Pharmacology

Question 1

Chloramphenicol MOA

Answer 1

• blocks peptidyltransferase at 50S bacterial ribosomal subunit
• bacteriostatic

Question 2

3 adverse effects of Chloramphenicol

Answer 2

1. anemia ( dose dependent)
2. aplastic anemia ( dose independent)
3. gray baby syndrome ( in premature infants, because they lack liver UDP- glucuronyl transferase)

Question 3

What are 2 clinical uses for Chloramphenicol? causing agents?

Answer 3

1. Meningitis
   - Haemophilus influenzae
   - Niesseria meningitidis
   - Streptococcus pneumoniae
2. Mountain spotted fever
   - Rickettsia rickettsii

Question 4

what is a mechanism of resistance for Chloramphenicol

Answer 4

Plasmid-encoded acetyltransferase inactivates the drug

Question 5

What class of drug is Azithromycin

Answer 5

Macrolide

Question 6

MOA for Azithromycin

Answer 6

• Inhibit protein synthesis by blocking translocation (macroSLIDES)
• bind to 23S rRNA of 50S ribosomal subunit
• bacteriostatic

Question 7

Clinical use for Azithromycin (4)

Answer 7

1. atypical pneumonias
   - mycoplasma
   - chlamydia
   - legionella
2. STI - chlamydia
3. gram + cocci
   - streptococcal infection in patients allergic to penicillin
4. B. pertussis

Question 8

Adverse effects of Azithromyocin

Answer 8

MACRO

1. gastrointestinal Motility issues
2. Arrhythmia caused by prolonged QT interval
3. acute Cholestatic hepatitis
4. Rash
5. eOsinophilia

Question 9

drug interaction of Azithromyocin

Answer 9

increase serum concentration of theophylline and oral anticoagulants

Question 10

what is a MOA of Clarithromycin and Erythromycin

Answer 10

inhibit cytochrome P450

Question 11

what is a mechanism of resistance for Macrolides

Answer 11

methylation of 23S rRNA-binding site, prevents binding of drug

Question 12

What is the class of drug for Ciprofloxacin

Answer 12

Fluoroquinolones

Question 13

MOA of Ciprofloxacin

Answer 13

• Inhibit prokaryotic enzymes topoisomerase II ( DNA gyrase) and topoisomerase IV
• bactericidal

Question 14

Fluoroquinolones can not be mixed with what

Answer 14

antacids

Question 15

clinical use for Ciprofloxacin

Answer 15

gram - rods of urinary and GI tracts
- Pseudomonas
- Neisseria
some gram +

Question 16

adverse effects of fluoroquinolones

Answer 16

GI upset
superinfections
skin rashes 
headache 
dizziness

Question 17

are are less common side effects of fluoroquinolones

Answer 17

leg cramps and myalgias

Question 18

Fluoroquinolones are contraindicated in who

Answer 18

pregnant women
nursing mothers

less than 18 years due to cartilage damage
older than 60 also taking Prednisone : tendontitis or tendon rupture irks

Question 19

impact on other organs of Flurorquinolones

Answer 19

prolong QT interval

Question 20

MOA of tetracyclines

Answer 20

• bind 30S and prevent attachment of aminoacyl-tRNA
• bacteriostatic
• limited CNS penetration

Question 21

what can you not take tetracyclines with

Answer 21

• milk (Ca2+) and antacids (Ca2+ or Mg2+)

- iron-containing preparations b/c divalent cations inhibit drugs’ absorption in the gut

Question 22

Renal failure patients can take what tetracycline and why

Answer 22

Doxycycline b/c fecally eliminated

Question 23

clinical use for tetracycline

Answer 23

Borrelia burgdorferi
M. penumoniae
Rickettsia
Chlamydia

Question 24

Adverse effects of tetracycline

Answer 24

GI distress
discoloration of teeth
inhibition of bone growth in children
photosensitivity

Question 25

tetracycline is contraindicated in who

Answer 25

pregnant women

Question 26

what is a mechanism of resistance for tetracyclines

Answer 26

- increase uptake | - decrease efflux out of bacterial cells by plasmid-encoded transport pumps

Question 27

MOA of cephalosporins

Answer 27

- Beta-lactam drugs that inhibit cell wall synthesis but are less susceptible to penicillinases - bactericidal

Question 28

Name organisms not covered by 1st-4th generation cephalosporins ? any exceptions

Answer 28

``` LAME Listeria Atypicals ( chlamydia, mycoplasma) MRSA ( Ceftraline, 5th) Enterococci ```

Question 29

Name 1st generation cephalosporins

Answer 29

Cefazolin | cephalexin

Question 30

what cephalosporin is sued prior to surgery to prevent S. aureus wound infections

Answer 30

Cefazolin

Question 31

1st generation cephalosporins treat against what

Answer 31

Proteus Mirablils E.Coli Klebsiella

Question 32

name 2nd generation cephalosporins

Answer 32

Cefaclor Cefoxtin Cefuroxime FAke FOX FUR

Question 33

what organisms do 2nd generation cephalosporins cover

Answer 33

``` HENS PEcK H influenzae Enterobacter aerogenes Neisseria spp Serratia Proteus E coli Klebsiella pneumoniae ```

Question 34

Name 3rd generation cephalosporins

Answer 34

ceftriaxone cefotaxime ceftazidime

Question 35

what organisms do 3rd generation cephalosporins cover

Answer 35

serious gram (-) infections resistant to other beta lactams

Question 36

what does Ceftriaxone used to treat

Answer 36

meningitis gonorrhea disseminated Lyme disease

Question 37

what does Ceftazidime treat

Answer 37

pseudomonas

Question 38

name 4th generation cephalosporins

Answer 38

cefepime

Question 39

what organisms do cefepime cover

Answer 39

gram (-) organisms with increased activity against pseudomonas and gram (+) organisms

Question 40

name 5th generation cephalosporin

Answer 40

Ceftaroline

Question 41

what does Ceftaroline cover

Answer 41

``` broad gram (+) and gram (-) organism coverage including MRSA - not pseudomonas ```

Question 42

adverse effects of cephalosporins

Answer 42

hypersensitivity reactions autoimmune hemolytic anemia disulfiram-like reaction vitamin K deficiency

Question 43

what are drug interaction with cephalosporins?

Answer 43

- cross-reactivity with penicillins | - increases nephrotoxicity in aminoglycosides

Question 44

what is mechanism of resistance for cephalosporins

Answer 44

Structural change in penicillin-binding proteins ( transpeptidase)