
Q

Inhibit the activity of reverse transcriptase by binding to a site other than the nucleotide-binding site.

Used HIV infections

Is this type of target for stopping viral disease

A

Non-nucleotide reverse transcriptase inhibition

105
Q

Interfere with the HIV encoded enzyme integrase

Is this type of target for stopping viral disease

A

Genome integration

106
Q

Inhibits virally encoded protease, which cleave viral polyproteins to release individual proteins

Used to treat HIV and hep C.

Is this type of target for stopping viral disease

A

Assembly and release of viral particles

107
Q

Action of antifungal medication

Azoles

Interfer with the cytoplasmic membrane by targeting a steroid called ____

A

Ergosterol

108
Q

Action of antifungal medication

Echinocandins

Interfer with B13 glucagon synthesis

Treats Candida yeast infections

This is the target

A

Cell wall synthesis

109
Q

Action of antifungal medication

Griseofulvin

Used to treat skin and nail infections
Active only against fungi that invades keratinized cells

Targets this part of fungal infections

A

Cell division

110
Q

Action of antifungal medication

Flucytosine

Used to treat systemic yeast infections

Targets this part of fungal infections

A

Nucleic Acid synthesis

111
Q

Action of antifungal medication

Tavaborole

Used to topically treat nail infections

Targets this part of fungal infections

A

Protein synthesis

112
Q

Medication that interferes with Protozoan parasites targets this

A

Biosynthic pathways

113
Q

Medications that target worms(helmiths) target this

A

Neuromuscular function

114
Q

First antibiotic produced

A

Penicillin G

115
Q

Any chemical used to treat any disease

A

Chemotherapeutic agents

116
Q

What was used to treat syphilis

A

Arsenic

117
Q

Chemical naturally produced by one microbe that affects different types of bacteria

A

Antibiotic

118
Q

How does penicillin become ampicillin & methicillin

A

Altering structure

119
Q

Causes greater harm to microbes than to human host

A

Selective toxicity

120
Q

Extended spectrum penicillins have a greater activity against these 2 species

But less active against gram positive

A

Enterobacteriaceae

Pseudomonas

121
Q

Inhibits protein synthesis

Bacterocide/ static

A

Bacteriostatic

122
Q

Bactericidal against aerobic and facultative bacteria, bind to the 30S subunit, blocking initation of translation and causing misreading of mRNA. Toxicity limits use.

Are this class. With these examples (3)

_____ this specific antibiotic from this class is used in non prescription antibiotic ointments

$$$$$$$

A

Aminoglycoside

Streptomycin, Gentamicin, Neomycin

Neomycin

123
Q

Bacteriostatic against many Gram-positive bacteria ad well as the most common causes of atypical pneumonia; bind to the 50S Ribosome subunit, preventing the continuation of protein synthesis.

Name is class and examples

$$$$$$$$

A

Macrolides

Erythromycin
Azithromycin

124
Q

Bacterioatatic against a variety of Gram-positive and Gram-negative bacteria. Bind to the 50S preventing protein synthesis

Last resort

Is a lincosamide (class)

name the antibiotic

A

Clindamycin

125
Q

Clindamycin a (lincosamide)
Azithromycin & erythromycin (Macrolides)

Interfer with bacteria how

A

Binding to the 50S Ribosome subunit

126
Q

Tetracycline (end in -line) & Aminoglycosides ( gentamicin, neomycin, and streptomycin)

Interfere with bacteria how?

A

Bind to the 30S Ribosome subunit

127
Q

Augmentum

A

Penicillin combined with “B-lactamases inhibitor”

128
Q

Cephalosporins are resistant to B lactamase but are less effective against…

A

Gram positive

129
Q

Vancomycin works only against gram (+ or -)

A

+

130
Q

Aminoglycosides work against (Aerobic or Anaerobic)

A

Aerobic

131
Q

Tetracycline works against gram (+ or -)

A

Both

132
Q

Macorlides work well against gram (+ or -)

A

+

133
Q

Chloramphenicol works against gram (+ or -)

A

Both

134
Q

Fluoroquinolones (Ciprofloxacin) works well against gram (+ or -)

A

Both

135
Q

Sulfonamides

A

inhibit folic acid production

136
Q

Polymixin B is the first skin antibiotic binds to gram (+ or -) and damages cell membrane

A

-

137
Q

Do antiviral drugs work against latent infections

A

No

138
Q

Penicillin V is taken 4x daily; azithromycin is taken 1x daily

Which has the longer half life

A

Azithromycin

139
Q

Dysbiosis is…

A

Imbalance of normal flora

140
Q

The ____ of Gram-negative blocks penicillin

A

Outer membrane

141
Q

B-lactam have a high therapeutic index

They inhibit _____ enzymes needed to form peptide bridges between adjacent glycan strands

Only effective against (Growing / Non Growing) bacteria

A

Penicillin-binding proteins

Growing

142
Q

Bacterialcidal against gram-positive
Interfere with transport of peptidoglycan precursors across the cytoplasmic membrane

Common ingredient in nonprescription antibiotic creams

A

Bacitracin

143
Q

These bacterial statics bind to the 30S and block Initation and translation

Also, cause misreading of mRNA by ribosome past Initation

A

Aminoglycosides

144
Q

These 30S Block tRNA attachment and prevent translation

A

Tetracycline and Glycyclines

145
Q

Macrolides bind to the 50S and prevent the continuation of…

A

Translation

146
Q

Bacteriostatic against a variety of gram-positive and gram-negative bacteria. Bind to the 50S Ribosome, preventing the continuation of protein synthesis

Family (lincosamide)

A

Clindamycin

147
Q

____ inhibits DNA or RNA nucleic acid synthesis

Block prokaryotic RNA polymerase; prevent initation of transcription

Bacterialcidal against Gram-positive, some gram-negatives, MYCOBACTERIUM TUBERCULOSIS

A

Rifamycins

148
Q

Inhibit DNA or RNA nucleic acid synthesis

Inhibit topoisomerase enzymes that maintain supercoiling of DNA

A

Fluoroquinolones

149
Q

Bacterialcidal against a wide variety of gram-positive and gram-negative

Inhibit topoisomerase (enzyme that maintains super coiling of DNA)

A

Fluoroquinolones (Ciprofloxacin)

150
Q

Bacterialcidal against Gram-positive and some gram-negatives

Bind RNA polymerase, blocking the initation of RNA synthesis

A

Rifamycins (Rifampin)

151
Q

This is the lowest concentration that prevents growth in vitro

A

Minimum inhibitory concentration MIC

152
Q

Which is a method of acquired resistance that eliminates medication from within bacterial cell

A

Efflux pump

153
Q

Bacteria mutate and select for resistant stains

What is a method Dr’s. use to combat this resistance

A

Combination therapy

Multiple antibiotics

154
Q

Clostridium difícil

Carbapenem-resistant Enterobacteria (CRE)

Drug resistant Neisseria gonorrhea

Are all labeled this threat level

A

Urgent

155
Q

MRSA

Drug resistant Streptococcus pneumonia

Drug resistant TB

Vancomycin resistant S. aureus

Are all this threat level by CDC

A

Concerning

156
Q

Decreased uptake in medicine,
Gram-negative, is by this method

A

Porin Protiens