Inhibitors of DNA function

Question 1

(Quinolones):_________ is renally eliminated but it is a CYP450 inhibitor

Answer 1

Ciprofloxacin

On table, pay attention to fluoroquinolones actions and spectrum:

Question 2

Fluoroquinolones

For only urinary infections use________.

For both urinary and respiratory infections use_______.

For respiratory infections use only_______.

Answer 2

Question 3

Urinary track infections

For uncomplicated lower UTI (Cystitis) use:

For Cystitis, what fluoroquinolones are effective but should be reserved for bad cases?

For uncomplicated upper UTI (pyelonephritis) what medications to use?

Answer 3

What is TPM-SMX?

–> trimethoprim sulfamethoxazole.

Question 4

Complicated UTIs:

Usually what kind of gram stain seen in its causative agents?

For cystitis use:_____.

For pyelonephritis use:______.

Answer 4

Question 5

Sample questions:

Answer 5

Resistance emerges in about 1 in 107-109 organisms - likely due to one or more point mutations in binding site on DNA gyrase or possibly changes in drug permeability into organism

Plasmid-mediated resistance to fluoroquinolones has been increasing in U.S. hospitals. One type involves Qnr proteins that protect DNA gyrase from fluoroquinolones, while the other type codes for a variant of an aminoglycoside acteyltransferase that modifies ciprofloxacin.

Question 6

Mechanism of action of fluoroquinolones:

Answer 6

What do fluoroquinolones inhibit?

Are they bactericidal or bacteriostatic?

Question 7

Resistance to Fluoroquinolones

Seen in what organism?

Answer 7

Question 8

Fluoroquinolones pharmacokinetics:

They are primarily excreted by the ______.

The half-life is increases in situations of renal failure for ______ and ______, which means they require renal adjustment (dosing).

No renal adjustment need it for_________.

Answer 8

Question 9

Antimicrobial spectrum:

Atypical and anaerobes mostly covered by what generation fluoroquinolones?

Answer 9

For gram positive cocci use _____ or _______, which are respiratory quinolones.

For gram negative cocci use_______.

For gram positive rods use________.

Question 10

Antimicrobial spectrum:

For gram negative rods use_______.

For anaerobes and atypical organism use_______.

Answer 10

Question 11

Sample question:

Answer 11

.The drug of choice for treatment of a first episode of mild to moderate C. difficile infection is:

A.Levofloxacin

B.Metronidazole

C.Vancomycin

D.Clindamycin

Question 12

Fluoroquinolones adverse reactions:

What does Boxed Warning refers to?

Answer 12

Drug-drug interactions can occur between fluoroquinolones and _______ and ______.

What reduces the absorption of ciprofloxacin? How do you acommodate this?

Question 13

Nitrofurantoin

MOA:

Answer 13

Most commonly used ________ antiseptic.

Why not used for systemic infection?

Why do mammalian cells are not affected?

Question 14

Nitrofurantoin pharmacokinetics:

Contraindicated in what conditions why?

What form of the drug is absorbed more slowly?

Answer 14

Question 15

Nitrofurantoin clinical uses:

What organisms are generally resistant to Nitrofurantoin?

Usually good against _______ (from table).

Answer 15

Gram-negative rods

E. Coli (plus enteric gram negative) –> uncomplicated UTIs

(Pseudomonas, Proteus species generally resistant)

Question 16

Sample questions

Answer 16

Nitrofuratoin adverse reactions:

Should not be given durign what trimester of pregnancy?

Question 17

Metronidazole

Answer 17

Question 18

Metronidazole pharmacokinetics

Metabolism is primarily_______, so be careful with patients with ________.

Also, it could interact with _______.

What precautions should breast feeding moms take?

Answer 18

Question 19

Metronidazole clinical usage:

Treats mainly______ and _______.

Answer 19

Question 20

Metronidazole adverse reaction:

It can lead to exacerbation of _________.

Answer 20

It can inhibit _________.

Antabuse-like effect if it is consumes with _________.

Question 21

Sample questions:

Answer 21

Question 22

Sulfonamides-Trimethoprim

Answer 22

Question 23

Sample questions:

Answer 23

Question 24

Sulfonamides resistance:

Answer 24

Question 25

Sulfonamides – Synergism with Trimethoprim

This combination is ________.

Answer 25

Question 26

Sulfonamides – Synergism with Trimethoprim

Answer 26

Question 27

Sulfonamides pharmacokinetics:

They are weak acids generally well absorbed in the_________.

Best to take on an empty stomach but with ________.

It can cause protein binding displacement of bilirubin and predispose to___________ in neonates.

Answer 27

Question 28

Sulfonamides pharmacokinetics:

Answer 28

Question 29

Sulfonamides spectrum:

It covers all negative rods except________.

Answer 29

Question 30

Pseudomonas –> burn infections treated by silver sulfadiazine.

Answer 30

Question 31

Sulfonamides adverse reactions:

What out for rash response in _______ syndrome.

Answer 31

Question 32

Sulfonamides adverse reactions:

Answer 32

Question 33