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pharm quiz 6 questions

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Glucocorticoids diminish the progressive spread of an inflammatory focus, in part, by:

a. Suppressing pituitary levels of ACTH
b. Reducing the release of lysosomal enzymes which digest surrounding cells
c. Increasing blood pressur
b. Reducing the release of lysosomal enzymes which digest surrounding cells
Cimetidine is given to a dog that is also being treated with benzodiazepines. The effect you expect will be that the dog will be less sedate and need a higher dose of benzodiazepines.

a. True
b. False
b. False
Which of the following antithyroid drugs will inhibit peripheral tissue 5'-deiodination of T4 to T3 as well as thyroidal production of thyroid hormones?

a. Methimazole (MMI)
b. Radiocontrast agents (such as iopanoic acid)
c. Pro
e. b and c
A succinate ester attached to the glucocorticoid base structure allows this preparation to be administered by which of the following routes?

a. Intravenous
b. Subcutaneous
c. Topically on the cornea
d. Intraarticular
e. All of the above
Molly is an epileptic and is treated with phenobarbital. She develops a gastric ulcer and the vet treats her with cimetidine, an agent that inhibits the microsomal enzyme system. What would you expect to see?

a. Molly becomes more active
b. Molly becomes more sleepy
Flunixin is used to treat which of the following non-analgesic clinical conditions?

a. Renal failure
b. Autoimmune skin disease
c. Hypotension associated with endotoxemia
d. Congestive heart failure
e. Urinary blad
c. Hypotension associated with endotoxemia
Aspirin is a potent inhibitor of platelet aggregation at low dosages administered at infrequent intervals. Which two reasons explain this effect?
I. Platelet cyclooxygenase and thromboxane production is very sensitive to aspirin.
II. Vascular e
b. I and III
Dr. Knowitall has just recently attended continuing education seminars. He tells Dr. Doitbetter that misoprostol, a prostaglandin E derivative, is a new drug that can be used for the treatment of gastric ulcers. It works by:

a. increasing gas
e. all of the above
Inhibition of cyclooxygenase results in:

a. a decrease in the synthesis of norepinephrine
b. a reduction in the formation of angiotensin II
c. decreased synthesis of PGE2
d. decreased synthesis of leukotrienes
e. r
c. decreased synthesis of
When combining antimicrobial drugs, which of the following terms does NOT describe a beneficial result:

a. Synergy
b. Potentiation
c. Additivity
d. Agonism
e. None of the above
d. Agonism
You seek to use penicillin G in a horse to achieve maximal tissue concentrations before ophthalmological surgery. It distributes rapidly (peak concentration in 1 hour) and you anticipate a 2 hour surgery. The elimination halflife is 0.5 hours. If the vol
d. 16
You are faced with treating a 10 year old male miniature poodle for its first bout of increased urinary frequency possibly associated with a lower urinary tract infection. Which (one or more) of the following clinical procedures would most help you empir
d. a and b
Why are high concentrations of the beta lactam antimicrobials penicillins and cephalosporins achieved in the urine?
a. These drugs are weak bases and are moved up a concentration gradient to the urine by the organic base transport system in the pro
b. These drugs are weak acids and are moved up a concentration gradient to the urine by the organic acid transport system in the proximal tubules of the kidney.
Which two antimicrobial drugs both represent agents with a “wide” spectrum, including antirickettsial and/or antiprotozoal activity?
a. Aminoglycosides; Macrolides
b. Quinolones; Penicillins
c. Tetracyclines; Sulfonamides
d. Peni
c. Tetracyclines; Sulfonamides
Which statement best describes the trend of the antimicrobial spectrum difference as one moves from a first generation cephalosporin to a third generation cephalosporin?
a. More effective for gram positive infections.
b. More effective for gra
e. b, c, and d
Which of the following would be an antagonistic antimicrobial combination?
a. A tetracycline and an aminoglycoside
b. A penicillin and an aminoglycoside
c. A sulfa and trimethoprim
d. A cephalosporin and a fluoroquinolone
e. Non
a. A tetracycline and an aminoglycoside
Which of the following statements regarding aminoglycoside antimicrobials is TRUE?
a. They are widely distributed into tissues due to high lipid solubility.
b. They are bacteriostatic at therapeutic concentrations.
c. They are well-absorb
d. They are not effective against anaerobic organisms.
Which of the following statements best characterizes the difference in antimicrobial spectrum of a third generation cephaloporin compared to a first generation cephalosporin?
a. Third generation cephalosporins generally have a better gram positive
d. Third generation cephalosporins generally have a better gram negative and anaerobic spectrum than first generation cephalosporins.
Which of the following statements about antimicrobial mechanisms of action is FALSE?:
a. Sulfa drugs prevent the incorporation of PABA into folic acid.
b. Penicillins inactivate transpeptidase, a critical enzyme for bacterial cell well synthes
e. Fluoroquinolones inhibit the 50S ribosome inolved with bacterial protein synthesis.
Which of the following is sufficient to explain how one may take advantage of the in vivo synergistic antimicrobial effect of an aminoglycoside with a penicillin when the two drugs inactivate each other in vitro?
a. Synthesize a penicillin which is
c. Administer the drugs in separate syringes.
Which of the following is not considered an essential for successful antibacterial therapy?
a. Drug must be present for a sufficient amount of time.
b. The drug must be bactericidal
c. The drug must come in contact with the microbe.
b. The drug must be bactericidal
Which of the following drug combinations is a synergistic combination of two antimicrobial drugs?
a. Amoxicillin and clavulanic acid
b. Trimethoprim and sulfadiazine
c. Lincosamide lincomycin and penicillin G
d. Fluroquinolone enrofl
b. Trimethoprim and sulfadiazine
Which of the following drug classes cannot be given in the same syringe as a penicillin drug, but does, when given separately, successfully synergize with the penicillin?
a. Quinolones
b. Lincosamides
c. Sulfonamides
d. Tetracyclines
e. Aminoglycosides
Which of the following does NOT pair up an antimicrobial drug class properly with its mechanism of action?
a. Macrolide; Inhibits ribosome synthesis
b. Chloramphenicol; inhibits 50S ribosomal subunit effect on peptide chain elongation
c.
d. Sulfonamide; competitively inhibit acetoacetate in its role of citric acid synthesis
Which of the following correctly pairs up an antimicrobial drug class properly with one of its primary toxicities?
a. Sulfonamides; bile stone formation
b. Quinolones; Cartilage damage in young animals
c. Chloramphenicol; renal disease
b. Quinolones; Cartilage damage in young animals
Which of the following antimcrobials is also used at low dosages intravenously to bind endotoxin?
a. Flunixin
b. Cuprimyxin
c. Polymixin
d. Amoxicillin
e. Richard Nixon
c. Polymixin
Which of the following antimicrobial drugs or classes is LEAST lipophilic?
a. Chloramphenicol
b. Fluroquinolones
c. Trimethoprim/sulfonamide
d. Aminoglycosides
e. Tetracyclines
d. Aminoglycosides
Which of the following antimicrobial drugs is generally considered bactericidal when given alone at standard dosages?
a. Flunixin
b. Lincosamides
c. Cephalosporins
d. Tetracyclines
e. Sulfonamides
c. Cephalosporins
Which drugs are NOT generally useful against anaerobic infections?
a. The semisynthetic penillin amoxicillin
b. Penicillin G
c. Metronidazole
d. Aminoglycosides
e. All of the above are useful for anaerobic infections
d. Aminoglycosides
Which drug characteristic is most important when considering the choice of an antimicrobial to manage a chronic infection of the central nervous system?
a. Long elimination halflife
b. Anaerobic spectrum
c. Bacteriocidal mechanism
d.
e. Lipophilicity
When using aminoglycosides or fluoroquinolone antimicrobials, which of the following best represents the pharmacokinetic monitoring target for most effective and/or least toxic therapy?
(Tmax = time to maximum plasma drug concentration; Cmax = maxi
b. Highest Cmax/MIC or AUC/MIC
When surgically treating a contaminated wound (as in a flesh wound of a dog hit by a car), which of the following statements describe an appropriate choice, timing, and pattern of perioperative antimicrobial therapy?
a. Antimicrobial tehrapy is not
b. Administer a semisynthetic penicillin or cephalosporin at high intermittent intravenous doses starting preferably no later than 4 hours after the wound but timed to reach peak plasma concentrations at the beginning of surgery.
When an antimicrobial drug is called "time-dependent," the "time" being referred to is when the antimicrobial drug⬦
a. plasma concentration achieves its maximum (i.e. peak).
b. plasma concentration becomes undetectable af
c. plasma concentration is above the minimum inhibitory concentration (MIC).
What problem in pups is most frequently associated with the use of tetracyclines in a pregnant bitch?
a. Nephrotoxicity
b. Discoloration of bones and teeth
c. Drug allergy
d. Yellow discoloration of the skin
e. Increased inciden
b. Discoloration of bones and teeth
What pair of reasons (separated by the semicolon) best accounts for the clinical efficacy and improved safety by administering the aminoglycoside gentamicin at an interval 12 times longer than its halflife (2 hours?)
a. Gentamicin distributes slowl
c. The toxicity of gentamicin is related to the plasma trough concentration which is diminished with less frequent administration; Antibacterial activity is prolonged by a post-antibiotic effect of aminoglycosides.
What is the main reason fluoroquinolones are banned from use in food animals in the U.S. (except for one product in poultry)?
a. It causes a dose-dependent reversible bone marrow toxicity in man.
b. It causes an idiosynchratic often fatal marr
c. There is concern over the development of bacterial resistance to these drugs by human pathogens.
What is the role of clavulanic acid when it is combined with the semisynthetic penicillin, amoxicillin?
a. Clavulanic acid has no antimicrobial activity of its own and it inhibits activity of the beta-lactamase enzyme made by the microbe.
b. C
a. Clavulanic acid has no antimicrobial activity of its own and it inhibits activity of the beta-lactamase enzyme made by the microbe.
What is the main reason chloramphenicol is banned from use in food animals in the U.S?
a. It causes a dose-dependent reversible bone marrow toxicity in man
b. It causes an idiosynchratic irreversible bone marrow toxicity in man
c. It caus
b. It causes an idiosynchratic irreversible bone marrow toxicity in man
What chemical structure, shared between penicillins and cephalosporins, is key to the mechanism of action of these antimicrobials?
a. reactive ethyl ester attached to a phenyl ring
b. multiple carboxyl substituents on a cyclohexane ring
c
e. 4 element ring including an amide linkage
What characteristic of an antimicrobial is particularly useful in managing the intracellular Brucella organism?
a. Effectiveness against anaerobes
b. Lipophilicity
c. Weak base
d. Can be given orally
e. Not a protein synthesis i
b. Lipophilicity
Two antimicrobials which currently banned from use in most food animal species in the U.S. due to human safety or bacterial resistance concerns are:
a. Penicillin G; Aminoglycosides
b. Sulfonamides; Macrolides
c. Tetracyclines; Lincosamid
d. Chloramphenicol; Fluoroquinolones
The serum halflife of potassium penicillin G is short requiring either constant rate intravenous or q 4-6 hour intravenous or intramuscular administration. What pharmaceutical alteration is used most commonly today in veterinary medicine to allow less fr
d. Complexation with the local anesthetic procaine
The serum halflife of potassium penicillin G is 0.5 hours in the horse and the serum halflife of gentamicin is 2 hours. Which of the following (note: all parts must be correct) explains why penicillin is generally administered every 6 hours when gentamic
c. Penicillin is a time-dependent antimicrobial meaning that its efficacy is determined by the time above a minimum inhibitory concentration (MIC), whereas gentamicin is concentration-dependent meaning that its antimicrobial efficacy is optimized by achieving high peak concentrations.
The potentiated sulfonamide trimethoprim/sulfa inhibits bacterial growth at 2 sequential steps in DNA synthesis. The two steps are: (both must be correct and in the correct order).
a. 1) Inhibition of beta lactamase by the sulfonamide; 2) Inhibiti
d. 1) Inhibition of folic acid synthesis from PABA by sulfonamide; 2) Inhibition of dihydrofolate reductase by trimethoprim.
The concept of antibacterial activity being bactericidal or bacteriostatic is an oversimplification because:
a) bacteria really don’t die when exposed to “bactericidal” antimicrobial drugs
b) using too low a dosage of a bacteriocidal agen
e) b and c
Sulfonamide crystals in the urine are generally not a problem in which species which lacks enzymes to acetylate the sulfonamide?
a) horse
b) cow
c) dog
d) man
e) chicken
c) dog
Skin infections in dogs and cats are often due to ß-lactamase-producing Staphylococcus infections. Which of the following antimicrobials would be narrow spectrum yet have a high likelihood of being effective in such an infection?
a. Semisynthetic
b. Semisynthetic penicillin oxacillin
Semisynthetic penicillins like ampicillin or cephalosporins are reasonable first-time empirical choices for urinary tract infections (UTIs) in dogs and cats. What two facts account for this efficacy?
a. The majority of UTIs are due to gram positive
c. The majority of UTIs are due to gram negative organisms susceptible to these drugs at high concentrations; ampicillin and cephalosporin are secreted in high concentration into the urine.
Prophylactic usage of bactericidal antimicrobials is most rational in which of the following clinical scenarios?
a. Following placement of intravenous and urinary catheters for fluid and insulin therapy in a diabetic ketoacidotic patient in the int
a. Following placement of intravenous and urinary catheters for fluid and insulin therapy in a diabetic ketoacidotic patient in the intensive care unit.
Polymixin, at antimicrobial dosages, are too toxic for systemic administration to mammals. However, at low dosages, polymixin is administered to:
a) bind flunixin
b) bind the pili of gram negative bacteria
c) act as a detergent to clean yo
d) bind endotoxins
Plasmid-derived antimicrobial resistance is most common with which one of the following antimicrobial classes?
a. Penicillins
b. Cephalosporins
c. Aminoglycosides
d. Sulfonamides
e. Lincosamides
c. Aminoglycosides
Perioperative prophylaxis with antimicrobials is a controversial topic. However, most agree that, assuming proper aseptic technique is used, perioperative prophylactic antimicrobial therapy is NOT rational in wounds which are:
a) clean
b) clean
a) clean
Once-a-day dosing of aminoglycosides is less nephrotoxic than dividing the same dosage into more frequent doses because:
a. toxicity of these drugs is associated with a higher trough concentration of plasma.
b. the duration of the kidney's exp
d. a, b and c
Of protein synthesis inhibitors, which antimicrobial drug is banned from food animal use because of irreversible aplastic anemias it causes in man?
a. The lincosamide clindamycin
b. The sulfa drug sulfadiazine
c. Chloramphenicol
d. T
c. Chloramphenicol
Of the following antimicrobials or antimicrobial classes, which are NOT generally considered to be bacteriostatic at therapeutic concentrations?
a. Chloramphenicol
b. Trimethoprim/sulfadiazine combination
c. Tetracyclines
d. Lincosam
b. Trimethoprim/sulfadiazine combination
Mastitis is an important problem of dairy cattle. In a survey of the Georgia Veterinary Diagnostic Laboratory in Tifton in 1994, statistics showed cultured microbes were sensitive in the following percentages.E. coli: 85% sensitive to ampicillin; 69% sen
b. Periodic alternating intramammary ampicillin and Novobiocin administration
Infectious (transferable) drug resistance, involving multiple drug resistance genes via pili by gram negative organisms, is called:
a. plasmid resistance
b. beta-lactamase resistance
c. DNA gyrase resistance
d. Acquired resistance
a. plasmid resistance
If faced with a serious gram negative infection, which of the following antimicrobials would NOT be an appropriate empirical choice for therapy because of its spectrum?
a. Enrofloxacin, a fluroquinolone
b. Third generation cephalosporin
c
d. Erythromycin, a macrolide
If an animal contracts an infection by an organism residing in your hospital, this animal has a (n):
a. nosocomial infection
b. colonization resistance infection
c. plasmid resistant infection
d. a nasal infection
e. prophylacti
a. nosocomial infection
Combinations for known mixed infections require four quadrant therapy, that is antimicrobial activity against gram negative, gram positive, aerobic and and anaerobic bacteria. Which of the following drugs used in combination DO NOT achieve this spectrum
e. Trimethoprim/sulfa; macrolide erythromycin
A horse, grazing in a field, is gored in its flank by a bull. Which statement is most appropriate way to describe the wound and whether antimicrobial therapy is merited?
a. This is a clean-contaminated wound and use of antimicrobial prophylaxis is
c. This is a dirty wound and antimicrobial therapy should be directed at all 4 quadrants - gram positive, gram negative, aerobes and anaerobes.
A mechanism by which a microorganism can become resistant to a drug without previously being exposed to the drug involves:
a. Natural selection
b. Increased transport of drug into the microbe
c. Plasmid resistance
d. Increased drug m
c. Plasmid resistance
Adaptive post-exposure resistance associated with gram negative organisms refers to which phenomenon following exposure to multiple frequent dosages of an antimicrobial drug?:
a. The transient increase in uptake of a drug into the bacterium
b.
e. b and c
Adverse reactions to the aminoglycoside antimicrobials include all of the following EXCEPT:
a. Auditory ototoxicity
b. Vestibular ototoxicity
c. Bone marrow suppression
d. Neuromuscular blockade
e. Nephrotoxicity
c. Bone marrow suppression
All of the following antimicrobials are susceptible to bacterial resistance caused by the secretion of beta-lactamases EXCEPT:
a. Penicillin G
b. The semisynthetic penicillin, ampicillin
c. Penicillin V
d. The tetracycline, oxytetrac
d. The tetracycline, oxytetracycline
All of the drugs EXCEPT WHICH ONE would be reasonable empirical choices for an anaerobic bacterial infection?
a. Metronidazole
b. Penicillin G
c. Amoxicillin and clavulanic acid
d. Third Generation Cephalosporin
e. Aminoglyc
e. Aminoglycoside gentamicin
Antimicrobial drugs are often classified in text books by mechanism of action and whether that mechanism will result in killing or inhibiting growth of a microbe. However, when applying antimicrobial therapy to a patient, what information is necessary be
e. Drug concentration at the site of infection
Bactericidal drugs should be considered in all but which of the following clinical situations?:
a. In an immunosuppressed patient
b. In life-threatening septicemia
c. For treatment of infection during routine glucocorticoid use
d. a,
d. a,b, and c are all appropriate uses of bactericidal drugs.
Clavulanic acid is given in combination with the penicillin class drug amoxicillin (commercial combination product is Clavamox®) in order to:
a. reduce the risk of allergic reactions to amoxicillin.
b. prolong amoxicillin’s halflife in the
d. inactivate ß-lactamase thereby extending amoxicillin’s antibacterial spectrum.
Chloramphenicol is not allowed in food animal medicine because:
a. it is concentrated in the kidney tissue and retained for over a year.
b. miniscule quantities can cause an irreversible bone marrow suppression in man.
c. there is a dose-
b. miniscule quantities can cause an irreversible bone marrow suppression in man.

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