Question

A 68 year old male smoker with severe chronic obstructive pulmonary disease (COPD) (forced expiratory volume in one second (FEV1) 48% predicted) was admitted to the Accident and Emergency Department (A & E) for the fourth time this year. He presented to A & E doctor with high fever, increased productive cough with expectoration of yellow sputum and shortness of breath. Upon admission to the ward, chest X-ray showed infiltrates. From his previous medical record, the doctor notices the detection of Pseudomonas aeruginosa in his prior admission. 

a) Which class of antibiotics is the drug of choice to be given to the patient? Give ONE example and state the route of administration. (3 marks)

b) What is the mechanism of action for this antibiotic? (5 marks)

c) List at least FOUR common adverse effects (2 marks)

d) Name TWO potential drug-drug interactions associated with this class of antibiotics and explain the mechanism of such drug-drug interaction involved (4 marks)

e) State TWO mechanisms of resistance which may develop with this antibiotic (4 marks)

f) State FOUR reasons for the increase in prevalence of antibiotic resistance over the years (2 marks)

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