Presentation of assignment • Please prepare answer to all questions in a word-processed copy (A4 paper) • Margins must be 2cm on the left hand side of each page • Lines of word- processed material must be separated by 1.5 line spaces • Answers should be references based on VANCOUVER STYLE from credible sources only (at least one reference for each answers) 1- Explain what the most appropriate hand washing technique would be for each of the following three scenarios: a) Prior of food handlings b) Immunising a client with a Flu Vaccination in your pharmacy c) A surgeon preparing for surgery Provide a rationale for your answer 2- Which of the product which used in hand washing in the table below would be the most appropriate for use in each of the above settings in Question 1 Agent Aust R # Group Uses Antimicrobial activity 70% v/v Ethyl Alcohol/ Aqium® Gel 66%w/v Alcohols • Skin Antiseptic • Reduced activity against viruses Benzalkonium chloride Quaternary Ammonium Compounds • Skin Antiseptic • Irrigations • Eye Drop Preservative • Sporostatic Chlorhexidine gluconate Chlorhexidine and other diguanides • Pre-op skin Antiseptic • Surgical Hand Scrubs • Treat wounds • Bladder Irrigations • Slow acting • Residual effect Chloroxylenol- Roxenol/ Medol 61404 Phenols • Skin Antiseptic • Medicated Soaps • Inanimate surfaces • Denature by soap 3- State three reasons why it is necessary to determine the MIC for antibiotics in Vitro? 4- Discuss the Mechanism of action of PcG on E.coli, in your answer discuss a) The Mechanism and affinity of PcG for Penicillin Binding Proteins. Compare the affinity preferences of E.coli for PcG and Cefotaxime b) The significance of the cell shape observed Microbiologically (use diagrams) c) The significance of the concentration of the PcG (ie less than or greater than the MIC) 5- Refer to the Mechanism of resistance to Beta-lactams discussed in Goodman and Gilman’s the pharmacological Basis of therapeutics (12th edition) to explain the result obtained in the laboratory with respect to I. The beta- lactam resistance shown by S. aureus M908 II. The beta- lactam resistance shown by S. aureus CP11 6- How is the resistance shown by newly emerging resistance Gram Negative Organism carrying the NDM-1 gene different to those discussed in question 5? 7- Examine the Laboratory data collected for the aminoglycoside activities against strains CP10 AND CP11. Discuss the possible mechanism for the SmR in these strains? (be concise in your answer and make it clear how you use the data in reaching your conclusion. You are for one choice and the reason for that choice instead of the others) 8- Describe the contribution of B-lactamases to the Indirect Pathogenicity of some bacteria? 9- Explain what is meant by antimicrobial stewardship. Describe how the role of an “antibiotic pharmacist” contributes to antibiotic stewardship? 10- What is the WHO Essential Medicines List? List the antibacterial and dosage forms available on the most recent list (April 2015)?

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