Sulfa Antibacterials and Trimethoprim: Inhibitors of Folate Synthesis Flashcards
Which of the following statements is true? (select all that apply)
A. Humans are able to synthesize folic acid
B. Humans are unable to synthesize folic acid
C. Bacteria are able to synthesize folic acid
D. Bacteria are unable to synthesize folic acid
B, C
Bacteria must synthesize their own folic acid because they cannot absorb from human diet
Which of the following statements is true regarding the N4 group on the sulfonamide?
A. Substitution with an electron withdrawing group will increase activity
B. Substitution is required for antibacterial activity
C. Substitution with an electron withdrawing group will decrease activity
D. Unsubstitution is required for antibacterial activity
D.
Unsubstituted –NH2 group para to sulfonamide moietiy is required for antibacterial activity
True or False
Alteration of the benzene ring is unfavorable
True
Which of the following statements is true regarding the highlighted part of the sulfonamides? (select all that apply)
A. N1 can be substituted with electron withdrawing groups to increase antibacterial activity
B. N1 can be substituted with electron withdrawing groups to reduce crystalluria
C. N1 substituion with electron withdrawing groups cause a decrease in antibacterial activity
D. N1 susbtitution with electron withdrawing groups incrase crystalluria
A, B
What is the IV to PO ratio of sulfonamides?
A. 1:10
B. 1:1
C. 1:5
D. 5:1
B. 1:1
the 1:5 is the ratio of trimethoprim to sulfonamide
How do the sulfonamides get metabolized? (select all that apply)
A. No metabolism
B. N-acetylation (NAT)
C. glucoronidation
D. Sulfation
B, C
(metabolites are inactive)
Which of the following medication interact with sulfonamides?
A. Warfarin
B. Oral hypoglycemic agents
C. methotrexate
D. phenytoin
E. All of the above
E.
Remeber WOMP, effects may be increased because the sulfonamides cause displacement from PBB
Emma is a 1.5 month old glamorous child who unfortunately got an infection. Which of the following can poor Emma get if you give her a sulfonimide.
A. Hematopoietic Disturbances
B. Hypersensitivity
C. Kernicterus
D. Steven-Johnson Syndrome
C. Kernicterus
CNS disorder in newborns
As redblood cells break down they release bilirubin
Bilirubin binds to bile and then its eliminated. In the newborns those systems are not developed yet. Sulfonimides will displace the bilirubin and then it goes up to the CNS causes CNS effects
True or False
Will Furosemide cause sulfa allergy?
False
Its a Non-Antibacterial the sulfonamide, its not substitued
True or False
Will sulfamethoxale cause sulfa allergies
True
True, the NH2 is free and can be substituted
Which two are toxic metabolites of sulfamethaxole? (select all that apply)
A. hydroxylamine metabolite
B. N-Nitroso metabolite
C. benzopyrene
D. sulfadiazine
A, B
Which of the following patients is at increased risk of sulfamethoxazole toxic metabolites?
A. Fast Acetylators
B. Slow Acetylators
C. Both
D. None of the above
B.
Which of the following are covered by sulfonimides?
A. gram positive
B. gram negative
c. atypicals
D. all of the above
E. a and b
D
The following pairs are treated with sulfonimides. Which pair of microbe and conditions is incorrect.
A. Nocardia: Pneumonia
B. Nocardia: Conjunctivitis
C. Chlamydia trachomatis: Conjunctivitis
D. E. Coli: cystitis
B
True of False
Sulfonamides are effective against anaerobes
False
Cepillin was in the lab trying to create a new sulfonimide drug to name it Sevallin. He ran into a problem when his drug wasnt working like it was the first few days. He noticed that the PABA and his drug were fighting. What mechanism of bacterial resistnace is most likely going on?
A. alteration of enzyme dihydropteroate synthase
B. dihydropteroate synthase is not not being blocked
C. overproduction of PABA
D. Underproduction of PABA
C
