Penicillin Allergy Review
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Questions and Answers

Which statement accurately distinguishes between antibiotics and antimicrobial drugs?

  • Antibiotics are produced by microbes and harm other microbes, while antimicrobial drugs can be synthetic and suppress microorganisms. (correct)
  • Antibiotics are chemicals produced by humans, while antimicrobial drugs can be produced by any microbe.
  • Antibiotics are active against many species of microorganisms, while antimicrobial drugs are only active against a few species.
  • Antibiotics only refer to synthetic agents, while antimicrobial drugs include natural and synthetic agents.

    • Which best describes narrow-spectrum antibiotics?

  • They are less preferred due to their limited activity. (correct)
  • They are only produced synthetically in laboratories.
  • They are active against a wide variety of microbes.
  • They have the ability to harm a large number of microorganisms.

    • What is one of the main challenges mentioned in the text regarding antimicrobials?

  • Limited availability of broad-spectrum antibiotics.
  • The lack of effective synthetic antimicrobial agents.
  • Organisms that do not respond to any available drugs. (correct)
  • Toxicity issues only associated with newer drugs.

    • How have modern antimicrobial agents impacted morbidity and mortality?

    <p>Reduced both morbidity and mortality from infections.</p> Signup and view all the answers

    What sets broad-spectrum antibiotics apart from narrow-spectrum antibiotics?

    <p>Broad-spectrum antibiotics can target a wide variety of microbes.</p> Signup and view all the answers

    Why is continued progress needed in antimicrobial therapy according to the text?

    <p>As a response to evolving microbial resistance and limitations posed by certain drugs.</p> Signup and view all the answers

    What is the first rule of antimicrobial therapy?

    <p>Match the drug with the infecting organism</p> Signup and view all the answers

    Which technique is described as the quickest, simplest, and most versatile for identifying microorganisms?

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

    When should positive identification of an infecting organism be established?

    <p>As soon as possible</p> Signup and view all the answers

    What is the primary consideration when prescribing an antimicrobial drug according to the text?

    <p>Considering host defenses and infection site</p> Signup and view all the answers

    What is the most common indication for using multiple antibiotics?

    <p>Initial therapy of severe infection with unknown etiology</p> Signup and view all the answers

    In antimicrobial therapy, what does an additive response mean?

    <p>The effect of combination is equal to sum of individual effects</p> Signup and view all the answers

    Why might treatment with more than one antibiotic be required for an infection?

    <p>When infectious microbes differ in drug susceptibility</p> Signup and view all the answers

    What is a potentiative interaction in antimicrobial therapy?

    <p>When effect of combination is greater than sum of individual effects</p> Signup and view all the answers

    Why should dosages be adjusted in antimicrobial therapy?

    <p>To produce drug concentrations greater than MIC for the infection</p> Signup and view all the answers

    What new method can detect very low titers of bacteria and viruses according to the text?

    <p>PCR test or nucleic acid amplification test</p> Signup and view all the answers

    What is the primary cause of the gradual increase in resistance in microbes?

    <p>Spontaneous mutations in the microbe's DNA</p> Signup and view all the answers

    In the process of conjugation, what constitutes an R factor?

    <p>Two unique DNA segments: one for drug resistance mechanisms and one for DNA transfer</p> Signup and view all the answers

    How do antibiotics create selection pressure favoring the growth of drug-resistant organisms?

    <p>By eliminating sensitive organisms</p> Signup and view all the answers

    Which type of antibiotics are most effective in facilitating the emergence of drug-resistant organisms?

    <p>Broad-spectrum antibiotics</p> Signup and view all the answers

    What is a superinfection as described in the text?

    <p>An infection that occurs during treatment for a primary infection due to overuse of antibiotics</p> Signup and view all the answers

    Why are superinfections more likely to occur in patients receiving broad-spectrum antibiotics?

    <p>Because broad-spectrum antibiotics kill more normal flora than narrow-spectrum drugs</p> Signup and view all the answers

    What is the significance of hospitals as sites of intensive antibiotic use?

    <p>Hospitals promote the emergence of extremely drug-resistant organisms</p> Signup and view all the answers

    Which mechanism of drug resistance involves decreasing the concentration of a drug at its site of action?

    <p>Decreasing active uptake of drugs</p> Signup and view all the answers

    What is the primary concern associated with acquired resistance to antibiotics?

    <p>Clinical crisis due to ineffective drugs</p> Signup and view all the answers

    Which gene codes for a powerful form of β-lactamase that can inactivate various β-lactam antibiotics?

    <p>NDM-1 gene</p> Signup and view all the answers

    Which drug class disrupts specific biochemical reactions leading to a decrease in the synthesis of essential cell constituents?

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

    What is the main impact of drugs that cause nonlethal inhibition of bacterial protein synthesis?

    <p>Slowing microbial growth</p> Signup and view all the answers

    Which drug is known for increasing the permeability of bacterial cell membranes, causing leakage of intracellular material?

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

    Which enzyme does most drugs that suppress viral replication inhibit?

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

    What is one of the ways microbes resist certain drugs like tetracyclines and gentamicin?

    <p>Decreasing active uptake of drugs</p> Signup and view all the answers

    What is the characteristic outcome of drugs that inhibit bacterial cell wall synthesis?

    <p>Promotion of bacterial lysis and death</p> Signup and view all the answers

    Which drug directly binds to nucleic acids or interacts with enzymes required for nucleic acid synthesis?

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

    What is one of the drawbacks of using multiple antibiotics according to the text?

    <p>Possible antagonism of antimicrobial effects</p> Signup and view all the answers

    Which of the following is NOT mentioned as an approved indication for antimicrobial prophylaxis?

    <p>Treatment of viral infections</p> Signup and view all the answers

    Why are serum drug levels monitored during antimicrobial therapy?

    <p>To avoid toxicity from excessive levels</p> Signup and view all the answers

    Which antibiotics belong to the beta-lactam family according to the text?

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

    What is the principal adverse effect of penicillins according to the text?

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

    Why do bacteria take up excessive amounts of water and rupture when exposed to penicillins?

    <p>Because penicillins cause them to burst</p> Signup and view all the answers

    What is an important clinical indicator of success in antimicrobial therapy according to the text?

    <p>Reduction of fever and resolution of signs and symptoms related to the affected organ system</p> Signup and view all the answers

    Why must antimicrobial prophylaxis be carefully considered before administration?

    <p>To weigh the benefits against risks like toxicity and allergic reactions</p> Signup and view all the answers

    Why are penicillins considered practically ideal antibiotics according to the text?

    <p>They are active against a variety of bacteria and have low direct toxicity</p> Signup and view all the answers

    What common misuse of antibiotics is highlighted by the CDC?

    <p>Treatment for viral infections</p> Signup and view all the answers

    Which penicillin has the broadest antimicrobial spectrum among the ones mentioned in the text?

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

    What is the main reason for the broadened spectrum of penicillins against gram-negative bacilli?

    <p>Enhanced ability to penetrate the gram-negative cell envelope</p> Signup and view all the answers

    Which organism is NOT susceptible to piperacillin according to the text?

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

    What is the primary difference between amoxicillin and ampicillin in terms of acid stability?

    <p>Amoxicillin is more acid stable</p> Signup and view all the answers

    Which drug can cause bleeding secondary to disrupting platelet function?

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

    In the United States, which beta-lactamase inhibitor is NOT used as a fixed-dose combination with a penicillin?

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

    What are the three primary factors determining bacterial resistance to penicillins?

    <p>Inability of penicillins to reach PBPs, inactivation by bacterial enzymes, and production of PBPs with low affinity for penicillins</p> Signup and view all the answers

    What role does the β-lactam ring play in the antibacterial action of penicillins?

    <p>Being essential for antibacterial action</p> Signup and view all the answers

    What pathogen has developed two distinct types of MRSA over the years?

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

    Which type of MRSA is more prevalent between health care-associated MRSA and community-associated MRSA?

    <p>Health care-associated MRSA</p> Signup and view all the answers

    Which type of penicillins are classified as antipseudomonal penicillins?

    <p>Extended-spectrum penicillins</p> Signup and view all the answers

    Which bacterium is not susceptible to the antibacterial action of Penicillin G?

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

    What is the principal concern associated with the use of Penicillin G?

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

    What is the term used to describe the complete antigen that stimulates antibody formation?

    <p>Hapten-protein</p> Signup and view all the answers

    Why is skin testing important for patients with a history of penicillin allergy?

    <p>To determine the likelihood of anaphylaxis</p> Signup and view all the answers

    Which characteristic differentiates penicillin V from penicillin G?

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

    Why are cephalosporins avoided in patients with a history of anaphylaxis to penicillin?

    <p>Due to the risk of cross sensitivity</p> Signup and view all the answers

    What is the primary benefit of desensitization schedules when administering penicillin?

    <p>Reduced risk of allergic reactions</p> Signup and view all the answers

    What should be readily available during penicillin desensitization procedures to manage potential risks?

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

    Which drugs are specifically mentioned as effective and safe alternatives for patients with penicillin allergy?

    <p>Vancomycin, erythromycin, and clindamycin</p> Signup and view all the answers

    What is the primary reason for avoiding penicillinase-resistant penicillins in infections caused by non–penicillinase-producing staphylococci?

    <p>Lower efficacy compared to penicillin G</p> Signup and view all the answers

    Why are ampicillin and amoxicillin classified as broad-spectrum penicillins?

    <p>They cover a wide range of bacterial species</p> Signup and view all the answers

    What is the significance of altering the side chain of penicillins by pharmaceutical chemists?

    <p>Resistance to beta-lactamases</p> Signup and view all the answers

    Which of the following drugs should be used with caution in patients taking other drugs that prolong the QT interval?

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

    What is the mechanism of action of fosfomycin against bacteria?

    <p>Disruption of peptidoglycan synthesis</p> Signup and view all the answers

    Which of the following bacteria is NOT susceptible to aztreonam?

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

    What is the primary reason for the minimal cross-allergenicity of aztreonam with penicillins and cephalosporins?

    <p>Little structural resemblance</p> Signup and view all the answers

    Which of the following adverse effects is NOT commonly associated with aztreonam?

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

    How does aztreonam primarily exert its antimicrobial effect?

    <p>Inhibition of cell wall synthesis</p> Signup and view all the answers

    Why are most first-generation cephalosporins destroyed by β-lactamases?

    <p>They lack an extended side chain.</p> Signup and view all the answers

    What distinguishes cefiderocol from other cephalosporins mentioned in the text?

    <p>It lacks a β-lactam ring.</p> Signup and view all the answers

    Why are third-generation cephalosporins considered the most prescribed from the generations mentioned?

    <p>They have the broadest antimicrobial spectrum.</p> Signup and view all the answers

    Which drug mentioned in the text is specifically tailored for MDR gram-negative infections?

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

    What contributes to the highly resistant nature of fifth-generation cephalosporins?

    <p>Extended-spectrum beta-lactamases production</p> Signup and view all the answers

    What distinguishes second-generation cephalosporins from first-generation ones regarding resistance to β-lactamases?

    <p>They possess an extended side chain.</p> Signup and view all the answers

    What is the most common adverse reaction seen with cephalosporins according to the text?

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

    Which cephalosporin is specifically mentioned as being used for surgical prophylaxis?

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

    Which organisms are primarily targeted by second-generation cephalosporins?

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

    Which characteristic sets third-generation cephalosporins apart from the first and second generations?

    <p>Gram-negative coverage</p> Signup and view all the answers

    In which type of infection are fourth-generation cephalosporins like cefepime particularly effective?

    <p>Hospital-acquired pneumonia</p> Signup and view all the answers

    Which carbapenem antibiotic is specifically mentioned as not being active against MRSA?

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

    What makes imipenem unique in terms of its antimicrobial spectrum compared to other antibiotics?

    <p>Broad activity against Gram-negative bacilli</p> Signup and view all the answers

    What is the mechanism of action of vancomycin against bacterial cells?

    <p>Inhibits cell wall synthesis</p> Signup and view all the answers

    Why is vancomycin not effective against gram-negative bacteria?

    <p>Lacks penetration through gram-negative cell walls</p> Signup and view all the answers

    What is the primary adverse effect of telavancin therapy?

    <p>Taste disturbance and foamy urine</p> Signup and view all the answers

    When should vancomycin dosage be reduced to minimize the risk of renal toxicity?

    <p>When serum creatinine level increases by 50%</p> Signup and view all the answers

    Which organism is NOT listed as susceptible to vancomycin in the text?

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

    What is the primary difference in the approved indications between vancomycin and telavancin?

    <p>Telavancin for skin infections, Vancomycin for respiratory infections</p> Signup and view all the answers

    What differentiates telavancin from vancomycin in terms of mechanism of action?

    <p>&quot;Telavancin binds to bacterial cell membrane&quot;</p> Signup and view all the answers

    "Red man syndrome" associated with vancomycin is primarily characterized by:

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

    "Red man syndrome" associated with vancomycin can be caused by:

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

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