ADVANCED PHARMACOLOGY TEST 1
QUESTIONS & VERIFIED CORRECT
ANSWERS LATEST VERSION
Beta lactamase inhibitors - CORRECT ANSWER Clavulanic acid, sublactam,
taxobactam
Unasyn - CORRECT ANSWER Ampicillin and sulbactam
Augmentin - CORRECT ANSWER Amoxicillin clavulanic acid
Hapten - CORRECT ANSWER Drug +plasma protein severe allergic reaction
Mechanisms resistance to beta lactamase - CORRECT ANSWER Inactivation by beta
lactamase, mutation trans peptidase target, impaired penetration of drug into organism,
drug effluent pumps
MRSA - CORRECT ANSWER Resistant organisms produce PBPs with decreased
affinity for binding beta lactam antibiotics
Impaired penetration of drug into organosm - CORRECT ANSWER Absence of porins
or down regulation of porins or porins smaller
Drug efflux pumps - CORRECT ANSWER Nonspecific, spit out whatever bacteria
doesn't need, major mechanism MDR
Prevention of resistance steains - CORRECT ANSWER Testing, choose right
antibiotic, complete course therapy, don't use antibiotic when not indicated
Mutidrug resistant organisms - CORRECT ANSWER Organisms that are resistant to 1
or more class of organisms. Drug efflux pumps
Penicillin - CORRECT ANSWER Bactericidal
Penicillin adverse effects - CORRECT ANSWER GI distress, oral/vaginal candidiasis,
rash, anaphylaxis
Cephalosporins - CORRECT ANSWER More stable against beta lactamases,
increased range activity
1st generation cephalosporin - CORRECT ANSWER Cefazolin, cephalexin
,G+, susceptible beta lactamase
2,3 generations cephalosporins - CORRECT ANSWER Broader spectrum,
Increase resistance beta lactamase, increase half life, some cross BBB
4,5 generations cephalosporins - CORRECT ANSWER Cefepine, excellent resistance
most beta lactamase, excellent CNS penetration, ceftaroline against MRSA
Adverse reactions cephalosporins - CORRECT ANSWER Hypersensitivity, fever, skin
rashes, nephritis, granulocytopenia, hemolytic anemia, anorexia
Cefotetan - CORRECT ANSWER Avoid ETOH! Disulfiram like reaction with this
cephalosporins
Treatment for C diff from broad spectrum cephalosporin - CORRECT ANSWER
Vancomycin, metrondiszole
Example monobactam - CORRECT ANSWER Aztreonam
IV or IM
Active against G neg only
Tolerated by PCN allergic patiemts
Example carbapenem - CORRECT ANSWER Imipenem, IV or IM only
Widest spectrum of any beta lactam, must prescribe with cilastin to inhibit first pass
elimination by renal enzyme dehydropeptidase, low crossreactivity for PCNs. Good for
meningitis, peritonitis in really sick patients
Vancomycin - CORRECT ANSWER Cell wall inhibitor but not beta lactam, glycopeptide
structure, best treatment for MRSA and G+. Only use Italy to treat antibiotic induced
colitis, C. difficile and staph entericolitis
Must monitor peak and trough, poorly absorbed po
Vancomyicin - CORRECT ANSWER Bacterocidal for G +
Vancomycin - CORRECT ANSWER Poor oral bioavailability, 90% GFR eliminated, if
renal impairments can have accumulation.
Vancomycin Adverse Effect - CORRECT ANSWER Ototoxicity if given with
aminoglycoside!!
Tissue irritation at injection site, chill and fever
Red man syndrome - CORRECT ANSWER Vancomycin if Tate of infusion too fast.
Histamine release, hypotension, flush, skin rash. Prevent by 1-2 hr infusion or pretreat
with antihistamine
, Advantages vancomycin - CORRECT ANSWER Not susceptible to beta lactamase, no
PCN allergy
Classes of protein synthesis inhibitors - CORRECT ANSWER Tetracycline, macrolides,
oxazolidinones and aminoglycosides
Inhibitors bacterial translation - CORRECT ANSWER Interfere with bacterial ribosome,
may affect protein synthesis in human cells, complete inhibition of protein synthesis may
not be enough to kill bacteria. Antibiotics bind to bacterial ribosome to block bacterial
protein synthesis
Examples of Tetracyclines - CORRECT ANSWER Tetracycline, oxytetracycline,
doxycycline, demeclocycline
Tetracycline uses - CORRECT ANSWER H pylori, cholera, acne, tick fever
Elimination tetracycline - CORRECT ANSWER Bile and urine, Hilary excretion effects
flora of lower regions GI tract
Absorption tetracycline - CORRECT ANSWER Oral absorption decreased by antacids,
dairy Ca, bismuth, Fe, food, alkaline pH,
Adverse effects tetracycline - CORRECT ANSWER B/c interaction with Ca can
sequester in bone and teeth. Don't use in pregnancy or kids less than 8. Also
photosensitive
Adverse effects tetracycline - CORRECT ANSWER With diuretics causes
nephrotoxicity. Nausea/vomit, epigastric, heartburn, diarrhea
Macrolides example - CORRECT ANSWER Erythromycin, azithromycin, clarithtomycin
Macrolides - CORRECT ANSWER Broad spectrum, bacteriostatic, at high levels
bacteriocidal, enhanced activity at alkaline pH,
H pylori treatment - CORRECT ANSWER Clarithromycin and ompeprazole
Macrolides interactions - CORRECT ANSWER Erythromycin and clarithromycin potent
inhibitors of CYP 450!!
Affect blood levels of warfarin, statins, Ca channel blockers, azolve antifungals
Azithromycin does not inhibit CYP450!!!
Macrolides adverse effects - CORRECT ANSWER GI especially with erythromycin,
N/V, diarrhea, hepatptoxic, flatulemce, jaundice, anorexia. Erythromycin increases GI
motility
QUESTIONS & VERIFIED CORRECT
ANSWERS LATEST VERSION
Beta lactamase inhibitors - CORRECT ANSWER Clavulanic acid, sublactam,
taxobactam
Unasyn - CORRECT ANSWER Ampicillin and sulbactam
Augmentin - CORRECT ANSWER Amoxicillin clavulanic acid
Hapten - CORRECT ANSWER Drug +plasma protein severe allergic reaction
Mechanisms resistance to beta lactamase - CORRECT ANSWER Inactivation by beta
lactamase, mutation trans peptidase target, impaired penetration of drug into organism,
drug effluent pumps
MRSA - CORRECT ANSWER Resistant organisms produce PBPs with decreased
affinity for binding beta lactam antibiotics
Impaired penetration of drug into organosm - CORRECT ANSWER Absence of porins
or down regulation of porins or porins smaller
Drug efflux pumps - CORRECT ANSWER Nonspecific, spit out whatever bacteria
doesn't need, major mechanism MDR
Prevention of resistance steains - CORRECT ANSWER Testing, choose right
antibiotic, complete course therapy, don't use antibiotic when not indicated
Mutidrug resistant organisms - CORRECT ANSWER Organisms that are resistant to 1
or more class of organisms. Drug efflux pumps
Penicillin - CORRECT ANSWER Bactericidal
Penicillin adverse effects - CORRECT ANSWER GI distress, oral/vaginal candidiasis,
rash, anaphylaxis
Cephalosporins - CORRECT ANSWER More stable against beta lactamases,
increased range activity
1st generation cephalosporin - CORRECT ANSWER Cefazolin, cephalexin
,G+, susceptible beta lactamase
2,3 generations cephalosporins - CORRECT ANSWER Broader spectrum,
Increase resistance beta lactamase, increase half life, some cross BBB
4,5 generations cephalosporins - CORRECT ANSWER Cefepine, excellent resistance
most beta lactamase, excellent CNS penetration, ceftaroline against MRSA
Adverse reactions cephalosporins - CORRECT ANSWER Hypersensitivity, fever, skin
rashes, nephritis, granulocytopenia, hemolytic anemia, anorexia
Cefotetan - CORRECT ANSWER Avoid ETOH! Disulfiram like reaction with this
cephalosporins
Treatment for C diff from broad spectrum cephalosporin - CORRECT ANSWER
Vancomycin, metrondiszole
Example monobactam - CORRECT ANSWER Aztreonam
IV or IM
Active against G neg only
Tolerated by PCN allergic patiemts
Example carbapenem - CORRECT ANSWER Imipenem, IV or IM only
Widest spectrum of any beta lactam, must prescribe with cilastin to inhibit first pass
elimination by renal enzyme dehydropeptidase, low crossreactivity for PCNs. Good for
meningitis, peritonitis in really sick patients
Vancomycin - CORRECT ANSWER Cell wall inhibitor but not beta lactam, glycopeptide
structure, best treatment for MRSA and G+. Only use Italy to treat antibiotic induced
colitis, C. difficile and staph entericolitis
Must monitor peak and trough, poorly absorbed po
Vancomyicin - CORRECT ANSWER Bacterocidal for G +
Vancomycin - CORRECT ANSWER Poor oral bioavailability, 90% GFR eliminated, if
renal impairments can have accumulation.
Vancomycin Adverse Effect - CORRECT ANSWER Ototoxicity if given with
aminoglycoside!!
Tissue irritation at injection site, chill and fever
Red man syndrome - CORRECT ANSWER Vancomycin if Tate of infusion too fast.
Histamine release, hypotension, flush, skin rash. Prevent by 1-2 hr infusion or pretreat
with antihistamine
, Advantages vancomycin - CORRECT ANSWER Not susceptible to beta lactamase, no
PCN allergy
Classes of protein synthesis inhibitors - CORRECT ANSWER Tetracycline, macrolides,
oxazolidinones and aminoglycosides
Inhibitors bacterial translation - CORRECT ANSWER Interfere with bacterial ribosome,
may affect protein synthesis in human cells, complete inhibition of protein synthesis may
not be enough to kill bacteria. Antibiotics bind to bacterial ribosome to block bacterial
protein synthesis
Examples of Tetracyclines - CORRECT ANSWER Tetracycline, oxytetracycline,
doxycycline, demeclocycline
Tetracycline uses - CORRECT ANSWER H pylori, cholera, acne, tick fever
Elimination tetracycline - CORRECT ANSWER Bile and urine, Hilary excretion effects
flora of lower regions GI tract
Absorption tetracycline - CORRECT ANSWER Oral absorption decreased by antacids,
dairy Ca, bismuth, Fe, food, alkaline pH,
Adverse effects tetracycline - CORRECT ANSWER B/c interaction with Ca can
sequester in bone and teeth. Don't use in pregnancy or kids less than 8. Also
photosensitive
Adverse effects tetracycline - CORRECT ANSWER With diuretics causes
nephrotoxicity. Nausea/vomit, epigastric, heartburn, diarrhea
Macrolides example - CORRECT ANSWER Erythromycin, azithromycin, clarithtomycin
Macrolides - CORRECT ANSWER Broad spectrum, bacteriostatic, at high levels
bacteriocidal, enhanced activity at alkaline pH,
H pylori treatment - CORRECT ANSWER Clarithromycin and ompeprazole
Macrolides interactions - CORRECT ANSWER Erythromycin and clarithromycin potent
inhibitors of CYP 450!!
Affect blood levels of warfarin, statins, Ca channel blockers, azolve antifungals
Azithromycin does not inhibit CYP450!!!
Macrolides adverse effects - CORRECT ANSWER GI especially with erythromycin,
N/V, diarrhea, hepatptoxic, flatulemce, jaundice, anorexia. Erythromycin increases GI
motility
