ANTI-INFECTIVES ANTIBACTERIAL DRUGS WORKMAN AND LACHARITY UNDERSTANDING
PHARMACOLOGY
Chapter 08: Anti-Infectives: Antibacterial Drugs
Workman & LaCharity: Understanding Pharmacology: Essentials for Medication
Safety, 2nd Edition
MULTIPLE CHOICE
BASIC CONCEPTS
1. Which type of bacteria cause infection when a patient’s immune system is impaired?
a. Pathogenic
b. Nonpathogenic
c. Gram-negative
d. Opportunistic
ANS: D
Pathogenic bacteria cause disease or tissue damage while nonpathogenic bacteria do not.
Opportunistic bacteria cause disease or tissue damage only when the immune system is not
working well.
DIF: Cognitive Level: Remembering REF: p. 115
2. What does the term “virulence” mean?
a. Bacteria that do not cause infection or systemic disease
b. How easily a bacterium can be killed by antibiotic therapy
c. How well bacteria can invade and spread within the body
d. How many different types of bacteria an antibiotic can kill
ANS: C
Virulence is a measure of how well or efficiently a microorganism can gain entry into the
body, reproduce there, and make the host sick even when the host has a normal immune
system. The more virulent a bacterium is, the more dangerous it is and the harder it is to kill or
eliminate.
DIF: Cognitive Level: Remembering REF: p. 115
3. What is the main feature of an opportunistic infection?
a. It usually leads rapidly to sepsis.
b. Children are not susceptible to this type of infection.
c. It is most often caused by pathogenic microorganisms.
d. It is only found in people who are immunosuppressed.
ANS: D
, We have many microorganisms that are on or in our bodies and do not cause an infection
because our immune systems are able to keep their numbers low and prevent them from
moving beyond their normal body location. For example, we all have E. coli in our intestinal
tracts and this does not cause us harm as long as our immune systems are working well. Even
if a few E. coli leave the intestinal tract and enter the blood or the urine, they usually do not
cause an infection because our immune systems get rid of these organisms when they are
located where they do not belong. However, a person with a suppressed or weak immune
system may not be able to remove or destroy these organisms when they are located outside of
the intestinal tract and an infection develops. This is called an opportunistic infection because
the organism is taking advantage of the host’s weakened immune system and using the
opportunity to grow elsewhere in the body.
DIF: Cognitive Level: Remembering REF: p. 115
4. Which problem is a sign or symptom of an allergic or anaphylactic response to an
antibacterial drug?
a. Diarrhea
b. Hair loss
c. High blood pressure
d. Swelling of the face or lips
ANS: D
Most antibacterial drugs induce diarrhea when taken for a week or longer because they kill off
so many of the normal bacteria in the intestinal tract. This is not an allergy and the immune
system is taking no part in causing the diarrhea. Hair loss is not a common side effect of
antibacterial therapy nor is it an allergic reaction. When a true systemic allergic reaction
occurs, it is usually accompanied by low blood pressure because of widespread blood vessel
dilation. This blood vessel dilation of a true allergic response often causes swelling of the
face, lips, and tongue.
DIF: Cognitive Level: Remembering REF: p. 117
5. Which drug category includes the penicillins?
a. Protein synthesis inhibitors
b. Cell wall synthesis inhibitors
c. DNA synthesis inhibitors
d. Metabolism inhibitors
ANS: B
The action of penicillin is disruption of the ability of a bacterium to make, repair, or maintain
its cell walls. So, penicillins belong to the cell wall synthesis inhibitor class of antibacterial
drugs. Penicillins do not interfere with the bacteria’s ability to make proteins, make DNA, or
metabolize.
DIF: Cognitive Level: Remembering REF: p. 118
6. Which drug is a first-generation cephalosporin?
a. Cefepime (Maxipime)
b. Cefotaxime (Claforan)
c. Cefoxitin (Mefoxin)
d. Cefazolin (Kefzol)
, ANS: D
Only cefazolin (Kefzol) is a first-generation cephalosporin. The other drugs are all
cephalosporins but cefepime is fourth-generation, cefotaxime is third-generation, and
cefoxitin is second-generation.
DIF: Cognitive Level: Remembering REF: p. 121
7. Which two drug types have almost identical chemical structures?
a. Aminoglycosides and “sulfa drugs”
b. Macrolides and fluoroquinolones
c. Penicillins and cephalosporins
d. Tetracyclines and penicillins
ANS: C
Both the penicillins and the cephalosporins have a beta lactam ring as part of their chemical
structures, making them nearly identical in how they work and the side effects they have. All
of the other drugs on this list have unique chemical structures.
DIF: Cognitive Level: Remembering REF: p. 121
8. Which drug is most often used to treat ear infections in children?
a. Imipenem (Primaxin)
b. Amoxicillin (Amoxil)
c. Vancomycin (Vancocin)
d. Sulfamethoxazole/trimethoprim (Bactrim)
ANS: B
Most of the bacteria that invade the middle ear of children (and adults) have cell walls and are
sensitive to the less potent cell wall synthesis inhibitors, especially amoxicillin. Both
imipenem and vancomycin are powerful antibacterial drugs and are only used for severe
infections that do not respond to less potent drugs. Sulfamethoxazole/trimethoprim is used
mainly for infections of the urinary tract.
DIF: Cognitive Level: Remembering REF: p. 123
9. Which protein synthesis inhibitors can raise the pressure inside the brain?
a. Aminoglycosides
b. Macrolides
c. Lincosamides
d. Tetracyclines
ANS: D
Of the drugs on this list, only the tetracyclines have a potential adverse effect of increasing
pressure inside the brain.
DIF: Cognitive Level: Remembering REF: p. 131
10. Which drug can cause tooth discoloration when given to young children?
a. Aminoglycosides
b. Macrolides
c. Lincosamides
PHARMACOLOGY
Chapter 08: Anti-Infectives: Antibacterial Drugs
Workman & LaCharity: Understanding Pharmacology: Essentials for Medication
Safety, 2nd Edition
MULTIPLE CHOICE
BASIC CONCEPTS
1. Which type of bacteria cause infection when a patient’s immune system is impaired?
a. Pathogenic
b. Nonpathogenic
c. Gram-negative
d. Opportunistic
ANS: D
Pathogenic bacteria cause disease or tissue damage while nonpathogenic bacteria do not.
Opportunistic bacteria cause disease or tissue damage only when the immune system is not
working well.
DIF: Cognitive Level: Remembering REF: p. 115
2. What does the term “virulence” mean?
a. Bacteria that do not cause infection or systemic disease
b. How easily a bacterium can be killed by antibiotic therapy
c. How well bacteria can invade and spread within the body
d. How many different types of bacteria an antibiotic can kill
ANS: C
Virulence is a measure of how well or efficiently a microorganism can gain entry into the
body, reproduce there, and make the host sick even when the host has a normal immune
system. The more virulent a bacterium is, the more dangerous it is and the harder it is to kill or
eliminate.
DIF: Cognitive Level: Remembering REF: p. 115
3. What is the main feature of an opportunistic infection?
a. It usually leads rapidly to sepsis.
b. Children are not susceptible to this type of infection.
c. It is most often caused by pathogenic microorganisms.
d. It is only found in people who are immunosuppressed.
ANS: D
, We have many microorganisms that are on or in our bodies and do not cause an infection
because our immune systems are able to keep their numbers low and prevent them from
moving beyond their normal body location. For example, we all have E. coli in our intestinal
tracts and this does not cause us harm as long as our immune systems are working well. Even
if a few E. coli leave the intestinal tract and enter the blood or the urine, they usually do not
cause an infection because our immune systems get rid of these organisms when they are
located where they do not belong. However, a person with a suppressed or weak immune
system may not be able to remove or destroy these organisms when they are located outside of
the intestinal tract and an infection develops. This is called an opportunistic infection because
the organism is taking advantage of the host’s weakened immune system and using the
opportunity to grow elsewhere in the body.
DIF: Cognitive Level: Remembering REF: p. 115
4. Which problem is a sign or symptom of an allergic or anaphylactic response to an
antibacterial drug?
a. Diarrhea
b. Hair loss
c. High blood pressure
d. Swelling of the face or lips
ANS: D
Most antibacterial drugs induce diarrhea when taken for a week or longer because they kill off
so many of the normal bacteria in the intestinal tract. This is not an allergy and the immune
system is taking no part in causing the diarrhea. Hair loss is not a common side effect of
antibacterial therapy nor is it an allergic reaction. When a true systemic allergic reaction
occurs, it is usually accompanied by low blood pressure because of widespread blood vessel
dilation. This blood vessel dilation of a true allergic response often causes swelling of the
face, lips, and tongue.
DIF: Cognitive Level: Remembering REF: p. 117
5. Which drug category includes the penicillins?
a. Protein synthesis inhibitors
b. Cell wall synthesis inhibitors
c. DNA synthesis inhibitors
d. Metabolism inhibitors
ANS: B
The action of penicillin is disruption of the ability of a bacterium to make, repair, or maintain
its cell walls. So, penicillins belong to the cell wall synthesis inhibitor class of antibacterial
drugs. Penicillins do not interfere with the bacteria’s ability to make proteins, make DNA, or
metabolize.
DIF: Cognitive Level: Remembering REF: p. 118
6. Which drug is a first-generation cephalosporin?
a. Cefepime (Maxipime)
b. Cefotaxime (Claforan)
c. Cefoxitin (Mefoxin)
d. Cefazolin (Kefzol)
, ANS: D
Only cefazolin (Kefzol) is a first-generation cephalosporin. The other drugs are all
cephalosporins but cefepime is fourth-generation, cefotaxime is third-generation, and
cefoxitin is second-generation.
DIF: Cognitive Level: Remembering REF: p. 121
7. Which two drug types have almost identical chemical structures?
a. Aminoglycosides and “sulfa drugs”
b. Macrolides and fluoroquinolones
c. Penicillins and cephalosporins
d. Tetracyclines and penicillins
ANS: C
Both the penicillins and the cephalosporins have a beta lactam ring as part of their chemical
structures, making them nearly identical in how they work and the side effects they have. All
of the other drugs on this list have unique chemical structures.
DIF: Cognitive Level: Remembering REF: p. 121
8. Which drug is most often used to treat ear infections in children?
a. Imipenem (Primaxin)
b. Amoxicillin (Amoxil)
c. Vancomycin (Vancocin)
d. Sulfamethoxazole/trimethoprim (Bactrim)
ANS: B
Most of the bacteria that invade the middle ear of children (and adults) have cell walls and are
sensitive to the less potent cell wall synthesis inhibitors, especially amoxicillin. Both
imipenem and vancomycin are powerful antibacterial drugs and are only used for severe
infections that do not respond to less potent drugs. Sulfamethoxazole/trimethoprim is used
mainly for infections of the urinary tract.
DIF: Cognitive Level: Remembering REF: p. 123
9. Which protein synthesis inhibitors can raise the pressure inside the brain?
a. Aminoglycosides
b. Macrolides
c. Lincosamides
d. Tetracyclines
ANS: D
Of the drugs on this list, only the tetracyclines have a potential adverse effect of increasing
pressure inside the brain.
DIF: Cognitive Level: Remembering REF: p. 131
10. Which drug can cause tooth discoloration when given to young children?
a. Aminoglycosides
b. Macrolides
c. Lincosamides
