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Microbiology > Microbiology Drugs > Flashcards

Microbiology Drugs Flashcards

1
Q

Antimicrobials drugs that inhibits the folic acid synthesis and reduction ( DNA methylation) ;

A
  1. Sulfonamides.
  2. Trimethoprim
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2
Q

Which type of penicillin use as IV and IM ?

A

Penicillin G

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3
Q

Which type of penicillin used as oral ?

A

Penicillin V

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4
Q

Which Antimicrobials drugs contains Beta lactam ring ?

A
  1. Penicillin.
  2. Cephalosporins.
  3. Carba-penems
  4. Monobactam (Aztreo-nam).
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5
Q

Mechanism of penicillin:

A

Penicillin break down of the bacterial cell wall by inhibition of the cross-linking of transpeptidase, therfore, it’s prevent the cell wall formation— lead to increasing the osmotic pressure in the cell —- lyisis of the cell .

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6
Q

Penicillin doesn’t affects the human cell wall due to :

A

Because the human cell wall consist of L-Ala (not D-Ala like the bacteria )

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7
Q

Cross linking of the bacterial cell wall occurs by :

A

Transpeptidase( penicillin binding protein )

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8
Q

Clinical use of penicillin :

A
  1. Gram + (s.pneumonea, s. Pyogenes {specially for sore throat}, Actinomyces )
  2. Gram (-) cocci : mainly(N.meningitis)
  3. Spirochets :( T.pallidum)
  4. Penicillinase sensitive.
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9
Q

What is penicillinase ?

A

B-lactamase enzyme present in the periplasm of the gram (-) bacteria .

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10
Q

Mechanism of penicillinase “B-lactamase” ?:

A

Destruction of beta lactam ring.

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11
Q

Adverse effect of penicillin:

A
  1. Hypersinsivity (type1,2,3,4)
  2. Jaresch-herxeimer reaction
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12
Q

What’s the hypersinsivity reaction of penicillin ?

A
  1. Type 1 hypersinsivity
  2. Type 2 hypersinsivity ( Hemolytic anemia ).
  3. Type 3 hypersinsivity (Serum sickness).
  4. Type 4 hypersinsivity (Maculopapular rash).
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13
Q

Hemolytic anemia that cause by penicillin, which typer of hypersinsivity reaction is considered?

A

Typer 2 hypersensitivity

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14
Q

Maculopapular rash that cause by penicillin, which type of hypersinsivity reaction considered ?

A

Type 4 hypersinsivity reaction

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15
Q

Resistance of penicillin by :

A
  1. Penicillinase(B-lactamase)
  2. Modification of PBP( changing of penicillin-binding protein )
  3. Reduced bacterial cell pentration by:
    *Gram (-) bacteria “that have outer membrane “.
    *decrease number of porins channel ( that responsible for transporting chemical element to outside and inside the bacterial call ).
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16
Q

Which drug increase the duration of penicillin in the blood by decrease the penicillins renal secrtion?

A

Probencid

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17
Q

B-lactamase inhibitors :

A
  1. Clavulanic acid
  2. Sul-bactam
  3. Tazo-bactam
  4. Avi-bactam
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18
Q

Penicillinase-sensitive penicillin (anino-penicillins): oral, IV ..?

A
  1. Amoxicillin (oral)
  2. Ampicillin (IV)
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19
Q

Mechanism of Penicillinase-sensitive penicillin :

A

The same with penicillin but have more Penetration of porin channels of gram (-) bacteria .

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20
Q

Augmentin it’s :

A

Amoxicillin + clavulenic acid

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21
Q

Augmentin (Amoxicillin +clavulanic acid) uesed for :

A

Resistance cases of otitis media

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22
Q

Unasyn (Ampiccillin +sulbactum) uesed for :

A

Surgical infection

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23
Q

Clinical use of penicillinase-sensitive penicillin :

A
  • HHELPSS :
  • H-influenza,
  • H-pylori,
  • E.coli,
  • Listeria
  • Proteus
  • Salmonella,
  • Shigella, ++++ enterococci
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24
Q

Penicillinase- resistance penicillins (antistaphylococcal penicillins ):

A
  1. Dicl-oxa-cillin.
  2. Naf-cillin.
  3. Oxa-cillin.
  4. Methi-cillin.
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25
Q

Mechanism of Penicillinase- resistance penicillins (antistaphylococcal penicillins ):

A

Same with penicillin.

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26
Q

Why Penicillinase- resistance penicillins are resistance to penicillinase ?

A

Because “bulky side chain R group “ block access of B-lactamase to B-lactamase ring.

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27
Q

Clinical use of Penicillinase- resistance penicillins (antistaphylococcal penicillins ):

A

S.aureus skin infection{cellulitis and impetigo, folliculitis } (except MRSA resistance)

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28
Q

Adverse effect of Penicillinase- resistance penicillins (antistaphylococcal penicillins ):

A
  1. Hypersinsivity
  2. Acute Interstitial nephritis.
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29
Q

Antipseudomonal penicillins :

A
  1. Pi-pera-cillin,
  2. Ticar-cillin .
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30
Q

Piperacillin, ticarcillin used for :

A

1.Pseudomonas
2. Most gram (+) bacteria

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31
Q

Ticarcillin + clavulonate =

A

Time-nitin

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32
Q

Piperacillin+ tazobactam =

A

Zosyn

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33
Q

Penicillin is bactericidal or bacteriostatic

A

Bacteriocidal

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34
Q

Cephalosporins is bactericidal or bacteriostatic

A

Bactericidal

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35
Q

Mechanism of cephalosporins ?

A

B-lactam drugs that inhibit cell wall synthesis but are less susceptible to penicillinase .

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36
Q

Which organism not covered (not effected ) by 1st-4th generation of cephalosporins ?

A

LAME
1. Listeria
2. Atypical {mycobacterium, chlamydia}
3. MRSA
4. Enterococci

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37
Q

1st generation of cephalosporin:

A
  1. Cefa-zolin,
  2. Ceph-alexin.
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38
Q

2nd generation of cephalosporin:”

A
  1. Cefa-clor,
  2. Cefo-xitin,
  3. Cefu-roxime.
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39
Q

3rd generation of cephalosporin :

A
  1. Cef-triaxone,
  2. Cef-tazidime
  3. Cef-podoxime,
  4. Cefo-taxime
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40
Q

4th generation of cephalosporin:

A

Cefepime

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41
Q

5th generation of cephalosporin:

A

Cefta-roline

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42
Q

Clinical use of 1st generation of cephalosporin:

A

** KEP:-
1. Proteus
2. E.coli
3. Klebsiella pneumonia

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43
Q

Which drug used prior to surgery to prevent s.aureus wound infection ?

A

Cefazolin

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44
Q

Clinical use of 2nd generation of cephalosporin

A

KEP +SHEN
1. H-influnza
2. Enterobacter
3. Niesseria
4. Serratia

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45
Q

Which drug from 3rd generation of cephalosporin used for meningitis and gonorrhoea and disseminated Lyme disease ?

A

Ceftriaxone

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46
Q

Which drug from 3rd generation of cephalosporin used for pseudomonas?

A

Ceftazidime

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47
Q

Which generation of cephalosporins covered the listeria and MRSA and enterococcus but not covered the pseudomonas ?

A

5th genereation(ceftraoline)

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48
Q

Which drugs have this adverse effects: hypersinsivity reaction, autoimmune hemolytic anemia, disulfiram-like reaction, vit K deficiency , hypoprothombinemia, increasing of neurotoxicity of aminoglycosides ?

A

Cephalosporins

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49
Q

Carba-penems drugs :

A
  1. Imi-penem.
  2. Mero-penem.
  3. Erta-penem.
  4. Dori-penem.
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50
Q

Which drugs that inhibitor of renal dehydropeptidase 1?

A

Cilastatin

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51
Q

Why the 5th generation of cephalosporins covers the listeria and enterococcus and MRSA ?

A

Because it’s bind on another site that the fist 4 generation bind to it, it bind to PBP2a

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52
Q

Which drug of carbapenems inhibit by renal dehydropeptidase ?

A

Imipenem

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53
Q

Which drug of carbapenems have CNS toxicity side effect (seizures)?

A

Imipneme

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54
Q

Why the meropneme bitter than imipneme ?

A
  1. Because the imipneme break down by renal dehydropeptidase-1
  2. Because the imipneme have CNS toxicity side effect (siezures)
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55
Q

Monobactams (aztreonam) mechanism of action:

A
  1. Prevent the peptidoglycan cross-linking by binding to PBP-3 (only in G-negative).
  2. Synergistic with aminoglycosides .1+1=3
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56
Q

Clinical use of monobactams :

A
  1. For penicillin allergic.
  2. Patient those with renal insufficiency who can’t tolerate aminoglycosides
  3. Gram (-) rod only
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57
Q

Which drug that have the highly resistance to B-lactamase ?

A

Carbapenems

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58
Q

Which drug that have highly sensitive to B-lactamase ?

A

Penicillins

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59
Q

Penicillin binding protein :
1. PBP-3 :?
2. PBP-2a ?

A
  1. PBP-3: aztreonam
  2. PBP-2a: ceftaroline.
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60
Q

اقوى سلاح لل: gram - bacteria

A

B-lactamase

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61
Q

Mechanism of vancomycin :

A

Inhibit cell wall peptidoglycan formation by binding D-ala D-ala portion of cell wall precursor .

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62
Q

Why Vancomycin can’t affects the gram (-) bacteria ?

A

Because it has too large molecule that can’t pentrate the outer membrane of the gram (-) bacteria

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63
Q

Which drugs cause red man syndrome as adverse effects?

A

Vancomycin

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64
Q

Which drug can cause nephrotoxicity , ototoxicity, thrombophlebitis?

A

Vancomycin

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65
Q

Which syndrome characterised by diffuse flushing of the whole body, and non specific mast cell degranulation “histamin release” ?

A

Red man syndrome

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66
Q

Treatment of red man syndrome. :

A
  1. Stop the drug
  2. Give Anti-Histamines
  3. Restart the medication
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67
Q

Mechanism of resistance of vancomycin ?

A

Via amino acid modification of D-Ala D-Ala to D-Ala D-Lac

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68
Q

Treatment of MRSA by:

A

.6 ادويه

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69
Q

Treatment of VRSA by :

A
  1. Quinu-pristin
  2. Dalfo-pristin
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70
Q

All protein synthesis inhibitor are bacteriostatic except :

A

Aminoglycosides

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71
Q

Amino glycoside is bactericidal due to

A

Miss reading of mRNA

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72
Q

Which of protein synthesis inhibitor are variable( bacteriostatic + bacteriocaidal) ?

A
  1. Dlafo- pristin.
  2. Quinu-pristin.
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73
Q

Protein synthesis inhibitor divided into : 30s inhibitor and 50s inhibitor, which drug are the 30s inhibitors ?

A
  1. Aminoglycosides
  2. Tetracycline
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74
Q

Protein synthesis inhibitor divided into : 30s inhibitor and 50s inhibitor, which drug are the 50s inhibitors ?

A
  1. Chloramphenicol
  2. Clindamycin
  3. Marcrolides
  4. Linezolides
  5. Strepto-gramins
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75
Q

Aminoglycosides drugs:

A
  • “GNATS “
    1. Genta-mycin
    2. neo-mycin
    3. Amikacin
    4. Tobra-mycin
    5. Strepto-mycin
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76
Q

Mechanism of aminoglycosides :

A
  1. Irreversible inhibtion of initiation complex though binding to 30s subunit causing missreading of mRNA
  2. Block translocation
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77
Q

Why aminoglycosides ineffective aginst anaerobes ?

A

Because it require O2 for uptake

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78
Q

Which drugs use for severe gram (-) rod infection , and also can be synergistic with B-lactam antibiotics ؟

A

aminoglycosides

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79
Q

Which aminoglycosides used for bowel surgery and hepatic encephalopathy ?

A

Neomycin

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80
Q

Aminoglycoside it synergistic with B-lactam antibiotics , it’s rare to used alone. Which aminoglycoside drug that use with vancomycin to treatment the endocarditis ?

A

Vancomycin + gentamycin

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81
Q

Aminoglycoside it synergistic with B-lactam antibiotics , it’s rare to used alone. Which aminoglycoside drug that use with ampicillin to treatment the neonatal meningitis ?

A

Ampicillin +gentamycin

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82
Q

Advers effects of aminoglycosides :

A

NNOT
1. Nephrotoxicity,
2. Neuromuscular blockage (⬇️ Ach) ,
3. Ototoxicity (specially when used with loop diuretics,
4. Teratogen

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83
Q

Which drug have this adverse effects: Nephrotoxicity, neuromascular blockage (⬇️ Ach) , ototoxicity (specially when used with loop diuretics, teratogen

A

Aminoglycoside

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84
Q

Mechanism of resistance of aminoglycosides :

A
  • Bacterial transferase enzyme inactivate the drug by :
    1. Acetylation
    1. Phosphorylation
    1. Adenylation
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85
Q

Bacterial transferase enzyme inactivate the aminoglycoside by :

A

1.acetylation
2. Phosphorylation
3. Adenylation

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86
Q

Tetracycline drugs :

A
  1. Tetra-cycline
  2. Doxy-cycline
  3. Mino-cycline
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87
Q

Mechanism of tetracycline :

A

Bind to 30s and prevent attachment of aminoacyl-tRNA

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88
Q

Don’t take tetracycline with milk (calcium) antacid or iron due to :

A

The milk , antacids and irons decrease the absorption of the tetracycline in the gut.

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89
Q

Which drug have ability to accumulate intracellularly and make them very effective aginst rickettsia and chlamydia ?

A

Tetracycline

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90
Q

Which drug can use for borrelia burgdorferi and. M.pneumoniae, rickettsia and chlamydia and also used for treat acne ?

A

Tetracycline

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91
Q

Which drug can used in patient with renal faliure and have effect aginst MRSA?

A

Doxycycline

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92
Q

Which type of tetracycline not used as antibiotics, used as ADH antagonist, so it’s given for SIADH?

A

Demeclocycline

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93
Q

Which drugs have this adverse effects :
GI distress, discoloration of teeth, inhibition of bone growth in children , photosensivity, contraindicated in pregnance ?

A

Tetracycline

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94
Q

Which drug have this mechanism of resistance : ⬇️ Uptake or ⬆️ efflux out of bacterial cell by plasmid -encode transport pumps ?

A

Tetracycline

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95
Q

Clinical uses for tetracycline :

A
  1. Zoonosis : borrelia, M.pneumonea.
  2. Intracellular orgasnism : chlamydia, rickettsia
  3. Acne: prpprionecacterium
  4. Doxycycline : 1. Can use in case-of bacterial infection in patient with renal failure because it does not effect on kidney 2. MRSA
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96
Q

Drugs with photo-sensivity :

A
  1. Aminoglycosides
  2. Tetracycline
  3. Sulfonamides
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97
Q

Gly-cyl-cycline: drug

A

Tige-cycline.

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98
Q

What is tigecycline ?

A

tetracycline derivative bind to 30s and inhibit protein synthesis

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99
Q

Clinical use of tigecycline :

A

For multidrug-resistance (MRSA,VRE)

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100
Q

Mechanism of action of chloramphenicol :

A

Bind to 50s and inhibit peptidyltransferase

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101
Q

Clinical use for chloramphenicol:

A
  1. Meningitis,
  2. Rocky moutain spotted fever (in case of pregnancy for the 1st and 2nd trimester only )
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102
Q

Which drug if used it the pregnant women in the first and seconde trimester does not have side effect, but if she used it in the 3d trimester can lead to gray baby syndrome ?

A

Chloramphenicol

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103
Q

Gray baby syndrome cause by which enzyme lack in liver ?

A

Liver UDP-glucu-rony-ltransferase.

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104
Q

Which drug have this mechanism of resistance: plasmid-encoded acetyltransferase inactivates the drug

A

Chloramphenicol

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105
Q

Which syndrome characterised by : vomiting, ashen grey color of the skin, poor muscle tone, cyanosis, CV collapse ?

A

Gray baby syndrome

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106
Q
  1. Gray baby syndrome cause by :
  2. Gray man syndrome cause by :
  3. Red man syndrome cause by:
A
  1. Gray baby syndrome cause by :chloramphenicol
  2. Gray man syndrome cause by :amidarone
  3. Red man syndrome cause by: vancomycin
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107
Q

Macrolides:

A
  1. Az-thromycin
  2. Clari-thromycin
  3. Erthromycin
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108
Q

Mechanism of macrolides:

A

Inhibition of protein synrthesis by blocking translocation , bind to the 23S rRNA of the 50s subunit

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109
Q

Mechanism of clindamycin :

A

Block peptide transfer (translocation) at 50s ribosoma subunit “ same as macrolides

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110
Q

Which drug Block peptide transfer (translocation) at 50s ribosoma subunit “ same as macrolides

A

Clindamycin

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111
Q

Clinical uses of clindamycin :

A
  1. Anaerobic infection
  2. Group A strep infection
  3. MRSA
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112
Q

Which drugs cause pseudomembranous colitis as side effects ?

A
  1. Clindamycin
  2. Streptogramin
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113
Q

Mechanism of resistance of clindamycin :

A

As macrolides “methylation”

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114
Q

Oxazolidinones drug:

A

Linezolid

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115
Q

Mechanism of linezolid:

A

Inhibit protein synthesis by binding to 50s subunit- prevent formation of initial complex

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116
Q

Clinical uses of linezolid:

A

Last line for bacterial resistance (MRSA,VRE)

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117
Q

Which drug have thius adverse effects: bone marrow supression especially thrombocytpnea), peripheral neuropathy, serotonin syndrome when given with SSRIs (selictive serotonin reuptake inhibitors)

A

Linezolid

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118
Q

How linezolid lead to serotonin syndrome ?

A

When giver the linezolid with SSRIs , the linezolid is weak MAOIs (increase serotonin)+ SSRIs also increase the sertonin, taking the twice togther lead to serotonin syndrome

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119
Q

Which drug have point mutation of ribosomal RNA as mechanism of resistance ?

A

Linezolid

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120
Q

Which drugs can cause prephral neuropathy ?

A
  1. Linezolid
  2. isoniazid
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121
Q

Azithromycin, larithromycin, erthromycin, for which group of drug belongs?

A

Microlides

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122
Q

Which drug have this mechanism of action: ihibit protein synthesis by blocking translocation, bind to the 23s rRNA of the 50s ribosomal subuint?

A

Macrolides

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123
Q

How the macrolides effect aginst intracellular organisms?

A

By concentration inside the macrophage and other cells

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124
Q

Clinical use of macrolides :

A
  1. Atypical pneumonias ( Mycoplasma,chlamydia , legionella)
  2. Upper respiratory infection :( str. Pneumonia, str. Pyogenes, proteussis ).
  3. Streptococcal infection in patient allergic to penicillin.
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125
Q

Which drug of microlides can used in motility disoreder of GIT ( eg, gastroparesis) ?

A

Erthromycin

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126
Q

Erthromycin bind to which receptor in GIT, that leade to smooth muscle contraction ?

A

Motilin receptor

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127
Q

adverse effects of macrolide

A

GAARE
1. Gastrointistinal motility issues,
2. Arrhythmia
3. Acute cholestatic hepatitis
4. Rash
5. Esinophilia

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128
Q

Which macrolides inhibit cytochrome p-450 that lead to increase serum concentration of theophyline, oral anticoagulants ?

A

Erthromycin and clarithromycin

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129
Q

Mechanism of resistance of macrolides:

A

Methylation of 23s rRNA-binding site ,prevent binding of drugs.

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130
Q

Sulfonamides drugs :

A
  1. Sulfa-methoxazole (SMX)
  2. Sulfa-soxazole
  3. Sulfa-diazine
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131
Q

Which drug have this mechanism : inhibit dihydropteroate synthesis ?

A

1.Sulfonamide
2. Dapsone

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132
Q

Which bacteriostatic drug converts to bacteriocidal when combined with trimethoprim ?

A

Sulfonamides

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133
Q

Which drug have the following adverse effects : hypersensivity reaction, hemolysis if G6PD deficient, bind to albumin ?

A

Sulfonamides

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134
Q

Which drug have the following mechanism of resistance :
1. Altered enzyme ( bacterial dihydropteroate synthase)
2. ⬇️ uptake
3. ⬆️PABA synthesis

A

Sulfonamides

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135
Q

Which drug have similar mechanism to sulfonamides but structurally distinct agent, and use for leprosy and pneumocystis jivovecii prophylaxis ?

A

Dapsone

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136
Q

Which drug inhibit bacterial dihydrofolate reductase, and may cause megaloblastic anemia leukopenia, granulocytopenia?

A

Trimethoprim

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137
Q

Trimethoprim side effects :

A

Bone marrow supression:
1. Megaoblastic anemia
2. Leukopnia
3. Granulocytopenia

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138
Q

Which drug causing sequential block of folate synthesis in case of used in combination with sulfonamides ?

A

Trimethoprim

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139
Q

How the trimethoprim lead to megaloblastic anemia ?

A

By effect on human dihydrofolate reductase

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140
Q

Which drugs are vairable (static\sidal) and synthesized by the streptomycess virginia ?

A

Strepto-gramins:- quinupristin, dalfopristin

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141
Q

Strepto gramins used for:

A
  1. MRSA
  2. VRE
  3. Staph
  4. Strept skin infection
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142
Q

Fluroquinolones drugs :

A
  1. Cipro-floxacin
  2. Nor-floxacin
  3. Levo-floxacin
  4. Oflo-floxacin
  5. Moxi-floxacin
  6. Gemi-floxacin
  7. Eno-xacin
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143
Q

Which drugs inhibit prokaryotic enzymes topoisomerase 2 gyrse and topoisomerase 4 ?

A

Floroquinolones

144
Q

Which drugs use for gram (-) rods of urinary and GI tract and some gram(+) organsims and otitis externa “ ?

A

Fluroquinolones

145
Q

“Cipro drops “ ( fluroquinolones derivatives) used for :

A

Otitis externa

146
Q

Which drugs have this adverse effects:, tendonitis or tendon rapture in people > 60 or patient taking prednisalon, cartilage damage in children, leg cramps and myalgias ,and may cause prolong QT interval ?

A

Fluroquinolones

147
Q

Fluroquinolones contraindicated in :

A
  1. Old age -tendonitis
  2. Children <18 - cause cartilage damage
    3 . Pregnant women
  3. Nursing mother
148
Q

Which fluroquinolon derivatives inhibit cytochrome p-450 ?

A

Ciprofloxacin

149
Q

Which drugs have this mechanism of resistance: chromosome-encoded mutation in DNA gyrase, plasmid- mediated resistance efflux pumps ?

A

Fluroquinolones

150
Q

Lipopeptide drug that disrupts cell membrane of gram (-) cocci by creating transmembrane channels ?

A

Depatomycin

151
Q

Which drug have the following adverse effects :myopathy, rhabdo-myolysis ?

A

Depato-mycin

152
Q

Which drug form toxic free radical metabolites in the bacterial cell that damage DNA that lead to cell death .

A

Metronidazole

153
Q

What’s meaning of metronidazole prodrug ?

A

It’s inactive form of metronidazole

154
Q

Activation of metronidazole (from prodrug to active drug) occurs by reduction, which organisms cand reducing it ?

A

Anaerobic bacteria

155
Q

Why metronidazole work as antiprotozoa ?

A

Because it effects on the anaerobes, protozoa doesn’t have mitochondria so it’s anaerobes

156
Q

Clinical uses of metronidazole :

A

1.Antiprotozoa “GGET” : giardia, entamobea, trichomonas, gradnerella vaginalis,
2. Anaerobic bacteria( bacteroides, c.difficile).
3. Can use in place of amoxicillin in triple therapy of H.pylori
4. Anaerobic infection below the diaphragm

157
Q

Which drug has the following adverse effects: disulfram-like reaction( severe flushing, tachycardia, hypotension), metallic state .

A

Metronidazole

158
Q

Prophylaxis of tuberculosis :

159
Q

Prophylaxis of M.avium-intracellulare :

A

Azithromycin, rifabutin

160
Q

Treatment of tuberculosis:

A
  1. Rifampin
  2. Isoniazide
  3. Pyrazimaide
  4. Ethambutol
161
Q

Treatment of M.avium-intracellulare :

A
  1. Azithromycin + ethambtul ( can also add rifabultin or ciprofluxacin )
  2. Clarithromycin + ethambtul ( can also add rifabultin or ciprofluxacin )
162
Q

Treatment of M.leprae:
1. For tuberculoid form :
2. For lepromatous form :

A
  1. For tuberculoid form :dapsone and rifampin.
  2. For lepromatous form :dapsone + rifampin + clofazimine
163
Q

Which drug used for treatment of tuberculosis by this mechanism :inhibit of bacterial DNA-dependent RNA polymerase .

164
Q

Which drug used for treatment of tuberculosis by this mechanism : inhibit mycolic acid synthesis

165
Q

Which drug used for treatment of tuberculosis by this mechanism : inhibition of arabinosyl transferase ?

A

Ethambutol

166
Q

Which drug used for treatment of tuberculosis and have this side effects : hepatotoxicity ,optic neuropathy?

A

Ethambutol

167
Q

Which drug used for treatment of tuberculosis and have this side effects : hepatotoxicity red-orange body fluids, cytopnia , increase cyt p-450 :

168
Q

Which drug used for treatment of tuberculosis and have this side effects : neurotoxicity, hepatoxicity, vit B6 deficiency , decrease cyt p-450

169
Q

Which drug used for treatment of tuberculosis and have this side effects : hepatotoxicity and hyperuricemia?

A

Pyrazinamide

170
Q

Rifamycins drugs:

A
  1. Rifa-mpin.
  2. Rifa-butin
171
Q

Which tuberculosis drug inhibit cytochrome P-450

A

, isoniazid

172
Q

Isoniazid (inactive) converts to isoniazid( active) by:

A

Catalase peroxidase( that release from bacteria )

173
Q

Which gene encoded the catalase peroxidase enzyme ?

174
Q

Reisistance of isoniazide by mutation of which gene ?

175
Q

Which tuberculosis drug increase cytochrome P-450

176
Q

Which drugs block translocation?

A
  1. Macrolides
  2. Clindamycin
  3. Aminoglycosides
177
Q

Dehydrofolate reductase :
1. In human inhibit by :
2. In baceria inhibit by :

A
  1. In human inhibit by : methotrexate
  2. In baceria inhibit by : trimethoprim, pyrimehamine
178
Q

Mechanism of rifampin ?

A

Inhibition of DNA dependent RNA polymerase

179
Q

Which drug used for tuberculosis as 2nd line and cause tinnitus, vertigo, ataxia, nephrotoxicity ?

A

Streptomycin

180
Q

Which antimicrobial prophylaxis used in case of high risk for endocarditis and undergoing surgical or dental procedures ?

A

Amoxicillin

181
Q

Which antimicrobial prophylaxis used in case of exposure to gonorrhea ?

A

Ceftriaxone + azithromycin

182
Q

Which antimicrobial prophylaxis used in case of history of recurrent UTI

183
Q

Which antimicrobial prophylaxis used in case of exposure to meningiococcal infection :

A

Ceftriaxone , ciproflocxacin, rifampin.

184
Q

Which antimicrobial prophylaxis used in case of pregnant women carrying group B strep?

A

Intrapartum penicillin G or ampicillin

185
Q

Which antimicrobial prophylaxis used in order to prevention of gonococcal conjunctivitis in newborn ?

A

Erthromycin ointment on eyes

186
Q

Which antimicrobial prophylaxis used to prevention postsurgical infectioon due to s.aureus ?

187
Q

Which antimicrobial prophylaxis used to strep pharyngitis in child with prior rheymatic fever?

A

Benzathine penicillin G or oral penicillin V

188
Q

Which antimicrobial prophylaxis used in case off exposure to syphilis

A

Benzathine penicillin G

189
Q

Prophylaxis of HIV patients in case of CD4<200, with pneumocystis pneumonea ,

190
Q

Prophylaxis of HIV patients in case of CD4< 100, with pneumocystis pneumonea ,toxoplasmosis :

191
Q

Prophylaxis of HIV patients in case of CD4<50, with mycobacterium avium complex infection :

A

Azithromycin or clarithromycin

192
Q

Treatment of MRSA:

A
  1. Vanco-mycin
  2. Dapto-mycin
  3. Linezolid
  4. Tige-cycline
  5. Cefta-roline
  6. Doxy-cycline
193
Q

Treatment of VRE :

A
  1. Linezolid,
  2. Streptogramins (quinupristin, dalfopristin)
194
Q

Different between amphotericin B and nyastatin in the clinical used:

A

Amphotericin uesd in systemic mycosis, but nyastatin used only in topical mycosis

195
Q

Why Amphotericin B used only in case of severe fungal infection ?

A

Because it “amphoterrible” (have severe side effects )

196
Q

Antifungal therapy that work on cell membrane integrity “ form membrane pores “

A

Polyenes :
1. Amphotericin B
2. Nyastatin

197
Q

Antifungal therapy that inhibit nucleic acid synthesis :

A

Flu-cyto-sine

198
Q

Antifungal therapy that inhibit cell wall synthesis :

A

Echino-candins:
1. Anidul-fungin
2. Caspo-fungin
3. Muca-fungin

199
Q

Antifungal therapy that inhibit lanosterol synthesis :

A

Ter-bina-fine

200
Q

Antifungal therapy that inhibit ergosterol synthesis :

A

Azoles :
1.clotrim-azole.
2. Flu-con-azole
3. Itra-con-azole
4. Keto-con-azole
5. Mi-con-azole
6. Vori-con-azole

201
Q

Which drugs bind to ergosterol and forms membrane pores that allow leakage of elctrolytes?

A

Polyenes: amphotricin, nyastatin

202
Q

Which antifungal drugs have the following side effects :fever, chills (shake and bake), hypotension, nephrotoxicity, arrhythmias, anemia , IV phelebitis (amphoterrible)?

A

Amphotericin B

203
Q

The nephrotoxicity that cause by amphotricin can decrease it by :

204
Q

Which antifungal drugs inhibit DNA and RNA biosynthesis by conversion to 5-fluorouracil by cytosine deaminase ?

A

Flucytosine

205
Q

Which antifungal drug used with combination with amphotricin to treat the systemic mycosis ?

A

Flucytosine

206
Q

Side effect of flucytosine:

A

Bone marrow supression

207
Q

Which antifungal drugs inhibit fungal stgerol(ergosterol) synthesis, by inhibition of the cytochrome P-450 enzyme that converet lanosterol to ergosterol

208
Q

Azoles inhibit fungal ergosterol synthesis by :

A

Inhibition of cytochrome P-450 that converts lanosterol to ergosterol

209
Q

Which enzyme convert lanosterol to ergosterol in fungi?

A

14-alpha-demethylase (Cytochrome P-450)

210
Q

Which azoles drug used for : chronic suppression of cryptococcal meningitis in AIDS patients?

A

Fluco-nazole

211
Q

Which azoles drug used for : blastomyces, coccidioides, histoplasma?

A

Itra-con-azoles

212
Q

Which azoles drug used for : atypical fungal infection?

A
  1. Clotrim-azoles,
  2. Mi-con-azoles
213
Q

Which azoles drug used for : aspergillus and candida?

A

Voriconazole

214
Q

Which azoles drug used for :aspergillus and mucorales infections?

A

Isavu-con-azole

215
Q

Which antifungal dugs that can cause testesterone synthesis inhibition , gynecomastia

A

Azoles: specially”ketoconazoles”.

216
Q

Azoles side effects:

A
  1. Testosterone synthesis inhibition ,
  2. Gynecomastia,
  3. Liver dysfunction (by inhibition of cytochrome P-450
217
Q

Azoles can cause liver dysfunction by :

A

by inhibition of cytochrome P-450

218
Q

Which antifungal drug inhibit the fungal enzyme squalene epoxide ?

A

Ter-bina-fine

219
Q

Clinical uses of terbinafne :

A

Dermato-phytoses (especially onychomycosis -fungal infection of finger or toe nails)

220
Q

What’s onychomycosis -

A

Type of dermatophytoses that characterized by fungal infection of finger or toe nails

221
Q

Which antifungal drugs inhibit cell wall synthesis by inhibition synthesis of B-glucan ?

A

Echinocandins

222
Q

Clinical uses of echinocandins :

A

Invasive aspergillus and candida

223
Q

Which anti-fungal drug can cause GI upset and flushing ( by histamine release )?

A

Echinocandines

224
Q

Which antifungal therapy interferes with microtubule function, disrupts mitosis. Deposites in keratin containing tissue ?

A

Griseo-fulvin

225
Q

anti-malaria therapy

A

Chloro-quine

226
Q

What happen when chloroquine block detoxification of heme into hemozin ?

A

Heme accumulates and it is toxic to plasmodia

227
Q

Clinical uses of chloroqine :

A

Treatment of plasmodial species (except P.falciparum)

228
Q

Artemether\lumefantrine or atovaquone\ proguani used for :

A

P.falciparum

229
Q

For long treatment of malaria use :

A
  1. Quinidine
  2. Arte-sunate.
230
Q

Side effects of chlorquine :

A

Retinopathy

231
Q

Antihelminthic theapy that act as microtubule inhibitor :

A

Mebendazole

232
Q

Infection by HIV occurs by fusion, fusion of HIV consist of two mechanisms :
1. Attachment.
2. Penetration
Which drgus inhibit this mechanism?>

A
  1. Attachment : mara-viroc
  2. Penetration: Enfu-virtide
233
Q

HIV converts from RNA to DNA by reverse transcriptase to pentrate the nuceleus of the cell, we can prevent this pentration by :

A

reverse transcriptase inhibitors

234
Q

reverse transcriptase inhibitors: two types

A
  1. NRTI “nucleotide reverse transcriptase inhibitors”
  2. NNRTI “ Non nucleotide reverse transcriptase inhibitors”
235
Q

Integrase enzyme responsible for intigration of the HIV DNA with the Cell DNA , (After converting the HIV RNA to DNA ),whcih drug can prevent this process .

A

Integrase inhibitors :3 drugs the ends by “ gravir”
1. Dolute-gravir.
2. Elvite- gravir.
3. Ralte- gravir.

236
Q

HIV utilize the proteolytic enzyme “protease” to lytic the protein that form after translation, we can prevent this process by :

A

Inhibition of protease enzyme

237
Q

Protease inhibitor :(for HIV therapy)

A

Drugs that end by “navir”
1. Ataza-navir,
2. Lopi-navir,
3. Indi-navir etc…

238
Q

General HIV therapy :

A
  1. Fusion inhibitors
  2. Reverse transcriptase inhibitors
  3. Intigrase inhibitors.
  4. Protease inhibitors
239
Q

Viral protein synthesis inhibitors :

A

Interferon-alpha

240
Q

Viral uncoting inhibitors :

A
  1. Aman-tadine,
  2. Riman-tadine .
241
Q

Viral nucleci acid synthesis inhibitor :

A
  1. Guanosine analogs (acyclovir, ganciclovir).
  2. Viral DNA polymerase inhibitors ( cidofovir, foscarnet )
  3. Guanine nucleutide synthesis ( ribavirin )
242
Q

Viral Guanosine analogs :

A

1.Acy-clovir.
2.ganci-clovir.
3. Famci-clovir
4. Valacy-clovir

243
Q

Direct viral DNA polymerase inhibitors:

A
  1. Cidofovir.
    2.foscarnet.
244
Q

Guanine nucleutide synthesis :

245
Q

Neuroaminidase it’s enzyme that utilised it the virus to release from the cell, we can inhibit this enzyme by neuroaminidase inhibitors :

A
  1. Oselta-mivir.
  2. Zana-mivir
246
Q

Drug of Choice to CMV :

A

Ganciclovir

247
Q

Acy-clovir, famci-clovir, valacy-clovir this drugs use for

A

Viral dependent nucleosides :
1. HSV,
2. VZV,
3. Herpes zoster.

248
Q

Why acyclovir have few adverse effects ?

A

Because it work only on infected cells

249
Q

Drug of choice for HZV:

A

Famciclovir

250
Q

Which drug have bitter oral bioavailability:
1. Acyclovir
2. Valacyclovir

A

Valacyclovir

251
Q

Which antiviral therapy can cause obstructive crystalline nephropathy that may lead to acute renal failure ?

A

Acyclovir, famiclovir.valacyclovir

252
Q

How to prevent the side effect that can develped after adminstration of acyclovir and other derivatives (obstructive crystalline nephropathy that may lead to acute renal faliure) ?

A

By good hydration

253
Q

Amphotricin B can cause nephropathy, how we can treat this side effect ?

A

By good Hidration

254
Q

Mutated of viral thymidine kinase lead to resistance of which drugs ?

A

Acyclovir and dervitaives

255
Q

What’s the different between ganciclovir and val-ganciclovir ?

A

Valganciclovir have better bioavailability

256
Q

Side effects of ganciclovir:

A
  1. Bone marrow supression
  2. Renal toxicity
257
Q

Foscarnet mechanism of action

A

Direct inhibition of DNA\RNA polymerase , and HIV reverse transcriptase inhibitor.

258
Q

CMV form resistance aginst ganciclovir by:

A

Mutated viral kinase

259
Q

If CMV form resistance aginst ganciclovir, which drug we can use in the case ?

260
Q

Foscarnet clinical uses :

A
  1. CMV retinitis.
  2. Resistance of ganciclovir aginst CMV.
  3. Resistance of acyclovir aginst HSV.
261
Q

Side effects of foscarnet :

A
  1. Nephrotoxicity
  2. Electrolytes abnormalitis “ hypokalemia, hypomagnesemia” that can lead to seizures
  3. Seizures ( by decrease Mg\ Na )
262
Q

Mechanism of resistrance of foscarnet :

A

Mutated DNA polymerase

263
Q

Cidofovir similar in mechanism and clinical uses with which antiviral drug ?

264
Q

Cidofovir better than foscarnet by :

A
  1. Long half life
  2. Does not cause electrolites abnormalitis like the foscarnet
265
Q

Clinical uses of interferon beta :

A

Multiple sclerosis

266
Q

Clinical uses of interferon gamma:

A

chronic granulomatus disease.

267
Q

Which antiviral drug used in case of: chronic hepatits B,and C, kapsi sarcoma, hairy cell leukaemia, condylomata acuminata, renal cell carcinoma, malignant melanoma?

A

Interferon alpha

268
Q

Hepatitis C therapy :

A
  1. Ledipasvir
  2. Ribavirin
  3. Sofos-bu-vir
  4. Sime-pre-vir
269
Q

HCV protease inhibitor :

A

Sime-pre-vir

270
Q

Viral phosphoprotein (NS5A) inhibitor. That used for HCV:

A

Ledi-pas-vir

271
Q

Which anti-HCV inhibit synthesis of guanine nucleotides ?

272
Q

Which drug inhibit HCV RNA-dependent RNA polymerase ?

A

Sofos-bu-vir

273
Q

MecA gene encoded of :

274
Q

Cell wall synthesis occur by two mechanisms :

A
  1. Peotidoglycan synthesis
  2. Peptidoglycan cross-linking
275
Q

Peptidoglycan synthesis inhibitors :

A

Glycopeptides :
1. Vancomycin
2. Biucatricin

276
Q

Peptidoglycan cross-linking inhibitors ( transpeptidase inhibitors )

A
  1. Penecillinase sensitive penicillin
  2. Penicillinase resistance penicillin
  3. Anti-pseudomonal
  4. Caphalosporins
  5. Carbapenems
  6. Monobactam
277
Q

Ribosomes consist of :

A
  1. 50 s subunit (large subunit)
  2. 30 s subunit (small subunit)
278
Q

Unasyn it’s combination between :

A
  1. Ampicillin
  2. Sulbactam
279
Q

Augmintin it’s combination between:

A
  1. Amoxicillin
  2. Clavulenic acid
280
Q

Otitis media cause by

A

H-influnza

281
Q

Neonatal meningitis cause by :

282
Q

Tratment of neonatal meningitis :

A

Ampicillin

283
Q

Patient in ventilation, infected by pneumonia, which bacteria cause this pneumonia and which drugs most used to treated it?

A
  • Cause: pseudomonas,
  • treatment 4’th generation of cephalosporins :”cefepime”.
284
Q

Disulfiram- like reaction cause by inhibition of which enzyme ?

A

Acetyl dehyd dehydrogenase

285
Q

Which drug from B- lactams antibiotics work as disulfiram ?

A

Caphaosporins

286
Q

How cephalosporins cause Vit k deficiency ?

A
  1. By killing the bacteria flora that found in the intestine and responsible for production of vitamin K .
  2. By decrease the activation of vitamin K in liver by inhibition of Epoxide reductase enzyme .
287
Q

Why to avoid to uses of warfarin with cephalosporins?

A

To prevent the severe deficiency of vitamin k, because the two drugs decrease the activity of vitamin k in the liver by inhibition of epoxide peroxidase.

288
Q

The reason of contraindication of cephalosporins with aminoglycosides ?

A

Because the cephalosporine increase the risk of nephrotoxicity of amninoglucosides

289
Q

What’s ESBL “extended spectrum B-lactamase:

A

It’s type of B-lactamase that resistance to most B-lactam antibiotics : penicillin cephalosporins, monobactam.

290
Q

Which bacteria contains ESBL “extended spectrum B-lactamase:

A

Only gram (-) bacteria : KEEP-3S
1. Klibsella
2. E.coli
3. Enterobacter
4. Pseudomonas
5. Salmonella
6. Serratia
7. Shigella

291
Q

Drug of choice for ESBL :

A

Carbapnems

292
Q

Which drug used with imipneme to increase the half-life of the drug ?

A

Cilastatin

293
Q

How the imipenem cause seizures ?

A

By inhibition of GABA receptors

294
Q

Why. The monobactams effects only on gram negative bacteria ?

A

Because it bind to PBP-3 that found only in gram (-) bacgteria

295
Q

What’s meaning of synergetic effect of the drugs ?

296
Q

Which drug synergetic with monobactam ?

A

Aminoglycosides

297
Q

Vancomycin it’s bacteriosidal aginst all of the bacteria except one bacteria work as bacteristatic :

298
Q

Vancomycin used as IV except on case that used as oral, which case ?.

A

In case of pseudomembranous colitis that cause by c.difficile

299
Q

How the red man syndrome occurs ?

A

When the doctor administrate the vancomycin to the patient rapidly

300
Q

administration of amoxicillin to patient with EBV pharyngitis lead to :

A

Maculopapular rash

301
Q

Why the aminogycosides are bactericidal ?

A

Due to miss-reading of mRNA

302
Q

Neomycin clinical use:

A
  1. Bowel surgery .
  2. Hepatic encephalopathy
303
Q

How the neomycin can treat the hepatic encephalopathy ?

A

Neomycin kill the gram (-) bacteria that located as normal flora in GIT-this bacteria produce amonia ,when neomycin kill this bacteria it lead to decrease production of amonia that cause hepatic encephalopathy

304
Q

Plasmed encoded of transport pump, it’s cause resistance for tetracycline, by which mechanism ?

A

By decrease uptake of the drug and increase efflux out of the drug

305
Q

Which drug inhibit peptidyltransferase ?

A

Chloramphenicol

306
Q

Drug of choice of rocky-mountain spotted fever :

A

Doxycycline

307
Q

Drug of choice of rocky-mountain spotted fever in case of pregnancy : (for 1’st and 2nd trimester only)

A

Chloramphenicol

308
Q

Using of chloramphenicol after the 2nd trimester of pregnancy lead to

A

Gray- babe syndrome

309
Q

Side effects of chloramphenicol

A
  1. Anemia
  2. Aplastic anemia
  3. Gray baby syndrome
310
Q

Liver responsible for detoxification of chloramphenicol by which enzyme?

A

UDP-Glucoronyltransferase

311
Q

Treatment of gray baby syndrome

A
  1. Stop the drug
  2. Exchange transfusion phenobarbital (enzyme inducer- increase UDP-Glucoronyltransferase)
312
Q

Which drug inactivate by acyl-transferase enzyme than encoded by plasmid ?

A

Chloramphenicol

313
Q

Treatment of anaerobic bacteria above the diaphragm :

A

Clindamycin

314
Q

Treatment of anaerobic bacteria below the diaphragm :

A

Metronidazole

315
Q

Initial complex inhibitors :

A
  1. Aminoglycoside :by bind to 30s
  2. Linezolid : by bind to 50s
316
Q

Which syndrome characterised by : fever, confusion, agitation, hyperrflexia?

A

Serotonin syndrome

317
Q

Antimicrobial drugs that inhibit translocation

A
  1. Macrolide
  2. Clindamycin
318
Q

Which antimicrobial drug use for gastropariesis “GI motility disorders “

A

Erythromycin

319
Q

Combination between Quinupristin and Dalfopristin =

320
Q

For simple UTI we use :

A

Sulfamethoxazole

321
Q

Using of sulfonamide for new-born lead to

A

Kernicterus

322
Q

To long duration of penicillin, we administration it in combination with :

A

Probenecid

323
Q

Mechanism of Antifungal therapy: “

A
  1. Protein synthesis inhibitor
  2. Nucleic acid synthesis inhibitor
  3. Lanosterol synthesis inhibitor
  4. Ergosterol synthesis inhibitor ( inhibit the enzyme, or formation of membrane pores )
324
Q

Which enzyme inhibit by azoles ?

A

14-alpha-demethylase (cytochrome p-450)

325
Q

Candida infection therapy : (1st, 2nd, 3rd lines )

A
  1. 1st line : fluconazoles
  2. 2nd line : echinocandins
  3. 3rd line amphotrisin B
326
Q

Which two drug that use for dermatophysis ?

A
  1. Teribuinafine
  2. Griseofulvin
327
Q

Which anti fungal drug deposit in keratin-containing tissue. ?

A

Grieseofulvin

328
Q

Microtubule inhibitors : in fungal , in human, in protozoa ?

A
  1. In fungal : griseofulvin
  2. In protozoa : mebendazole
  3. In human : anti-cancer therapy : paclitaxil, vincristine
329
Q

Mechanism of anti-malarial therapy :

A

block detoxification of heme into hemozin

330
Q

Which anti-fungal therapy characterised by the following side effects: teratogenic, carcinogenic, disulfram like reaction, decrease cytochrome p-450

A

Griseofulvin

331
Q

The main mechanisms of HIV therapy

A
  1. Fusion inhibitors
  2. Reverse transcriptase inhibitor
  3. Integrase inhibitor
  4. Protease inhibitor
332
Q

Side effect of integrase inhibitor of HIV :

333
Q

Side effect of protease inhibitors of HIV

A

Metabolic complications :
1. Lipodystrophy
2. Dyslipidemia
3. Insulin resistance

334
Q

Monophosphorylation of acyclovir by :

A

Thymidine kinase (viral kinase )

335
Q

Monophosphorylation of ganciclovir by

A

CMV viral kinase

336
Q

Which virus conatins thymidine kinase ?

337
Q

Side effects of acyclovir

A
  1. Obstruction crystalline nephropathy
  2. Acute renal failure
338
Q

Side effects of ganciclovir

A
  1. Bone marrow suppression
  2. Renal toxicity
339
Q

Mechanism of ribavirin

A

Inhibit inosine monophosphate dehydrogenase, that convert IMP to GMP

340
Q

Initial complex consist of

A
  1. 50s
  2. 30s
  3. mRNA
  4. Initiator tRNA
341
Q

Peptide bond that connects the two tRNA formed by

A

Peptidyltransferase

342
Q

TMP-SMX mechanism :

A

Sequentially block of folic acid synthesis

343
Q

What’s kernicterus

A

Newborn have physiological jaundice that characterised by high level of bilirubin, bilirubin bind to albumin to prevent the penetration the BBB, using of sulfonamide lead to bind of the drug to albumin, therefore the bilibrubin will be free in the blood and it will pass BBB and deposit in basal ganglia and cause kernicterus

344
Q

Which drug may cause hemolysis in case of G6PD deficiency

A
  1. Dapsone
  2. Sulfonamide
345
Q

Triple therapy of H.pylori

A
  1. Clarithromycin
  2. PPI
  3. Amoxicillin or metronidazole
346
Q

Treatment of megaloblastic anemia that cause by trimephorime ?

A

Folonic acid ( that convert to tetrahydrofloic acid with out dihydrofloate reductase

347
Q

Drug of choice to atypical (chlamydia, mycoplasma) :

348
Q

Drug of choice to listeria (neonatal meningitis ):

A

Ampicillin + gentamycin

349
Q

Drug of choice to meningitis

A

Ceftriaxon

350
Q

Drug of choice to pseudomonas

A
  1. Cefepime
  2. Ceftazidim,
351
Q

Drug of choice to ESBL

A

Carbapenems

352
Q

Which antimicrobial drugs may cause disulfram like reaction

A
  1. Metronidazole
  2. Cephalosporins
  3. Griseofulvin
353
Q

Which antimicrobial drug may cause metallic test

A
  1. Metronidazole
  2. Terbinafine
354
Q

Prophylaxis of meningitis

355
Q

Drug of choice for atypical pneumonia

A

Azithromycin

356
Q

Treatment of gonorrhea infection

A

Azithromycin + ceftriaxone

357
Q

Daptomycin inactivate by

A

Pulmonary surfactant

Microbiology (13 decks)

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