Introduction to antimicrobials

Question 1

s. aureus can cause

Answer 1

enterocolitis

Question 2

Candida albicans can cause

Answer 2

vagina, mouth (thrush)

Question 3

C. difficile can cause

Answer 3

pseudomembranous colitis
مهمممم

Question 4

risk factors for superinfection

Answer 4

in hospital > 6 days
6>age>60
Broad spectrum antibiotics

Question 5

drugs that cannot be absorbed by GI

شو مواصفاتها وليش منعطيها

Answer 5

high molecular weight, highly polar

to act locally on GIT

Question 6

Drugs CI in pregnancy

Answer 6

FAST CAT

F: fluoroquinolones
S: sulfa
C: chloramphenicol
T: tetracyclines
A: aminoglycosides

Question 7

Definitive therapy

Answer 7

treating exactly the causative agent depending on its sensitivity test
Empiric therapy

Question 8

Prophylactic therapy

Answer 8

giving antibiotic to prevent the spread among contacts

Question 9

rifampin as Prophylactic therapy to prevent

Answer 9

meningococcal meningitis

Question 10

Giving chloroquine to patient traveling to Africa to prevent

Answer 10

malaria

الملكة صابتها ملاريا

Question 11

Preoperative to prevent opportunistic infections

Answer 11

oral neomycin in
colorectal procedure

فرصة جديدة
Neo+ opportunistic

Question 12

In dental procedures to prevent bacterial myocarditis in patients with abnormal
heart valves, Recommended therapy:

Answer 12

2 grams of amoxicillin one hour before the procedure

50 mg\kg in children up to 2 grams

In people allergic to penicillin we give 600 mg clindamycin orally

Question 13

To prevent recurrent UTI

Answer 13

Co-Trimoxazole

Question 14

To prevent rheumatic fever with patients with recurrent tonsillitis

Answer 14

benzathine penicillin (1 injection monthly)

Question 15

To prevent hepatic coma

Answer 15

oral neomycin with lactulose

Question 16

Drug resistance

Answer 16

If the maximal tolerated dose of antimicrobial does not affect the bacterial growth

Question 17

Drug resistance caused by

Answer 17

1. Decreased accumulation
   • Decreased uptake or increased efflux of an antibiotic
2. Enzymatic inactivation
   • Such as beta-lactamases that inactivate beta-lactams antibiotics

Question 18

Drug resistance prevented by

Answer 18

Ensure an appropriate indication, dose, duration

Restrict use of drug combination to appropriate situations

Question 19

aminoglycosides toxic effect

Answer 19

ototoxicity

أمين أذنه بتوجعه

Question 20

chloramphenicol toxic effects

Answer 20

aplastic anemia

الكلور بعمل فقر 🩸

Question 21

Hypersensitivity vs Toxic effect

Answer 21

Hypersensitivity not dose related

Toxic effect Dose related

Question 22

Advantages of combining antimicrobials

Answer 22

To delay or avoid the development of resistance

To broaden the spectrum (empiric therapy)

To obtain potentiation (synergistic effect)

Question 23

synergistic effect example

Answer 23

using B-lactams & aminoglycosides in endocarditis

o Beta lactams will destroy the cell wall allowing the aminoglycoside to enter the
cell and act on ribosomes

بيتا بدها تكسر جدار الميكروب عشان تفتح لأمين طريق ويقدر يدخل

Question 24

Co-amoxiclav

Answer 24

amoxicillin (antibiotic) & clavulanic acid (which is beta-lactamase inhibitor

Question 25

Co-trimoxazole

Answer 25

2 bacteriostatic effects (sulfamethoxazole &
trimethoprim) combined to give bactericidal effect

Question 26

Bactericidal antibiotic

Answer 26

Penicillin

Cephalosporins

Aminoglycosides

Fluoroquinolones

Carbapenems

Question 27

Disadvantages of combining antimicrobials

Answer 27

Combining bactericidal & bacteriostatic drugs have no clinical significance
Higher risk of superinfections and side effects

Question 28

Cell wall synthesis inhibitors
( bactericidal)

Answer 28

beta-lactams (penicillin, cephalosporins, carbapenems, monobactams) & non-B-
lactams (vancomycin, bacitracin)

Question 29

Cell wall synthesis inhibitors active against which MO

Answer 29

Only active against dividing bacteria They are bactericidal antibiotics

Question 30

The R side chain determine

Answer 30

the spectrum of the drug, antimicrobial stability against
stomach acidity, control susceptibility against beta-lactamase enzyme

Question 31

an enzyme produced by some bacteria and inactivate beta- lactam antibiotics
(such as staph. Aureus)

Answer 31

Beta-lactamase

Nooooote

To avoid resistance, we can use Beta-lactamase inhibitor

Question 32

Given to protect B-lactam ring from degradation by inhibiting beta-lactamase

Answer 32

clavulanic acid, tazobactam, sulbactam, avibactam

Given in fixed combinations with specific penicillin or cephalosporin

Question 33

Co-amoxiclav

Answer 33

amoxicillin + clavulanic acid

Question 34

Antiseptic

Answer 34

when we use antimicrobial to sterilize living tissue

Question 35

Disinfectant

Answer 35

when we use antimicrobial to sterilize non-living tissue

Question 36

In case of penicillin and allergy, which of this drug is not recommended

Answer 36

Oral erythromycin

cause more GI side effects

Question 37

To prevent influenza

Answer 37

oseltamivir

أوسي مفلوز

Question 38

In bone marrow transplantation to prevent viral infections

Answer 38

acyclovir

فيها حرف v

كلوڤر الئاسي

Question 39

In bone marrow transplantation to prevent fungal infections

Answer 39

fluconazole

Question 40

The major Problem with antimicrobial agents

Answer 40

Drug resistance