Sulfonamides, Trimetoprim & Quinolones
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Questions and Answers

What is the mechanism of action of sulfonamides in bacteria?

  • Substituting PABA needed for folate formation (correct)
  • Inhibiting DNA gyrase
  • Enhancing protein synthesis
  • Blocking the binding of trimethoprim

Why are side chains useful in sulfonamides?

  • To substitute for PABA in bacterial protein synthesis
  • To aid in the formation of folate required for protein synthesis (correct)
  • To enhance the solubility of sulfonamides at acidic pH
  • To prevent bacteria from recognizing sulfonamides as PABA

What cellular events are initiated by osteoclastic bone resorption and followed by osteoblastic bone formation?

  • Bacterial resistance to sulfonamides
  • Synthesis of sulfonamides
  • Production of purines
  • Formation of new bone tissue (correct)

Which organisms are susceptible to sulfonamides' inhibition of dihydropteroate synthase?

<p>Both gram-positive and gram-negative bacteria (B)</p> Signup and view all the answers

Why is Pseudomonas aeruginosa resistant to sulfonamide antibiotics?

<p>It has an intrinsic mechanism that prevents sulfonamide action (D)</p> Signup and view all the answers

What do sulfonamides inhibit to disrupt the production of folate?

<p>Dihydropteroate synthase (A)</p> Signup and view all the answers

In which pH conditions are sulfonamides more soluble?

<p>Alkaline pH (A)</p> Signup and view all the answers

What is the mechanism of action of pyrimethamine when combined with sulfadoxine?

<p>Inhibiting dihydrofolate reductase (B)</p> Signup and view all the answers

Which condition is Sulfasalazine commonly used for?

<p>Ulcerative colitis (B)</p> Signup and view all the answers

How are sulfonamides and their inactive metabolites mainly excreted?

<p>Urine (B)</p> Signup and view all the answers

What is the role of sodium sulfacetamide in topical treatment?

<p>Treating bacterial conjunctivitis (C)</p> Signup and view all the answers

In which conditions is mafenide acetate used topically?

<p>Burn sites (B)</p> Signup and view all the answers

Which sulfonamide is preferred over mafenide acetate for preventing infection of burn wounds?

<p>Silver sulfadiazine (B)</p> Signup and view all the answers

What is the drug of choice for infections like Pneumocystis jiroveci pneumonia?

<p>Sulfamethoxazole (B)</p> Signup and view all the answers

What can cause sulfonamide resistance due to overproduction of PABA?

<p>Mutations (C)</p> Signup and view all the answers

What is the first-line therapy for the treatment of Acute Toxoplasmosis?

<p>Sulfadiazine + Pyrimethamine (C)</p> Signup and view all the answers

Which drug combination blocks sequential steps in the folate synthesis pathway?

<p>Sulfadoxine + Pyrimethamine (C)</p> Signup and view all the answers

Which oral agent is used as a 2nd line treatment for Malaria?

<p>Pyrimethamine (Fansidar) (A)</p> Signup and view all the answers

Which topical agent is effective in the treatment of bacterial conjunctivitis?

<p>Sodium sulfacetamide (A)</p> Signup and view all the answers

In which condition is Sulfasalazine widely used?

<p>Ulcerative colitis (B)</p> Signup and view all the answers

What is a particularly serious and potentially fatal type of skin and mucous membrane eruption associated with sulfonamide use?

<p>Stevens-Johnson syndrome (A)</p> Signup and view all the answers

Which adverse effect of sulfonamides can lead to kidney failure and potentially be fatal?

<p>Hematuria (B)</p> Signup and view all the answers

What is the recommended treatment for crystalluria caused by sulfonamides?

<p>Administering sodium bicarbonate to alkalinize the urine (A)</p> Signup and view all the answers

Which condition can sulfonamides provoke in patients with glucose-6-phosphate dehydrogenase deficiency?

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

In which condition may sulfonamides cause hemolytic or aplastic anemia?

<p>Hematopoietic disturbances (C)</p> Signup and view all the answers

Which adverse effect of sulfonamides is treated by increasing urine flow?

<p>Crystalluria (C)</p> Signup and view all the answers

What is the agent of choice for moderately severe to severe pneumocystis pneumonia?

<p>Intravenous Trimethoprim-Sulfamethoxazole (B)</p> Signup and view all the answers

Which adverse effect is not associated with trimethoprim among the adverse effects of TMP-SMX?

<p>Nausea and vomiting (A)</p> Signup and view all the answers

What is the potential consequence of trimethoprim inhibiting creatinine secretion at the distal renal tubule?

<p>Mild elevation of serum creatinine (A)</p> Signup and view all the answers

Which condition may be effectively treated using oral pyrimethamine with a sulfonamide combination?

<p>Toxoplasmosis (B)</p> Signup and view all the answers

What are some untoward reactions associated with the combination of trimethoprim-sulfamethoxazole with sulfonamides?

<p>Leukopenia and granulocytopenia (D)</p> Signup and view all the answers

How does trimethoprim inhibit bacterial growth?

<p>By inhibiting the conversion of dihydrofolic acid to tetrahydrofolic acid (C)</p> Signup and view all the answers

What is a common mechanism of resistance to trimethoprim?

<p>Reduced drug binding due to altered reductase (C)</p> Signup and view all the answers

How is trimethoprim excreted from the body?

<p>50-60% in urine (B)</p> Signup and view all the answers

What impact does kidney disease have on trimethoprim dosage?

<p>Dosage needs to be reduced (B)</p> Signup and view all the answers

Which area of the body does trimethoprim show better antibacterial activity in due to its acidity?

<p>Cerebrospinal fluid (B)</p> Signup and view all the answers

When is oral trimethoprim commonly used alone?

<p>In urinary tract infections (D)</p> Signup and view all the answers

Which fluoroquinolone is considered the drug of choice in multi-drug resistant TB?

<p>Levofloxacin (C)</p> Signup and view all the answers

What causes emerging resistance to fluoroquinolones?

<p>Point mutations in the target enzyme (C)</p> Signup and view all the answers

What is a key feature of Levofloxacin that results in its high dose and short course administration?

<p>Superior strength against gram-positive organisms (D)</p> Signup and view all the answers

Which organisms are fluoroquinolones active against, besides gram-positive bacteria?

<p>Atypical pneumonia agents and intracellular pathogens (D)</p> Signup and view all the answers

What does resistance to one fluoroquinolone generally confer to other members of the class?

<p>Cross-resistance (C)</p> Signup and view all the answers

Why are Gatifloxacin, Gemifloxacin, and Moxifloxacin considered part of the latest group of fluoroquinolones?

<p>Improved activity against gram-positive organisms (A)</p> Signup and view all the answers

What is the mechanism of action of fluoroquinolones?

<p>Inhibition of bacterial DNA synthesis (C)</p> Signup and view all the answers

Which fluoroquinolone is known for its superior activity against gram-positive organisms?

<p>Levofloxacin (D)</p> Signup and view all the answers

What is the primary reason for using fluoroquinolones in combination with a second active agent when treating staphylococcal infections?

<p>To prevent emergence of resistance while on therapy (B)</p> Signup and view all the answers

Which fluoroquinolone is considered the least active against both gram-negative and gram-positive organisms?

<p>Norfloxacin (B)</p> Signup and view all the answers

Which group of fluoroquinolones possess excellent gram-negative activity and moderate to good activity against gram-positive bacteria?

<p>Ciprofloxacin, Levofloxacin, Ofloxacin (B)</p> Signup and view all the answers

What is the recommended timing for taking oral fluoroquinolones in relation to products containing divalent and trivalent cations?

<p>2 hours before (A)</p> Signup and view all the answers

Which fluoroquinolone does not require dosage adjustment for renal failure due to its metabolism in the liver?

<p>Moxifloxacin (D)</p> Signup and view all the answers

Which fluoroquinolone is considered effective in urinary tract infections caused by Pseudomonas aeruginosa?

<p>Levofloxacin (D)</p> Signup and view all the answers

For which type of infections are fluoroquinolones (except norfloxacin) commonly used?

<p>Respiratory tract infections (B)</p> Signup and view all the answers

Which fluoroquinolone is specifically mentioned as the drug of choice for prophylaxis and treatment of Anthrax?

<p>Ciprofloxacin (A)</p> Signup and view all the answers

In which condition are Levofloxacin and Ofloxacin recommended as alternative treatment options?

<p>Chlamydial Urethritis (A)</p> Signup and view all the answers

What is a common side effect associated with Fluoroquinolones?

<p>Dizziness (D)</p> Signup and view all the answers

Which factor is identified as a risk factor for tendinitis associated with Fluoroquinolones?

<p>Renal insufficiency (D)</p> Signup and view all the answers

What is a potential complication that can occur with Gatifloxacin, Levofloxacin, Gemifloxacin, and Moxifloxacin use?

<p>QTC interval prolongation (A)</p> Signup and view all the answers

When should Fluoroquinolones be avoided in relation to pregnancy?

<p>In the absence of specific data (D)</p> Signup and view all the answers

Which type of infection do Levofloxacin, Gemifloxacin, and Moxifloxacin effectively treat?

<p>Lower respiratory tract infections (C)</p> Signup and view all the answers

What is a condition in which Fluoroquinolones should be used with caution due to potential complications?

<p>Uncorrected hypokalemia (B)</p> Signup and view all the answers

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