PRO

Question 1

MOA of Macrolides

Answer 1

Binds to 50S sub unit and prevents TRANSLOCATION

Question 2

One of the best treatment for community acquired Pneumonia

Answer 2

Macrolides

Question 3

Best treatment for Hospital acquired pneumonia

Answer 3

3rd generation cephalosporins because most likely cause - Pseudomonas (gram negative)

Question 4

Most common clinical uses of Macrolides

Answer 4

1) Str.pyogenes Str.pnemoniae
2) N.gonorrhoea
3) C.diptheria
4) Gardenella vaginalis
5) Legionella
6) Mycoplasma (atypical)

Question 5

Common side effects of macrolides

Answer 5

• —> Stomach upset
• —> Deafness at high doses
• —> Increased QT interval (inhibition of CYP450)

Question 6

How do organisms acquire resistance to macrolides?

Answer 6

Methylation of the drug binding sites on the 50S subunit

Question 7

Mmm.. mm (Pnemonic for Macrolides)

Answer 7

Macrolides
MAC
Mycoplasma
Motility receptors (activate)
Methylation(resistance)

Question 8

Advantages of Clarithro over Erythro?

Answer 8

Covers MAC, and mycoplasma better

1st line drug for H.Pylori MAC infection

Question 9

Azithromycin clinical uses

Answer 9

1st line drug for

1) Legionarres pneumonia
2) chlamydia Trachomatis
3) Donovanosis
4) chancroid

Question 10

Distinctive feature of Clindamycin

Answer 10

Covers anaerobes especially Bact.Fragilis

Not sensitive against Chlamydia, Mycoplasma, Rickettsiae

Question 11

Most striking side effect of Clindamycin

Answer 11

Psedomembranous enterocolitis (superinfection by clostridium difficlie)

Question 12

MOA of Vancomycin

Answer 12

Binding to D ala D ala sites to hinder the transglycosylation that hinders peptidoglycan chain elongation.

Question 13

Vancomycin clinical uses

Answer 13

Serious gram positive infections e.g Hospital acquired MRSA, enterococci

Question 14

Drug of choice for C.diff

Answer 14

Metronidazole

Vancomycin (back up drug)

Question 15

How does VRSA develop resistance ?

Answer 15

D ala replaced by D lactate

Question 16

MOR of penicillins and cephalosporins

Answer 16

Production of beta-lactamases
Alteration of penicillin binding sites
Change in porin structure (gram negative)

Question 17

Difference between action of Penicillin and Vancomycin

Answer 17

Penicillin- inhibits transpeptidase( cross linking enzyme)

Vancomycin- inhibits transglycolase enzyme (elongation of peptidoglycan chain stopped)

Question 18

Drug of choice for Treponema

Answer 18

Pencillin G

Question 19

Antibacterial spectrum of Penicillin

Answer 19

Most Gram positive cocci and bacilli
Gram negative cocci
But no Gram negative Bacilli

Question 20

Name the B lactam antibiotics which are beta lactamase resistant

Answer 20

Very narrow spectrum anti Staphylococci penicllins.(methicillin nafcillin oxacillins)

Question 21

How do MRSA develop resistance to methicillin

Answer 21

Altering PBP

Question 22

Drug of choice for Listeria

Answer 22

Ampicillin

Question 23

Clinical uses of Ampicillin

Answer 23

Respiratory tract inf (sinusitis, otitis media, bronchitis)

Meningitis (in combo with 3rd gen cephalo/chloramphenicol)

Question 24

What are the penicillins that are antipsedomonal in nature?

Answer 24

Very broad spectrum penicillins ( piperacillin carbenicillin)

Question 25

Piperacillin uses

Answer 25

Pseudomonas Klebsiella immunocompromised patients with serious gram negative infections

Question 26

1st Generation cephalosporin spectrum

Answer 26

Only gram positive cocci E.coli, Klebsiella Some proteus surgical prophylaxis

Question 27

Its a FACt that im a FOXy and FURry man

Answer 27

Cefaclor Cefoxitine Cefuroxime

Question 28

3rd gen cephalosporins uses

Answer 28

Empirical treatment for meningitis

Question 29

One ceph to avoid in neonates

Answer 29

Ceftriaxone (mostly excreted in bile which is underdeveloped in neonates)

Question 30

what are the organisms not covered by cephalosporins

Answer 30

L- listeria A- atypicals (chlamydia and mycoplasma) M- MRSA E- enterococci

Question 31

What is a drawback of Iminepem

Answer 31

inhibited by dehydropeptidase in renal tubules | so always given Cilastatin

Question 32

1st choice drug for Lyme disease (Borella)

Answer 32

Tetracyclines