Review of Pharmacology - 9E (2015)

Review of Pharmacology
Chemotherapy A: General Considerations and Non-specific...
178. Ans. (a) Tobramycin (Ref: KDT 6/e p719, 720)
Aminoglycosides require oxygen for transport in the bacterial cell. These are therefore ineffective against anaerobic
organisms.
179. Ans. (c) Linezolid (Ref: KDT 6/e p733)
180. Ans. (d) Spectinomycin (Ref: Katzung 10/e p761, 762)
• Ceftriaxone is contraindicated in patients having severe allergy to penicillins.
• Tetracyclines are not effective against gonorrhoea.
• Although ciprofloxacin is effective as a single dose treatment of gonorrhoea but it is contraindicated in pregnancy.
• Spectinomycin can be given as single dose treatment of PPNG.
181. Ans. (a) Rifampicin (Ref: KDT 6/e p742)
Rifampicin and ciprofloxacin are used for the prophylaxis of meningococcal meningitis.
182. Ans. (b) Erythromycin (Ref: KDT 6/e p729)
Diagnosis is atypical pneumonia and Doc is erythromycin.
183. Ans. (d) Amikacin (Ref: KDT 6/e p719, 720)
• Drugs used to treat anaerobic organisms include:
• Metronidazole
• Moxifloxacin and Trovafloxacin
• Vancomycin
• Clindamycin
• Chloramphenicol
Aminoglycosides are ineffective against anaerobic organisms
184. Ans. (d) Vancomycin (Ref: KDT 6/e p732)
• Severe allergy to penicillins rule out the use of amoxicillin and cefazolin.
• Vancomycin is highly effective against MRSA and enterococcal infections.
• Drugs for VRSA and VRE (Vancomycin Resistant Enterococcus faecalis) include linezolid and daptomycin.
185. Ans. (b) Linezolid (Ref: KDT 6/e p733)
186. Ans. (c) Metronidazole (Ref: KDT 6/e p799, 800)
187. Ans. (b) Daptomycin (Ref: KDT 6/e p741)
Daptomycin is a newer antibiotic that acts by causing depolarization of bacterial cell membranes. It is effective in MRSA,
VRSA and even streptogramin resistant SA infections as well as VRE infections. It can cause myopathy in patients taking
statins.
188. Ans. (b) A drug effective against anaerobe should be included in the antibiotic regimen (Ref: KDT 6/e p679, 680)
Abdominal sepsis is a mixed type of infection caused by both aerobic and anaerobic organisms. Ampicillin and gentamicin
will inhibit most of the aerobic organisms but these are not effective against anaerobic organisms. Therefore metronidazole
or clindamycin should be included in the treatment regimen.
189. Ans. (b) Chloramphenicol (Ref:Katzung 11/e p803)
The patient’s shows decreased erythrocytes, leukocytes, and platelets. This condition is called pancytopenia or aplastic
anemia. It occurs due to suppression of stem cell function in the bone marrow. Chloramphenicol can cause both dosedependent
and dose-independent aplastic anemia. Dose-dependent aplastic anemia associated with chloramphenicol is
reversible after the medication is withdrawn. Dose-independent anemia is usually severe and may be fatal.
190. Ans. (c) Vancomycin (Ref: KDT 6/e p732)
191. Ans. (d) Ethambutol (Ref: KDT 6/e p673)
Aminoglycosides, Amphotericin B, cephalosporins, vancomycin, flucytosine and ethambutol require dose reduction even
in mild renal failure.
192. Ans. (c) Ciprofloxacin (Ref: KDT 6/e p689)
193. Ans. (b) Chloramphenicol (Ref: KDT 6/e p717; Satoskar Bhandarkar, 19/e p694)
194. Ans. (c) Pentamidine (Ref: Robbins 7/e p640; KDT 6/e p686,806)
• All of the options mentioned can cause folic acid deficiency resulting in megaloblastic anemia but pentamidine rarely
causes this side effect.
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