Urinary Antiseptics and Metronidazole

Question 1

indications for the use of ciprofloxacin

Answer 1

• active against pen/cephalo/AG resistant strains
• oral option for pseudomonas
• traveller’s diarrhoea (E coli, salmonella, shigella, campylobacter jejuni)
• complicated UTI
• anthrax caused by bacillus anthracis

Prostatitis

Question 2

what are the 3rd gen FQ?

Answer 2

levofloxacin, moxifloxacin

Question 3

why 3rd gen are used for, and their advantages?

Answer 3

better coverage against gram + bacteria (esp against s.pneumoniae), atypicals (MCL), used as second line for TB

Question 4

DDI with FQ?

Answer 4

increase levels of warfarin and cyclosporine

Question 5

3rd gen FQs are also known as?

Answer 5

respiratory quinolones as they trat resp infection caused by s.pneumoniae and atypicals

Question 6

use of cotrimethazole

Answer 6

• uncomplicated UTI
• pneumocystis pneumonia caused by Pneumocystis jiroveci
• MRSA
• resp tract infections caused by haemophilius sp and klebsiella spp

Question 7

Nitrofurantoin used to treat

Answer 7

lower UTI

• e coli, enterococci

Question 8

polymyxins moa?

Answer 8

disrupts the phospholipid bilayer by increasing cell permeability with a detergent-like action

Question 9

polymyxins indication?

Answer 9

for multidrug resistant gram -ve bacteria

colistin (CMS); lung infection caused by Pseudomonas

polymyxin B: UTI, blood infections due to P.aeruginosa

Question 10

fosfomycin MOA?

Answer 10

inhibits the action of phosphoenolpyruvate synthetase -> blocks formation of NAM

Question 11

fosfomycin indication

Answer 11

UTI, synergistic effect with B lactam ABx

active against gram +ve: s.aureous, entercoccus
gram -ve : P.aeruginosa, Klebisella pneumoniae

Question 12

metronidazole indication

Answer 12

• Anaerobic organisms (Bacteroides species and CD [CDAD])
• 2nd line for CDAD
• H pylori
• Protozoa infection: E. histolytica, trichomonas vaginalis (vaginitis), giardia lambia (Giardiasis)
• Surgical prophylaxis (30-60min before incision)

Question 13

metronidazole MOA?

Answer 13

MD acts an as electron acceptor, forming cytotoxic free radicals -> resulting in protein and DNA damage

reducing potential more in anaerobic organisms

Question 14

Which drugs must be taken on an empty stomach?

Answer 14

Tetracycline and FQs and Fosfomycin

Question 15

Which drug has an adverse effect of prolonged QT interval?

Answer 15

Macrolides and FQs

Question 16

Which drug’s adv effect is peripheral neuropathies?

Answer 16

FQs and Linezolid

Question 17

Which drugs’ adv effect is haemolytic anaemia caused by G6PD def?

Answer 17

Nitrofurantoin, Sulfonamides, Cotrimoxazole

Question 18

Which drugs must be avoided for pts with myasthenia gravis?

Answer 18

Ciprofloxacin (actually FQ), Polymyxin, AGs

Question 19

Which drugs are used as part of the triple therapy for H.pylori?

Answer 19

Metronidazole, Clarithromycin (Macrolides)

Question 20

Which drugs are bacteriostatic?

Answer 20

Sulfonamides, Tetracyclines, Clindamycin, Linezolid, Macrolides
http://pharmwarthegame.blogspot.com/2019/06/bactericidal-vs-bacteriostatic-mnemonics.html

Question 21

Which drugs are bactericidal?

Answer 21

Polymyxin, Quinolones, Vancomycin, Metronidazole, AGs, b-lactams
http://pharmwarthegame.blogspot.com/2019/06/bactericidal-vs-bacteriostatic-mnemonics.html

Question 22

What is the difference between bacteriostatic and bactericidal?

Answer 22

Bacteriostatic: Arrest the cell growth, stop growing

“bacteriostatic” means that the agent prevents the growth of bacteria (i.e., it keeps them in the stationary phase of growth), and “bactericidal” means that it kills bacteria.

Question 23

drugs used to treat CDAD

Answer 23

first line: vancomycin

second line: metronidazole

Question 24

which drugs effective against pseudomonas?

Answer 24

FQ, polymyxin, fosfomycin,

• anti-pseudomonal (piperacillin + tazobactam)
• cephalosporins: third gen = cefezidime, 4th gen = cefepine, 5th gen = ceftabiprole
• carbpenem: imipenem, etrapenem
• monobactam: aztreonam
• AG

Question 25

what is similar to the DNA gyrase in eukaryotic cells?

Answer 25

DNA topoisomerase II

Question 26

adverse effect of FQ

Answer 26

1. C.D colitis (esp with cipro)
2. Aortic aneurysm
3. QT interval prolongation
4. risk of dysglycaemia in diabetic patients
5. Anthropathy (joint problem)
6. peripheral neuropathy
7. GI distress
8. Phototoxicity
9. Tendinitis or tendon rupture

Question 27

counselling for cotrimoxazole?

Answer 27

drink full cup of water

Question 28

which drug has more bacterial resistance than FQ and Co-TS

Answer 28

nitrofurantoin