Drug Resistance, Sulfonamides, Trimethoprin

Question 1

Needs to be used with Dihydropteroate Synthase (DHPS) in folate biosynthesis to make 7,8-Dihydropteroate.

Answer 1

pABA

Question 2

Folate (FH4) is made from this crucial molecule.

Answer 2

7,8-Dihydropteroate

Question 3

These drugs competitively inhibit PABA.

Answer 3

Sulfonamides

Question 4

Sulfonamides are a type of _______.

Answer 4

Anti-folate.

Question 5

MOA of Sulfonamides.

Answer 5

Competitively inhibit pABA, which is needed for folate synthesis.

Question 6

These drugs decrease the Dihydropteroate precursor.

Answer 6

Sulfonamides

Question 7

Mammals and folates.

Answer 7

Mammals cannot make folic acid, so they have to get it in the diet.

Question 8

These anti-folate drugs have a free para-amino acid.

Answer 8

Sulfonamides

Question 9

Sulfonamides bacteriocidal or static?

Answer 9

Static.

Delayed bacteriostatic effect.

Question 10

Concentrated in the urine, and effective in aerobic Gram + and -.

Answer 10

Sulfonamides

Question 11

Folate is used for what kind of metabolism?

Answer 11

One-carbon unit transfer reactions

Question 12

Converts dUMP to dTMP

Answer 12

Thymidylate cycle

Question 13

Part of the Folate pathway and makes dTMP

Answer 13

Thymidylate cycle

Question 14

These are needed in order for the Thymidylate cycle to work

Answer 14

Folate derivatives

Question 15

Folate synthesis inhibitor.

Answer 15

Trimethoprim

Question 16

A folic acid analog that inhibits folate synthesis by blocking DHFR (Dihydrofolic Reductase).

Answer 16

Trimethoprim

Question 17

How do microbes prevent microbial disease?

Answer 17

Create an inhospitable environment by lowering the pH.

Question 18

Host microbes make these, which insert into the cell walls of bad bacteria to create pores and cause cell death.

Answer 18

Colicins

Question 19

What is a microbial disease?

Answer 19

An overpopulation of microbes that colonize sterile zones, and a small number of them are pathogenic.

Question 20

How does microbial disease occur?

Answer 20

Exposure through ingestion, inhalation, or a wound, or thru a superinfection.

Question 21

How do microbes cause disease?

Answer 21

1) Through tissue invasion and immune over-response.

2) Make exo and endotoxins (LPS).

Question 22

Anti-microbial proteins found in body fluids that defend against bad bacteria.

Answer 22

Defensins.

Question 23

Using a single drug to treat a disease.

Answer 23

Monotherapy.

Question 24

This therapy uses microbes to kill bad bacteria without harming the host.

Answer 24

Antimicrobial therapy.

Question 25

Bacterial shape and how they stain is known as bacterial ________.

Answer 25

Taxonomy

Question 26

These antimicrobial drugs are most used by general dentists.

Answer 26

Attack cell wall and protein synthesis.

Question 27

What does the gram stain tell you?

Answer 27

Thickness and composition of the cell wall.

Question 28

Bacteriostatic or cidal drugs recommended if you are immunocompromised?

Answer 28

CIDAL!

Question 29

A lack of antimicrobial effect at the highest drug concentration that's tolerable to the host.

Answer 29

Drug resistance.

Question 30

When a protective substance, like pus, prevents the antibiotic from getting to the site of infection.

Answer 30

Escape

Question 31

Escape in the oral cavity.

Answer 31

Biofilm

Question 32

There's a pre-existing mechanism in the bacteria that makes it naturally resistant to the drug.

Answer 32

Intrinsic/Natural resistance.

Question 33

When species that used to be sensitive to a drug are no longer sensitive to it.

Answer 33

Acquired resistance.

Question 34

Acquired drug resistance can be _______ or ________.

Answer 34

Chromosomal; Extrachromosomal

Question 35

Ways that bacteria can spread acquired drug resistance extrachromosomally.

Answer 35

Transformation Transduction Conjugation

Question 36

Chromosomal spread of resistance is through ______.

Answer 36

Replication

Question 37

Interfere with the normal metabolism within cells.

Answer 37

Antimetabolites

Question 38

What do bacteria use to make DNA?

Answer 38

Folate derivatives.

Question 39

These inhibit folate metabolism in bacteria to stop DNA synthesis.

Answer 39

Anti-folates.

Question 40

Can either inhibit a reaction or incorporate into the DNA as an analog and disrupt the metabolism.

Answer 40

Anti-metabolites.

Question 41

Synthetic antibiotics bc they're man-made structural analogs.

Answer 41

Anti-folates

Question 42

These two things are needed to make 7,8-Dihydropteroate synthase.

Answer 42

pABA and Dihydropteroate Synthase

Question 43

Create a delayed bacteriostatic effect.

Answer 43

Sulfonamides

Question 44

Has a free para-amino group.

Answer 44

Sulfonamides

Question 45

This is needed to convert dUMP to dTMP in the Thymidylate cycle so that bacteria can make nucleotides.

Answer 45

Folate

Question 46

Inihibits DHFR

Answer 46

Trimethoprim (TMP)

Question 47

Folate analogue that inhibits DHFR

Answer 47

Trimethoprim

Question 48

Analogue of dTMP

Answer 48

TMP (Trimethoprim)

Question 49

Converts 7,8-Dihydrofolate to Folate.

Answer 49

DHFR

Question 50

Bacteriostatic and NOT delayed.

Answer 50

Trimethoprim

Question 51

Rationale for blocking the folate synthesis pathway at two steps rather than just one.

Answer 51

1) Decreased chance of drug resistance. | 2) Has a greater effect at stopping bacterial replication if two steps are blocked rather than one.

Question 52

These drugs concentrate in the urine, so they're used to treat UTI's and p. cervicii pneumonia.

Answer 52

Sulfonamides + Trimethoprim

Question 53

Adverse event of Sulfonamides + Trimethoprim when used to treat p. cervicii pneumonia (PCP).

Answer 53

Increased CNS effects

Question 54

Oral manifestation of folate deficiency.

Answer 54

Chronic ulcers.

Question 55

Folate deficiency is commonly seen in:

Answer 55

- Chronic alcoholics - Elderly - People with Folate malabsorption