antibiotics

Question 1

structural components of gram negative bacteria?

Answer 1

LPS, lipid bilayer of cytoplasmic membrane, hydrophilic pores, nutrient receptor proteins on outer membrane

Question 2

structural components of gram positive bacteria?

Answer 2

teichoic & teichuonic acid, lipid bilayer of cytoplasmic membrane, nutrient transport proteins of cytoplasmic membrane

Question 3

what are the 3 common drug targets that utilize selective toxicity?

Answer 3

1. disrupt genetic machinery 2. block protein synthesis 3. disrupt cell wall/membrane synthesis

Question 4

an agent that will kill the bacteria

Answer 4

bactericidal

Question 5

an agent that will inhibit the growth of the bacteria, but will not kill the bacteria

Answer 5

bacteristatic

Question 6

do bacteristatic or bactericidal agents rely on the host immune system to get rid of microbe?

Answer 6

bacteristatic

Question 7

lowest concentration of an antimicrobial agent that will inhibit the visible growth of bacteria in liquid culture

Answer 7

minimum inhibitory concentration (MIC)

Question 8

the concentration of antibiotic from the original MIC plate that shows NO GROWTH after subculture.

Answer 8

Minimum Bactericidal Concentration (MBC)

Question 9

treatment of high-risk patients that have become infected but are asymptomatic.

Answer 9

Pre-emptive therapy

Question 10

treatment of a symptomatic patient without further testing or confirmation of the organism.

Answer 10

empiric therapy

Question 11

treatment once the pathogenic organism has been identified and appropriate drug identified.

Answer 11

definitive tx

Question 12

generally a low dose therapy used as a secondary prophylaxis. Problem that caused initial infection is likely still present.

Answer 12

suppressive tx

Question 13

what are the very drug resistant organisms

Answer 13

ESKAPE
Enterococcus faecium	
Staphylococcus aureus	
Klebsiella pneumoniae	
Acinetobacter baumanni	
Pseudomonas aeruginosa	
Enterobacter species

Question 14

which drug is an example of reduced drug entry into the organism via change in overall charge of membrane as a mechanism of resistance?

Answer 14

daptomycin

Question 15

which drug is an example of increased drug export via efflux pump as a mechanism of resistance from the organism?

Answer 15

tetracycline

Question 16

which drug is an example of changes in expression enzymes that activate the prodrug as a mechanism of resistance?

Answer 16

metronidazole

Question 17

which drug is an example of expression of enzymes by the organism that destroy the drug as a mechanism of resistance?

Answer 17

aminoglycosides (streptomycin)

Question 18

which drug is an example of expression beta lactamase as mechanism of resistance?

Answer 18

amoxicillin

Question 19

which drug is an example of impaired drug binding to the original target as a mechanism of resistance?

Answer 19

TMP-SMX

Question 20

which drug have bacteria developed new or different pathways that are not inhibited by drug?

Answer 20

vancomycin

Question 21

what links the NAM-NAG peptidoglycan monomers b/w the NAM-NAG chains in the layer?

Answer 21

penicillin binding proteins

Question 22

what beta lactamase inhibitor is used with PCN oftn?

Answer 22

clavulanic acid (augmentin)

Question 23

which penicillins are broad spectrum?

Answer 23

amoxicillin, ampicillin

Question 24

which penicillins are beta-lactamase resistant?

Answer 24

methicillin, nafcillin, oxacillin

Question 25

which generation beta lactam antibiotics have good CNS penetration?

Answer 25

3rd & 4th generation cephalosporins

Question 26

which generation: ceftriaxone, cefotaxime, cefdinir, cefixinme

Answer 26

3rd generation cephalosporin

Question 27

which generation: cefepime

Answer 27

4th generation cephalosporin

Question 28

which PBP inhibitors have less hypersensitvity?

Answer 28

Aztreonam

Question 29

which class of drugs need to be coadministered with cilastatin to prevent inactivation in kidney?

Answer 29

carbapenems

Question 30

which PBP inhibiting drug have GI side effects?

Answer 30

carbapenems

Question 31

which beta lactam antibiotic does not inhibit PBP?

Answer 31

vancomycin

Question 32

focfomycin is associated with tx of what?

Answer 32

UTI

Question 33

which protein synthesis are associated with nephrotoxicity and ototoxicity?

Answer 33

aminoglycosides

Question 34

erythromycin, clarithromycin, and azithromycin and associated with what subgroup?

Answer 34

macrolides

Question 35

which class of drugs Binds to 30S (perhaps 50S as well) and blocks formation of initiation complex (Step 1)?

Answer 35

aminoglycosides

Question 36

which class of drugs Binds to the 50S and impairs the translocation to the “P” site (Step 4)?

Answer 36

macrolides

Question 37

which class of drugs Binds to the 30S subunit of the ribosome and prevents binding of a new aminoacyl-tRNA to “A” site (Step 2)?

Answer 37

tetracyclines

Question 38

which protein synthesis inhibitor binds calcium and disrupts growth of teeth?

Answer 38

tetracyclines

Question 39

which drug is assc'ed with gray baby syndrome, suppression of RBC?

Answer 39

chloramphenicol

Question 40

which drug is very effective against resistant organisms, and works by inhibiting the formation of the ribosomal-fMet-tRNA complex?

Answer 40

linezolid

Question 41

clindamycin is broad spectrum or narrow spectrum?

Answer 41

narrow spectrum

Question 42

which drug inhibits topoisomerase II and IV?

Answer 42

ciprofloxacin and levofloxacin

Question 43

of the fluroquinolones, which group has the best activity against gram positive?

Answer 43

group 3

Question 44

which drug is used for mild-moderate C diff infxn?

Answer 44

metronidazole

Question 45

which drug sticks to LPS and punches holes in the membrane?

Answer 45

polymyxin B

Question 46

which types of antibiotics to use for complicated infxns?

Answer 46

PCN + lactamase inhibitor

Question 47

what drugs do you most commonly choose from to tx MRSA?

Answer 47

vancomycin, linezolid, daptomycin

Question 48

what is empiric tx for osteomyelitis

Answer 48

vancomycin, cephalosporins

Question 49

what drugs should you use for septic arthritis or in general, blood infxns?

Answer 49

3rd-4th generation cephalosporins (Cefdinir/Ceftriaxone/Cefotaxime/Cefixime; Cefepime)

Question 50

why can you use PCN or amoxicillin to tx pharyngitis?

Answer 50

b/c microbes are more likely to be gram+

Question 51

what are the common drugs that are prescribed for UTI?

Answer 51

TMP SMX, fluoroquinolone

Question 52

what is the broad spectrum powerhouse that is used to tx intra-abdominal infxns?

Answer 52

ticarcillin + clavulanate

Question 53

tx of C diff?

Answer 53

moderate: metronidazole severe: vancomycin

Question 54

what to use for community acquired bacterial meningitis?

Answer 54

ceftriaxone or cefotaxime + vancomycin

Question 55

what to use for neonatal meningitis (

Answer 55

ampiciliin+ cephalosporin +/- gentamicin

Question 56

what to use for sepsis or endocarditis?

Answer 56

3rd/4th gen ceph + vancomycin

Question 57

beside linezolid or daptomycin, what else can you use to tx resistant enterococci?

Answer 57

tigecycline

Question 58

which beta lactams are beta lactamase resistant?

Answer 58

methicillin/nafcillin/oxavillin Cefepime Aztreonam Carpamenems