Advanced Pharmacology Exam 4 questions with verified solutions

Advanced Pharmacology Exam 4 Questions d d d d d




With Answers [Verified] d d




Gram positive vs gram negative slide? examples? -
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- gram positive cell wall as thick peptidoglycan so retains the purple dye; ex: staph
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aureus, strep pneumoniae, clostridium
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- gram negative cell has thin peptidoglycan cell wall and other lipopolysaccharide and protein outer
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membrane surrounding it, so it doesn't retain purple dye well; it will stain pink; ex: E. coli,
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pseudomonas, H. pylori, neisseria gonorrhea, salmonella d d d d d




Obligate aerobes vs obligate anaerobes vs facultative anaerobes vs microaerophiles vs aerotolerant
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organisms - d d




d d d d d d d d d d d d d d d d d - obligate aerobes need O2- will be at top of test tube
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- obligate anaerobes- poisoned by oxygen; will be at bottom of test tube
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- facultative anaerobes- grow with or without oxygen- will grow throughout test tube, mostly at top
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ddue to more ATP developed from O2
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- microaerophiles- need O2 but can be poisoned at high concentrations of O2; will be on upper but
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not top of test tube
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- aerotolerant organisms- does not require oxygen as it is an anaerobe, but it doesn't get poisoned
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by oxygen, so it grows throughout test tube evenly
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What can strep pneumoniae cause? -
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d d d d d d d d d d d d d d d d d - bacterial meningitis
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- sinusitis
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- otitis media
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- pneumonia
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bacteriostatic vs bactericidal - d d d d




- bacteriostatic- stops bacteria from growing, but doesn't kill it, but will assist body in
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getting rid of it d d d




- bactericidal- kills the bacteria
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,How does antibiotic resistance occur? -
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- bacteria can alter enzymatic targets, site of action, can create cell membrane,
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decreased permeability, and can create efflux pump to pump antibiotic out
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Why is neisseria gonorrhea mainly resistant to penicillin now? -
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it produces beta-lactamases (penicillinases) which destroys the antibiotic with the beta
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lactam nucleus aka penicillin
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Empiric vs prophylactic vs definitive tx -
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d d d d d d d d d d d d d d d d d - empiric- aka presumptive tx based on evidence based guidelines
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- prophylactic- infection prevention- pretx for those in close contact with infected pts of
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TB/meningitis, pretx for pts undergoing dental extractions who have implanted prosthetic devices,
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such as heart valves
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- definitive- based on culture
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What antibiotics work on cell wall synthesis? -
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d d d d d d d d d d d d d d d d d - beta lactams- penicillins, cephalosporins, glycopeptides
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What do penicillin V and G Benzathine work against? Indications? What do they each treat better? -
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- works against aerobic gram positive organisms like S. pneumoniae, group A beta-
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hemolytic streptococci, syphilis (T. pallidum)
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- indicated to tx GABHS/strep, pneumonia, and syphilis
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- Penicillin V- better success rate at treating GABHS
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- Penicillin G Benzathine (Bicillin)- more failure of tx for group A beta hemolytic strep (GABHS);
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better to treat syphilisd d d




What amoxicillin and amoxicillin/clavulanic acid (penicillins) work against? What are they indicated
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to treat? What do they treat better compared to other penicillins? -
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- treats both gram positive organisms like S. pneumoniae, group A beta-hemolytic
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streptococci

- it has greater activity against gram negative bacteria than other penicillins
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- indicated to tx endocarditis prophylaxis, community acquired pneumonia, H. pylori, acute otitis
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media, acute bacterial rhinosinusitis, lyme disease in kids, strep pharyngitis (GABHS)
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,- treats pediatric GABHS because it tastes better
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What is the MOA of penicillins? What are the cautions and contraindications of penicillins? adverse
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drug effects? -d d d




d d d d d d d d d d d d d d d d d - prevent bacterial cell wall synthesis during active multiplications, causing cell wall
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death

- BACTERICIDAL against susceptible bacteria- kills bacteria
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- caution in those with hypersensitivity reactions like stevens johnson syndrome
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- caution in renal impairment
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- compatible in pregnancy, lactation, and pediatrics
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- N/V/D, candidiasis, maculopapular rash, C. diff, anaphylaxis (rare), penicillin G benzathine (bicillin),
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there may be pain at injection site
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T/F: it is common to develop a maculopapular rash from with amoxicillin BUT it does not always
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represent a true allergy as it may not happen in subsequent uses -
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d d d d d d d d d d d d d d d d d true



T/F: those with mono have a higher chance of developing maculopapular rash to penicillins
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especially amoxicillin - d d d




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What are first generation cephalosporins? What do they work against? What are they indicated to
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treat? - d d




d d d d d d d d d d d d d d d d d cefazolin, cephalexin d




- work against gram positive cocci, including MSSA (methicillin-sensitive S. aureus), S. epidermidis,
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and most streptococci, E. coli (gram negative)
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- indicated to treat cellulitis, uncomplicated cystitis, impetigo, GABHS
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Which cephalosporin can be first line tx of mild cellulitis? -
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d d d d d d d d d d d d d d d d d cephalexin


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, What are second generation cephalosporins? What do they work against? What are they indicated
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to treat? -
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d d d d d d d d d d d d d d d d d cefuroxime, cefprozil, cefaclor d d




- works against gram positive cocci, like MSSA and S. epidermis, most streptococci, E. coli (gram
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negative), BUT MOST IMPORTANTLY HAS INCREASED ACTIVITY AGAINST H. INFLUENZAE (gram
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negative organism) d




- indicated for cellulitis, acute exacerbation, acute otitis media, GABHS, lyme disease,
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uncomplicated UTI d




What are third generation cephalosporins? What do they work against? -
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d d d d d d d d d d d d d d d d d ceftriaxone, cefdinir, cefpodoxime d d




- works against gram positive cocci, including MSSA, S. pneumoniae, H. influenzae (gram negative),
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E. coli (gram negative), BUT NOW IT INCLUDES N. GONORRHOEAE AND N. MENINGITIDIS (both
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gram negative) d




What is are the differences in indications for ceftriaxone, fedinir, cefpodoxime? -
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- ceftriaxone- bacterial meningitis, community acquired pneumonia, uncomplicated
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gonorrhea, PID, uncomplicated UTI (healthy females only)
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- cefdinir- COPD exacerbation, acute otitis media, and strep pharyngitis
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- cefpodoxime- bacterial bronchitis, community acquired pneumonia, acute bacterial rhinosinusitis,
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acute otitis media, GABHS
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What characteristics of a patient is an example of a complicated UTI? -
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d d d d d d d d d d d d d d d d d - male d




- pregnant female
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- UTI spread to kidneys
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What is the MOA of cephalosporins? What are adverse drug effects? What are caution and
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contraindications? - d d




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