Test 1 Topic List

Question 0

___________ investigated the success of “Dropsy” and discovered the herbal tea used was produced from the extract of leaves of the foxglove (later renamed Digitalis purpurea).

Answer 0

William Withering

Question 1

What is Alexander Fleming known for ?

Answer 1

Sir Alexander Fleming cultures the fungus, “Penicillium” in 1928
Collaboration led to growing it and using Penicillin commercially on infected troops in WWII. Nobel prize in medicine in 1945. Noted that newer antibiotics were needed from organisms resistant to penicillin, calling this phenomenon “Achilles heel”

Question 2

__________, a former pharmacist, added an amendment to the Food, Drug, and Cosmetic Act. Helped create the Doctor-Pharmacist-Patient pathway in obtaining illegal drugs.

Answer 2

Hubert Humphrey

Amendment know as : Humphrey-Durham Amendment to the Food, Drug, and Cosmetic Act.

Question 3

A patient develops pancytopenia from taking chloramphenicol. This is an example of :
A. Adverse drug reaction
B. Side effect
C. A response to a drug that is unfavorable or unintended.
D. A and C.

Answer 3

D. A and C

An ADR is a response to a drug that is noxious amd unintended and occurs at doses normally used for man for prophylaxis, diagnosis, of therapy of disease.

Question 4

Drugs such as warfarin and digoxin are at a higher risk for causing adverse drug reactions because of their ______ therapeutic index.

Answer 4

Narrow

Question 5

Who discovered Penicillin?

Answer 5

Alexander Fleming

Question 6

An important component for drug-resistant bacteria is the _______

Answer 6

Use and misuse of antibiotics

Question 7

What is the best way to control antimicrobial resistance ?

Answer 7

Decreasing inappropriate antibiotic use.

Question 8

Legally a generic drug must have a _____% bioequivelance to the trade drug.

Answer 8

20

Question 9

Name examples of blood-borne pathogens

Answer 9

HIV, Hep B, Hep C, Viral hemorrhagic fevers.

Caution: IV drug users, needles, unprotected sex

Question 10

Cellulitis related to community acquired MRSA infection should be diagnosed early and treated with medications such as :

Answer 10

Septra or Doxycycline

Vancomycin where MRSA infections exceed 15% of isolate

Question 11

T/F Antimicrobial resistance does not require previous exposure to the drug.

Answer 11

True.

Mutations occur I’m the gene that encodes the target proteins, so it no longer binds to the drug. Random events. Resistance through mutation.

Question 12

Predisposing risk factors of cellulitis:

Answer 12

Disruption in skin barrier(trauma, wounds,bites,breaks in skin,IV drugs)
Inflammation (eczema, radiation)
Pre-existing skin infections (impetigo, tinea pedis)
Varicella and edema (due to venous insufficiency)
Lymphatic obstruction following surgical procedures

Question 13

Mechanism of action, fluoroquinolones

Answer 13

Broad spectrum antibiotic
Inhibition of DNA= destruction of DNA
Only class of antimicrobials that are direct inhibitors of bacterial DNA synthesis.
Bactericidal agents. Ex. Ciprofloxacin, moxifloxacin,levofloxacin

Question 14

Examples of Fluroquinolones

Answer 14

Ciprofloxacin, Levofloxacin, Moxifloxacin, Gemifloxacin
NOT considered first line for mild infection
Reserve for bacterial infections that are resistant.
Empirical usage: Short term & Severe: sinusitis, pyelonephritis, UTIs, prostatitis, diarrhea. Tx 10-14 days
Avoid milk. Empty stomach. Watch breastfeeding. Preg C-ok

Question 15

Mechanism of action, cephalosporins

Answer 15

Interferes with cell wall synthesis.
Broad spectrum. (Resistance develops easily)
Beta-Lactam antibiotics
Bactericidal and effective against rapidly growing organisms.
1st gen: Keflex :URI,UTI, skin (gram +)
2nd gen: Ceftin, Ceclor, Cefprozil: otitis media, pharyngitis (mostly gram +)
3rd gen: Cefixime: otitis media, pharyngitis,tonsillitis, copd exac(mostly gram -)
Watch for penicillin allergy

Question 16

CDC bacterial and fungal microbes ranked as URGENT threats to resistance

Answer 16

Clostridium difficile
Carbapenem-resistant Enteribacteriaceae (CRE)
Drug-resistant Neisseria gonorrhorae***

Question 17

Tetracyclines

Answer 17

Tetracycline and Doxycycline
Antibiotics that inhibit protein synthesis (bacteriostatic)
First choice: acute bacterial exac of COPD, chlamydia, rickettsial infect
Preg D: don’t use, stains teeth of baby, don’t prescribe for kids <8 stain teeth, photosensitivity
Watch contraceptives! Breakthrough pregnancy, back up protection
Bacterial infections gram + or gram -

Question 18

Macrolides, mechanism of action

Answer 18

Erythromycin, Azithromycin, Clarithromycin
Otitis media, acute bronch or PNS in COPD pt, community acquired PNA, Pharyngitis,Sinusitis
P450 3A4 system. Inhibit metabolism of many drugs.
Bacteriostatic OR Bactericidal
Inhibits protein synthesis
Erythromycin: watch cardiac arrhythmias! Prolonged QT patients

Question 19

Sulfonamides, mechanism of action

Answer 19

Sulfa drugs , trimethoprim/sulfamethoxazole (TMP/SMX) Bactrim DS, Septra DS
Wide spectrum
UTIs, acute exac of COPD
Bacteriostatic
Competitive antagonists inhibit enzyme activity preventing reproduction of activity

Question 20

Furuncle, carbuncle treatment

Answer 20

I&D to promote drainage is treatment. Culture. Usually MRSA

Vanc for systemic infection beyond skin abscess

Question 21

Cystitis treatment

Answer 21

Dysuria, frequency, urgency, supra pubic pain, hematuria

Nitrofurantoin
Trimethoprim-sulfamethoxazole

Question 22

First line topical treatment for head lice (pediculosis capitis)

Answer 22

Topical Lindane

Antiparisitic agent.
Shake well, apply gloves

Question 23

Cellulitis MRSA purulent drainage treatment

Answer 23

Clindamycin, amoxicillin +Trimethoprim-Sulfamethoxazole(Bactrim), amoxicillin + doxycycline, or Linezolid