Pharmacology of Antibiotics and Sulfonamides
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Questions and Answers

Which of the following drugs belongs to the category of Sulfonamides?

  • Minocycline
  • Sulfadoxine (correct)
  • Doxycycline
  • Trimethoprim

    • Which of the following adverse effects is not associated with Sulfonamides?

  • Photosensitivity
  • Hypersensitivity
  • Stevens-Johnson Syndrome
  • Diarrhea (correct)
  • Hemolytic Anemia

    • Which of the following is a Bacteriostatic antibiotic?

  • Sulfonamides (correct)
  • Trimethoprim (correct)
  • Fluoroquinolones
  • Minocycline (correct)

    • Which of the following medications is used to treat UTIs?

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

    What is the mechanism of action of Trimethoprim?

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

    Which of the following cephalosporins is commonly used for the treatment of gonorrhea?

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

    Which cephalosporin generation is known for its high resistance to B-lactamases?

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

    Which of the following cephalosporins is NOT mentioned as having a potential adverse effect of alcohol intolerance?

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

    Which of the following cephalosporins is commonly used as surgical prophylaxis?

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

    Which cephalosporin generation typically has the highest activity against Pseudomonas aeruginosa?

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

    Which of the following adverse effects is associated with Carbapenems?

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

    Which of the following is NOT a characteristic of Carbapenems?

    <p>Low CSF activity (C)</p> Signup and view all the answers

    Which 3rd generation cephalosporin is noted in the text as having the potential for calcium precipitates?

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

    Which of these medications is considered a fluoroquinolone?

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

    What adverse effect is associated with metronidazole?

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

    Which of these antivirals is used for the treatment of CMV?

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

    Which of these antiretroviral categories inhibits the integration of viral DNA into the host's genome?

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

    Which of these medications is a nucleoside reverse transcriptase inhibitor (NRTI)?

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

    Which of these medications is used to treat influenza A and B?

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

    Which medication is used to reduce transmission of herpes between monogamous partners?

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

    What antiviral medication is derived from fats?

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

    Which of the following antibiotics is commonly used to treat infections caused by Pseudomonas aeruginosa?

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

    Which of the following antibiotic categories has a broad-spectrum activity and is known to be effective against anaerobic infections?

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

    Which of the following antibiotics is given in combination with cilastatin to prevent its degradation in the kidneys?

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

    Which of the following antibiotics is known for causing QT prolongation as an adverse effect?

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

    Which of the following antibiotics is commonly used for the prophylaxis of dental procedures to prevent endocarditis?

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

    Which of the following antibiotics is known for its use in the treatment of Legionnaires’ disease?

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

    Which of the following antibiotic categories is known for its broad-spectrum activity and is also associated with potential adverse effects like dental staining and skeletal growth depression in children?

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

    Which of the following antibiotics is known to have a significant impact on gut bacteria when used for longer periods, potentially leading to Clostridium difficile infections?

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

    Which of the following medications is used for the treatment of fungal infections and is administered intravenously only?

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

    Which of the following medications would be most appropriate for a patient with a fungal infection who is experiencing a severe adverse effect of nephrotoxicity?

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

    Which of the following medications is a protease inhibitor used for the treatment of Hepatitis C?

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

    Which of the following medications is known to interact with CYP450 enzymes, so grapefruit juice should be avoided during its administration?

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

    Which of the following medications is classified as a nucleoside reverse transcriptase inhibitor (NRTI)?

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

    Which of the following drugs is commonly used to treat vaginal yeast infections?

    <p>Clotrimazole (A), Miconazole (D)</p> Signup and view all the answers

    Which of the following is a potential adverse effect of first-generation antihistamines?

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

    Which of the following is a class of drugs frequently used in the management of asthma?

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

    Which of the following medications is classified as a long-acting beta agonist (LABA)?

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

    Which of the following is a potential adverse effect associated with the use of ketoconazole?

    <p>Inhibition of testosterone (C)</p> Signup and view all the answers

    Which of the following antifungal drugs is known to penetrate the cerebrospinal fluid (CSF)?

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

    Which of the following is a common adverse effect of antihistamines that affects the eyes?

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

    Which of the following is a potential interaction with ketoconazole?

    <p>Avoidance of antacids and H2 blockers (B)</p> Signup and view all the answers

    Study Notes

    Exam 2 - Weeks 2 & 3 Pharmacology

    • Exam covers weeks 2 and 3 of the pharmacology course.

    Week 2 Agenda

    • Antimicrobial Therapy Basics
      • Cell wall synthesis inhibitors:
        • Penicillins
        • Vancomycin
        • Cephalosporins
        • Carbapenems
      • Ribosomal protein synthesis inhibitors:
        • Macrolides
        • Aminoglycosides
        • Lincosamides
        • Tetracyclines
      • Folic acid synthesis inhibitors:
        • Sulfonamides
        • Trimethoprim
      • Nucleic acid synthesis inhibitors:
        • Fluoroquinolones
        • Metronidazole (Flagyl)
    • Antivirals - DNA, RNA, and Antiretrovirals (discussed in week 3)
    • Antifungals - Polyenes, Azoles, and Topical/superficial

    Week 3 Agenda

    • Antihistamines and Bronchodilators,
    • Antihyperlipidemics,
    • Anticoagulants and Fibrinolytics,
    • Tuberculosis drugs

    Antimicrobial Therapy Basics

    • Antibiotic Mechanisms of Action:
      • Antibiotics can inhibit or kill target cells by affecting cell walls, enzyme action, protein synthesis, and nucleic acid synthesis.
    • Antibiotic Spectrum:
      • Narrow spectrum antibiotics affect fewer microbes, and broad spectrum antibiotics affect many microbes.
    • Resistance:
      • Resistance supports bacterial growth, making it difficult to treat infections.
      • Acquired, innate, and environmental resistances complicate treatment.
    • Superinfections:
      • Antibiotics can affect the "good" microbes, allowing for secondary infections to take over.
    • Bacteria of Concern: - "Urgent": - Candida aureus - Clostridium difficile (C-diff) - Carbapenem-resistant Enterobacteriaceae (CRE) - "Serious": - Vancomycin-resistant Enterococci (VRE) - Methicillin-resistant Staphylococcus aureus (MRSA)

    Beta Lactam Ring

    • Beta-lactamases: Enzymes that break down the beta-lactam ring in antibiotics.
    • Beta-lactamase inhibitors: Drugs that prevent beta-lactamases from inactivating antibiotics.

    Cell Wall Synthesis Inhibitors

    • Bactericidal
    • Detail of Penicillins, Vancomycin, Cephalosporins, Carbapenems

    Penicillins

    • Narrow-spectrum (penicillinase-sensitive): Penicillin G, Penicillin V
    • Narrow-spectrum (penicillinase-resistant): Nafcillin, Oxacillin, Dicloxacillin
    • Broad-spectrum: Ampicillin, Amoxicillin
    • Broad-spectrum antipseudomonal: Ticarcillin, Piperacillin
    • Adverse effects: Allergic reactions; oral contraceptives may be affected.

    Vancomycin

    • Narrow-spectrum
    • Used for: C-diff (oral), MRSA (IV)
    • Adverse Effects: Hypersensitivity reactions (red man syndrome), ototoxicity, nephrotoxicity, thrombophlebitis.

    Cephalosporins

    • 5 generations with increasing CSF activity. -First generation (susceptible to B-lactamases), -Second generation, -Third generation (resistant to B-lactamases), -Fourth generation, -Fifth generation
    • Adverse effects: Allergic reactions, bleeding, calcium deposits (lung/kidney), and alcohol intolerance.

    Carbapenems

    • Broad-spectrum with large CSF activity.
    • Used for: Pseudomonas aeruginosa (severe hospital infections).
    • Adverse effects: Hypersensitivity, GI issues, suprainfections, and seizures.

    Ribosomal Protein Synthesis Inhibitors

    • Bacteriostatic
    • Include Macrolides, Aminoglycosides, Lincosamides, and Tetracyclines

    Macrolides

    • Broad-spectrum with no CSF activity
    • Used for: Legionnaire's disease, whooping cough, diphtheria, and prophylactic dental or heart conditions.
    • Adverse effects: QT prolongation, jaundice, auditory impairment

    Aminoglycosides

    • Broad-spectrum
    • Used for: Pseudomonas aeruginosa
    • Adverse effects: Ototoxicity, nephrotoxicity

    Lincosamides

    • Broad-spectrum with anaerobic penetration
    • Used for: Bone, lung, oral, pelvic infections
    • Adverse effects: Affects gut bacteria for 2+ weeks (C-diff), glossitis, stomatitis, esophagitis

    Tetracyclines

    • Broad-spectrum
    • Used for: Malaria prophylaxis, Rocky Mountain Spotted Fever, Lyme disease, and acne.
    • Adverse effects: Dental staining, skeletal growth depression in children, photosensitivity, and organ toxicity

    Folic Acid Synthesis Inhibitors

    • Bacteriostatic
    • Include Sulfonamides and Trimethoprim
    • Adverse effects: Crystalluria, Stevens-Johnson syndrome, hemolytic anemia, and photosensitivity.

    Sulfonamides

    • Broad-spectrum
    • Used for: Ear infections, eye infections, UTIs, Traveler's diarrhea, burns
    • Adverse effects: Crystalluria, Stevens-Johnson syndrome, hemolytic anemia, photosensitivity

    Trimethoprim

    • Broad-spectrum
    • Used for: UTIs, ear infections, bronchitis, HIV/AIDS
    • Adverse effects: Megaloblastic anemia, leukopenia, granlocytopenia

    Nucleic Acid Synthesis Inhibitors

    • Bactericidal
    • Include Fluoroquinolones and Metronidazole.

    Fluoroquinolones

    • Broad-spectrum
    • Used for: Typhoid, TB, GU infections, UTIs
    • Adverse effects: Tendonitis, long QT, photophobia, taste disorders.

    Metronidazole

    • Broad-spectrum.
    • Used for: Parasitic diseases, Trichomoniasis, C-diff
    • Adverse effects: Reddish-brown urine, metallic taste, Disulfirim reaction, and oral candidiasis

    Antivirals

    • DNA Antivirals

    • RNA Antivirals

    • Antiretrovirals

    • Detail each category.

    Antifungals

    • Polyenes

    • Azoles

    • Topical/superficial

    • Detail each category.

    Fungal Infections

    • Systemic vs superficial
    • Opportunistic vs non-opportunistic
    • Opportunistic infections occur in immunocompromised individuals; Healthy individuals can get non-opportunistic infections.

    Polyenes

    • Used for: Fungal infections
    • Adverse effects: Transfusion reaction, nephrotoxic, hypokalemia, and bone marrow repression.
    • Example: Amphotericin B

    Azoles

    • Inhibit creation of ergosterol
    • Adverse effects:
    • Example: Itraconazole, Fluconazole, Ketoconazole

    Topical/Superficial Antifungals

    • Used for: Ringworm, yeast infections, thrush
    • Examples: Tolnaftate, Nystatin, Clotrimazole, Miconazole

    Antihistamines and Bronchodilators

    • Antihistamines: First generation, second generation

    • Bronchodilators: Short-acting beta agonists (SABAs), long-acting beta agonists (LABAs), inhaled steroids, monoclonal antibodies, LTRAS, and other miscellaneous topics

    Histamine Release

    • The body's response to histamine release, detailed.

    Antihyperlipidemics

    • HMG-CoA reductase inhibitors (statins),
    • *Fibrates, Bile acid binding resins,
    • Niacin,
    • Cholesterol absorption inhibitors,
    • PCSK9 inhibitors,
    • Detailed information for every topic.

    Statins

    • First line to treat elevated LDL
    • Adverse effects: Myopathy, rhabdomyolysis, hyperglycemia, joint pain.
    • Indications: Elevated LDL, to stabilize plaque to prevent MI
    • Contraindications: Fibrates, Macrolides

    Fibrates

    • Upregulate LPL (lipoprotein lipase)
    • Adverse effects: NVD
    • Indications: Hyperlipidemia
    • Contraindications: Statins, Gallstones, Pregnancy

    Bile Acid Binding Resins

    • Binds to bile acids in intestines, forming complex

    • Adverse effects: NVD, Decrease absorption of fatsoluble vitamins

    • Indications: Hyperlipidemia

    • Contraindications: Other drugs (don't take 1-2 hours prior)

    Niacin (Nicotinic Acid/Vitamin B3)

    • Inhibits lipase, and reduces VLDL and LDL
    • Adverse effects: Flushing, Pruritus, NV, Hyperuricemia
    • Indications: Hyperlipidemia

    Cholesterol Absorption Inhibitors

    • Blocks cholesterol absorption.
    • Adverse effects: Myopathy.
    • Indications: Hyperlipidemia (lowers by 20% alone).
    • Contraindications: Liver dysfunction, Pregnancy

    PCSK9 Inhibitors

    • PCSK9 inactivates LDL receptors.
    • Inactivating PCSK9 allows more LDL receptors to remove LDL.
    • Adverse effects: Nasopharyngitis, pruritus, allergic reactions
    • Indications: Hyperlipidemia (lowers by up to 60%)

    Anticoagulants and Fibrinolytics

    • Indirect thrombin inhibitors (e.g., heparin),,
    • Vitamin K antagonists (e.g., warfarin),,
    • Direct factor Xa inhibitors,
    • Direct thrombin inhibitors,
    • Antiplatelet drugs (e.g., aspirin),,
    • Fibrinolytics (e.g., tissue plasminogen activator (tPA))

    Heparin

    • Mechanism of Action: Inactivates factor Xa and inhibits thrombin.
    • Monitoring: Monitor PTT (2-3x normal)
    • Adverse Effects: Heparin-induced thrombocytopenia (HIT), osteoporosis
    • Reversal Agent: Protamine sulfate

    LMWH (Low Molecular Weight Heparin)

    • Examples: Enoxaparin, Dalteparin, Tinzaparin

    Vitamin K Antagonists (Warfarin)

    • Mechanism of Action: Vitamin K antagonist
    • Monitoring: Monitor INR (2-4.5)
    • Slow acting (3 days).
    • Adverse effects: Increased bleeding, possible drug interactions (avoid grapefruit juice).
    • Pregnancy Class X.
    • Reversal Agent: Prothrombin-complex concentrates (immediate), Vitamin K (6-12 hours).

    Direct Factor Xa Inhibitors

    • Examples: Rivaroxaban, Apixaban, Edoxaban
    • Monitoring: Not needed. Do not use with artificial heart valves

    Direct Thrombin Inhibitors

    • Examples: Bivalirudin, Argatroban, Dabigatran
    • Do not use with artificial heart valves

    Antiplatelet Drugs

    • Mechanism of Action: Thromboxane A2 inhibitors (e.g., aspirin), ADP receptor inhibitors (e.g., clopidogrel), Glycoprotein IIb/IIIa inhibitors. Note-super aspirins used in stent replacements.
    • Examples: Aspirin, Ticlopidine, Clopidogrel, Prasugrel, Abciximab, Tirofiban

    Fibrinolytics/Thrombolytics

    • Mechanism of Action : Directly convert plasminogen to plasmin, degrading fibrin clots.
    • Examples: Urokinase, Streptokinase, Tenecteplase, Alteplase (tPA), Reteplase
    • Reversal Agent: Aminocaproic acid

    Anti-Tuberculosis Drugs

    • MDR-TB : Resistance to at least rifampin and isoniazid.

    • XDR-TB: Resistance to at least rifampin, isoniazid, and fluoroquinolones and an injectable second-line drug (aminoglycosides)

    • Detailed information for each.

      • Use of DOT (directly observed therapy).
      • Intermittent dosing.

    Latent TB

    -Two treatment options
  - Isoniazid every day for 9 months (270 doses)
  -Isoniazid + rifampin every week for 3 months (12 doses)

    Additional Drug information for Anti-tuberculosis medications

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    Description

    This quiz covers various aspects of antibiotics, focusing on sulfonamides and cephalosporins. Test your knowledge on mechanisms of action, adverse effects, and the clinical use of different antibiotic classes. Perfect for students in pharmacology courses.

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