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ID - Exam 1: DNA Synthesis Inhibitors

Total questions: 20

Worksheet time: 14mins

Name
Class
Date
1.

Which of the following statements are true regarding the fluoroquinolones in terms of MOA and PK?

a)

Inhibits Topoisomerases II and IV, inhibiting DNA replication

b)

Fluoroquinolones are bactericidal agents

c)

Every agent EXCEPT for moxifloxacin does NOT require renal dose adjustments for renally impaired patients.

d)

Fluoroquinolones are bacteriostatic agents

e)

Every agent EXCEPT for moxifloxacin requires renal dose adjustments for renally impaired patients.

2.

Which of these black box warnings is true for the fluoroquniolones?

a)

"May cause tendon rupture"

b)

"May cause C. difficile-associated pseudomembranous colitis"

c)

May cause ototoxicity and nephrotoxicity"

d)

"May cause disulfiram-like reactions"

e)

"May cause an increase in all-cause mortality"

3.

Of the following protein synthesis inhibitor classes, which of them share with fluoroquinolones the risk of QT prolongation?

a)

Macrolides

b)

Lincosamides

c)

Aminoglycosides

d)

Oxazolidinones

e)

Tetracyclines

4.

Of the following protein synthesis inhibitor classes, which of them share with fluoroquinolones the risk of peripheral neuropathy?

a)

Macrolides

b)

Lincosamides

c)

Aminoglycosides

d)

Oxazolidinones

e)

Tetracyclines

5.

Of the following protein synthesis inhibitor classes, which of them share with fluoroquinolones an interaction with dairy, mineral supplements, and/or antacids that prevents proper absorption of the antibiotic from the GI tract?

a)

Macrolides

b)

Lincosamides

c)

Aminoglycosides

d)

Oxazolidinones

e)

Tetracyclines

6.

Which of the following drug-specific information is true for each fluoroquinolone discussed in class?

a)

Cipro has unique drug-drug interactions based on its inhibition of the CYP1A2 enzyme.

b)

Levaquin covers Pseudomonas aeruginosa.

c)

Avelox does NOT cover Pseudomonas aeruginosa.

d)

Levaquin can cover Streptococcus pneumoniae, but Cipro cannot.

e)

Cipro, Levaquin, and Avelox are only given by PO.

7.

Which of the following bacterial classes do the fluoroquinolones completely or have some coverage of (including the respiratory fluoroquinolones)? Select all that apply.

a)

Gram-negative rods

b)

Gram-negative coccobacilli

c)

Atypicals

d)

Gram-positive cocci

e)

Anaerobes

8.

Which of the following is true of the MOA and PK of the folate antagonists (i.e., Bactrim)? Select all that apply.

a)

Together, SMX and TMP inhibit the synthesis of folate, an essential intermediate required for DNA precursor synthesis

b)

Dose adjustments are NOT required for renally impaired patients.

c)

When performing weight-based-dosing, calculations are performed using the TMP component of Bactrim.

d)

Bactrim is only given PO.

e)

Bactrim's SMX and TMP contents are formulated in a 5:1 ratio

9.

Which of the following are unique (with relation to other DNA Synthesis Inhibitors) adverse effects of the Folate Antagonists? Select all that apply.

a)

Steven-Johnsons Syndrome/Toxic Epidermal Necrolysis

b)

Crystalluria

c)

Tendon Rupture

d)

Hyperkalemia

e)

Peripheral neuropathy

10.

Which of the following drugs, if taken concurrently with Bactrim, could increase the risk of drug-induced hyperkalemia? Select all that apply.

a)

Lisinopril

b)

Warfarin

c)

Ramipril

d)

Lovastatin

e)

Azilsartan

11.

Which of the following DNA Synthesis inhibitors should patients with G6PD deficiency avoid due to increased risk of hemolytic anemia?

a)

Septra DS

b)

Avelox

c)

Macrobid

d)

Macrodantin

e)

Flagyl

12.

Which of the following true statements regarding the coverage of the Folate Antagonists? Select all that apply.

a)

Bactrim covers ALL versions of Staphylococcus aureus - MSSA, CA-MRSA, and HA-MRSA

b)

Bactrim has coverage against all the Clostridia, but does not have coverage against Bacteroides fragilis.

c)

Bactrim has coverage against Pneumocystis jirovecii (fungus) and Toxoplasma gondii (protozoan).

d)

Bactrim has coverage against Gram-negative rods, although there is emerging resistance (e.g. Pseudomonas aeruginosa)

e)

Bactrim has coverage against Legionella pneumophila.

13.

Which of the following statements are true for nitrofurans' MOA and PK? Select all that apply.

a)

Inhibits bacterial enzymes involved in both DNA and protein synthesis following conversion by bacterial flavoproteins into reactive intermediates.

b)

Nitrofurans are bacteriostatic agents.

c)

Since nitrofurans can achieve therapeutic serum concentrations, they are often used for sepsis and other wide-scale infections.

d)

Nitrofurans require dose adjustments for renally impaired patients; furthermore, they are contraindicated if renal impairment is severe enough (i.e. CrCl < 60 mL/min)

e)

Nitrofurans are available PO, IV, and IM.

14.

Since nitrofurans cover the common causes of UTIs, which of these bacteria would you expect Macrobid to cover?

a)

Acinetobacter baumannii

b)

Enterococcus spp.

c)

Escherichia coli

d)

Klebsiella pneumoniae

e)

Staphylococcus saprophyticus

15.

Which of the following statements are true of the nitroimidazoles' (and thus, Flagyl's) MOA and PK?

a)

They are converted to reactive intermediates by obligate aerobic intracellular processes, resulting in DNA structural damage.

b)

They are bactericidal agents.

c)

All aerobic bacteria are intrinsically resistant to nitroimidazoles

d)

Flagyl can be expected to reach 100% oral bioavailability.

e)

Aside from PO and IV forms, metronidazole can also be found as a topical (vaginal) formulation (MetroGel)

16.

Which of these items could potentially induce disulfiram-like reactions with Flagyl (PO) if fully ingested? Select all that apply.

a)

Great Value Vanilla Bean Extract

b)

Listerine Mouthwash

c)

Hennessy

d)

NyQuil Cough and Flu Liquid Elixir

e)

Mr. Pibb (i.e., generic Dr. Pepper)

17.

Which of the following organisms does Flagyl cover? Select all that apply

a)

Clostridioides difficile

b)

Clostridium perfringens

c)

Bacteroides fragilis

d)

Trichomonas vaginalis (Protozoa)

e)

Giardia lamblia (Protozoa)

18.

Of the DNA Synthesis Inhibitors, which classes share the adverse effect of peripheral neuropathy with the Oxazolidinones (Protein Synthesis Inhibitor)? Select all that apply.

a)

Nitroimidazoles

b)

Nitrofuran

c)

Folate Antagonists

d)

Fluoroquinolones

e)

Reverse Transcriptase Inhibitors

19.

Although it's known that warfarin generally "reacts with everything," which of the following DNA Synthesis Inhibitors is NOT known to interact with warfarin?

a)

Avelox

b)

Macrodantin

c)

Flagyl

d)

Levaquin

e)

Septra DS

20.

Which of the DNA Synthesis Inhibitors can cause CNS disturbances, where headaches and dizziness are mild symptoms and severe symptoms entail delirium, hallucinations, and seizures?

a)

Cipro

b)

Septra DS

c)

Flagyl

d)

Macrobid

e)

Bactrim