AntiMicroBial Flashcards by

This is a macrolide that inhibits the growth and reproduction of microorganism.
A. Amikacin
B. Vancomycin
C. Erythromycin
D. Cephalexin

C. Erythromycin

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The main target of this drug is topoisomerase II which regulates overwinding or unwinding of the DNA *
A. Chloramphenicol
B. Fluroquinolone
C. Cetriaxone
D. Ketoconazole

B. Fluoroquinolone

Fluoroquinolones are a class of antibiotics that target bacterial DNA topoisomerases, including topoisomerase II (also known as DNA gyrase) and topoisomerase IV. These enzymes are essential for DNA replication, transcription, repair, and recombination in bacteria. By inhibiting these enzymes, fluoroquinolones prevent proper DNA replication and transcription, leading to bacterial cell death. The other options listed have different mechanisms of action:

A. Chloramphenicol inhibits bacterial protein synthesis by binding to the 50S ribosomal subunit.
C. Ceftriaxone is a beta-lactam antibiotic that inhibits bacterial cell wall synthesis.
D. Ketoconazole is an antifungal medication that interferes with the synthesis of ergosterol, a key component of fungal cell membranes.

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Bactericidal drugs are preferred for *
A. Endocarditis
B. WBC of 700
C. with strong immunity
D. Paients with tumors

A. Endocardiis

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Examples of narrow spectrum antibioics, EXCEPT *
A. oxacillin
B. cephalexin
C. cefazolin
D. ceftriaxone

D. Ceftriaxone

Broad spectrum
Cabapenems
Tetracyclines
3rd gen (Ceft, Cefo)
Cefoperazone
Cefotaxime
Cefixime

Ceftriaxone is the exception here, as it is a broad-spectrum antibiotic. It is effective against a wider range of bacteria, including many gram-positive and gram-negative bacteria. Ceftriaxone is often used to treat infections like pneumonia, bacterial meningitis, and gonorrhea, among others, where a broad-spectrum antibiotic is necessary.

Oxacillin, cephalexin, and cefazolin are primarily effective against certain gram-positive bacteria and have a more limited range of activity against gram-negative bacteria.

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Examples of narrow spectrum antibiotics, EXCEPT*
a. methicillin
b. cloxacillin
c. cefazolin
d. imipenem

d. imipenem

Broad spectrum
Cabapenems
Tetracyclines
3rd gen (Ceft, Cefo)
Cefoperazone
Cefotaxime
Cefixime

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Which of the following Penicillins are used for prophylaxis of Rheumatic fever
A. Pen V
B. Pen G Procaine
C. Pen G Benzathine
D. Pen G

C. Pen G Benzathine

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Penicillin can cause seizure to which of the following patients? *
A. Newborns
B. Patients with Chronic Kidney Disease
C. Patients with Liver disease
D. A and B
E. A and C

D. A and B

A. Newborns
B. Patients with Chronic Kidney Disease
Newborns and patients with chronic kidney disease are at increased risk of seizures when administered penicillin. In newborns, the risk is due to the immaturity of their neurological and metabolic systems, making them more susceptible to the neurological side effects of certain medications, including penicillin.

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Anti staphylococcal penicillin that can cause interstitial nephritis *
A. Cloxacillin
B. Oxacillin
C. Methicillin
D. Nafcicillin

C. Methicillin

Methicillin has been associated with the development of interstitial nephritis, a form of kidney inflammation. This adverse effect is one of the reasons why methicillin is less commonly used nowadays in clinical practice.

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The following are covered by 1st generation cephalosporin, EXCEPT *
A. Proteus
B. Klebsiella
C. Haemophilus
D. E.coli

C. Haemophilus

1st gen: PEcK

1st generation cephalosporins, such as Cefadroxil, Cefazolin, and Cephalexin, cover a range of bacteria including Proteus mirabilis, E. coli, and Klebsiella (often summarized as PEcK). However, they have limited or no activity against Haemophilus species. Haemophilus coverage is more characteristic of some 2nd and 3rd generation cephalosporins.

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3rd Generation Cephalosporin that is anti-pseudomonas *
A. Cefazolin
B. Cefipime
C. Ceftazidime
D. Cefuroxime

C. Ceftazidime
or Cefoperazone

Ceftazidime is specifically known for its effectiveness against Pseudomonas aeruginosa, making it a valuable choice in treating infections caused by this bacterium. The other options listed are different generations of cephalosporins and do not have the same level of activity against Pseudomonas:

A. Cefazolin is a 1st generation cephalosporin.
B. Cefepime is a 4th generation cephalosporin, not 3rd.
D. Cefuroxime is a 2nd generation cephalosporin.

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Cephalosporin with gram positive and Pseudomonas coverage *
A. Cefazolin
B. Cefepime
C. Cetazidime
D. Cefuroxime

B. Cefepime

Cefepime, a 4th generation cephalosporin, is known for its broad spectrum of activity. It covers a wide range of Gram-positive bacteria and is also effective against Pseudomonas aeruginosa. This dual coverage makes it a versatile choice in certain infections. The other options do not provide the same combined coverage:

A. Cefazolin (1st generation) has good Gram-positive coverage but limited Pseudomonas coverage.
C. Ceftazidime (3rd generation) is effective against Pseudomonas but has less Gram-positive coverage.
D. Cefuroxime (2nd generation) has a broader Gram-positive coverage but is not particularly effective against Pseudomonas.

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Cephalosporin has no coverage on the following, EXCEPT *
A. Listeria
B. Ureaplasma
C. MRSA
D. E. coli

D. E. coli

Cephalosporins are generally effective against a range of Gram-negative bacteria, including E. coli. They are known for not covering the following:

A. Listeria
B. Ureaplasma (an atypical bacterium)
C. MRSA (Methicillin-Resistant Staphylococcus Aureus)
These limitations are often summarized by the mnemonic “LAME,” indicating that cephalosporins lack activity against Listeria, Atypicals (like Ureaplasma), MRSA, and Enterococci.

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Which of the following has coverage for gram +, gram - and anaerobics? *
A. Cephalosporins
B. Monobactams
C. Carbapenems
D. Vancomycin

C. Carbapenems

Carbapenems, such as Imipenem, are known for their broad-spectrum activity, which includes effective coverage against Gram-positive, Gram-negative, and anaerobic organisms. They are often referred to as “super drugs” for their wide range of antimicrobial activity.

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Tetracyclines are contraindicated to pregnant women and *
A. < 8 yo
B. 9 yo and above
C. < 18 yo
D. 19 yo and above

A. < 8 yo

Tetracyclines are not recommended for use in children under 8 years old due to the potential for adverse effects on bone and teeth development.

VACUUM YOUR BEDROOM TONIGHT

Vibrio cholera
Acne
Chlamydia
Ureaplasma urealyticum
Mycoplasma pneumonia
Borrelia burgdorferi
Rickettsia
Tularemia

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TRUE about Erythromycin *
A. Effective against Gram - bacteria
B. Bacteriostatic at low concentration
C. Bacteriostatic at high concentration
D. Bactericidal at low concentration

B. Bacteriostatic at low concentration

Erythromycin is known to be bacteriostatic at low concentrations, meaning it inhibits the growth and multiplication of bacteria without necessarily killing them. At higher concentrations, it can become bactericidal, effectively killing the bacteria.

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Antibiotic-associated colitis.
A. Cefuroxime
B. Clindamycin
C. Neilmicin
D. Rifampicin

B. Clindamycin

Clindamycin is notably associated with the development of antibiotic-associated colitis, particularly due to its effect on the normal flora of the colon and its potential to promote the growth of Clostridium difficile, a bacterium that can cause severe colitis.

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Drug of choice for cryptococcal meningitis in AIDS patients *
A. Amphotericin B
B. Flucytosine
C. Griseofulvin
D. Fluconazole

D. Fluconazole

Fluconazole is commonly used as the initial or maintenance treatment for cryptococcal meningitis, especially in AIDS patients, due to its ability to penetrate the central nervous system effectively.

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Prophylaxis used to prevent influenza for adults *
A. Amantadine
B. Rimantadine
C. Ribavarin
D. Acyclovir

A. Amantadine

Amantadine is used for the prophylactic treatment of influenza in adults, as it can prevent infections when used before exposure to the influenza virus and can also reduce the severity of symptoms if used shortly after the onset of illness.

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Acetaminophen increases risk of hematologic toxicity
A. Stavudine (d4T)
B. Zidovudine (AZT)
C. Indinavir
D. Nevirapine

B. Zidovudine

Drug Resistance
- Occurs due to mutations in the reverse transcriptase enzyme of HIV.
Adverse Reactions
- Headache
- Nausea and Vomiting (N&V)
- Myalgias (muscle pains)
- Anemia
- Neutropenia (low levels of neutrophils)
- Macrocytosis (enlarged red blood cells)
Pharmacokinetics
- Administration route: Oral (PO), well absorbed.
- Metabolism: Rapidly metabolized by the liver.
Notes
- Use of acetaminophen increases the risk of hematologic toxicity when taken with Zidovudine. This is particularly important due to Zidovudine’s effects on red and white blood cells, which can be exacerbated by the concurrent use of acetaminophen.

Results in immature virus formation
A. Stavudine (d4T)
B. Zidovudine (AZT)
C. Indinavir
D. Nevirapine

C. Indinavir

Indinavir is a protease inhibitor used in the treatment of HIV. It works by inhibiting the HIV protease enzyme, which is essential for the maturation of new virus particles. By inhibiting this enzyme, indinavir leads to the production of immature, non-infectious viral particles.

Metabolized interacellularly to dideoxynucleoide triphosphate which inhibits reverse transcriptase and incorporates into viral DNA. Subsequent nucleoides fail to bind to ddATP because it lacks the necessary free 3’ OH group, thus DNA chain terminaion occurs. *
A. Zalcitabine
B. Zidovudine (AZT)
C. Didanosine
D. Stavudine (d4T)

C. Didanosine

Didanosine (ddI) is a nucleoside reverse transcriptase inhibitor (NRTI) used in the treatment of HIV. It is metabolized inside cells to its active form, dideoxyadenosine triphosphate (ddATP), which competes with natural nucleotides for incorporation into viral DNA by reverse transcriptase. Its lack of a 3’ hydroxyl group prevents the addition of further nucleotides, thereby terminating the DNA chain extension.

Drug of choice for Arena viruses
A. Amantadine
B. Ribavarin
C. Idoxorudine
D. Foscarnet

B. Ribavarin

Mnemonic for Ribavirin (RIBAvirin):

RSV.
Influenza B.
Arenaviruses (such as Lassa fever).

Drug of choice for herpes simplex keratis
A. Amantadine
B. Ribavarin
C. Idoxorudine
D. Foscarnet

C. Idoxuridine

Idoxuridine is specifically used for the treatment of herpes simplex keratitis, a condition affecting the eye.

Hepatotoxic guanine analog *
A. Acyclovir
B. Ganciclovir
C. Amantadine
D. Vidarabine

B. Ganciclovir

Ganciclovir is a guanine analog known to have potential hepatotoxic effects.

The following aminoglycosides are given intravenously EXCEPT * A. Amikacin B. Neilmicin C. Neomycin D. Gentamicin

C. Neomycin All given intravenously (IV) except Neomycin, which is used topically.

The following are teratogenic EXCEPT A. Ribavirin B. Tetracycline C. Azithromycin D. Griseofulvin

C. Azithromycin Azithromycin, a macrolide antibiotic, is generally not considered teratogenic and is often used in certain infections during pregnancy. Ribavirin, Tetracycline, and Griseofulvin, on the other hand, are known to be teratogenic.

The following causes ototoxicity, EXCEPT A. Vancomycin B. Streptomycin C. Gentamicin D. Spectinomycin

D. Spectinomycin Spectinomycin is an aminocyclitol antibiotic used primarily for the treatment of gonorrhea and is not commonly known to cause ototoxicity. In contrast, Vancomycin, Streptomycin, and Gentamicin are known to have ototoxic effects.

Vitamin that is given with Isoniazid in patents with PTB A. Thiamine B. Niacin C. Pyridoxine D. Riboflavin

C. Pyridoxine Pyridoxine, also known as Vitamin B6, is often administered alongside Isoniazid to prevent peripheral neuropathy, a potential side effect of Isoniazid therapy.

Cytochrome P450 Inhibitor except* A. Rifampin B. Metronidazole C. Isoniazid D. all of the above

A. Rifampin

What is the purpose of the carbapenem-cilastatin combination? A. Cilastatin protects carbapenem from dehydropeptidase I in the kidney, prolonging its antibacterial effects. B. Carbapenem protects cilastatin from dehydropeptidase I, prolonging its antibacterial effects. C. Cilastatin induces the activity of dehydropeptidase I. D. Carbapenem causes seizures when given as monotherapy

A. Cilastatin protects carbapenem from dehydropeptidase I in the kidney, prolonging its antibacterial effects. Cilastatin is combined with carbapenems like imipenem to inhibit the enzyme dehydropeptidase I in the kidneys. This enzyme would otherwise degrade the carbapenem, reducing its effectiveness. By inhibiting this enzyme, cilastatin prolongs the antibacterial effect of the carbapenem.

Bacitracin is given topical because this could happen when taken internally A. hepatotoxicity B. neurotoxicity C. nephrotoxicity D. ototoxicity

C. Nephrotoxicity Adverse Effects: -Highly nephrotoxic when administered systemically. -Poorly absorbed through the skin, which limits its action to local antibacterial activity.

Empiric therapy for pharyngitis is A. Ampicillin B. Terbinafine С. Chloroquine

A. Ampicillin Ampicillin is a broad-spectrum penicillin antibiotic that is commonly used to treat bacterial pharyngitis, especially when the causative agent is suspected to be Streptococcus pyogenes (Group A Streptococcus). The other options, B. Terbinafine (an antifungal medication) and C. Chloroquine (an antimalarial and anti-inflammatory medication), are not typically used for treating pharyngitis.

For numbers 3-6. Biochemical enzyme inhibitors * Choices: A. TMP SMX B. AZT C. Levofloxacin D. Bacitracin 3. DNA gyrase inhibitor 4. DHF reductase inhibitor 5. Reverse transcriptase inhibitor 6. Biosyntheic pathway inhibitor

3. DNA gyrase inhibitor C. Levofloxacin Fluoroquinolones (-floxacin) 4. DHF reductase inhibitor Trimethoprim- Sulfamethoxazole 5. Reverse transcriptase inhibitor NRTI : AZT (Zidovudine) 6. Biosynthetic pathway inhibitor Bacitracin

9-13. Match the resistance of antibiotics * A. Inactivation by enzyme B. overproduction of target C. RNA methylation D. reduced uptake into cell E. active efflux from the cell 9. Tetracycline 10. Sulfonamide 11. Chloramphenicol 12. Erythromycin 13. Aminoglycoside

9. Tetracycline E. Active efflux from the cell 10. Sulfonamide B. Overproduction of target 11. Chloramphenicol D. Reduced uptake into cell 12. Erythromycin C. RNA methylation 13. Aminoglycoside A. Inactivation by enzyme

25-30. Match the Sulfa drug with the indication * A. Burn B. Nocardiosis C. UTI D. Ulcerative colitis E. Ocular infection F. Toxoplasmosis 25. Sulfamethoxazole 26. Sulfasalazine 27. Silver sulfadiazine 28. Sulfacetamide 29. Sulfisoxazole 30. Sulfadiazine + pyrimethamine

25. Sulfamethoxazole C. UTI 26. Sulfasalazine D. Ulcerative colitis 27. Silver sulfadiazine A. Burn 28. Sulfacetamide E. Ocular Infection 29. Sulfisoxazole B. Nocardiosis 30. Sulfadiazine + pyrimethamine F. Toxoplasmosis

36-38. Mode of Action of AntiFungals * A. Griseofluvin B. Amphotericin B C. Flucytosine 36. Binds to ergosterol 37. Inhibit thymidylate synthetase 38. inhibit microtubule function

36. Binds to ergosterol B. Amphotericin B 37. Inhibit thymidylate synthetase C. Flucytosine 38. inhibit microtubule function A. Griseofluvin

40-43. Antifungal ADR * A. Itraconazole B. Griseofluvin 40. Teratogenic 41. Hepatotoxicity 42. Hypokalemia 43. Hypertriglyceridemia

40. Teratogenic B. Griseofluvin 41. Hepatotoxicity B. Griseofluvin 42. Hypokalemia A. Itraconazole 43. Hypertriglyceridemia A. Itraconazole

44-48. Match the drug with the analog A. Guanine B. Thymidine C. Phosphate 44. Acyclovir 45. Ganciclovir 46. Idoxuridine 47. Trifluride 48. Foscanet

44. Acyclovir A. Guanine 45. Ganciclovir A. Guanine 46. Idoxuridine B. Thymidine 47. Trifluride B. Thymidine 48. Foscanet C. Phosphate

50-55. Antiviral MOA * A. inhibits uncoating B. inhibits reverse transcriptase C. inhibits viral DNA polymerase D. inhibits neuraminidase E. inhibits viral aspartate F. inhibits HIV protease 50. Oseltamivir 51. Indinavir 52. Zidovudine 53. Foscarnet 54. Amantadine 55. Saquinavir

50. Oseltamivir D. Inhibits neuraminidase 51. Indinavir F. Inhibits HIV protease 52. Zidovudine B. Inhibits reverse transcriptase 53. Foscarnet C. Inhibits viral DNA polymerase 54. Amantadine A. Inhibits uncoating 55. Saquinavir F. Inhibits HIV protease

56-60. Antiprotozoal MOA * A. lindane B. pyrimethamine C. mebendazole D. ivermectin E. primaquine 56. induces seizures in ectoparasite 57. inhibit folate synthesis 58. disrupt microtubule 59. helminthic glutamate-gated channel antagonist 60. crosslinking of glutathione

56. induces seizures in ectoparasite A. lindane 57. inhibit folate synthesis B. pyrimethamine 58. disrupt microtubule C. mebendazole 59. helminthic glutamate-gated channel antagonist D. ivermectin 60. crosslinking of glutathione E. primaquine

61-64. Antiprotozoal ADR * A. Quinine B. Lindane C. Thiabendazole D. Mefloquine 61. Arrhythmia 62. Cinchonism 63. Hepatotoxicity 64. Syncope

61. Arrhythmia B. Lindane 62. Cinchonism A. Quinine 63. Hepatotoxicity C. Thiabendazole 64. Syncope D. Mefloquine

65-69. Antiviral ADR * A. Acyclovir B. Ganciclovir C. Foscarnet D. Amantadine E. Idoxuridine 65. Hematotoxicity 66. Nephrotoxicity 67. Neurotoxicity 68. Livedo reticularis 69. Photophobia

65. Hematotoxicity B. Ganciclovir 66. Nephrotoxicity C. Foscarnet 67. Neurotoxicity A. Acyclovir 68. Livedo reticularis D. Amantadine 69. Photophobia E. Idoxuridine

70-75. Antiviral Nucleotide analog * A. thymidine B. adenosine C. cytosine D. non-nucleoside 70. Zidovudine 71. Didanosine 72. Zalcitabine 73. Stavudine 74. Nevirapine 75. Delavirdine

Nucleotide Analog: Thymidine analog Zidovudine (AZT) Stavudine (d4T) Adenosine analog: Didanosine (ddI) Cytosine analog: Zalcitabine (ddC) Non-Nucleoside Analogs: Nevirapine Delavirdine

80. Match the Drug with the Adverse Drug reaction * A. Yellowing of teeth B. Gray Baby Syndrome C. Redman's Syndrome D. Blue Green Blindness E. Red orange urine 76. Vancomycin 77. Chloramphenicol 78. Rifampicin 79. Tetracycine 80. Ethambutol

76. Vancomycin C. Redman's Syndrome 77. Chloramphenicol B. Gray Baby Syndrome 78. Rifampicin E. Red orange urine 79. Tetracycine A. Yellowing of teeth 80. Ethambutol D. Blue Green Blindness

94-100. Protein synthesis inhibitors A. Formation of initiation complex B. Amino Acid Incorporation C. Formation of Peptide Bond D. Translocation 94. Azithromycin 95. Chloramphenicol 96. Clarithromycin 97. Clindamycin 98. Netilmicin 99. Tetracycline 100. Erythromycin

Aminoglycosides: * Netilmicin Tetracyclines: Chloramphenicol: * Chloramphenicol (Chloromycetin) Macrolides: * Erythromycin (prototype) * Clarithromycin * Azithromycin Lincosamide: * Clindamycin