Pharmacology Quiz: Cephalosporins & Addison’s Disease
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Questions and Answers

Which of the following conditions can be treated with 2nd generation cephalosporins?

  • Hyperlipidemia
  • Chronic kidney disease
  • Dermatitis
  • Lower respiratory tract infections (correct)

Cefaclor is more potent against gram-negative bacteria than cefuroxime.

False (B)

What is the brand name for cysteine hydrochloride?

Zinacef

Cefuroxime is effective against _________ (specific bacteria) such as Staphylococcus and Streptococcus.

<p>gram-positive cocci</p> Signup and view all the answers

Match the drug with its route of administration:

<p>Cefuroxime = Oral, IV, IM Cefaclor = Oral Ceftin = Oral, IV, IM Ceclor = Oral</p> Signup and view all the answers

What is a primary cause of Addison’s disease?

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

Addison’s disease primarily affects individuals over the age of 50.

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

What hormone does the pituitary gland fail to produce in secondary adrenal insufficiency?

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

People with Addison’s disease may experience extreme _____ and weight loss.

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

Match the symptoms with their descriptions:

<p>Extreme fatigue = A feeling of incessant tiredness Low blood pressure = A state of insufficient blood flow Salt craving = A desire for salty foods Hypoglycemia = Abnormally low blood sugar levels</p> Signup and view all the answers

Which of the following is NOT a risk factor for Addison’s disease?

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

Corticosteroid medications have side effects such as weight gain and hypertension.

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

Name one type of adrenal insufficiency besides primary adrenal insufficiency.

<p>Secondary Adrenal Insufficiency or Tertiary Adrenal Insufficiency</p> Signup and view all the answers

Which antibiotic is effective against both Gram-negative and Gram-positive bacteria, particularly Pseudomonas aeruginosa?

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

Cefixime is primarily used for treating Gram-positive infections.

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

What type of infections is Cefdinir primarily used for?

<p>Bronchitis, sinusitis, pneumonia</p> Signup and view all the answers

Ceftibuten is effective for treating acute bacterial exacerbations of __________.

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

Match the following antibiotics with their primary bacterial targets:

<p>Cefdinir = M.catarrhalis, S.pneumoniae Cefixime = E.coli, H.influenzae Cefpodoxime = S.pneumoniae, S.pyogenes Ceftibuten = Klebsiella, Proteus</p> Signup and view all the answers

Which of the following antibiotics can treat uncomplicated gonorrhea?

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

Cefoperazone is administered orally.

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

Which of the following adverse reactions is potentially fatal?

<p>C. difficile-associated diarrhea (C)</p> Signup and view all the answers

Name one Gram-negative bacterium that Cefpodoxime targets.

<p>E.coli</p> Signup and view all the answers

Vancomycin is available in both oral and intravenous formulations.

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

What is the mechanism of action of glycopeptide antibiotics?

<p>Inhibiting peptidoglycan synthesis.</p> Signup and view all the answers

Vancomycin may cause _____ at the injection site due to its irritating properties.

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

Match the following glycopeptide antibiotics with their formulations or indications:

<p>Vancomycin = Infections due to Gram-positive bacteria Telavancin = Complicated skin and soft tissue infections Oral Vancomycin = C. difficile colitis Vials of Vancomycin = 500 mg, 1 g, 5 g, 10 g</p> Signup and view all the answers

Which pregnancy category does Vancomycin fall under?

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

Telavancin should be avoided in pregnant women due to teratogenic effects.

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

What are common reactions associated with the use of glycopeptide antibiotics?

<p>Chills, fever, and ototoxicity.</p> Signup and view all the answers

Which of the following is NOT a feature of 5th generation cephalosporins?

<p>Limited to Gram-positive bacteria (C)</p> Signup and view all the answers

Monobactams have activity against both anaerobic and Gram-positive bacteria.

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

What is the brand name for Ceftaroline?

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

Ceftobiprole is effective against ___________ positive bacteria including MRSA.

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

Which of the following is a primary indication for Aztreonam?

<p>Infections resistant to beta lactamases (C)</p> Signup and view all the answers

Match the following drugs with their brand names:

<p>Ceftaroline = Teflaro Ceftobiprole = Zeftera Aztreonam = Cayston</p> Signup and view all the answers

Ceftaroline can be used to treat complicated skin and soft tissue infections.

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

What type of bacteria are Monobactams specifically effective against?

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

What is the mechanism of action of Daptomycin?

<p>Binds to cell membrane causing depolarization (B)</p> Signup and view all the answers

Daptomycin is contraindicated for use in pediatric patients younger than one year of age.

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

What are the indications for using Daptomycin?

<p>Infections caused by Gram-positive bacteria, including sepsis and endocarditis, MRSA and vancomycin resistant skin and soft tissue infections.</p> Signup and view all the answers

Daptomycin is an example of a ____.

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

Which of the following is a common adverse effect of Daptomycin?

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

Match the following antibiotics with their indicated use:

<p>Daptomycin = Gram-positive infections Tetracyclines = Bacterial protein synthesis inhibition</p> Signup and view all the answers

Tetracyclines should be avoided during pregnancy.

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

Dairy products like _____ should be avoided when taking Tetracyclines.

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

Flashcards

Addison's Disease

A rare chronic condition where the adrenal glands don't produce enough cortisol and aldosterone, crucial hormones for regulating the body's stress response and electrolyte balance.

Causes of Addison's Disease

Autoimmune response, tuberculosis, HIV/AIDS, cancer cells, hemorrhage in the adrenal glands, and amyloidosis are all potential causes of Addison's disease.

Risk Factors for Addison's Disease

Type 1 Diabetes, hypoparathyroidism, hypopituitarism, Graves' disease, vitiligo, chronic thyroiditis, dermatitis herpetiformis, and testicular failure are all risk factors associated with Addison's disease.

Secondary Adrenal Insufficiency

Happens when the pituitary gland, located in the brain, doesn't produce enough ACTH, a hormone that stimulates the adrenal glands to produce cortisol.

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Primary Adrenal Insufficiency

Occurs when the adrenal glands are damaged, leading to insufficient production of cortisol and aldosterone.

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Tertiary Adrenal Insufficiency

Arises when the hypothalamus, another brain region, doesn't produce enough corticotropin-releasing hormone, which triggers the pituitary to release ACTH.

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Signs & Symptoms of Addison's Disease

Extreme fatigue, weight loss, darkened skin patches, low blood pressure, salt craving, hypoglycemia, and digestive issues are common symptoms of Addison's disease.

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Pharmacological Treatment for Addison's Disease

Synthetic forms of cortisol, like hydrocortisone (Cortef) and prednisone (Rayos), are used to replace the missing hormone and manage Addison's disease.

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Cefuroxime (Ceftin, Zinacef)

Cefuroxime is a second-generation cephalosporin antibiotic with broad-spectrum activity against gram-positive and gram-negative bacteria. It is effective against common respiratory pathogens, including Streptococcus, Staphylococcus, Haemophilus influenzae, and E. coli. Cefuroxime is often used to treat respiratory tract infections (URTI, LRTI), sinusitis, otitis media, and urinary tract infections (UTIs).

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Cefaclor (Ceclor)

Cefaclor is another second-generation cephalosporin antibiotic with a similar spectrum of activity to cefuroxime. However, it has slightly less potent activity against gram-negative bacteria, making it more effective against Streptococcus and Staphylococcus. It is commonly used for treating ear infections (otitis media), as well as other respiratory infections.

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Second-generation cephalosporins

Second-generation cephalosporins are a class of antibiotics with a broad-spectrum of activity against a variety of bacteria, including both gram-positive and gram-negative organisms.

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Gram-negative Activity of Second-generation Cephalosporins

A key feature of second-generation cephalosporins is their enhanced activity against gram-negative bacteria, including Haemophilus influenzae, Escherichia coli, Klebsiella pneumoniae, and Proteus mirabilis. This makes them effective for treating infections involving these bacteria, such as respiratory infections and UTIs.

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Clinical Uses of Second-generation Cephalosporins

Second-generation cephalosporins are commonly used for treating a variety of infections including respiratory tract infections (URTI, LRTI), sinusitis, otitis media, and urinary tract infections (UTIs). They are also effective against skin and soft tissue infections.

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Cefdinir (Omnicef)

Cefdinir is an oral antibiotic effective against common respiratory tract bacteria, including Haemophilus influenzae, Moraxella catarrhalis, and some Gram-positive bacteria.

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Cefixime (Suprax)

Cefixime is an oral antibiotic that effectively targets Gram-negative bacteria like E. coli and Haemophilus influenzae. It also has limited coverage against some Gram-positive bacteria.

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Cefpodoxime (Vantin)

Cefpodoxime is an oral antibiotic known for its good activity against both Gram-negative bacteria (like Haemophilus influenzae) and Gram-positive bacteria (like Streptococcus pneumoniae).

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Cefoperazone (Cefobid)

Cefoperazone is a broad-spectrum antibiotic effective against a wide range of microorganisms, including Gram-negative bacteria (E. coli, Pseudomonas aeruginosa), and some Gram-positive bacteria.

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Ceftibuten (Cedax)

Ceftibuten is an oral antibiotic that primarily targets Gram-negative bacteria like E. coli and Klebsiella. It also has some activity against Gram-positive bacteria.

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Gram-negative Bacteria

Gram-negative bacteria commonly targeted by these antibiotics include Escherichia coli (E. coli), Haemophilus influenzae, Klebsiella, Proteus, and Pseudomonas aeruginosa.

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Gram-positive Bacteria

Gram-positive bacteria commonly targeted by these antibiotics include Staphylococcus, Streptococcus, and certain strains of Streptococcus pneumoniae.

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Spectrum of Activity

Gram-negative bacteria targeted by these antibiotics, for example E. coli, H. influenzae, Klebsiella, Proteus, Neisseria, Enterobacter, Pseudomonas.

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Broad-spectrum antibiotics

A group of antibiotics that targets a wide range of bacteria, including both gram-positive and gram-negative bacteria.

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5th generation cephalosporins

A specific type of antibiotic known for its effectiveness against methicillin-resistant Staphylococcus aureus (MRSA) and other gram-positive bacteria.

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Monobactams

A class of antibiotics that have a single beta-lactam ring in their structure.

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Aztreonam

A specific Monobactam antibiotic with a limited spectrum of activity, mainly targeting aerobic gram-negative bacteria.

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Methicillin-resistant Staphylococcus aureus (MRSA)

A type of bacteria that is notoriously resistant to many common antibiotics, making it difficult to treat infections caused by them.

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Streptococcus pneumoniae

A specific type of gram-positive bacteria that can cause various infections, including pneumonia.

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Pseudomonas aeruginosa

A bacterial species that can cause respiratory tract infections and other infections.

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Glycopeptide Antibiotics

A class of antibiotics that inhibit peptidoglycan synthesis, a key component of bacterial cell walls.

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Vancomycin

A glycopeptide antibiotic used to treat serious infections caused by Gram-positive bacteria, including sepsis, endocarditis, and meningitis. It is also prescribed for C. difficile colitis.

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Red Man Syndrome

A common side effect of vancomycin, characterized by a red flushing of the skin, accompanied by itching and a feeling of warmth.

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Nephrotoxicity

A rare but serious side effect of vancomycin that can cause damage to the kidneys.

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Glycopeptide Antibiotic Mechanism of Action

A type of antibiotic that works by inhibiting the synthesis of peptidoglycan, a crucial component of bacterial cell walls. They are typically used to treat infections caused by Gram-positive bacteria.

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Telavancin

A glycopeptide antibiotic used to treat complicated skin and soft tissue infections, as well as hospital-acquired pneumonia.

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Teratogenic Effect of Telavancin

A serious risk associated with telavancin, potentially affecting the developing fetus and causing birth defects.

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Ototoxicity

A potential adverse effect of telavancin, which is a rare but possible risk.

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What is Daptomycin?

Daptomycin is an antibiotic used to treat serious infections caused by Gram-positive bacteria, including MRSA and vancomycin-resistant strains.

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How does Daptomycin work?

Daptomycin works by binding to bacterial cell membranes, disrupting their function and causing rapid cell death.

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How is Daptomycin administered?

Daptomycin is available as an intravenous (IV) powder for injection or solution for administration.

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What are the potential side effects of Daptomycin?

Possible side effects of Daptomycin include gastrointestinal (GI) disturbances, rash, headache, and, in rare cases, muscle discomfort or weakness.

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Who cannot use Daptomycin?

Daptomycin is contraindicated in pediatric patients younger than one year of age.

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What are Tetracyclines?

Tetracyclines are a class of antibiotics that primarily work by inhibiting bacterial protein synthesis.

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What are Tetracyclines used to treat?

Tetracyclines are commonly used to treat various infections, including those caused by bacteria like Chlamydia, Mycoplasma, and some Rickettsia species.

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How are Tetracyclines administered?

Tetracyclines are available in oral formulations, commonly taken several times a day, and their dosage varies depending on the specific medication and the age of the patient.

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Study Notes

Diabetes Mellitus

  • Diabetes mellitus is a condition affecting how the body uses blood sugar (glucose).
  • The cause varies by type, but all types can lead to excess sugar in the blood.
  • Types include Type 1, Type 2, and Gestational diabetes.

Diagnosis

  • Normal Glucose Tolerance: Fasting plasma glucose <100 mg/dL (5.6 mmol/L), two hours after glucose load <140 mg/dL (7.8 mmol/L), HbA1c <5.7%
  • Prediabetes: Fasting plasma glucose 100-125 mg/dL (5.6-6.9 mmol/L), two hours after glucose load ≥ 140-199 mg/dL (7.8-11.0 mmol/L), HbA1c 5.7%-6.4%
  • Diabetes Mellitus: Fasting plasma glucose ≥126 mg/dL (7.0 mmol/L), two hours after glucose load ≥200 mg/dL (11.1 mmol/L), HbA1c ≥6.5%

Causes

  • Insulin resistance: Cells in muscles, fat, and liver don't respond to insulin properly.
  • Autoimmune disease: The immune system attacks insulin-producing cells in the pancreas.
  • Hormonal imbalances: During pregnancy, the placenta releases hormones that cause insulin resistance.

Symptoms

  • Increased thirst (polydipsia) and dry mouth
  • Frequent urination
  • Fatigue
  • Blurred vision
  • Unexplained weight loss
  • Numbness or tingling in hands or feet
  • Slow-healing sores or cuts
  • Frequent skin and/or vaginal yeast infections

Non-Pharmacological Treatment

  • Lifestyle modifications: Diet, physical activity, weight management, stress management
  • Self-monitoring: Blood sugar monitoring, ketone testing
  • Patient education: Diabetes education, continuous learning
  • Medical follow-up: Regular checkups, eye exams, foot exams

Types of Diabetes (in Detail)

Type 1 Diabetes

  • Hallmark: Selective beta cell (B cell) destruction, absolute insulin deficiency
  • Subtypes: Immune-mediated (Type 1a), Idiopathic (Type 1b)
  • Demographics: Younger than 30 years at diagnosis, but onset can occur at any age. Highest incidence in northern Europe and Sardinia.
  • Risk Factors: Family history & genetics, geography, age
  • Symptoms: Feeling more thirsty than usual, urinating a lot, bed-wetting (night), feeling very hungry, losing weight without trying, irritable or having mood changes, tired and weak, blurry vision
  • Pharmacological Treatment: Insulin replacement (rapid-acting, short-acting, intermediate-acting, long-acting).

Type 2 Diabetes

  • Heterogeneous group of conditions: Insulin resistance and relative deficiency in insulin secretion
  • Risk Factors: Obesity, age (40 and above), family history.
  • Symptoms: Polydipsia, polyuria, polyphagia
  • Pharmacological Treatment: Lifestyle modifications, oral antidiabetic agents (first-line therapy), insulin (later stage).

Gestational Diabetes

  • Occurs during pregnancy: Placenta and placental hormones create insulin resistance that is most pronounced in the last trimester.
  • Diagnosis is established during any abnormality in glucose levels during pregnancy.

Cushing Syndrome

  • Cushing syndrome occurs when the body has too much cortisol for an extended period.
  • Causes include: Excessive cortisol production (stress hormone) in the body, prolonged use of glucocorticoids (e.g. Prednisone, Dexamethasone), pituitary adenoma, nodular hyperplasia of the adrenal gland, ectopic production of ACTH (e.g. adrenal cortical adenoma, lung, pancreas, thyroid, and thymus tumors).
  • Risk Factors: Age (25 to 50 yo), gender (70% female, 30% male), people who take cortisol medication, chronic stress conditions, obesity, - uncontrolled type 2 diabetes.
  • Main Symptoms include: Moon face (round face), fatty hump in neck (buffalo hump), purple stretch marks (purple striae).
  • Additional Symptoms include: hypertension, diabetes, red cheeks, easy bruising on the arms and legs, generalized weakness and tiredness (fatigue), osteoporosis, hypokalemia, blurry vision and dizziness, weak muscles and thinner arms and legs, libido changes (sex drive) and erectile dysfunction, stunted growth in children, and excessive hair growth

Pharmacological Treatment (In Detail)

  • Steroid Synthesis Inhibitors: Mitotane, Metopirone, Ketoconazole, Mifepristone (Inhibit specific steps of cortisol synthesis)
  • Non-Pharmacological Treatment: Trans-sphenoidal adenomectomy, hypophysectomy, Bilateral adrenalectomy, Radiotherapy for pituitary adenoma, dietary changes, stress management, and exercise.

Additional Topics (Drugs from Various Presentation Slides)

  • Cell Wall Inhibitors (Penicillins): These antibiotics work by interfering with the synthesis of bacterial cell walls. Natural penicillins (e.g., penicillin G), semi-synthetic penicillins (e.g., penicillin V), and penicillinase-resistant penicillins (e.g., nafcillin, oxacillin, dicloxacillin) are examples, along with aminopenicillins, extended-spectrum, and combination penicillins.

  • Glycopeptides (Vancomycin, Telavancin, Teicoplanin, Dalbavancin, Oritavancin): These antibiotics inhibit cell wall synthesis, and are generally active against gram-positive bacteria

  • Lipopeptides (Daptomycin): Active against gram-positive bacteria—they kill the bacteria by disrupting their cell membranes.

  • Sulfonamides and Trimethoprim: These drugs block bacterial synthesis of dihydrofolic acid, thereby interfering with bacterial growth.

  • Oxazolidinones (Linezolid, Tedizolid): These drugs inhibit bacterial protein synthesis in different ways.

  • Aminoglycosides (Amikacin, Gentamicin, Streptomycin, Neomycin) These interfere with bacterial protein synthesis.

  • Macrolides (Erythromycin, Clarithromycin, Azithromycin): Inhibits bacterial protein synthesis.

  • Chloramphenicol: Active against several bacteria by interfering with protein synthesis within the bacterial cell

  • Tetracyclines: Inhibit bacterial protein synthesis.

  • Carbapenems: Broad-spectrum antibiotics often used for serious bacterial infections. Imipenem (along with cilastatin, as it is unstable), ertapenem, doripenem, and meropenem are examples.

  • Fluoroquinolones: These drugs inhibit bacterial DNA replication via various enzymes. Ciprofloxacin, levofloxacin, Moxifloxacin are examples.

  • Antifungals: Various classes of drugs for combating fungal infections, including polyenes, imidazoles, triazoles, allylamines, echinocandins, and others—their mechanisms differ and target specific aspects of fungal cell wall integrity and metabolic processes.

Important Note: This summary is for general study purposes and does not substitute professional medical advice. Always consult with healthcare providers for accurate and personalized information about any medical condition or treatment.

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Test your knowledge on the uses of 2nd generation cephalosporins and conditions related to Addison’s disease. The quiz includes matching exercises, identifying symptoms, and understanding drug effectiveness against bacteria. Perfect for students in pharmacology or medicine.

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