Lecture 5

Question 1

Selman Waksman

Answer 1

• coined phrase ‘antibiotics’
• discovered actinomycin in soil bacteria
• appreciation for ethical responsibility in implementation of antibiotics

Question 2

Anne Sheafe Miller

Answer 2

• first patient treated with penicillin
• treated by dr fulton

Question 3

Antibiotic impact on medicine

Answer 3

• US death rate from infections fell
• shifted focus from prognosis to cure

Question 4

Modes of action

Answer 4

• cell wall synthesis
• protein synthesis
• nucleic acid synthesis
• metabolic pathways
• membrane function
• ATP synthase

Question 5

Targets of antibacterial drugs

Answer 5

• cell membrane
• cell wall
• protein synthesis
• nucleic acid synthesis
• biological metabolic compound synthesis

Question 6

Penicillin

Answer 6

• preventing formation of bacterial cell wall
• penicillin, amoxicillin

Question 7

antibiotic efficacy

Answer 7

• pharmacokinetic and pharmacodynamic principles (metabolizing)
• species of bacteria
• bacterial load
• site of infection

Question 8

bactericidal

Answer 8

kill bacteria
- aminoglycosides, beta-lactams, fluoroquinolones, glyopeptides

Question 9

bacteriostatic

Answer 9

prevent growth
- tetracyclines, lincosamides, macrolides, sulfonamides

Question 10

dosing antibiotics

Answer 10

• site of infection, susceptibility of infecting organism, drug toxicity
• medicines, supplements, or foods can interact
• dosing by group

Question 11

adverse reactions

Answer 11

• 1/5 hospitalized patients
• allergic reaction v toxicity
• elderly, co-morbidities, hospitalized patients at higher risk

Question 12

allergy

Answer 12

immune mediated reaction or hypersensitivity

Question 13

Renal adverse reactions

Answer 13

• renal failure
• most common

Question 14

Cardiac

Answer 14

QT prolongation

Question 15

Hematologic

Answer 15

• low platelets
• low white blood cell

Question 16

Dermatologic

Answer 16

• rash
• steven johnson syndrome (inflammatory)

Question 17

Neurologic

Answer 17

hearing loss

Question 18

Other

Answer 18

• hepatotoxicity
• drug induced fever or diarrhea

Question 19

Acute otisis media in children

Answer 19

• 84% of encounters resulted in antibiotic prescriptions
• mean duration 9-10 days
• 75% of cohort received 10 day durations

Question 20

Walsh McDermott

Answer 20

Use AB responsibly
- pivotal role in deploying penicillin for civilian use

Question 21

antibiotic resistance causes

Answer 21

• widespread use
• increase antibiotic exposure

Question 22

impact of AB resistance

Answer 22

• global spread, treatment challenges, increasing US deaths, economic damage

Question 23

antibiotic resistance

Answer 23

• reducing intracellular AB concentrations (increased efflux, decreased influx)
• antibiotic inactivation (enzymatic modification, chemical degradation)
• target site alteration (mutation, protection, elimination of target site)

Question 24

genetics of AB resistance

Answer 24

• point mutations
• genomic rearrangements
• horizontal gene transfer

Question 25

B-lactamase

Answer 25

- enzymes that break down B-lactam ring - lead to antibiotic resistance - emerged following 3rd generation cephalosporins

Question 26

multidrug resistance

Answer 26

- MRSA, extended spectrum B-lactamase producing e.coli, carbapenemase producing community acquired K pneumoniae - driven by person to person transmission in the community - antibiotics in agriculture