REVIEW QUESTIONS

ANTIMICROBIAL CHEMOTHERAPY

1.Define the following tems:

1. Chemotherapeutic agent
2. Antimicrobial agent
3. Antibiotics
4. Semisynthetic drugs
5. Synthetic drugs
6. Bactericidal drug
7. Bacteristatic drug
8. Side effects
9. Selective toxicity
10. Therapeutic index
11. Therapeutic dose
12. Toxic dose
13. Narrow-spectrum drug
14. Broad spectrum drug
15. Minimum inhibitory concentration
16. Minimum cidal concentration/ Minimum lethal concentration

2.Complete the following table

Antibacterial Primary Spectrum Site Mechanism Shortfalls Mechanism

agent effect + major targeted of action of
organisms resistance
Penicillins
Cephalosporins
Bacitracins
Vancomycin
Rifampin
Ciprofloxacin
Tetracycline
Streptomycin
Gentamycin
Chloramphenicol
Erythromycin
Sulphonamide
Trimethoprim
3.Below is an ideal structure of a bacterial cell.
Label it
For each labeled site, mention the antibacterial agent working on that area and how
it works
NB: Add more labels to your structure to cover all antibacterial agents mentioned in
the table above

4.How is selective toxicity possible with the following antibacterial agents

1. Cephalosporins
2. Penicillins
3. Aminoglycosides
4. Tetracyclines
5. Chloramphenicol
6. Erythromycin
7. Sulphonamide
8. Trimethoprim

5. Discuss different ways of transferring bacterial drug resistance.

1. Mutation -- Spontaneous
Due to transponson involvement
2. Conjugation
3. Transformation
4. Transduction
6. Discuss the five major mechanisms of drug resistance and give an example for
each.
1. Prevention of drug transport into the cell
2. Efflux mechanism
3. Enzyme inactivation
4. Modification of the binding site
5. Resistant metabolic pathway

7. Discuss the effects of the following drug combinations.

1. Indifference
2. Additive
3. Antagony
4. Synergy

8.Would there be any advantage to administering a bacteriostatic antibacterial

agent along with penicillin? Explain your answer.

9.Give a brief description of the following methods;

1. Kirby Bauer
2. E Test

10.List the antimycobacterials and describe how they work.

1. Streptomycin
2. Rifampin
3. Isoniazid
4. Cycloserine
5. Ethambutol
6. Pyrazinamide

11.Discuss the mode of action of the following combined drugs

1. Cotri-moxazole
2. Augmentin
Gonococcus antibiotic resistance
There has been a steady increase in plasmid-mediated antimicrobial resistance
to Neisseria gonorrhea since 1976. Penicillinase-producing N gonorrhea
(PPNG) now accounts for +/- 7% of isolated gonococci. It is believed that these
plasmids may have been initially acquired from Haemophilus ducreyi.
A chromosomal mutation encoding for tetracycline resistance in N gonorrhea
was also recognized in 1985. Now about 1% of gonococci isolated in sexually
transmitted infections are both Penicillin and tetracycline resistant.
Despite the widespread resistance, N gonorrhea is sensitive to a number
of newer drugs, particularly quinolones (e.g. ciprofloxacin) and the cephalosporins.
3.1. What mechanism(s) of resistance does N gonorrhea use against
Penicillin? (3)
3.2. What are the side effects experienced with tetracycline administration? (3)
3.3. What is the mode of action of
a. Ciprofloxacin. (2)
b. Cephalosporins. (2)
3.4. What is a plasmid? (1)
3.5. Explain how plasmid is transferred from one cell to another by
conjugation. (4)
3.6. List the other 3 ways by which drug resistance can be conferred. (3)
3.7. What type of drug interaction is represented in the diagram1 below? (2)
3.8. Still on diagram 1, drug A is Sulfonamide and drug B is Trimethoprim.
Suggest the most probable explanation for the type of interaction seen.
(Clue: base your explanation on their mode of action.) (10)