Ch. 39-44

All of the following are characteristics of Tetracyline Antibiotics EXCEPT: -Have a broad spectrum of activity that includes gram positive, gram negative, chlamydial infections, cholera, and Lyme Disease. -Includes the antibiotics Doxycycline and Minocycline -Taking them with dairy foods in the diet INCREASES absorption via chelation with calcium ions -Deposition in the bone and teeth causes temporary stunting of growth and discoloration of teeth, therefore they are contraindicated for use in childen under 8 years of age. -phototoxicity is a concern. -Bind reversibly to the 30S Subunit of the Bacterial Ribosome.

-Taking them with dairy foods in the diet INCREASES absorption via chelation with calcium ions False: Decreased absorption w/ dairy

T/F? for both 1. The Malarial Plasmodium parasites, in their digestion of hemoglobin as a nutrient, produce a toxic molecule called Hemozoin. 2. Antimalarial Drugs ( Chloroquine, Mefloquine) bind to the toxic hemozoin molecules and prevent them from being converted into less toxic Heme molecules.

1. False - parasites convert toxic heme, to non toxic hemozoin so that they don't self destruct from the heme 2. False- Antimalarials bind to the "toxic heme" to prevent it from being converted to less toxic hemozoin. Accumulation then of toxic heme destroys parasite and RBC

Match the Flouroquinolone Antibiotic to the corresponding Generation : 1. Nalidixic Acid ( Neggram) 2. Ciprofloxacin ( Cipro) 2. Norfloxacin ( Noroxin ) 3. Ofloxacin ( Floxin ) 4. Levofloxacin ( Levaquin ) 5. Moxifloxicin ( Avelox)

1. First Generation 2. Second Generation 3. Second Generation 4. Second Generation 5. Third Generation 6. Fourth Generation

In looking at the mechanism of action for Folic Acid Antagonists, Prokaryotic bacterial cells, because they are impermeable to folic acid, obtain their needed folic acid via_______________________, while human eukayotic cells obtain their needed folic acid via ______________ for cell utilization. (Diet/Intracellular Synthesis)

1. Intracellular Synthesis 2. Diet

The Anti-Parastic Drug _________________hyperpolarizes the parasite's nerve and muscles cells, leading to cell death, while the Anti-Parasitic Drug _______________ interferes with the uptake of glucose , so that the cell loses energy and dies. Albendazole (Albenza) , Ivermectin (Stromectol) Ivermectin (Stromectol) , Albendazole (Albenza)

1. Ivermectin (Stromectol) 2. Albendazole (Albenza)

Match the Antibiotic Drug to the Antibiotic Drug Class: 1. Clotrimazole ( Lotrimin) 2. Amphotericin 3. Chloroquine 4. Mefloquine ( Liriam ) 5. Ivermectin ( Stromectol ) 6. Albendazole ( Albenza)

1.Anti-Fungal - topical 2.Anti-Fungal - IV 3.Anti-Malarial 4.Anti-Malarial 5.Anti-Helmintic Drug 6.Anti-Helmintic Drug

Match the Antibiotic Drug to the Antibiotic Drug class: 1.Ciprofloxacin ( Cipro) 2.Levofloxacin ( Levaquin) 3.Sulfamethoxazole 4.Trimethoprim 5.Bactrim DS 6.Rifampin 7.Isoniazid 8.Pyrazinamide

1.Flouroquinolone 2.Flouroquinolone 3. Folic Acid Antagonist 4. Folic Acid Antagonist 5. A combination Folic Acid Antagonist Drug 6.Anti-Mycobacterial Drug ( TB ) 7.Anti-Mycobacterial Drug ( TB ) 8.Anti-Mycobacterial Drug ( TB )

Match the Antibiotic Drug class with corresponding general Mechanism of Action: 1. Flouroquinolones 2. Folic Acid Antagonists 3. Antimycobacterials 4. AntiFungal Drugs 5 .Anti-Protozoal Drugs

1.Flouroquinolone: Inhibit Bacterial DNA Gyrase needed for bacterial DNA replication 2. Folic Acid Antagonist: Antagonizes cellular enzymes Dihydropteroate Synthetase and Dihydrofolate Reducatse needed for Bacterial DNA synthesis 3. Antimycobacterials: Generally target enzymes needed for WAXY MYCOLIC ACID Bacterial Cell Wall. 4. Antifungals: Target the characteristic ergosterol component of the cell membrane. 5. Antiprotozoals: Bind to the Heme Molecule within the RBC, raising the pH and destroying the parasite.

People who have Latent Tuberculosis Infection ( LTBI ) have about a _____________ (%) chance of going on to develop Active Tuberculosis.

10%

Match the Flouroquinoline Generation to the Flouroquinolone Spectrum of Activity ( slide # 3 ) 1st Generation Flouroquinolone 2nd Generation Flouroquinolone 3rd Generation Flouroquinolone 4th Generation Flouroquinolone

1st Gen: Moderate Gram - Activity, restricted to the tx of UTI 2nd Gen: Expanded Gram - Activity Some Activity against Gram + Bacteria Some Activity against Atypical Organisms (Mycoplasma , Chlamydia) 3rd Gen: Retain Expanded Gram - Activity, Improved Activity against Atypical Organisms (Mycoplasma, Chlamydia), Improved Activity against specific Gram + Bacteria 4th Gen: Improved Gram+ coverage Maintains expanded Gram- activity Less activity against Atypical Organisms Shows activity against Anaerobic Organisms

Active Mycobacterium Tuberculosis Therapy is best treated with: -One antibiotic for 6 to 12 days to decrease risk of developing resistant strains -A combination of antibiotics for 6 to 12 days to decrease risk of developing resistant strains -One antibiotic for 6 to 12 months to decrease risk of developing resistant strains -A combination of antibiotics for 6 to 12 months to decrease risk of developing resistant strains

A combination of antibiotics for 6 to 12 months to decrease risk of developing resistant strains

All of the following are Anti-Fungal Agents.....EXCEPT: Terbinifine ( Lamisil ) Miconazole ( Monistat) Terconazole ( Terazole ) Ketoconazole ( Nizoral ) Fluconazole ( Diflucan) All of the above are Anti-Fungal Agents

All of the Above

Which Folic Acid Antagonist Drug shows the greatest inhibition of bacterial growth? -Sulfamethoxazole -Trimethoprim -Sulfasalzine -Bactrim ( Sulfamethoxazole / Trimethoprim )

Bactrim ( Sulfamethoxazole / Trimethoprim )

The intestinal parasitic 'tapeworm' belongs to what major group of Helminth? Nematodes Trematodes Cestodes

Cestodes

The Folic Acid Antgaonist - Trimethoprim antagonizes Folic Acid synthesis and subsequent synthesis of Bacterial RNA & DNA by inhibiting the enzyme ___________________. -DNA Gyrase -Dihydrofolate Reductase -Dihydropteroate Synthase -Folic Acid Pyrimidase

Dihydrofolate Reductase

The Sulfonamide Folic Acid Antgaonists ( Sulfasalazine , Sulfamethoxazole) antagonize Folic Acid synthesis and subsequent synthesis of Bacterial RNA & DNA by inhibiting the BACTERIAL enzyme ___________________. -DNA Gyrase -Dihydrofolate Reductase -Dihydropteroate Synthase -Folic Acid Pyrimidase

Dihydropteroate Synthase

The component of the Fungal Cell that provides 'selective toxicity' for many of the Anti-Fungal Agents is the: -The peptidoglycan layer -Phospholipids -Cholesterol -Ergosterol

Ergosterol

All of the following drugs are classified as Aminoglycoside Antiobiotics......EXCEPT -Gentamycin ( Garamycin ) -Erythromycin -Streptomycin -Tobramycin

Erythromycin

Fungi are classified as : -Gram Positive Prokarytotic Organisms -Gram Negative Prokaryotic Organisms -Mycobacteria -Eukaryotic Organisms -Protozoa

Eukaryotic Organisms

T/F? The flu-like signs and symptoms of Malaria (Headache, fever, shivering, joing pain, vomitting, jaundice, hemoglobinuria) typically begin under a week following

False *Begin 8-25 days following infection

T/F? The Aminoglycosides, just as other antibiotic classes, have a WIDE THERAPEUTIC INDEX and therefore do not require therapeutic drug monitoring.

False *Narrow TI, Toxicity may be severe and irreversible

T/F? Fungal Infections that penetrate the skin and become systemic are easily treated with Amphotericin B , with minimal risk of toxicities and adverse side effects associated with its use.

False *used in spite of toxicity risk *Nickname Ampho-terrible

T/F? Helminths are a group of prokaryotic intestinal parasitic organsims that live in and feed off of hosts, receiving nurishment and protection while disrupting their hosts' nutrient absorption.

False- Eukaryotic

T/F? for both 1. Aminoglycoside Antibiotics are Indicated for the treatment of serious, life-threatening infections caused by Gram PositIve bacteria. 2. Aminoglycoside Antibiotics are associated with serious toxicites, such as ototoxity, nephrotoxicity, and neuromuscular toxicities.

False; True *Aminoglycoside abx tx GRAM NEG *No effect on gram +

T/F? For both statements 1. Generally, Macrolide Antibiotics are Indicated for the treatment of gram negative infections respiratory tract infections , with gram positive infections generally being more resistant to the effects of these protein synthesis inhibitors. 2. Macrolide Antibiotics have a spectrum of activity that is slightly wider than that of penicillins, and because of this, they are a common substitute for patients with Penicillin allergies

False; True *Macrolide abx tx GRAM POS *Gram - usually resistant to macrolide

The Flouroquinolones Antibiotics are generally effective against ____________________ (Gram +/-) organisms, with newer generations showing improved coverage against _____________________ (Gram +/-) organisms and atypical organisms (Mycoplasma, Chlamydia..etc)

Gram -, Gram +

All of the following are Common Clinical uses of Aminoglycoside Antiobiotics, EXCEPT. -Serious / Complicated gram negative skin, bone or soft tissue infections -Serious / Complicated gram negative urinary tract infection -Gram Negative - Septicemia -Gram Positive - Upper Respiratory Tract Infection

Gram Positive - Upper Respiratory Tract Infection

Which of the following is the mechanism of action for the Floroquinolone Antibiotics is: -Bind reversibly to the 30S subunit of the bacterial ribosome, inhibiting Protein Synthesis -Inhibit the bacterial enzyme, DNA Gyrase, which is needed for DNA replication -Antagonize Folic Acid synthesis -Cell Wall Inhibition

Inhibit the bacterial enzyme, DNA Gyrase, which is needed for DNA replication

All of the following statements regarding Protozoa are TRUE, ......EXCEPT: -Protozoa are eukaryotic organisms ( while bacteria are prokaryotic) -Protozoa are found only in moist places ( while bacteria are found everywhere) -Protozoa can ONLY divide and proliferate within a host organism. -The vast majority of protozoa parasites are Non-Pathogenic living as harmless commensals within the host -Protozoa can react to light and temperature changes -Most Protozoa can be seen by the naked eye.

Most Protozoa can be seen by the naked eye *False-most can only be seen by microscope

MALARIA, the mosquito born infectious disease is caused by PROTOZOA of the genus PLASMODIUM , and the SPECIES of Plasmodium responsible for the most dangerous form of MALARIA is...... Plasmodium Ovale Plasmodium Malariae Plasmodium Vivax Plasmodium Faliciparum

Plasmodium Faliciparum

All Mycobacterium species share a waxy cell wall , rich in Mycolic Acid, that is characteristically __________________ (thicker/thinner) than in many other bacteria, and this makes them highly resistant to antimicrobials.

Thicker

All of the following are Macrolide Antiobiotics.....EXCEPT. -Tobramycin ( Tobrex) -Erythromycin ( Erythrocin ) -Azithromycin ( Zithromax) -Clarithromycin ( Biaxin )

Tobramycin ( Tobrex)

T/F? Gram Negative Urinary Tract infections respond well to Trimethoprim / Sulfamethoxazole (Bactrim)

True

T/F? Malaria causing Plasmodium protozoa , once in the blood stream via a mosquito bite, invade Red Blood Cells, using hemoglobin in the RBC's as a nutrient for growth and replication.

True

T/F? The Spectrum of Activity of the Folic Acid Antagonists (Sulfa Drugs and Trimethoprim) are similar to each other, however, Trimethoprim is 20 to 50 fold more potent that the Sulfonamides (Sulfasalazine, Sulfamethoxazole)

True

T/F? The flouroquinolone antibiotic drugs are generally safe to take, however, they are also associated with rare but serious tendonopathy and neuropathy adverse effects.

True

T/F? The general usefullness of Tetracycline Antibiotics has been reduced due to bacterial resistance, and they are most commonly used in the treatment of moderately severe acne and rosacea

True

T/F? The bacterial (prokaryotic) ribosome is SMALLER (70S) than the mammalian (eukaryotic) ribosome (80S), is composed of subunits (50S & 30S) that are smaller than that of mammalian ribosome (60S & 40S), and this ultimately allows for the "selective toxicity" where Protein Synthesis Inhibitors CAN interact with the bacterial target , but spare the host cells.

True

The Mycobacteria , Mycobacterium Tuberculosis, is classified as: -Gram Positive -Gram Negative -Neither Gram Positive nor Gram Negative

neither

Common things treated w/ macrolides

strep staph URI LRI Skin infections (strep/staph) Community Acquired Pneumonia Pertussis bacterial COPD tonsillitis/pharyngitis Chlamydia Syphilis