Pharmacology for I&I

Question 1

What’s the difference btw an infection and a contaminant?

Answer 1

growth of pathogen found in sterile area; contaminant would have far less than an infection. Ex) 10,000 ml E. coli in urine vs. 100,000 ml

Question 2

Whats the benefit of a gram stain over urine culture to ID

Answer 2

stain can allow for rapid prelim. ID vs. hrs or months to ID culture

Question 3

Whats the benefit of urine culture vs. gram stain

Answer 3

more definitive

Question 4

When in the cell cycle life does it cause an endotoxin (referring to lipolysaccharide of gram -)

Answer 4

after death and lysis

Question 5

list the 3 categories of anti-infectives therapies

Answer 5

Prophylactic, Empiric, and Definitive

Question 6

If you were to choose an alternative form of a drug due to a known allergin, u’d be practicing which category of anti-infective therapy?

Answer 6

Empiric

Question 7

Choosing a bacteriocidal drug over a bacateriostatic for a pt who is immunocompromised would be an example of which anti-infective therapeutic category?

Answer 7

Empiric

Question 8

altering the choice of you drug due to factors like location, age, hepatic/renal function and pregnancy would be an example of what type of category for anti-infective therapy

Answer 8

Empiric

Question 9

describe how u can have a superinfection

Answer 9

when giving overly broad spectrum antibiotics (an infection on top of another that’s resistant) most often seen with definitive therapy

Question 10

Whats the biggest concern for beta-lactam toxicity particularly in renal impaired patients?

Answer 10

seizures

Question 11

What class of drug does imipenem belong too if an overdose can lead to seizures in renally impaired pts.

Answer 11

a beta-lactam

Question 12

What is tetracycline’s MOA

Answer 12

a protein synthesis inhibitor (binds to 30S ribosome blocks tRNA attachment for addition to elongating protein chain.

Question 13

Would tetracycline be considered bacteriostatic or bacteriocidal?

Answer 13

bacteriostatic b/c protein synthesis inhibitor.

Question 14

Clindamycin (Lincosamines) are known to most commonly cause:

Answer 14

C. diff.

Question 15

This drug can cause red man syndrome, hypersensitivity, ototoxicity, and nephrotoxicity

Answer 15

Glycopeptides (Vancomycin)

Question 16

This drug class works effectively against gram + organisms. It can also treat MRSA, pneumonia, endocarditis, osteomyelitis, and soft tissue abscess.

Answer 16

Glycopeptides (Vancomycin)

Question 17

How does tetracycline act as a bacteriostatic antibiotic

Answer 17

inhibits protein synthesis

Question 18

Doxycycline works to inhibit protein synthesis, which drug class does it belong too

Answer 18

tetracyclines

Question 19

what are the ADR’s of tetracyclines

Answer 19

dental stains, black hairy tongue, and photosensitivity

Question 20

why would you not want to give tetracyclines to children (except doxycycline)

Answer 20

dental stains

Question 21

what types of foods may decrease the effect of tetracyclines

Answer 21

cations such as calcium, mg++ etc.

Question 22

these drugs have a high risk for tendon rupture

Answer 22

Fluroquinolones

Question 23

How do fluroquinolones act as a bacteriocidal drug class.

Answer 23

Bind to DNA gyrase & topoisomerase, breaking DNA and leading to cell death

Question 24

Which type of bugs would fluroquinolones treat

Answer 24

gram + and -

atypicals

Question 25

Sulfonamides are a class of drugs that work as what

Answer 25

folate antagonists

Question 26

why are SMX & TMP often paired as synergistics?

Answer 26

inhibit folate synthesis in bacteria at different steps enhancing the affect

Question 27

What toxic effects although rare are of concern for overdosing sulfamethoxazole (SMX)

Answer 27

Steven Johnson Syndrome, N&V, and diarrhea

Question 28

What pt population are we most concerned about when prescribing SMX-TMP folate antagonists and why?

Answer 28

newborns, pregnant women and malnourished because they have low folate reserves which may lead to anemia.

Question 29

This drug class works against anaerobic and protozoa infections

Answer 29

Metronidazole (Nitroimidazoles)

Question 30

how do Nitroimidazoles (Metronidazoles) work against anaerobic and protozoa infections?

Answer 30

Part of the drug molecule forms free radicals which lead to damage DNA and cell death.

Question 31

What is the Black box warning for metronidazoles?

Answer 31

don’t take alcohol when on the drug. another ADR is peripheral neuropathy

Question 32

How does rifampin act against mycobacterial TB

Answer 32

inhibits RNA synthesis

Question 33

How does Isoniazid act against Mycobacterial TB

Answer 33

inhibits cell wall synthesis

Question 34

How does Ethambutol act against mycobacterial TB

Answer 34

inhibits cell wall synthesis

Question 35

How does Pryazinamide act against mycobacterial Tb

Answer 35

disrupts plasma membrane and energy metabolism

Question 36

Which class of drug would be most important to give within 72 hours of infection…. why?

Answer 36

Antivirals- Acyclovir because that’s when virus are most ferociously replicating.

Question 37

Which drug would could you treat malaria with….

Answer 37

Quinoline

Question 38

Which of the antimicrobacterial drugs would work most effectively against a latent form of TB

Answer 38

Isoniazid

Question 39

What drug interactions are we concerned about with Rifamycins

Answer 39

inducing CYP450 enzyme

Question 40

How does antiviral drugs such as acyclovir work

Answer 40

acts as nucleoside analog halting viral DNA replication

Question 41

Which drug would be best at treating fungal infection

Answer 41

Fluconazole

Question 42

How does Fluconazole work?

Answer 42

inhibits CYP450 enzyme, preventing production of ergosterol

Question 43

Which drug would be best against Candida albicans, Cryptococcus neoformans, and Coccidioidies immitis (valley fever)

Answer 43

Fluconazole

Question 44

how do probencids enhance the effect of beta-lactams

Answer 44

inhibit tubular secretions of antibiotic