Pharm Lecture 4- Antibiotics

Which statement is the most accurate?

• Influenza is a systemic illness and should be grouped with other ARis

• Antibiotic treatment does not improve resolution of infleunza infections or prevent complications

• Antibiotics is the best treatment for influenza

• Antiviral therapy should only be used during the winter months

Which of the following is a vital component of reducing inappropriate antibiotic use

• Patient education

• Antibiotic prophylaxis

• Writing less prescriptions

• Referring patients to someone else

• Let patients decide when they need antibiotics

Where are you least likely to find genes that confer antibiotic resistance

• Plasmids

• DNA

• Cell wall

• Being exchanged between bacteria

Which is not a mechanism of antibiotic resistance?

• Antibiotic resistance

• Enzymatic inactivation

• Increased uptake

• Increased removal

• Alteration of target sites

An antibiogram tells what percentage of bacteria are susceptible to an antimicrobial agent

• True

• False

In order to prevent pathogen resistance, it is best to follow shorter courses of antibiotic use with duration of therapy based on the time the patient takes to achieve clinical stability

• True

• False

Ability to bypass or overcome the immune system

• Pathogenicity

• Virulence

• None of the above

Measure of disease producing potential

• Pathogenicity

• Virulence

• None of the above

How do pathogen cause disease?

• Increase in number and over come the immune system

• Increase in number and disrupt cellular function

• Increase production of toxins and disrupt cellular function

• All of the above

Gram positive are red and gram negative are purple

• True

• False

Rod shaped

• Bacilli

• Cocci

• Spirilla

• None of the above

Spherical shape

• Bacilli

• Cocci

• Spirilla

• None of the above

Spiral shape

• Bacilli

• Cocci

• Spirilla

• None of the above

Anaerobic bacteria need oxygen but faculative do not

• True

• False

*this question isn't graded* - What are all 7  Gram positive bacteria?  all 13 Gram Negative?

What test identifies the bug and selects the drug?

• I&D

• C&S

• TURP

• CABG

Culture and sensitivity cannot be done after antibiotic treatment has started

• True

• False

If  an organism is known to have resistant strains what test would help to choose the best drug?

• Culture

• Occult blood study

• Trial and error

• Sensitivity

Which of the following should be considered when choosing an antibiotic?

• Drug that is most effective against the pathogen involved

• Drug with lowest side effect profile that will still be effective

• Drug that is safe for individual patient

• Least expensive drug that will still be effective

• All of the above

Which statement is the most true

• Bactericidals cause the death of susceptible bacteria directly

• Bacteriostatics inhibit the growth/reproduction of susceptible bacteria and cause death indirectly

• Bacteriocidals and bacteriostatics use the same mechanism of action

• A & B

• None of the above

One way bacteria develop resistance is by producing chemicals that act as antagonist to the drug

• True

• False

Which is not a benefit of combination antibiotic therapy?

• Requires higher doses of each drug – especially in serious infections

• Some antibiotics are synergistic when used together

• Useful for infections caused by more than one pathogen

• Some treatments require multiple antibiotic therapy such as TB

Which of the following situations would be the best time give a patient antibiotic prophylaxis to prevent infection?

• After GI/GU surgery

• Patient without known exposure to life threatening or chronic infection

• Patient undergoing non invasive surgery

• Before traveling to an area where infectious disease is endemic

• Patient who doesn't have cardiac valve disease or valve replacements

Which is not an adverse effect from antibiotics

• Renal toxicity

• GI tract toxicity

• Neuro toxicity

• Hyposensitivity

• Superinfections

Superinfections occur when a host's normal flora is destroyed by antibiotics from broad spectrum antibiotics or chronic long term use

• True

• False

Which is not a sulfa drug?

• Sulfadiazine

• Sulfamethoxazole

• Sulfatetride

• Sulfisoxazoles

• Sulfacetamide

Which does not describe the drug action of sulfonamides?

• Bacteriostatic

• Prevents synthesis of folic acid

• Affects all folic acid

• Once broad spectrum but high resistance has developed

• Treats UTI

This sulfa drug is a topical cream used to treat burns and prevent infections secondary to burns

• Sulfidiazine (microsulfon)

• Silver sulfadiazine (silvadeen)

• Sulfamethoxazole

• Sulfisoxazole

This Sulfa drug is combined with trimethoprim  to create a synergistic effect and treats, UTI,  Pneumocystis Jiroveci, Otitis media and COPD

• Sulfamethoxazole in Bactrim or Septra

• Silver Sulfadiazine (Silvadeen)

• Sulfadiazine (Microsulfon

• Sulfamethoxazole (Azo-Gantanol)

This sulfa drug is available PO and is combined with Phenazopyridine to create a mucosal analgesic-anesthetic confined to the urinary tract

• Sulfamethoxazole (Azo-Gatanol)

• Sulfamethoxazole (Bactrim or septra)

• Silver Sulfadiazine (Silvadeen)

• Sulfadiazine (Microsulfon)

This sulfa drug is available PO only as a suspension  and is combined with erythromycin a macrolide antibiotic to treat OM in young children

• Sulfisoxazole + phenazopyridine (Azo-Gantrisin)

• Azo Gantanol

• Silver Sulfadiazine (silvadeen)

• Pediazole

This Sulfa drug treats bacterial eye infections and should not be used for most pink eye infections, because they are usually viral

• Silver Sulfadiazine (Silvadeen)

• Sulfamethoxazole (Azo-Gantanol)

• Sulfacetamide Opthalmic

• Sulfisoxazole (Pediazole)

Pyridium is phenazopyridine prescribed seperately along with a sulfonamide because it may be cheaper, this should only be prescribed for two days. One side effect of this drug is that it stains contact lenses and turns urine bright   _______________

Steven-Johnson syndrome is a severe life threatening hypersensitivity complex affecting the skin and the mucus membranes and may be cause by illness or as a response to what drug class?

• Vacomycin

• Sulfonamides

• Quinolones

• A&C

• A&B

Which does not describe Penicillins?

• Bactericidal- inhibit cell wall synthesis

• AKA Beta lactams

• Broad spectrum

• Cause bacteria to die from cell lysis

• None of the above

Natural PCN includes beta lactam ring but this makes it susceptible to penicillinase enzyme that splits the ring and makes it ineffective

• True

• False

Natural penicillins carry a higher risk for allergic reactions but because of their broad spectrum they are able to kill many bacteria

• True

• False

Which is not a penicillinase(enzyme)- resistant penicillin?

• Dicloxacillin

• Penicillin G

• Methicillin

• Nafcillin

• Oxacillin

What is alarming about MSRA that was not true before?

• It is a nosocomial infection

• Becoming problem in community acquired infections

• Virulent strain of staph

• Ineffective in penicillinase producing bacteria

Which Penicillin drug is virtually always combined with clavulanic acid?

• Ticarcillin

• Piperacillin

• Amoxicillin

• Ampicillin

Which of the following is a penicillinase inhibiting chemical?

• Clauvulanic acid

• Tazobactam

• Sulbactam

• All of the above

Which of the following is not a penicillin-beta-lactamase inhibitor combination drug?

• Zosyn

• Augmentin

• Timentin

• Unasyn

• Zohan

Penicillins are usually used for Gram + infections and common side effects include nausea vomiting diarrhea and abdominal pain but may have life threatening or even fatal adverse effects

• True

• False

Besides monobactams what is another non penicillin beta lactam?

• Zosyn

• Carbapenems

• Timentin

• Augmentin

Which does not describe monobactams

• Narrow spectrum beta lactam

• Effective against aerobic gram - rods , no gram + or anaerobes

• PO, IM, IV routes

• Inhaled form Cayston used for Cystic Fibrosis

Which does not describe Carbapenems?

• Pseudomonas resistant to ertapenem

• Gram + and Gram - coverage

• Non resistant to most beta lactamases

• Used for moderate to sever infections

• Anaerobic coverage and p. aeruginosa

Cephalosporins, one of the most widely prescribed antibiotics, is classified into four generations based on their spectrum of activity. It is also similar to PCN but has superior coverage of bacteria within its spectrum

• True

• False

Which does not describe Cephalosporins?

• Beactericidal- inhibits cell wall synthesis in bacteria

• 1st generation has beta-lactam ring

• Good gram + coverage

• Good gram - coverage

• Innefective agains betalactamase