Ocular Chloramphenicol and Aplastic Anemia Association
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Questions and Answers

Which drug combination is most likely to increase the risk of QT prolongation and cardiac arrhythmias?

  • Warfarin and statins
  • Warfarin and antacids
  • Azithromycin and antacids
  • Azithromycin and statins (correct)

    • In the context of meibomian gland dysfunction, which antibiotic is highlighted for its anti-inflammatory effects?

  • Iodaron
  • Sotalol
  • Quinidine
  • Azithromycin (correct)

    • When comparing azithromycin and doxycycline in the treatment of meibomian gland dysfunction, which property differentiates doxycycline from azithromycin?

  • Antimicrobial effect
  • Anti-inflammatory effect
  • Metalloproteinase inhibition (correct)
  • Topical application

    • Which antibiotic is mentioned to have fewer side effects compared to tetracycline in the text?

    <p>Doxycycline</p> Signup and view all the answers

    Considering the potential drug interactions mentioned, which medication combination is warned about due to the increased risk of bleeding?

    <p>Warfarin and azithromycin</p> Signup and view all the answers

    What is the main impact of macrolides on bacterial cells?

    <p>Inhibition of bacterial protein synthesis</p> Signup and view all the answers

    Which of the following is NOT a clinical use of macrolides mentioned in the text?

    <p>Meibomian gland dysfunction</p> Signup and view all the answers

    For which condition is erythromycin ophthalmic ointment specifically used?

    <p>Superficial bacterial ocular infection</p> Signup and view all the answers

    What is a notable difference between azithromycin and doxycycline in treating urogenital Chlamydia infections?

    <p>Doxycycline is more effective for rectal infections in both men and women.</p> Signup and view all the answers

    What is a key consideration regarding the use of Azithromycin's Zmax extended-release suspension/liquid?

    <p>Must be taken with food to increase its effectiveness.</p> Signup and view all the answers

    What did the systematic review mentioned in the text conclude about azithromycin and doxycycline in the treatment of Meibomian Gland Dysfunction?

    <p>Azithromycin is a good alternative to doxycycline based on the reviewed studies.</p> Signup and view all the answers

    Which statement accurately reflects the findings of the systematic review regarding azithromycin and doxycycline?

    <p>Azithromycin has better safety and efficacy than doxycycline in treating Meibomian Gland Dysfunction.</p> Signup and view all the answers

    What is one of the advantages of using azithromycin over doxycycline according to the text?

    <p>Azithromycin has a broader spectrum of activity than doxycycline.</p> Signup and view all the answers

    In terms of protein synthesis, what effect does chloramphenicol have according to the text?

    <p>Chloramphenicol blocks protein synthesis by binding to the 50s ribosomal subunit.</p> Signup and view all the answers

    What side effect is associated with chloramphenicol use as mentioned in the text?

    <p>Aplastic anemia</p> Signup and view all the answers

    Which antibiotic is recommended for its better effect on improving the signs and overall clinical response in Meibomian Gland Dysfunction?

    <p>Oral Azithromycin</p> Signup and view all the answers

    In a randomized double-masked trial comparing oral Azithromycin and Doxycycline in Meibomian Gland Dysfunction, which group showed statistically significant better sign scores?

    <p>Oral Azithromycin group</p> Signup and view all the answers

    Which antibiotic was found to have lower cost and fewer side effects compared to the other in the treatment of Meibomian Gland Dysfunction?

    <p>Oral Azithromycin</p> Signup and view all the answers

    Which form of Azithromycin was used in the intervention comparing it to Doxycycline, according to the study?

    <p>1g once per week</p> Signup and view all the answers

    Which antibiotic was noted to control bacteria while also being valued for its anti-inflammatory effects in the context of decreasing inflammation and MMP9 effect?

    <p>Doxycycline</p> Signup and view all the answers

    What is the mechanism by which aplastic anemia is induced by chloramphenicol?

    <p>Chloramphenicol triggers cytotoxic effects in bone marrow cells</p> Signup and view all the answers

    Why was the use of Bacillus anthracis (anthrax) discontinued in the US?

    <p>Due to its association with aplastic anemia</p> Signup and view all the answers

    What is the role of intestinal bacteria in the metabolism of chloramphenicol?

    <p>Intestinal bacteria convert chloramphenicol into dehydrochloramphenicol</p> Signup and view all the answers

    What contributes to the increased cytotoxicity on DNA exhibited by derivatives of chloramphenicol?

    <p>Greater capacity of host marrow to generate toxic intermediates</p> Signup and view all the answers

    What is the main concern associated with systemic use of chloramphenicol in infants?

    <p>Systemic toxicity</p> Signup and view all the answers

    What is the estimated risk of developing aplastic anemia after topical use of chloramphenicol?

    <p>Less than one in a million treatment courses</p> Signup and view all the answers

    Based on the text, what is suggested as an alternative when there is resistance to fluoroquinolones?

    <p>Topical chloramphenicol in select cases</p> Signup and view all the answers

    What mechanism is proposed as a cause of aplastic anemia related to ocular chloramphenicol administration?

    <p>Conversion of chloramphenicol into dehdyrochloramphenicol by gut bacteria</p> Signup and view all the answers

    In what scenario might using chloramphenicol be considered despite the risk of aplastic anemia?

    <p>When a patient has vision-threatening keratitis that failed first-line antibiotic drops</p> Signup and view all the answers

    What class of antibiotics is mentioned as affecting intermediary metabolism along with sulfonamides and trimethoprim?

    <p>Folic Acid</p> Signup and view all the answers

    Which stage of the cycle do sulfa drugs come in to affect nucleic acid synthesis?

    <p>Early stage</p> Signup and view all the answers

    What is the effect of trimethoprim on the DHFR enzyme?

    <p>Inhibits it</p> Signup and view all the answers

    Which bacteria are sulfonamides effective against?

    <p>Both Gram-positive and Gram-negative bacteria</p> Signup and view all the answers

    What is the main target of trimethoprim among the cellular components?

    <p>Dihydrofolate reductase (DHFR) enzyme</p> Signup and view all the answers

    What is the role of pteridine and PABA in the metabolic cycle discussed?

    <p>Initiate the cycle</p> Signup and view all the answers

    How do trimethoprim and methotrexate differ in their action on the metabolic cycle?

    <p>Trimethoprim inhibits DHFR earlier than methotrexate</p> Signup and view all the answers

    What effect do sulfa drugs have on nucleic acid synthesis in bacteria?

    <p>Inhibit synthesis</p> Signup and view all the answers

    Which cellular component is targeted by pyrimethamine among the options provided?

    <p>&quot;Tetrahydrofolate&quot;</p> Signup and view all the answers

    When considering antibiotics in intermediary metabolism, where do sulfa drugs come into play?

    <p>At the beginning of the cycle</p> Signup and view all the answers

    What is the main impact of trimethoprim on dihydrofolate reductase (DHFR)?

    <p>Inhibition of DHFR enzyme</p> Signup and view all the answers

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