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More Antibiotics Tutoring for Pharmacology
By Alaina Darby
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Tuberculosis
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Isoniazid, rifampin, pyrazinamide, and kanamycin
Which of the following combinations is first line therapy for M. tuberculosis? Isoniazid, rifampin, pyrazinamide, and kanamycin Isoniazid, rifampin, paraaminosalicylic acid, and streptomycin Isoniazid, rifampin, paraaminosalicylic acid, and ethionamide Isoniazid, rifampin, pyrazinamide, and ethambutol d
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Clarithromycin and ciprofloxacin Clarithromycin and rifampin
Which of the following combinations is first line therapy for M. avium complex? Clarithromycin and ciprofloxacin Clarithromycin and rifampin Clindamycin and ethambutol Clindamycin and azithromycin a
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Which drugs are included in Rifater? Rifampin and isoniazid
Rifampin and pyrazinamide Rifampin, isoniazid, and pyrazinamide Rifampin, isoniazid, pyrazinamide, and ethambutol c
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When should the fourth drug be omitted in TB treatment?
For the initial 8 week daily treatment of option 1 when drug resistance is <4% For the initial 8 week daily treatment of option 1 when drug resistance is <2% For the 24 day three times a week treatment of option 3 when drug resistance is <4% For the 24 day three times a week treatment of option 3 when drug resistance is <2% a
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Organisms multiply slowly Organisms develop resistance
Which of the following is not a reason that TB is difficult to treat and therapy may last up to two years? Organisms multiply slowly Organisms develop resistance Organisms utilize host machinery Organisms live intracellularly c
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Which of the following does not describe isoniazid?
It is effective for intracellular bacteria It is cidal for bacteria living in macrophages It interferes with mycolic acid synthesis It is static for slow growing bacilli b
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Which of the following does not describe resistance to isoniazid?
Decreased ability to take up the drug Alternate pathway for cell wall synthesis Overproduction of target enzyme Emerges rapidly when used as a single agent b
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Which of the following is not true of isoniazid pharmacokinetics?
Well absorbed when given orally or can be given IV or IM Reaches therapeutic levels in CSF with inflamed meninges Acetylated in the liver by N-acetyl transferase Parental and metabolized compounds excreted renally a
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Peripheral neuropathy Nausea and vomiting
Which of the following adverse reaction can be corrected by supplementing with pyrodoxime? Hepatotoxicity Allergic reactions Peripheral neuropathy Nausea and vomiting c
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Which of the following adverse reactions is not dose related?
Hepatotoxicity Allergic reactions Peripheral neuropathy Nausea and vomiting b
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Peripheral neuropathy is more common for all but which of the following conditions?
Malnourishment Diabetes Cushing’s syndrome Alcoholism c
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Which of the following decreases the efficacy of isoniazid? Phenytoin
Diazepam Fluoxetine Hydrocortisone d
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Which of the following does not describe rifampin?
Resistance due to decreased binding to DNA-dependent RNA polymerase Inhibition of RNA synthesis mediated by binding to alpha subunit of RNA polymerase Spectrum includes both intra- and extracellular mycobacterium Produces bactericidal effects and is never given alone due to emergence of resistance b
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Absorption impaired by para-aminosalicylic acid
Which of the following does not describe the pharmacokinetics of rifampin? Absorption impaired by para-aminosalicylic acid Is well distributed throughout the body and CSF Undergoes little to no hepatic metabolism Does not need to be adjusted for renal dysfunction c
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Which of the following is not true of the adverse effects of rifampin?
Discolors bodily fluids an orange-red color Causes fever, chills and aches May cause nervous system effects Hepatotoxicity frequent in rapid acetylators d
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Which of the following describes drug interactions with rifampin?
Inhibits cytochrome P450 Increases bioavailability of anticoagulants Increased risk of pregnancy when taking oral contraceptives Probenecid decreases rifampin serum levels c
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Methicillin-resistant Staphylococcus aureus
Which of the following is not a therapeutic use of rifampin as a sole agent? Methicillin-resistant Staphylococcus aureus Prophylaxis for H. influenza meningitis Eradication of staphylococcus in nasal carriers Treatment of leprosy a
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Which of the following does describes ethambutol?
Produces a bactericidal effect in dividing bacteria Cross resistant with rifampin Disrupts the cell membrane Possible inhibition of RNA synthesis d
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Concentrates in kidneys, lungs, saliva
Which of the following does not describe the pharmacokinetics of ethambutol? Concentrates in kidneys, lungs, saliva Good distribution to all tissues including CSF Requires dose adjustment with renal dysfunction Partially metabolized in the liver b
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Which of the following is not an adverse reaction from taking ethambutol?
Optic neuritis Allergic reactions Hepatotoxicity Hyperuricemia c
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Which of the following describes pyrazinamide?
Increases pH within the acidic environment of the macrophage Converted to pyrazinamide from pyrazinoic acid Resistant strains may lack pyrazinamidase Only active against extracellular bacilli c
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Which of the following is not true of pyrazinamide?
May cause mild non gouty arthralgias Should be discontinued if hyperuricemia develops Exhibits dose related hepatotoxicity Metabolized in the liver and excreted via glomerular filtration b
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Which of the following is true of cycloserine?
Can be used for tuberculosis or mycobacterium avium complex as a first line agent Works by destabilizing the cell membrane in mycobacterium Is an antimicrobial that is effective against resistant organisms Can block D-alanine racemase and L-alanine synthetase c
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Which is not true of the pharmacokinetics of cycloserine?
Good absorption when administered orally Good distribution in uninflamed meninges Undergoes extensive hepatic metabolism Dose adjustment required for renal dysfunction c
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Central nervous system disorders are not reversible
Which of the following does not describe the adverse events associated with cycloserine? Central nervous system disorders are not reversible Cause contraindication in persons with a history of epilepsy May include headache, tremor, and vertigo Induces psychotic states and seizures a
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Which of the following is true of capreomycin? Bacteriocidal
Administered orally Causes nephrotoxicity High cross resistance c
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Which of the following is not a toxicity caused by ethionamide?
Gastrointestinal toxicity Hepatotoxicity Ototoxicity Thyroid toxicity c
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Which of the following is not true of ethionamide?
Structural analog of isoniazid Similar mechanism to isoniazid Administered by IM injection Distributes to CSF b
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Aluminum antacids reduce absorption Inhibits cytochrome P450
Which of the following is a drug interaction seen in isoniazid that is also seen in ethambutol? Aluminum antacids reduce absorption Inhibits cytochrome P450 Induces cytochrome P450 Corticosteroids decrease efficacy a
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