Intro

Question 1

Resistance develops in 1 of 2 ways

Answer 1

1. spontaneous mutation 2. Acquired resistance and selection

Question 2

What is MBC?

Answer 2

• minimum bactericidal concentration - lowest concentration of abx that KILLS 99.9 percent of inoculum - reserved for serious infections

Question 3

example of antagonistic abx?

Answer 3

-static and -cidal

Question 4

drugs CI in pregnancy include:

Answer 4

-Tetracycline - FQ - Aminoglycosides

Question 5

It is desirable to select the most ______. This will reduce both _____ to the pt and pot. dev. of _______

Answer 5

narrow- spectrum antimicrobial agent; toxicity and resistance

Question 6

____ can cause gray baby syndrome in newborns?

Answer 6

Chloramphenicol

Question 7

6 conditions of immune impairment that req increased dose regimens

Answer 7

1. Alcoholism 2. DM 3. HIV 4. malnutrition 5. elderly 6. immunosuppressive therapy

Question 8

Sensitivity of a drug is determined by _____.

Answer 8

disk diffusion

Question 9

_____ cause ototoxicity to the fetus?

Answer 9

Aminoglycosides

Question 10

3 ways of altered protein expression

Answer 10

1. Alteration of target site (ex- MRSA is gram pos. and resistant to Azithromyocin 2. reduced accumulation of drug (lipopolysaccaride layer or efflux pump) 3. Enzymatic inactivation (ex- B-lactam abx are susceptible to inactivation by B-Lactamases)

Question 11

_____ is when bacterial growth is not arrested by the highest concentration of antimicrobial that tolerated by the host

Answer 11

resistance

Question 12

super infections are due to overgrowth of opportunistic bugs like what 3?

Answer 12

1. Candida 2. Staph aureus 3. C. diff

Question 13

The ____ the CTI, the greater the selective toxicity to the pathogen

Answer 13

Higher (means the safer for the pt)

Question 14

signs of infection include what 2 things?

Answer 14

-fever - leukocytosis

Question 15

Bacteriocidal drugs function?

Answer 15

• kill bacteria - Exhibit either a concentration-dependent or time-dependent killing

Question 16

Is the placental barrier permeable to all abx?

Answer 16

yes

Question 17

Bacteriostatic drugs function?

Answer 17

-inhibit proliferation of bacteria - reduce the spread of infx until the immune sx can eradicate the invading pathogen

Question 18

_____ is the administration of abx preventively to reduce the risk of acquiring infections.

Answer 18

Chemoprophylaxis

Question 19

The use of broad specturm abx may lead to what?

Answer 19

• super infection by modifying natural bacterial flora

Question 20

2 conditions that require decreased dose/regimens

Answer 20

1. Hepatic 2. renal failure ** may cause increased accumlation of abx that can elad to toxicity

Question 21

3 mechanisms of synergistic abx?

Answer 21

1. increase abx accumulation 2. inhibit sequential rxn in metabolic pathway 3. inhibit inactivating enzymes

Question 22

which 2 have a high potential for urticaria and anaphylactic shock?

Answer 22

1. PCN 2. sulfonamides

Question 23

3 situations for prophylatic abx?

Answer 23

1. following exposure to bug 2. prevention of bacterial endocarditis (amox) 3. prevent post-surgical infection (Cefazolam)

Question 24

6 factors for selecting an abx?

Answer 24

1. ID the bug 2. sensitivity of the bug to the drug 3. severity and site of infection 4. existing pt factors 5. safety of antimicrobial agent 6. cost

Question 25

How is a gram stain beneficial to classify a microoranism?

Answer 25

- will help to somewhat classify, but a culture of the organism is req to accurately ID and to determine sensitivity

Question 26

2 abx that can cause decreased bone growth and decreased cartilage growth in young children?

Answer 26

tetracyclines and FQ

Question 27

What is selective toxicity?

Answer 27

The ability to kill an infecting microorganism without harming the host

Question 28

Name the 4 common pediatric Abx

Answer 28

1. PCN 2. Cephalosporins 3. Macrolides 4. Co-Triamoxazole

Question 29

combo abx are use for what 3 things?

Answer 29

1. serious infections 2. polymicrobial infections 3. empiric therapy in life threatening situations

Question 30

what is MIC?

Answer 30

- minimum inhibitory concentration - lowest concentration of abx that PREVENTS growth

Question 31

MBC are reserved for?

Answer 31

Endocarditis, meningitis, sepsis

Question 32

Broad spectrum abx and ex?

Answer 32

- effective against a wide range of microbial species (pos and neg) - Tetracyclines and chloramphenicol

Question 33

\_\_\_\_\_ may induce ototoxicity by direct actions on host cellular funsons

Answer 33

Aminoglycosides

Question 34

Narrow spectrum abx and example?

Answer 34

- abx that act only on single or restricted groups of bugs - PCN- G for gram pos.

Question 35

What is empiric therapy?

Answer 35

- presumptive or best guess therapy - should consist of 1 single broad specturm abx or a combo abx effective against gram pos and neg.

Question 36

2 examples of synergistic abx

Answer 36

1. B-lactam and Aminoglycoside 2. Sulfonamides and Trimethoprim

Question 37

2 ways of genetic alteration causing resistance?

Answer 37

1. spontaneous DNA mutation 2. plasmid transfer (due to mis useover use)

Question 38

Extended spectrum abx and Ex?

Answer 38

- effective against gram pos and some gram neg. - Amoxicillin

Question 39

\_\_\_\_\_ cause tooth dysplasia and inhibit fetal growth?

Answer 39

Tetracyclines

Question 40

the ____ and _____ of an abx influence its ability to transverse a natural barrier.

Answer 40

lipid solubility and pKa

Question 41

Bactericidal drugs should not be used with bacteriostatic drugs because......

Answer 41

-Bacerialcidal drugs work by decreaseing cell wall syn in developing bugs - static decrease numver of new organisms

Question 42

\_\_\_\_\_ facilitates penetration of some abx (PCN) into the CSF?

Answer 42

inflammation

Question 43

Why is a DM foot infection hard to treat?

Answer 43

-due to decreaed blood flow to the area

Question 44

\_\_\_\_\_\_ can cause Kernicterus in newborns?

Answer 44

Sulfonamides

Question 45

What is the CTI?

Answer 45

- Chemotherapeutic index - LD50 (toxicity to the pt)/ LD50 (toxicity to the bug)