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WorksheetsID - Exam 1: PS Inhibitors
Total questions: 22
Worksheet time: 22mins
Of the following protein synthesis inhibitors, which of them binds to the 50S subunit? Select all that apply.
Erythromycin
Amikacin
Tigecycline
Linezolid
Omadacycline
Of the following protein synthesis inhibitors, which of them binds to the 30S subunit? Select all that apply.
Azithromycin
Amikacin
Tigecycline
Clindamycin
Omadacycline
Which are true of the macrolides, in terms of their MOA and PK? Select all that apply.
All members of this class bind to the 30S ribosomal subunit, inhibiting the transpeptidation process during bacterial protein synthesis
Macrolides are bacteriostatic agents
Azithromycin has a longer 1/2-life than the other macrolides discussed in class, clarithromycin and erythromycin
Azithromycin is able to achieve higher concentrations in tissues and phagocytes than in plasma
All the macrolides discussed in class (Zithromax, Biaxin, and EES) are all orally bioavailable
The macrolides we've covered in class generally cover the atypical bacteria (i.e. Legionella spp., Chlamydia spp., and Mycoplasma spp.), but each drug has their own unique coverages from each other. Which of these statements are FALSE? Select all that apply.
Biaxin has extra coverage against Haemophilus influenzae.
Erythromycin has extra coverage against Pseudomonas aeruginosa and CA-MRSA
Zithromax has extra coverage against Haemophilus influenzae and certain non-lactose fermenting Enterobacteriaceae
Biaxin has extra coverage against Enterobacter spp.
Zithromax has extra coverage against Pseudomonas aeruginosa.
Which of the following statements is true of lincosamides' PK and MOA? Select all that apply.
All lincosamides bind to the 50S ribosomal subunit, inhibiting transpeptidation during bacterial protein synthesis
All lincosamides are bacteriostatic agents
Lincosamides are usually dosed once daily due to their extremely long 1/2-lives
Clindamycin can penetrate through most tissues, including bone.
Clindamycin can be given via PO or IV
Which of the following is true for the spectrum of the lincosamide, Cleocin? Select all that apply.
Cleocin has additional coverage towards specific bacteria: Enterococcus spp., Clostridioides difficile, and Pseudomonas aeruginosa.
Cleocin is recommended for the treatment of infections caused by HA-MRSA.
If a patient's CA-MRSA strain comes back positive for the D-test, they should be treated with Cleocin.
Cleocin covers Streptococcus pyogenes and Corynebacterium diphtheriae.
In terms of anaerobes, Cleocin ONLY covers Clostridium perfringens
Which of these statements are true regarding the Oxazolidinones and Zyvox?
All members bind go the 50S subunit, inhibiting tRNA binding during bacterial protein synthesis.
It is bactericidal to Streptococcus spp., but bacteriostatic towards Enterococcus spp. and Staphylococcus spp.
Zyvox is available via PO and IV
Zyvox has coverage against the Gram-negative cocci, namely N. gonorrhoeae and N. meningitidis.
Between the two Clostridia we've discussed in class, Zyvox covers C. perfringens but NOT C. difficile.
Which of the following statements are FALSE regarding the Tetracyclines in terms of MOA and PK? Select all that apply.
All tetracyclines bind to the 30S ribosomal subunit, inhibiting tRNA during protein synthesis
Aside from Tigecycline, Doxycycline is the only other tetracycline that is excreted via feces (via bile); the rest of the tetracyclines are excreted via urine
Minocin and Vibramycin have shorter 1/2-lives than other tetracyclines
Tetracyclines are bacteriostatic agents
All tetracyclines have fairly large volumes of distribution
Which of the following statements are true regarding some drug-specific information in the tetracycline class? Select all that apply.
Tigecycline has a black-box warning: "Increase in all-cause mortality"
Minocin has the unique adverse effect of inducing a lupus-like syndrome.
Tygacil has coverage against Acinetobacter baumannii.
Doxycycline can only be given via PO.
Omadacycline can be given only via IV.
Per our directed reading guide, tetracyclines cover "atypical bacteria, with limited Gram-positive cocci and Gram-negative pathogen coverage." Which of these bacteria fit this description? Select all that apply.
Haemophilus influenzae
Moraxella catarrhalis
Rickettsia rickettsii
Borrelia burgdorferi
Staphylococcus spp.
How are Tygacil and Nuzyra "built different" from the other tetracyclines (i.e., Minocin and Vibramycin) in terms of bacterial coverage? Select the TRUE statement.
Tygacil and Nuzyra cover Pseudomonas aeruginosa, while Minocin and Vibramycin do not.
Tygacil and Nuzyra do not have coverage against Acinetobacter baumannii while Vibramycin and Minocin do.
Doxycycline and Minocin has broader coverage against the Gram-positive cocci, including MRSA, while Tygacil and Nuzyra do not.
Tygacil and Nuzyra can cover Gram-negative rods EXCEPT Proteus mirabilis and Pseudomonas aeruginosa.
All of the statements above are true.
Of the protein synthesis inhibitors, which adverse effect(s) is unique to the macrolides?
QT-interval prolongation
C. difficile-associated pseudomembranous colitis
Increase in all-cause mortality
Tooth discoloration in patients < 8 y.o.
Ototoxicity and Nephrotoxicity
Of the protein synthesis inhibitors, which adverse effect(s) is unique to the Lincosamides (i.e., Cleocin)?
QT-interval prolongation
C. difficile-associated pseudomembranous colitis
Increase in all-cause mortality
Tooth discoloration in patients < 8 y.o.
Ototoxicity and Nephrotoxicity
Of the protein synthesis inhibitors, which adverse effect(s) is unique to the Aminoglycosides?
QT-interval prolongation
C. difficile-associated pseudomembranous colitis
Increase in all-cause mortality
Tooth discoloration in patients < 8 y.o.
Ototoxicity and Nephrotoxicity
Of the following PS inhibitor classes, which of the following has increased risk of nephrotoxicity if taken concurrently with other nephrotoxic drugs?
Aminoglycosides
Tetracyclines
Lincosamides
Macrolides
Oxazolidinones
Of the following PS inhibitor classes, which of the following has weak MAOI activity (and thus can be expected to have similar drug-drug interactions like the MAOIs)?
Aminoglycosides
Tetracyclines
Lincosamides
Macrolides
Oxazolidinones
Of the following PS inhibitor classes, which of the following would have decreased efficacy if taken concurrently with CYP3A4 inducers (i.e. increased presence of CYP3A4) without any dose modifications?
Aminoglycosides
Tetracyclines
Lincosamides
Macrolides
Oxazolidinones
Of the following macrolides, which one does NOT inhibit CYP3A4 like the rest of the class (and thus will not expect to have interactions with CYP3A4 substrates)?
Erythromycin
Clarithromycin
Tobramycin
Clindamycin
Azithromycin
Of the following PS inhibitor classes, which of the following share the interaction of increasing anticoagulants' effects? Select all that apply.
Aminoglycosides
Tetracyclines
Lincosamides
Macrolides
Oxazolidinones
Which of the following statements are true regarding the PK of the aminoglycosides? Select all that apply.
They are eliminated via urine, unchanged.
Of the PS inhibitors we've covered, they have explicit requirements for dose adjustments for renally impaired patients.
Like vancomycin (glycopeptide), they all require therapeutic drug monitoring of serum drug concentrations.
They exhibit post-antibiotic effect (PAE), or continued suppression of bacterial growth after antimicrobial exposure despite plasma concentrations falling below MIC.
Gentamicin, Tobramycin, and Amikacin can all be given IV only.
Which of the following statements are FALSE regarding aminoglycoside bacterial coverage? Select all that apply.
All anaerobic bacteria and Enterococcus spp. are intrinsically resistant to them
They have coverage against Pseudomonas aeruginosa
They have coverage against Bacteroides fragilis
They have coverage against Haemophilus influenzae
They have coverage against Staphylococcus saprophyticus
Which of the following agents has the risk for inducing peripheral neuropathy and/or thrombocytopenia?
Zyvox
Zithromax
Nuzyra
Vibramycin
Amikacin
