Chapter·PharmacologyAntibiotics

Macrolides, ketolides, and lincosamidesDownloads

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1

A 60-year-old man with a history of coronary artery disease and hyperlipidemia presents to his internist for a follow-up visit 3 weeks after visiting an urgent care center for symptoms of cough, fever, and difficulty breathing. He had been prescribed erythromycin in addition to his usual regimen of rosuvastatin and aspirin. With which potential side effect or interaction should the internist be most concerned?

AMyalgia due to decreased rosuvastatin metabolism in the presence of erythromycin

BGastric bleeding due to decreased aspirin metabolism in the presence of erythromycin

CUnstable angina due to decreased rosuvastatin metabolism in the presence of erythromycin

DTinnitus due to decreased aspirin metabolism in the presence of erythromycin

EMetabolic acidosis due to decreased aspirin metabolism in the presence of erythromycin

2

An 8-year-old girl is brought to the emergency room for a 6-hour history of fever, sore throat, and difficulty swallowing. Physical examination shows pooling of oral secretions and inspiratory stridor. Lateral x-ray of the neck shows thickening of the epiglottis and aryepiglottic folds. Throat culture with chocolate agar shows small, gram-negative coccobacilli. The patient's brother is started on the recommended antibiotic for chemoprophylaxis. Which of the following is the primary mechanism of action of this drug?

AInhibition of the 50S ribosomal subunit

BInhibition of prokaryotic topoisomerase II

CInhibition of DNA-dependent RNA-polymerase

DInhibition of the 30S ribosomal subunit

EInhibition of peptidoglycan crosslinking

3

A 68-year-old man comes to the physician because of headache, fatigue, and nonproductive cough for 1 week. He appears pale. Pulmonary examination shows no abnormalities. Laboratory studies show a hemoglobin concentration of 9.5 g/dL and an elevated serum lactate dehydrogenase concentration. A peripheral blood smear shows normal red blood cells that are clumped together. Results of cold agglutinin titer testing show a 4-fold elevation above normal. An x-ray of the chest shows diffuse, patchy infiltrates bilaterally. Treatment is begun with an antibiotic that is also used to promote gut motility. Which of the following is the primary mechanism of action of this drug?

AInhibition of bacterial RNA polymerase

BInhibition of folic acid synthesis

CFree radical creation within bacterial cells

DInhibition of transpeptidase cross-linking at the cell wall

EInhibition of peptide translocation at the 50S ribosomal subunit

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