Review of Pharmacology - 9E (2015)

Chemotherapy A: General Consideration and Non-specific Antimicrobial Agents
• Antimicrobials/anti virals
––
Procaine penicillin G, Imipenem-cilastatin
––
Quinolones, acyclovir, isoniazid, ganciclovir, cycloserine
• Anaesthetics and analgesics
––
Meperidine, tramadol, local anaesthetics, class IB anti-arrhythmic agents
• Immunomodulatory drugs
––
Cyclosporine, tacrolimus (FK-506), OKT3, interferons
• Antipsychotics, antidepressants, lithium, theophylline, alcohol, barbiturate, benzodiazepines.
• Drugs abuse like amphetamine, phencyclidine, methylphenidate, flumazenil etc.
• As these drugs causes seizure, so these drugs should better be avoided.
• High dose of glucocorticoids lowers the seizure threshold. So cautious use in epileptics is required.
171. Ans. (b) Ciprofloxacin; (c) Cefotaxime (Ref: Harrison 17/e p920)
Recommended Rx of Gonococcal infection (Penicillinase producing NG):
Diagnosis
• Uncomplicated infection of urethra, cervix, rectum or pharynx – Ceftriaxone, cefixime
Rx of choice
• Alternative regimen – Spectinomycin, ceftizoxime, cefotaxim.
• Pregnancy – Spectinomycin
• Pediatric – Ceftriaxone
• Allergic to β-lactam drugs1 – Ciprofloxacin, Ofloxacin, Spectinomycin
172. Ans. (a) Metronidazole; (b) Imipenem and (e) vancomycin (Ref: Harrison 17/e p1005)
• Drugs effective against anaerobic organisms are:
––
Metronidazole – Ampicillin/Sulbactum
––
Ticarcillin/clavulanic acid – Imipenem
––
Meropenem – Chloramphenicol
––
Clindamycin – Vancomycin
173. Ans. (a) Cephalexin; (e) Doxycycline (Ref: KDT 6/e p673)
• The antibiotics which are safe in renal failure are:
––
Cephalexin – Cefaclor
––
Cefoperazone – Cefriaxone
––
Chloramphenicol – Clindamycin
––
Erythromycin – Carbenicillin
––
Azithromycin.
• Most tetracyclines are primarily excreted in urine by glomerular filtration; dose has to be reduced in renal failure;
doxycycline is an exception to this.
• The renal excretion of nitrofurantoin is reduced in azotemic patients; effective concentrations may not be reached in
urine, while toxicity increases; so it is contraindicaed in renal failure.
174. Ans. (e) Ciprofloxacin (Ref: KDT 6/e p690-691)
• Till recently chloramphenicol was drug of choice for typhoid fever. But due to emergence of resistant-strains of S.
typhi, it is no longer used now a days.
• Due to emergence of MDR S. typhi— either quinlones or third-generation cephalosporisn (e.g. ceftriaxone) are currently
recommended for empirical antibiotic treatment.
175. Ans. (b) Vancomycin (Ref: KDT 6/e p732, 733; Katzung 11/e p787)
176. Ans. (a) Amikacin (Ref: KDT 6/e p721)
Aminoglycosides can cause nephrotoxicity, ototoxicity and neuromuscular block.
177. Ans. (c) Clindamycin (Ref: KDT 6/e p731, 732)
• Clindamycin is excreted by biliary route and therefore can be used safely in renal dysfunction.
• Other drugs excreted in bile are:
––
Ampicillin
––
Nafcillin
––
Chloramphenicol
––
Novobiocin
––
Rifampicin
––
Doxycycline
571
Chemotherapy A: General Considerations Pharmacology and Non-specific...
https://kat.cr/user/Blink99/