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Intravenous amphotericin b causes infusion related

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Intravenous amphotericin B causes infusion relatedhypotension (via histamine release), fever, and chills,which may be attenuated by the prior administrationof NSAIDs and antihistamines. Adrenal steroids mayprovide supplementary stress support. AmphotericinB binds to ergosterol in fungal membranes, openingpores and disrupting membrane permeability.For antitubercular activity, isoniazid (INH) mustfirst be metabolically activated via a catalasepresent in mycobacteria. A decrease inexpression of the cat G gene that encodes thisenzyme is the mechanism of high-levelresistance to INH.Azithromycin is highly effective as an oral agent inthe management of pharyngitis caused by gram-positive cocci and may necessitate only a shortcourse of therapy. In patients who have markedhypersensitivity to penicillins, it is inappropriate touse a cephalosporin, even though cefaclor is activeagainst common oropharyngeal pathogens.Doxycycline should not be used in children. Onemust assume that complete cross-allergenicity existsbetween different members of the penicillin class ofantibiotics, and, in any case, penicillin G is not usuallygiven orally because of its lability in gastric acid.Vancomycin would need parenteral administration,and this antibiotic should be reserved for moreserious bacterial infections.Organisms associated with sexuallytransmitted diseases include chlamydia,Neisseria gonorrhea, Treponema (syphilis),Trichomonas, and Gardnerella vaginalis. Thelatter two organisms are effectively treatedwith the drug metronidazole. Metronidazolehas a chemical structure that results in adisulfiram-like effect on aldehydedehydrogenase, causing reactions withethanol. Patients should be cautioned not toconsume alcoholic beverages while on thisdrug.
Chapter 5Antimicrobial Drug List and Practice Questions2035.An 82-year-old hospitalized patient with creatinine clearance of 25 mL/min has a microbial infection requiring treatment with antibiotics. Whichof the following drugs is least likely to require a dosage adjustment, eithera smaller dose than usual or an increased interval between doses?A.AmphotericinBB.CeftriaxoneC.GentamicinD.Imipenem-cilastatinE.Vancomycin6.Whatdrugismostlikelytobeeffectiveinmostdiseasescausedbynematodes?A.ChloroquineB.MebendazoleC.MetronidazoleD.PraziquantelE.Pyrimethamine7.Whatantibioticeffectivelytreatsavarietyofcausativeorganismsforbacterial pneumonia, and also works at the 50S ribosomal subunit?A.AzithromycinB.CeftriaxoneC.DoxycyclineD.OfloxacinE.Clindamycin8.In bacterial meningitis, third-generation cephalosporins are commondrugs of choice. However, in neonatal meningitis they would not providecoverage if the infection was due to which of the following organisms?

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Term
Winter
Professor
jane smith

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