Antibiotics

Question 1

when selecting an anti-infective drug two categories of factors are used which are

Answer 1

Drug factors and Patient factors

Question 2

list the 4 drug factors used in selecting an anti-infective drug

Answer 2

Type of drug to be used
Correct dosage to use
Route of administration of drug
possible side effecr/toxicity of drug

Question 3

list the 7 patient factors used in selecting an anti-infective drug

Answer 3

immunological status
Age
disease state of patient
Presence of foreign bodies(e.g pacemakers and prostethics)
Pregnancy and lactation
History of drug allergy
Genetic traits(e.g fast or slow acetylators)

Question 4

Based on their actions antibiotics can be divided into 2 broad groups which are

Answer 4

Bactericidal - kills bacteria
Bacteristatic - inhibits bacteria growth and reproduction

Question 5

a patient with impaired immune mechanism requires what type of antibiotics

Answer 5

Bactericidial

Question 6

effectiveness of an anti-infective therapy is increased in patients with foreign bodies such as heart pacemakers
T or F

Answer 6

F
it is decreased as bacteria can decide to camp in those devices

Question 7

in very young and very old patients drug metabolism and excretion is decreased
T or F

Answer 7

T

Question 8

ototoxicity is a common side effect of antibiotics usually seen in _____

Answer 8

elderly people

ototoxicity is development of hearing or balance problem due to side effects of an administered drug

Question 9

Penicillin has a neurotoxic side effect when administered in patients with CNS disorder
T or F

Answer 9

T

Question 10

when administering aminoglycoside or polymyxin B therapy in patients with NMJ disorders there is an increased risk of developing neuromuscular blockade
T or F

Answer 10

T

Question 11

patient with G6PD deficiency may experience iron deficiency anemia when administered with sulfonamide
T or F

Answer 11

F
hemolytic anemia

Question 12

isoniazid(for tuberculosis) can cause hepatitis in slow acetylators
T or F

Answer 12

T

Question 13

list the 4 types of resistance exhibited by microbes

Answer 13

Innate resistance
Acquired resistance
multidrug resistance
superbugs

Question 14

list 3 bacteria that exhibit multidrug resistance

Answer 14

Vancomycin resistant entrococus (VRE)
Methicilin resistant Staphylococcus aureus (MRSA)
klebsiella pneumonia
extended spectrum beta lactamase (ESBL) producing gram negative bacteria
Cabapenemase producing gram negative bacteria

Question 15

list 3 superbugs

Answer 15

superbugs are microbes which are resistant to most commonly used antimicrobial examples include:
Proteus spp.
pseudomonas aeuruginosa
Acinetobacter baumanni
candida aures(fungu)

Question 16

list 4 mechanism of innate resistance

Answer 16

1.extra outer membrane in gram negative bacteria (that shields the peptidoglycan in the cell wall that antibiotics want to bind to)
2. production of antibiotics degrading enzymes(e.g B-lactamases in E.coli)
3. presence of antibiotics pumps(e.g Acrab-Tolc multi drug pump which pumps out antibiotics that have entered the cell, seen in E. coli)
4. Alteration of targets that antibiotics bind to

Question 17

list an example of vertical gene transfer (acquired resistance)

Answer 17

from parents to offspring

Question 18

list 3 horizontal method of gene transfer

Answer 18

Conjugation (via the use of sex pillus)
transduction(via bacteriophage lytic or lysogenic cycle)
transformation(uptake of DNA from the environment usually from dead bacteria)

Question 19

list two natural antibiotics produced from fungi

Answer 19

Penicillin(from penicillium notatum and cephalosporin(from cephalosporium acremonium)

Question 20

list 3 natural antibiotics produced from other bacteria

Answer 20

1. Gentamycin (from micromonospora spp.)
2. Polymyxin (from Bacillus polymyxa)
   3.Bacitrin (from chromobacter violaceum)

Question 21

list 5 antibiotics produced from actinomycetes (i.e streptomyces spp.)

Answer 21

1. chloramphenicol - S.venezuella
2. Erythromycin - S. erythreus
3. lincomycin - S. lincolinesis
4. Streptomycin - S. grisseus
5. Rifampicin - S. mediterenia
6. Tetracycline - S. rimosus and aureofasciens

Question 22

list 4 semi synthetic antibiotics

Answer 22

Semi synthetic antibiotics are derived from natural antibiotics but with greater spectrum and less side effects. examples include:
ampicillin
amoxicillin
tigecycline
doxycycline
Cefalexin (from cephalosporin)

Question 23

list 3 synthetic antibiotics

Answer 23

Synthetic antibiotics are completely synthesized from chemicals in the lab
1. trimethoprim
2. carbapenem
3. metronidazole
4. quinolones(e.g ciprofloxacin)
5. eravacycline

Question 24

list 3 antibiotics that act on 30s subunits of ribosome

Answer 24

aminoglycosides
Tetracycline
Tigecycline

Question 25

list 5 antibiotics that act on 50s ribosomal subunit

Answer 25

clindamycin streptogramins linezolid chloramphenicol Macrolides

Question 26

list 3 antibiotics that inhibit cell wall synthesis

Answer 26

Beta-Lactams (Penicillin, cephalosporin, carbapenem, monobactam) Vancomycin antimycobacterial e.g Isoniazid, ethambutol

Question 27

list examples in the following class of penicillin a. natural penicillin - b. Broad spectrum penicillin - c. anti pseudomonal penicillin - d. B-lactamase resistant penicillin - e. anti staphylococcal penicillin

Answer 27

a. benzylpenicillin, penicillin G b. aminopenicillin (e.g ampicillin, amoxicillin c. ticacillin, piperacillin, carbenicillin d. flucloxacillin e. dicloxacillin, naficillin

Question 28

list at least 2 examples of each generation of cephalosporin and characteristics of the generation

Answer 28

1st generation - have antibacterial spectra and potency like penicillin e.g cefalexine and cefazolin 2nd generation - more potency and better against gram -ve bacteria e.g cefoxitin, cefuroxime 3rd generation - even more potent and effective against gram -ve bacteria at the expense of reduced potency for gram +ve

Question 29

list 2 species which tetracycline is ineffective against

Answer 29

Pseudomonas aeuriginosa Proteus spp. nb: tetracycline is effective against both gram bacterias

Question 30

list 3 side effects of tetracycline use

Answer 30

poor tooth development in children less than 8 years anorexia sunburn tinnitus(ear ringing) fatty liver

Question 31

ingestion of expired tetracycline causes

Answer 31

Fanconi syndrome

Question 32

nb macrolide consist of deoxy sugars attached to a ring of macrocyclic lactones

Question 33

Tetracycline are used in treatment of disease such as

Answer 33

cholera acne syphilis malaria

Question 34

adverse effect of macrolides use include

Answer 34

QT wave elongation(erythromycin/clarithromycin) pyloric stenosis in children cholestasis

Question 35

what set of individuals should not use amphenicols

Answer 35

pregnant and lactating mothers

Question 36

list 3 adverse effect of chloramphenicol use

Answer 36

1. gray baby syndrome in infants 2. diarrhea 3. bone marrow suppression