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Questions and Answers
What mechanism do sulfonamides primarily use to inhibit bacterial growth?
What mechanism do sulfonamides primarily use to inhibit bacterial growth?
- Inhibition of DNA synthesis (correct)
- Inhibition of protein synthesis
- Inhibition of RNA transcription
- Destruction of cell wall integrity
What describes the classification of sulfonamides in terms of their action on bacteria?
What describes the classification of sulfonamides in terms of their action on bacteria?
- Bactericidal exclusively for anaerobes
- Bactericidal against all bacteria
- Bacteriostatic with a focus on gram positive bacteria
- Bacteriostatic mainly effective against gram negative bacteria (correct)
Which condition is a notable risk associated with the use of sulfonamides?
Which condition is a notable risk associated with the use of sulfonamides?
- Thrombocytopenia causing an increase in bleeding risk
- Kernicterus due to bilirubin displacement (correct)
- Hepatotoxicity resulting in liver failure
- Nephrotoxicity leading to acute kidney injury
What combination of drugs is referred to as Bactrim or Co-trimoxazole?
What combination of drugs is referred to as Bactrim or Co-trimoxazole?
What were sulfonamides recognized as in the development of antimicrobials?
What were sulfonamides recognized as in the development of antimicrobials?
What is the primary route of administration for difficile colitis to be effective?
What is the primary route of administration for difficile colitis to be effective?
Which of the following ribosome inhibitors is bactericidal?
Which of the following ribosome inhibitors is bactericidal?
What is a common type of toxicity associated with aminoglycosides?
What is a common type of toxicity associated with aminoglycosides?
What adverse effect is associated with vancomycin that results from IV administration?
What adverse effect is associated with vancomycin that results from IV administration?
Which of the following is a major reason for ordering a Vanco-trough in patients on vancomycin?
Which of the following is a major reason for ordering a Vanco-trough in patients on vancomycin?
Which adverse effect may increase with fast infusion of aminoglycosides?
Which adverse effect may increase with fast infusion of aminoglycosides?
Which of the following statements is true regarding the use of aminoglycosides in clinical settings?
Which of the following statements is true regarding the use of aminoglycosides in clinical settings?
Why should aminoglycosides not be mixed with amoxicillin in the same saline bag?
Why should aminoglycosides not be mixed with amoxicillin in the same saline bag?
What is the primary mechanism of action of quinolones?
What is the primary mechanism of action of quinolones?
Which condition is quinolone therapy NOT typically used to treat?
Which condition is quinolone therapy NOT typically used to treat?
What adverse effect is associated with quinolone use?
What adverse effect is associated with quinolone use?
What type of antibiotic is penicillin classified as?
What type of antibiotic is penicillin classified as?
Which of the following represents a mechanism of bacterial resistance to penicillin?
Which of the following represents a mechanism of bacterial resistance to penicillin?
Which adverse effect is NOT commonly associated with quinolone therapy?
Which adverse effect is NOT commonly associated with quinolone therapy?
In what patient population is the use of quinolones contraindicated?
In what patient population is the use of quinolones contraindicated?
What is the primary role of penicillin-binding proteins (PBPs) in bacterial cell wall synthesis?
What is the primary role of penicillin-binding proteins (PBPs) in bacterial cell wall synthesis?
Which of the following statements about beta-lactamase inhibitors is correct?
Which of the following statements about beta-lactamase inhibitors is correct?
What factor is NOT used to classify penicillin families?
What factor is NOT used to classify penicillin families?
Which penicillin has 100% oral bioavailability?
Which penicillin has 100% oral bioavailability?
Which of the following is NOT a common adverse effect of penicillin?
Which of the following is NOT a common adverse effect of penicillin?
What is the main pharmacokinetic characteristic of Penicillin G?
What is the main pharmacokinetic characteristic of Penicillin G?
Which antibiotic is resistant to beta-lactamase hydrolysis?
Which antibiotic is resistant to beta-lactamase hydrolysis?
What is the primary reason for the restricted use of carbenicillin today?
What is the primary reason for the restricted use of carbenicillin today?
What effect does the inflammation have on the pharmacokinetics of Penicillin G?
What effect does the inflammation have on the pharmacokinetics of Penicillin G?
What is one common adverse effect associated with the use of certain antimicrobials like metronidazole?
What is one common adverse effect associated with the use of certain antimicrobials like metronidazole?
Which condition is linked to blood dyscrasias as a side effect of certain antimicrobials?
Which condition is linked to blood dyscrasias as a side effect of certain antimicrobials?
What reaction may occur if alcohol is consumed while taking certain antimicrobials?
What reaction may occur if alcohol is consumed while taking certain antimicrobials?
What metabolic process is inhibited by antimicrobials, leading to increased concentrations of acetaldehyde after alcohol consumption?
What metabolic process is inhibited by antimicrobials, leading to increased concentrations of acetaldehyde after alcohol consumption?
What risk is associated with using certain antimicrobials in relation to drug interactions?
What risk is associated with using certain antimicrobials in relation to drug interactions?
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Study Notes
Antimicrobials Overview
- Antimicrobials are classified by their action against bacteria, including bactericidal and bacteriostatic effects.
- Susceptibility varies with bacterial type: Gram-positive, Gram-negative, anaerobes, atypicals, and Pseudomonas.
Sulfonamides
- Bacteriostatic agents primarily targeting Gram-negative bacteria.
- Inhibit DNA synthesis by blocking dihydropteroate and dihydrofolate synthesis.
- First used class of antimicrobials.
- Commonly used for uncomplicated Gram-negative urinary tract infections (UTIs).
- Toxicity includes kernicterus, hypersensitivity, and red man syndrome.
- Renal excretion noted; may cause nephrotoxicity.
Ribosome Inhibitors
- Divided into bactericidal (aminoglycosides) and bacteriostatic (tetracyclines, linezolid, chloramphenicol, clindamycin, macrolides, streptogramins).
- Aminoglycosides target the 30S ribosomal subunit and are primarily effective against aerobic Gram-negative bacteria.
- Often used in combination with beta-lactams for treating severe infections, e.g., sepsis.
- Known toxicities include nephrotoxicity, ototoxicity, and rare neuromuscular paralysis.
Quinolones
- Known for extensive tissue distribution, effective against UTIs, STIs, and respiratory infections.
- Contraindicated in children due to risks of arthropathy and tendon rupture.
- Common adverse effects include gastrointestinal disturbances, headache, dizziness, and renal issues.
- Cardiovascular effects may include hypotension and prolonged QT interval.
Beta-lactams
Penicillin
- First true antibiotic, essential for peptidoglycan layer synthesis in bacterial cell walls.
- Resistance mechanisms include alteration of penicillin-binding proteins (PBPs), reduced permeability, and beta-lactamase production.
- Classified by source, spectrum of activity, resistance to enzymes, and route of administration.
- Aminopenicillins like amoxicillin exhibit high bioavailability; toxicity may include diarrhea and rash.
Extended Spectrum & Resistance
- Anti-pseudomonal penicillins and combinations with beta-lactamase inhibitors (e.g., Augmentin) enhance activity against resistant bacteria.
- Key adverse effects of penicillins include allergic reactions, GI symptoms, and sodium overload from certain agents.
Adverse Effects Summary
- General toxicities across drug classes can include GI disturbances, neurotoxicity, blood dyscrasias, and hypersensitivity reactions.
- Specific monitoring required for drugs like vancomycin and aminoglycosides to prevent nephrotoxicity.
- Disulfiram-like reactions may occur with alcohol consumption during certain antimicrobial therapies.
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