Advanced Pharmacology Exam 4 Questions d d d d d
With Answers [Verified] d d
Gram positive vs gram negative slide? examples? -
d d d d d d d d
- gram positive cell wall as thick peptidoglycan so retains the purple dye; ex: staph
d d d d d d d d d d d d d d d d d d d d d d d d d d d d d d d d
aureus, strep pneumoniae, clostridium
d d d
- gram negative cell has thin peptidoglycan cell wall and other lipopolysaccharide and protein outer
d d d d d d d d d d d d d d d
membrane surrounding it, so it doesn't retain purple dye well; it will stain pink; ex: E. coli,
d d d d d d d d d d d d d d d d d
pseudomonas, H. pylori, neisseria gonorrhea, salmonella d d d d d
Obligate aerobes vs obligate anaerobes vs facultative anaerobes vs microaerophiles vs aerotolerant
d d d d d d d d d d d d
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
d d d d d d d d d d d
- obligate anaerobes- poisoned by oxygen; will be at bottom of test tube
d d d d d d d d d d d d
- facultative anaerobes- grow with or without oxygen- will grow throughout test tube, mostly at top
d d d d d d d d d d d d d d d
ddue to more ATP developed from O2
d d d d d d
- microaerophiles- need O2 but can be poisoned at high concentrations of O2; will be on upper but
d d d d d d d d d d d d d d d d d d
not top of test tube
d d d d
- aerotolerant organisms- does not require oxygen as it is an anaerobe, but it doesn't get poisoned
d d d d d d d d d d d d d d d d d
by oxygen, so it grows throughout test tube evenly
d d d d d d d d
What can strep pneumoniae cause? -
d d d d d d
d d d d d d d d d d d d d d d d d - bacterial meningitis
d d
- sinusitis
d
- otitis media
d d
- pneumonia
d
bacteriostatic vs bactericidal - d d d d
- bacteriostatic- stops bacteria from growing, but doesn't kill it, but will assist body in
d d d d d d d d d d d d d d d d d d d d d d d d d d d d d d d d
getting rid of it d d d
- bactericidal- kills the bacteria
d d d d
1|Page
,How does antibiotic resistance occur? -
d d d d d d
- bacteria can alter enzymatic targets, site of action, can create cell membrane,
d d d d d d d d d d d d d d d d d d d d d d d d d d d d d d
decreased permeability, and can create efflux pump to pump antibiotic out
d d d d d d d d d d
Why is neisseria gonorrhea mainly resistant to penicillin now? -
d d d d d d d d d d
it produces beta-lactamases (penicillinases) which destroys the antibiotic with the beta
d d d d d d d d d d d d d d d d d d d d d d d d d d d d
lactam nucleus aka penicillin
d d d
Empiric vs prophylactic vs definitive tx -
d d d d d d d
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
d d d d d d d d d
- prophylactic- infection prevention- pretx for those in close contact with infected pts of
d d d d d d d d d d d d d d
TB/meningitis, pretx for pts undergoing dental extractions who have implanted prosthetic devices,
d d d d d d d d d d d d
such as heart valves
d d d
- definitive- based on culture
d d d d
What antibiotics work on cell wall synthesis? -
d d d d d d d d
d d d d d d d d d d d d d d d d d - beta lactams- penicillins, cephalosporins, glycopeptides
d d d d d
What do penicillin V and G Benzathine work against? Indications? What do they each treat better? -
d d d d d d d d d d d d d d d d
d
- works against aerobic gram positive organisms like S. pneumoniae, group A beta-
d d d d d d d d d d d d d d d d d d d d d d d d d d d d d
hemolytic streptococci, syphilis (T. pallidum)
d d d d
- indicated to tx GABHS/strep, pneumonia, and syphilis
d d d d d d d
- Penicillin V- better success rate at treating GABHS
d d d d d d d d
- Penicillin G Benzathine (Bicillin)- more failure of tx for group A beta hemolytic strep (GABHS);
d d d d d d d d d d d d d d d d
better to treat syphilisd d d
What amoxicillin and amoxicillin/clavulanic acid (penicillins) work against? What are they indicated
d d d d d d d d d d d d
to treat? What do they treat better compared to other penicillins? -
d d d d d d d d d d d d
- treats both gram positive organisms like S. pneumoniae, group A beta-hemolytic
d d d d d d d d d d d d d d d d d d d d d d d d d d d d d
streptococci
- it has greater activity against gram negative bacteria than other penicillins
d d d d d d d d d d d
- indicated to tx endocarditis prophylaxis, community acquired pneumonia, H. pylori, acute otitis
d d d d d d d d d d d d d
media, acute bacterial rhinosinusitis, lyme disease in kids, strep pharyngitis (GABHS)
d d d d d d d d d d
2|Page
,- treats pediatric GABHS because it tastes better
d d d d d d d
What is the MOA of penicillins? What are the cautions and contraindications of penicillins? adverse
d d d d d d d d d d d d d d d
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
d d d d d d d d d d d d
death
- BACTERICIDAL against susceptible bacteria- kills bacteria
d d d d d d
- caution in those with hypersensitivity reactions like stevens johnson syndrome
d d d d d d d d d d
- caution in renal impairment
d d d d
- compatible in pregnancy, lactation, and pediatrics
d d d d d d
- N/V/D, candidiasis, maculopapular rash, C. diff, anaphylaxis (rare), penicillin G benzathine (bicillin),
d d d d d d d d d d d d d
there may be pain at injection site
d d d d d d
T/F: it is common to develop a maculopapular rash from with amoxicillin BUT it does not always
d d d d d d d d d d d d d d d d d
represent a true allergy as it may not happen in subsequent uses -
d d d d d d d d d d d d d
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
d d d d d d d d d d d d d d
especially amoxicillin - d d d
d d d d d d d d d d d d d d d d d true
What are first generation cephalosporins? What do they work against? What are they indicated to
d d d d d d d d d d d d d d d
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,
d d d d d d d d d d d d d
and most streptococci, E. coli (gram negative)
d d d d d d
- indicated to treat cellulitis, uncomplicated cystitis, impetigo, GABHS
d d d d d d d d
Which cephalosporin can be first line tx of mild cellulitis? -
d d d d d d d d d d d
d d d d d d d d d d d d d d d d d cephalexin
3|Page
, What are second generation cephalosporins? What do they work against? What are they indicated
d d d d d d d d d d d d d d
to treat? -
d d d
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
d d d d d d d d d d d d d d d d
negative), BUT MOST IMPORTANTLY HAS INCREASED ACTIVITY AGAINST H. INFLUENZAE (gram
d d d d d d d d d d d
negative organism) d
- indicated for cellulitis, acute exacerbation, acute otitis media, GABHS, lyme disease,
d d d d d d d d d d d d
uncomplicated UTI d
What are third generation cephalosporins? What do they work against? -
d d d d d d d d d d d
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),
d d d d d d d d d d d d d d
E. coli (gram negative), BUT NOW IT INCLUDES N. GONORRHOEAE AND N. MENINGITIDIS (both
d d d d d d d d d d d d d d
gram negative) d
What is are the differences in indications for ceftriaxone, fedinir, cefpodoxime? -
d d d d d d d d d d d d
- ceftriaxone- bacterial meningitis, community acquired pneumonia, uncomplicated
d d d d d d d d d d d d d d d d d d d d d d d d d
gonorrhea, PID, uncomplicated UTI (healthy females only)
d d d d d d
- cefdinir- COPD exacerbation, acute otitis media, and strep pharyngitis
d d d d d d d d d
- cefpodoxime- bacterial bronchitis, community acquired pneumonia, acute bacterial rhinosinusitis,
d d d d d d d d d d
acute otitis media, GABHS
d d d
What characteristics of a patient is an example of a complicated UTI? -
d d d d d d d d d d d d d
d d d d d d d d d d d d d d d d d - male d
- pregnant female
d d
- UTI spread to kidneys
d d d d
What is the MOA of cephalosporins? What are adverse drug effects? What are caution and
d d d d d d d d d d d d d d d
contraindications? - d d
4|Page
With Answers [Verified] d d
Gram positive vs gram negative slide? examples? -
d d d d d d d d
- gram positive cell wall as thick peptidoglycan so retains the purple dye; ex: staph
d d d d d d d d d d d d d d d d d d d d d d d d d d d d d d d d
aureus, strep pneumoniae, clostridium
d d d
- gram negative cell has thin peptidoglycan cell wall and other lipopolysaccharide and protein outer
d d d d d d d d d d d d d d d
membrane surrounding it, so it doesn't retain purple dye well; it will stain pink; ex: E. coli,
d d d d d d d d d d d d d d d d d
pseudomonas, H. pylori, neisseria gonorrhea, salmonella d d d d d
Obligate aerobes vs obligate anaerobes vs facultative anaerobes vs microaerophiles vs aerotolerant
d d d d d d d d d d d d
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
d d d d d d d d d d d
- obligate anaerobes- poisoned by oxygen; will be at bottom of test tube
d d d d d d d d d d d d
- facultative anaerobes- grow with or without oxygen- will grow throughout test tube, mostly at top
d d d d d d d d d d d d d d d
ddue to more ATP developed from O2
d d d d d d
- microaerophiles- need O2 but can be poisoned at high concentrations of O2; will be on upper but
d d d d d d d d d d d d d d d d d d
not top of test tube
d d d d
- aerotolerant organisms- does not require oxygen as it is an anaerobe, but it doesn't get poisoned
d d d d d d d d d d d d d d d d d
by oxygen, so it grows throughout test tube evenly
d d d d d d d d
What can strep pneumoniae cause? -
d d d d d d
d d d d d d d d d d d d d d d d d - bacterial meningitis
d d
- sinusitis
d
- otitis media
d d
- pneumonia
d
bacteriostatic vs bactericidal - d d d d
- bacteriostatic- stops bacteria from growing, but doesn't kill it, but will assist body in
d d d d d d d d d d d d d d d d d d d d d d d d d d d d d d d d
getting rid of it d d d
- bactericidal- kills the bacteria
d d d d
1|Page
,How does antibiotic resistance occur? -
d d d d d d
- bacteria can alter enzymatic targets, site of action, can create cell membrane,
d d d d d d d d d d d d d d d d d d d d d d d d d d d d d d
decreased permeability, and can create efflux pump to pump antibiotic out
d d d d d d d d d d
Why is neisseria gonorrhea mainly resistant to penicillin now? -
d d d d d d d d d d
it produces beta-lactamases (penicillinases) which destroys the antibiotic with the beta
d d d d d d d d d d d d d d d d d d d d d d d d d d d d
lactam nucleus aka penicillin
d d d
Empiric vs prophylactic vs definitive tx -
d d d d d d d
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
d d d d d d d d d
- prophylactic- infection prevention- pretx for those in close contact with infected pts of
d d d d d d d d d d d d d d
TB/meningitis, pretx for pts undergoing dental extractions who have implanted prosthetic devices,
d d d d d d d d d d d d
such as heart valves
d d d
- definitive- based on culture
d d d d
What antibiotics work on cell wall synthesis? -
d d d d d d d d
d d d d d d d d d d d d d d d d d - beta lactams- penicillins, cephalosporins, glycopeptides
d d d d d
What do penicillin V and G Benzathine work against? Indications? What do they each treat better? -
d d d d d d d d d d d d d d d d
d
- works against aerobic gram positive organisms like S. pneumoniae, group A beta-
d d d d d d d d d d d d d d d d d d d d d d d d d d d d d
hemolytic streptococci, syphilis (T. pallidum)
d d d d
- indicated to tx GABHS/strep, pneumonia, and syphilis
d d d d d d d
- Penicillin V- better success rate at treating GABHS
d d d d d d d d
- Penicillin G Benzathine (Bicillin)- more failure of tx for group A beta hemolytic strep (GABHS);
d d d d d d d d d d d d d d d d
better to treat syphilisd d d
What amoxicillin and amoxicillin/clavulanic acid (penicillins) work against? What are they indicated
d d d d d d d d d d d d
to treat? What do they treat better compared to other penicillins? -
d d d d d d d d d d d d
- treats both gram positive organisms like S. pneumoniae, group A beta-hemolytic
d d d d d d d d d d d d d d d d d d d d d d d d d d d d d
streptococci
- it has greater activity against gram negative bacteria than other penicillins
d d d d d d d d d d d
- indicated to tx endocarditis prophylaxis, community acquired pneumonia, H. pylori, acute otitis
d d d d d d d d d d d d d
media, acute bacterial rhinosinusitis, lyme disease in kids, strep pharyngitis (GABHS)
d d d d d d d d d d
2|Page
,- treats pediatric GABHS because it tastes better
d d d d d d d
What is the MOA of penicillins? What are the cautions and contraindications of penicillins? adverse
d d d d d d d d d d d d d d d
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
d d d d d d d d d d d d
death
- BACTERICIDAL against susceptible bacteria- kills bacteria
d d d d d d
- caution in those with hypersensitivity reactions like stevens johnson syndrome
d d d d d d d d d d
- caution in renal impairment
d d d d
- compatible in pregnancy, lactation, and pediatrics
d d d d d d
- N/V/D, candidiasis, maculopapular rash, C. diff, anaphylaxis (rare), penicillin G benzathine (bicillin),
d d d d d d d d d d d d d
there may be pain at injection site
d d d d d d
T/F: it is common to develop a maculopapular rash from with amoxicillin BUT it does not always
d d d d d d d d d d d d d d d d d
represent a true allergy as it may not happen in subsequent uses -
d d d d d d d d d d d d d
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
d d d d d d d d d d d d d d
especially amoxicillin - d d d
d d d d d d d d d d d d d d d d d true
What are first generation cephalosporins? What do they work against? What are they indicated to
d d d d d d d d d d d d d d d
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,
d d d d d d d d d d d d d
and most streptococci, E. coli (gram negative)
d d d d d d
- indicated to treat cellulitis, uncomplicated cystitis, impetigo, GABHS
d d d d d d d d
Which cephalosporin can be first line tx of mild cellulitis? -
d d d d d d d d d d d
d d d d d d d d d d d d d d d d d cephalexin
3|Page
, What are second generation cephalosporins? What do they work against? What are they indicated
d d d d d d d d d d d d d d
to treat? -
d d d
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
d d d d d d d d d d d d d d d d
negative), BUT MOST IMPORTANTLY HAS INCREASED ACTIVITY AGAINST H. INFLUENZAE (gram
d d d d d d d d d d d
negative organism) d
- indicated for cellulitis, acute exacerbation, acute otitis media, GABHS, lyme disease,
d d d d d d d d d d d d
uncomplicated UTI d
What are third generation cephalosporins? What do they work against? -
d d d d d d d d d d d
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),
d d d d d d d d d d d d d d
E. coli (gram negative), BUT NOW IT INCLUDES N. GONORRHOEAE AND N. MENINGITIDIS (both
d d d d d d d d d d d d d d
gram negative) d
What is are the differences in indications for ceftriaxone, fedinir, cefpodoxime? -
d d d d d d d d d d d d
- ceftriaxone- bacterial meningitis, community acquired pneumonia, uncomplicated
d d d d d d d d d d d d d d d d d d d d d d d d d
gonorrhea, PID, uncomplicated UTI (healthy females only)
d d d d d d
- cefdinir- COPD exacerbation, acute otitis media, and strep pharyngitis
d d d d d d d d d
- cefpodoxime- bacterial bronchitis, community acquired pneumonia, acute bacterial rhinosinusitis,
d d d d d d d d d d
acute otitis media, GABHS
d d d
What characteristics of a patient is an example of a complicated UTI? -
d d d d d d d d d d d d d
d d d d d d d d d d d d d d d d d - male d
- pregnant female
d d
- UTI spread to kidneys
d d d d
What is the MOA of cephalosporins? What are adverse drug effects? What are caution and
d d d d d d d d d d d d d d d
contraindications? - d d
4|Page
