Antibacterial: Guided Practice Set #1

Special concerns in using antimicrobials in newborns and young children:
1. Sulfonamides can be safely given to newborns
2. Tetracyclines should not be administered to children betlow the age of eight
3. Newborns should not be given chloramphenical because they are unable to metabolize the drug adequately.
4. B & C
Associated with "gray baby syndrome" which is characterized by pallor, cyanosis, and even death.
1. tetracyclines
2. chloramphenicol (Chloromycetin)
3. third-generation cephalosporins
4. A & B
Antibacterials regarded as generally safe to prescribe in pregnancy.
1. erythromycins
2. cephalosporins
3. tetracyclines
4. A & B
Antibiotic's clearance from the body most likely influenced by severe hepatic disease:
1. penicillins
2. clindamycin (Cleocin)
3. rifampin (Rimactane)
4. B & C
This antibiotic may cause hemolysis if prescribed to a patient with glucose-6-phosphate dehydrogenase deficiency:
1. penicillin V (Pen-Vee K, Veetids)
2. neomycin
3. Augmentin ( amoxicillin (Amoxil Polymox) and clavulanic acid)
4. sulfisoxazole (Gantrisin)
More likely to cause polyneuritis in patients who are"slow acelators"; this antibiotic is inactivated by the liver.
1. clindamycin (Cleocin)
2. isoniazid (INH)
3. nafcillin (Nafcil, Unipen)
4. vancomycin (Vancocin)
Synergistic antimicrobial combination:
1. amoxicillin-clavulanate
2. ampicillin -streptomycin
3. sulbactam-ampicillin
4. A, B & C
Combination of metronidazole (Flagyl) and penicillin in treating an abscess caused by beta-lactamase producing Bacteriodes and anaerobic streptococci is an example of:
1. synergistic drug treatment
2. antagonistic drug effects
3. additive drug effects
4. none of the above
Mechanism of action: amoxicillin (Amoxil Polymox)
1. inhibits bacterial cell wal biosynthesis
2. interferes with transpeptidation preventing peptidoglycan chain crosslinking.
3. both
4. neither
FALSE statement about penicillin G
1. treatment of choice for viridans group streptococcal endocarditis.
2. Pen G and Pen V are the two natural penicillins.
3. Pen G can be combined with procaine, extending drug half-life
4. Pen G most effective when given orally
Alternative antimicrobial drug(s) for treating penicillin-resistant S. aureus:
1. vancomycin (Vancocin)
2. nafcillin (Nafcil, Unipen)
3. methicillin (Staphcillin)
4. A, B & C
Suitable for treatment of bacterial meningitis caused by H. influenzae:
1. cefotaxime (Claforan)
2. cephalexin (Keflex)
3. cephalothin (Keflin)
4. cefadroxil (Duricef, Ultracef)
A sixty-year old male was recovering from bowel resection. The initial recovery period was unremarkable. Late on the third post-operative day the patient began hyperventilating with respiratory alkalosis. On the fourth post-operative day, the patient's condition rapidly worsened with a significant elevation of temperature (104.9 F), profound hypotension (65/38 mm Hg) and tachycardia. Urine output was very low with BUN and serum creatinine (5 mg%, which had increased from normal levels at admission) were elevated. . Gram staining of sputum, which was purulent, indicated gram-negative rods. WBC was 17000/mmseptic shock with a shift to the left. The diagnosis was fulminant bacteremia and septic shock. What mechanism is most likely responsible for this patient's tachycardia?
1. Direct effects of bacterial endotoxins on the SA node
2. Significant hypotension associated with low systemic vascular resistance.
3. bacterial endotoxins bind to muscarinic cholinergic receptors, thus removing the dominating cholinergic tone in the heart.
4. patient anxiety
Beta-lactamase inhibitor:
1. vancomycin (Vancocin)
2. sulbactam
3. clavulanate
4. B & C
Aminoglycosides antibacterial
1. hetacillin
2. aztreonam
3. gentamicin (Garamycin)
4. vancomycin (Vancocin)
Ototoxicity and nephrotoxicity associated with this antibiotic:
1. cefotaxime (Claforan)
2. amikacin (Amikin)
3. aztreonam (Azactan)
4. ceftriaxone (Rocephin)
Inhibits bacterial cell wall synthesis:
1. streptomycin
2. vancomycin (Vancocin)
3. doxycycline (Vibramycin, Doryx)
4. gentamicin (Garamycin)
A ninety two year-old female was brought to the emergency room following an episode of low blood pressure and disorientation at the nursing home. She had been refusing food and drank little. She was provided i.v glucose and was rehydrated. Over the next few days her condition worsened with increasing periods of incoherence. She exhibited hyperventilation with respiratory alkalosis and pulmonary congestion. Her body temperature was slightly subnormal and she was hypotensive (75/40 mm Hg) and tachycardic. Her pulmonary congestion worsened as did her blood gases. Digoxin was administered. Blood cultures indicated the present of E. coli, leading to a definitive diagnosis of E. coli septicemia. Which drug(s) would be appropriate to treat the septicemia?
1. cefotaxime (Claforan)
2. ceftriaxone (Rocephin)
3. aztreonam (Azactan)
4. all of the above
Properties of tetracycline (Achromycin):
1. inhibitor of bacterial cell wall synthesis
2. drug of choice in treating typhus
3. cleared primarily by the liver
4. A & B