EXAM 2 Misc antibiotics

Question 1

tertracycline MOA

Answer 1

reversibly bind to 30S subunit
Bacteriostatic, but may be bactericidal at high conc.

Question 2

tetracycline MOR

Answer 2

Decreased accumulation of tetracycline in bacteria bc of altered permeability or efflux pumps
Decreased access of tetracycline to ribosome because of ribosomal protection proteins
Enzymatic inactivation

Question 3

tetracycline drugs

Answer 3

tetracycline
doxycycline
minocycline

Question 4

tetracycline anologs

Answer 4

tigecycline
omadacycline
eravacycline

Question 5

tetracycline spectrum

Answer 5

MSSA and MRSA (mainly mino and doxy)
legionella

Question 6

tetracycline analog spectrum

Answer 6

MSSA
MRSA
BDA (bacteroides)

Question 7

tetracyclines and analogs absorption

Answer 7

Absorption can be impaired with consumption of di and trivalent cations
MAJOR DRUG INTERACTION

Question 8

tetracyclines and analogs distribution

Answer 8

Widely distributed into body tissue and fluids, prostate
Minimal CSF penetration

Question 9

tetracycline and demeclocycline elimination

Answer 9

renal elimination and require dose adjustments in renal insufficiency

Question 10

Doxy and minocycline elimination

Answer 10

non renal metabolism

Question 11

tetracycline analogs elimination

Answer 11

biliary elimination
dose adjust with liver disease (tige/erava)

Question 12

tetracycline adverse effects

Answer 12

GI: N/V especially with tigecycline
Photosensitivity
Pregnancy category D –> discoloration of teeth and decrease bone growth

Question 13

Which antibiotic will interact with cations cations so that oral absorption is impaired potentially leading to clinical failure?
Oral levofloxacin
Oral doxycycline
Oral ciprofloxacin
Oral minocycline
all of the above

Answer 13

all of the above

Question 14

Which of the following does NOT have activity against atypical bacteria (legionella)?
Azithromycin
Levofloxacin
Amoixicillin-clavulanate
Doxycycline
Moxifloxacin

Answer 14

Amoxacillin-Clavulanate

Question 15

Trimethoprim-Sulfamethoxazole MOA

Answer 15

TMP and SMX produce sequential block of folic acid synthesis
SMX: inhibits dihydropteroate synthetase
TMP: inhibits dihydrolate reductase
bactericidal

Question 16

TMP-SMX spectrum

Answer 16

MSSA
MRSA

Question 17

TMP-SMX elimination

Answer 17

Liver and kidney elimination
Dose adjustment when pts CrCl <30ml/min

Question 18

TMP-SMX adverse effects

Answer 18

Leukopenia, thrombocytopenia
Hypersensitivity – RASH (sulfonamide portion)
Crystalluria, hyperkalemia, increased creatinine

Question 19

TMP-SMX pregnancy

Answer 19

should not be used in term or lactating women

Question 20

TMP-SMX drug interactions

Answer 20

warfarin
incerases anticoag effects

Question 21

polymixin drugs

Answer 21

polymixin B
colistin

Question 22

polymyxin MOA

Answer 22

Cationic detergents
Binds anionic lipopolysaccharides that cause displacement of Ca and Mg which change permeability and leak cell contents  cell death
Concentration-dependent bactericidal activity

Question 23

polymyxin MOR

Answer 23

alteration of outer cell membrane
cross-resistance is observed

Question 24

polymyxin elimination

Answer 24

colistin and polymyxin B eliminated by nonrenal routes

Question 25

polymyxin spectrum

Answer 25

pseudomonas

Question 26

adverse effects polymyxins

Answer 26

nephrotoxicity neurotoxicity

Question 27

T/F Colistatin is often used to treat gram (-) aerobes because it is not associated with serious adverse effects

Answer 27

FALSE only used for infections due to pseudomonas because of nephro and neurotoxicity

Question 28

Clindamycin MOA

Answer 28

inhibits protein synthesis by exclusively binding 50S Bacteriostatic, but may bactericidal when present at high concentrations

Question 29

clindamycin MOR

Answer 29

Altered target sites Active efflux

Question 30

clindamycin spectrum

Answer 30

MSSA MRSA (more active against CA-MRSA) BDA

Question 31

clindamycin distribution

Answer 31

tissue penetration including bone; minimal CSF penetration

Question 32

clindamycin elimination

Answer 32

primarily metabolized by the liver Not removed during hemodialysis

Question 33

clindamycin adverse effects

Answer 33

C. Diff colitis GI: N/V/D/Dys

Question 34

which drugs cause C. diff colitis?

Answer 34

Clindamycin> ampicillin> penicillin, cephalosporin, carbapenems, FQs

Question 35

metronidazole MOA

Answer 35

Inhibits DNA synthesis selective toxicity against ferredoxins prodrug bacericidal

Question 36

metronidazole MOR

Answer 36

altered growth requirements altered ferredoxin levels

Question 37

metronidazole spectrum

Answer 37

BDA c. diff

Question 38

metronidazole distribution

Answer 38

DOES penetrate CSF

Question 39

metronidazole elimination

Answer 39

primarily metabolized by liver

Question 40

metronidazole adverse effects

Answer 40

GI: stomatitis, metallic taste CNS: peripheral neuropathy, seizures, encephalopathy Mutagenicity, carcinogenicity

Question 41

metronidazole drug interactions

Answer 41

Warfarin – anticoagulant effect Alcohol – disulfiram reaction

Question 42

Which antibiotic does NOT interact with warfarin? TMP-SMX Metronidazole Ciprofloxacin Clindamycin Clarithromycin

Answer 42

Clindamycin

Question 43

Which of the following is safe with pregnancy? Ampicillin Levofloxacin Doxycycline Metronidazole Telavancin

Answer 43

Ampicillin

Question 44

Which of the following does not require dosage adjustment in renal insufficiency? TMP-SMX Vancomycin Gentamycin Cefazolin Nafcillin

Answer 44

Nafcillin

Question 45

Which of the following is NOT associated with nephrotoxicity? Metronidazole Vancomycin Tobramycin Colistin Nafcillin

Answer 45

Metronidazole