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

    What do sulfonamides inhibit to disrupt the production of folate?

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

    In which pH conditions are sulfonamides more soluble?

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

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

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

    Which condition is Sulfasalazine commonly used for?

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

    How are sulfonamides and their inactive metabolites mainly excreted?

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

    What is the role of sodium sulfacetamide in topical treatment?

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

    In which conditions is mafenide acetate used topically?

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

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

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

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

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

    What can cause sulfonamide resistance due to overproduction of PABA?

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

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

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

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

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

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

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

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

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

    In which condition is Sulfasalazine widely used?

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

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

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

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

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

    In which condition may sulfonamides cause hemolytic or aplastic anemia?

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

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

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

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

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

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

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

    How does trimethoprim inhibit bacterial growth?

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

    What is a common mechanism of resistance to trimethoprim?

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

    How is trimethoprim excreted from the body?

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

    What impact does kidney disease have on trimethoprim dosage?

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

    When is oral trimethoprim commonly used alone?

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

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

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

    What causes emerging resistance to fluoroquinolones?

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

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

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

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

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

    What is the mechanism of action of fluoroquinolones?

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

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

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

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

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

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

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

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

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

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

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

    What is a common side effect associated with Fluoroquinolones?

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

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

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

    When should Fluoroquinolones be avoided in relation to pregnancy?

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

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

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

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