Principles of Antimicrobial Therapy
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Questions and Answers

What is a major determinant of a drug's ability to penetrate the blood–brain barrier?

  • Lipid solubility (correct)
  • Molecular size
  • pH of the bloodstream
  • Ionization at physiologic pH
  • Which of the following tissues has a natural barrier to drug delivery?

  • Kidney
  • Prostate (correct)
  • Pancreas
  • Liver
  • What is the primary characteristic of drugs that are able to penetrate the blood–brain barrier?

  • They have a high molecular weight
  • They are highly soluble in water
  • They are small and lipophilic (correct)
  • They are highly ionized
  • Which of the following antibiotics has limited penetration through the intact blood–brain barrier?

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

    What is the primary function of the tight junctions in the capillaries of the brain?

    <p>To impede the entry of molecules from the blood to the brain</p> Signup and view all the answers

    What is the factor that influences the penetration and concentration of an antibacterial agent in the CSF?

    <p>Lipid solubility of the antibiotic</p> Signup and view all the answers

    Which of the following antibiotics should be used with caution in patients with liver dysfunction?

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

    What is a consequence of poor perfusion in the lower limbs of a diabetic patient?

    <p>Difficulty in achieving therapeutic concentrations</p> Signup and view all the answers

    Why should neonates be treated with caution when using antibiotics such as chloramphenicol and sulfonamides?

    <p>Their renal or hepatic elimination processes are poorly developed</p> Signup and view all the answers

    Why should young children not be treated with tetracyclines?

    <p>They affect bone growth</p> Signup and view all the answers

    What should prescribers consult when considering the use of an antibiotic in pregnant or lactating patients?

    <p>The product labeling of the antibiotic</p> Signup and view all the answers

    Why may elderly patients require special consideration when using certain antibiotics?

    <p>They may have decreased renal or liver function</p> Signup and view all the answers

    What is a potential concern when administering antibiotics to pregnant women?

    <p>The antibiotic may cause detrimental effects to the fetus.</p> Signup and view all the answers

    Which of the following is a risk factor for infection with multidrug-resistant pathogens?

    <p>Prior antimicrobial therapy in the preceding 90 days</p> Signup and view all the answers

    Why are penicillins considered to be relatively safe?

    <p>They interfere with a site or function unique to the growth of microorganisms</p> Signup and view all the answers

    What is a consideration when selecting an antimicrobial agent for a patient?

    <p>The risk of resistance in the community</p> Signup and view all the answers

    Which of the following antibiotics should be avoided during pregnancy?

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

    Why are some antimicrobial agents reserved for life-threatening infections?

    <p>They have less specificity and may cause serious toxicity</p> Signup and view all the answers

    What is an important factor to consider in addition to the site of infection and severity of the illness when choosing an antimicrobial agent?

    <p>Cost of the medication</p> Signup and view all the answers

    Why is parenteral administration of antimicrobial agents used in some cases?

    <p>For drugs that are poorly absorbed from the GI tract</p> Signup and view all the answers

    What is a benefit of switching patients from IV to oral therapy when clinically stable?

    <p>Decreased length of stay</p> Signup and view all the answers

    What is an important consideration when selecting an antimicrobial agent for a patient?

    <p>The patient's ability to take oral medications</p> Signup and view all the answers

    What is a reason why vancomycin, clindamycin, daptomycin, and linezolid may be considered for the treatment of MRSA?

    <p>They are similarly effective in treating MRSA, but vary in cost</p> Signup and view all the answers

    Why is the oral route of administration preferred for mild infections?

    <p>It is suitable for patients who can be treated on an outpatient basis</p> Signup and view all the answers

    Which antibiotic exhibits a concentration-dependent killing effect?

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

    What best predicts the clinical efficacy of β-lactams and glycopeptides?

    <p>The percentage of time that blood concentrations of a drug remain above the MIC</p> Signup and view all the answers

    What is the effect of extended or continuous infusions of certain drugs?

    <p>Increasing the time above the MIC and killing more bacteria</p> Signup and view all the answers

    Which of the following drugs works best by optimizing the ratio of the 24-hour area under the concentration–time curve to MIC?

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

    What is the significance of the MIC in the context of antimicrobial therapy?

    <p>It is the minimum concentration of the drug required to inhibit bacterial growth</p> Signup and view all the answers

    What is the term used to describe the effect of certain antimicrobials where the clinical efficacy is best predicted by the percentage of time that blood concentrations of a drug remain above the MIC?

    <p>Time-dependent killing</p> Signup and view all the answers

    What is the primary concern in restricting the prophylactic use of antimicrobial agents?

    <p>To prevent the development of antibiotic resistance</p> Signup and view all the answers

    What is a common complication of antibiotic therapy that can lead to secondary infections?

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

    What is the result of antibiotic therapy that can lead to alterations in the normal microbial flora?

    <p>Overgrowth of opportunistic organisms</p> Signup and view all the answers

    What is the primary mechanism of ototoxicity caused by aminoglycosides?

    <p>Interference with membrane function in the auditory hair cells</p> Signup and view all the answers

    What is the term used to describe the serious hypersensitivity reactions that can occur with antibiotic therapy?

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

    What is the primary consideration in determining the duration of prophylactic antibiotic therapy?

    <p>The risk of antibiotic resistance</p> Signup and view all the answers

    What is the result of antibiotic therapy that can lead to the growth of resistant bacteria?

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

    What is the primary reason for restricting the use of prophylactic antibiotics to specific clinical situations?

    <p>To prevent the development of antibiotic resistance</p> Signup and view all the answers

    What is the common consequence of antibiotic therapy that can lead to secondary infections?

    <p>Disruption of the normal microbial flora</p> Signup and view all the answers

    What is the primary mechanism of antibiotic-associated hypersensitivity reactions?

    <p>Immune reactions to antimicrobial drugs</p> Signup and view all the answers

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