Podcast
Questions and Answers
What is the term for the maximum drug concentration during repeated dosing cycles?
What is the term for the maximum drug concentration during repeated dosing cycles?
Which sulfa antibiotic is classified as an oral absorbable drug?
Which sulfa antibiotic is classified as an oral absorbable drug?
What adverse reaction can occur with the use of sulfamethoxazole and trimethoprim?
What adverse reaction can occur with the use of sulfamethoxazole and trimethoprim?
Which bacterial species is NOT covered by sulfamethoxazole and trimethoprim?
Which bacterial species is NOT covered by sulfamethoxazole and trimethoprim?
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What is the mechanism of action of trimethoprim?
What is the mechanism of action of trimethoprim?
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Which Sulfa antibiotic is a topical agent?
Which Sulfa antibiotic is a topical agent?
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Which adverse drug reaction can be avoided by proper dosage adjustments?
Which adverse drug reaction can be avoided by proper dosage adjustments?
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What is the spectrum of activity of sulfamethoxazole and trimethoprim?
What is the spectrum of activity of sulfamethoxazole and trimethoprim?
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What severe skin reaction can occur due to sulfa antibiotics?
What severe skin reaction can occur due to sulfa antibiotics?
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Which bacterium does sulfamethoxazole and trimethoprim NOT cover?
Which bacterium does sulfamethoxazole and trimethoprim NOT cover?
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What is the mechanism of action of Linezolid (Zyvox®)?
What is the mechanism of action of Linezolid (Zyvox®)?
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Which clinical condition is NOT an indication for Vancomycin?
Which clinical condition is NOT an indication for Vancomycin?
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What is the target trough level of Vancomycin for UTI and skin/soft tissue infections?
What is the target trough level of Vancomycin for UTI and skin/soft tissue infections?
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What is the major adverse effect associated with Daptomycin (Cubicin®) therapy?
What is the major adverse effect associated with Daptomycin (Cubicin®) therapy?
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Which of the following statements regarding UTI evaluation is correct?
Which of the following statements regarding UTI evaluation is correct?
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What is the primary metabolic pathway for Linezolid (Zyvox®)?
What is the primary metabolic pathway for Linezolid (Zyvox®)?
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Which organism is Linezolid (Zyvox®) bacteriostatic against?
Which organism is Linezolid (Zyvox®) bacteriostatic against?
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In which condition is Daptomycin (Cubicin®) spectrum of activity limited to only Gram-positive organisms?
In which condition is Daptomycin (Cubicin®) spectrum of activity limited to only Gram-positive organisms?
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Which of the following is NOT a risk factor for hemolytic anemia in neonates?
Which of the following is NOT a risk factor for hemolytic anemia in neonates?
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Which condition does NOT warrant the use of IV antibiotics initially according to the text?
Which condition does NOT warrant the use of IV antibiotics initially according to the text?
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Which bacterial species is NOT mentioned in the text as covered by the antibiotics discussed?
Which bacterial species is NOT mentioned in the text as covered by the antibiotics discussed?
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Which antibiotic mentioned is preferred for its activity against multidrug-resistant Gram-negative organisms?
Which antibiotic mentioned is preferred for its activity against multidrug-resistant Gram-negative organisms?
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What is NOT an adverse effect associated with the use of Mafenide cream or solution?
What is NOT an adverse effect associated with the use of Mafenide cream or solution?
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Which antibiotic mentioned in the text has the unique property of inhibiting carbonic anhydrase?
Which antibiotic mentioned in the text has the unique property of inhibiting carbonic anhydrase?
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What type of infections is Silver Sulfadiazine 1% Cream commonly used for?
What type of infections is Silver Sulfadiazine 1% Cream commonly used for?
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Which of the mentioned antibiotics is NOT part of the glycopeptide antibiotics class?
Which of the mentioned antibiotics is NOT part of the glycopeptide antibiotics class?
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What distinguishes the pharmacokinetics of aminoglycosides in patients with cystic fibrosis compared to the general population?
What distinguishes the pharmacokinetics of aminoglycosides in patients with cystic fibrosis compared to the general population?
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What is a common clinical indication for the use of glycopeptide antibiotics like Vancomycin?
What is a common clinical indication for the use of glycopeptide antibiotics like Vancomycin?
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Which of the following bacteria is notably NOT covered by the antibiotics discussed?
Which of the following bacteria is notably NOT covered by the antibiotics discussed?
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What special property defines the dosing regimen of aminoglycosides to optimize their action?
What special property defines the dosing regimen of aminoglycosides to optimize their action?
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Study Notes
Pharmacokinetics Principles
- Peak: maximum drug concentration during repeated dosing cycles
- Trough: minimum drug concentration during repeated dosing cycles
- Steady state: rate of drug elimination = rate of administration, usually after 4-5 half-lives
Sulfonamides
- Classification: oral absorbable (sulfisoxazole, sulfamethoxazole, sulfadoxine), oral non-absorbable (sulfasalazine), topical agents (sulfacetamide, mafenide, silver sulfadalazine)
- Mechanism of Action: bacteriostatic inhibitors of folic acid synthesis
- Combined with Trimethoprim: bactericidal, prevents formation of active form of folic acid
- Adverse Effects: hypersensitivity reactions, Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis, exfoliative dermatitis, photosensitivity, nausea, vomiting, diarrhea, hepatotoxicity, bone marrow suppression
Sulfamethoxazole (SMZ) & Trimethoprim (TMP)
- Brand name: Bactrim
- IV solution: SMZ 80mg-TMP 16mg/mL
- DS tablet: SMZ 800mg-TMP 160mg
- SS tablet: SMZ 400mg-TMP 80mg
- Bioavailability: 70-90%, hepatically metabolized, renally eliminated
- Spectrum of activity: wide range of both Gram + and Gram - coverage, except Pseudomonas aeruginosa, Bacteroides fragilis, and Enterococci
- Indications: Nocardia sp., Stenotrophomonas maltophilia, MRSA, UTI, bacteremia, osteomyelitis, pneumonia, CNS infections, endocarditis, skin/soft tissue infections
- Adverse Effects: infusion reaction, ototoxicity, nephrotoxicity, acute tubular necrosis
Linezolid (Zyvox)
- Mechanism of Action: binds to bacterial 50S subunit of ribosomal RNA, prevents formation of functional 70S initial complex, disrupts bacterial translation process
- Bacteriostatic against Enterococci, bactericidal against Streptococci
- Spectrum of activity: covers Gram + organisms only, MRSA, VRE, Streptococcus sp., Staphylococcus sp.
- Clinical Uses: skin/soft tissue infections, pneumonia, bacteremia, intra-abdominal infections, endocarditis, CNS infections
- Adverse Effects: myelosuppression, optic and peripheral neuropathy, interactions with serotonergic medications
Daptomycin (Cubicin)
- Mechanism of Action: binds to components of cell membrane, causes rapid depolarization, inhibits intracellular synthesis of DNA, RNA, and protein
- Bactericidal, concentration-dependent
- Spectrum of activity: covers Gram + organisms only, MRSA, VRE, Streptococcus sp., Staphylococcus sp.
- Clinical Uses: skin/soft tissue infections, bacteremia, intra-abdominal infections, endocarditis
- Adverse Effects: risk of hemolytic anemia in G6PD deficiency, nausea, peripheral neuropathy, pulmonary fibrosis, liver injury, DRESS
Aminoglycosides
- Mechanism of Action: bind to 30S subunit, interfere with protein synthesis, block formation of initiation complex, misreading of mRNA
- Bactericidal, concentration-dependent killing, prolonged postantibiotic effect
- Clinical Indications: UTI, pyelonephritis, double coverage for Pseudomonas in septic shock, synergy for Gram + endocarditis, type III open fracture infection prophylaxis, cystic fibrosis
- Adverse Effects: nephrotoxicity, ototoxicity, contraindicated in patients with myasthenia gravis
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Description
Test your knowledge on pharmacokinetics principles including peak, trough, and steady state, along with understanding the uses, mechanism of action, and potential side effects of sulfa antibiotics. This quiz covers different classifications of sulfonamides such as oral absorbable drugs like Sulfisoxazole and Sulfamethoxazole, oral non-absorbable drug like Sulfasalazine, and topical agents like Sulfacetamide.
