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Pharmacology > L29: Misc Antimicrobials > Flashcards

L29: Misc Antimicrobials Flashcards

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1
Q

Which of the following is a Nitroimidazole?
A. Metronidazole
B. Nitrofuratoin
C. Rifaximin
D. Fidaxomicin

A

A. Metronidazole

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2
Q

Which class do Fidaxomicin, Rifaximin, Nitrofurantoin, and Metroidazole belong to?
A. Ribosome Agents
B. DNA/RNA Agents

A

B. DNA/RNA Agents

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3
Q

Linezolid, Chloramphenicol, and Clindamycin are ___ agents
A. Ribosome
B. DNA/RNA

A

A. Ribosome

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4
Q

What is an example of a Lincomycin?

What is an example of a Oxazolidinone?

A

Lincomycin
- Clindamycin

Oxazolidinones
- Linezolid

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5
Q

_____ damages DNA and is bactericidal (concentration dependent and rapid)
A. Metronidazole
B. Nitrofuratoin
C. Rifaximin
D. Fidaxomicin

A

A. Metronidazole

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6
Q

How does Metronidazole damage DNA?

A

Intracellular accumulation, then redox reactions w/ferredoxin (low O2 tension required!)

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7
Q

True or False: Metronidazole is active against aerobic microbes (amoeba, protozoa, gram - bacteria)

A

False - anaerobic

Note: There is low O2 tension found in anaerobes

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8
Q

Which of the following is curative for Trichomoniasis?
A. Metronidazole
B. Nitrofuratoin
C. Rifaximin
D. Fidaxomicin

A

A. Metronidazole

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9
Q

True or False: Resistance to metronidazole is limited

A

True

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10
Q

3 AE’s associated with Metronidazole?

A

1) Metallic taste, headache
2) Peripheral neuro, seizures, ataxia
3) BBW - carcinogen

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11
Q

True or False: Metronidazole should be avoided in 1st trimester of pregnancy

A

True

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12
Q

Which drug is the choice for gram (-) anaerobic infections?
A. Metronidazole
B. Nitrofuratoin
C. Rifaximin
D. Fidaxomicin

A

A. Metronidazole

  • less effective against gram (+) anaerobes and facultatives
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13
Q

____ is a urinary antiseptic that inhibits DNA/RNA/Proteins and is only used to treat lower UTI’s (not pyelo)
A. Metronidazole
B. Nitrofuratoin
C. Rifaximin
D. Fidaxomicin

A

B. Nitrofuratoin

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14
Q

Nitrofurantoin MOA involves bacterial reduction to high reactive ___

A

intermediates

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15
Q

Can patients w/bad kidneys use Nitrofurantoin?

A

no - contraindicated

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16
Q

AE associated w Nitrofurantoin?

A

1) Appetite suppression
2) Neuropathy, C. dif, Pulm tox

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17
Q

True or False: While acquired resistance is uncommon w/Nitrofurntoin use (and there is no cross resistance) – Pseudomonas and Proteus are innately resistant

A

True

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18
Q

Where do both Rifaximin and Fidaxomicin accumulate when given orally?

A

Gut/Feces

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19
Q

Both Rifaximin and Fidaxomicin bind and inhibit bacterial ____
A. RNA
B. DNA
C. DNAP
D. RNAP

A

D. RNAP

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20
Q

____ is a rifamycin, like rifampin. It treats gram (+) (-) and aerobes/anaerobes

____ is good for gram (+) and anaerobes, but NOT gram (-)

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A

Rifaximin; Fidaxomicin

21
Q

Two clinical uses of Rifaximin?
A. Acne/C. Dif
B. Traveler’s Diarrhea and C. diff
C. Only C. dif

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A

B. Traveler’s Diarrhea and C. diff

22
Q

Clinical use of Fidaxomicin?
A. Acne/C. Dif
B. Traveler’s Diarrhea and C. diff
C. Only C. dif

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A

C. Only C. dif

23
Q

____ belongs to the lincosamide class (note: only 1 drug belongs to this class) and has identical binding site to macrolides on 50S ribosomal rubunit. It is BACTERIOSTATIC !!
A. Clindamycin
B. Chloramphenicol
C. Linezolid

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A

A. Clindamycin

24
Q

Which drug is good against anaerobes and non-bacterial infections and can be used to treat skin/soft tissue infections caused by strep/staph in patients allergic to penicillin or community acquired MRSA/ORSA?
A. Clindamycin
B. Chloramphenicol
C. Linezolid

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A

A. Clindamycin

25
Which two agents are resistant to clindamycin?
Enterococci and gram (-) anaerobes
26
True or False: Clindamycin distributes to abscesses and is concentrated in phagocytic cells
True
27
Which drug is among the worst antimicrobial for promoting C. dif?
Clindamycin
28
Mutation / methylation of binding site on ribosome (MLS-Type B) is associated with use of which drug?
Clindamycin
29
Why do strains that are resistant to macrolides due to efflux respond to clindamycin?
Clindamycin is not a substrate for efflux pumps
30
True or False: Clindamycin induces methylase expression, so cross resistance with macrolides from methylation relies on constituitively active enzyme
False - clindamycin does NOT induces methylase expression, so cross resistance with macrolides from methylation relies on constituitively active enzyme (D Test)
31
What does a positive D test mean, in the case of Clindamycin?
Methylase is present that may mutate to become constitutive
32
______, a streptogramins B that has same binding site and mechanism as macrolides (50S) A. Dalfopristin B. Quinupristin
B. Quinupristin
33
True or False: Both Qunupristin and Dalfopristin are rapidly bactericidal
True
34
What is the function of Dalfopristin in Qunupristin-Dalfopristin?
Changes ribosome shape, making it easier for Qunupristin to bind (blocks PP formation)
35
Two uses of Qunupristin-Dalfopristin?
1) Gram (+) infections 2) Infective endocarditis
36
Both Qunupristin-Dalfopristin inhibit which CYP enzyme?
CYP3A4
37
What are three ways by which drug resistance develops in Qunupristin-Dalfopristin?
1) Increased drug efflux of dalfopristin 2) MLS-Type B - Modified ribosomal drug binding site via chromosomal mutation, ribosome methylation 3) Enzymatic inactivation
38
How do Oxazolidinones work? A. Binds to A site B. Binds to P site
B. Binds to P site, prevents formation of translation initiation complex by binding 23S on 50S
39
True or False: Oxazolidinones are bacteriostatic and have no cross resistance w/other 50S drugs
True
40
Four uses of Oxazolidinones?
1. Gram (+) anaerobe 2. Strep/Staph MRSA 3. Infections caused by E. faecium 4. VRE, gram (+) anaerobes
41
Which drug class is associated with headaches, thrombocytopenia, mitochondrial toxicity?
Oxazolidinones
42
What causes drug resistance in Oxazolidinones?
Point mutation in 23S rRNA of the 50S ribosomal subunit
43
____ reversibly binds to 50S subunit (site close to macrolides and clindamycine) and prevents peptide bond formation. It is BACTERIOSTATIC.
Chloramphenicol
44
True or False: Chloramphenicol can bind to 80S ribosome and mitochondrial 70S ribosome
False - it can bind to mitochondrial 70S but not 80S
45
Four uses of Chloramphenicol?
1. Broad spec against gram +/- 2. Ricettsiae 3. Anaerobes 4. Bacterial meningitis tx with severe B-lactam allergy
46
Gray Baby Syndrome (due to poor glucuronic acid conjugation) and Aplastic Anemia are AE associated with use of _____
Chloramphenicol
47
What causes drug resistance in Chloramphenicol?
Increased expression of inactivating enzyme Chloramphenicol Acetyltransferase
48
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