p.22
Vancomycin and Linezolid
What type of infection is Linezolid used to treat?
Vancomycin-resistant Enterococcus faecium infection.
p.8
Mechanisms of Action of Antibiotics
What is the mechanism of action (MOA) of cephalosporins?
They bind and inhibit penicillin-binding proteins, interfering with the biosynthesis of the peptidoglycan structure, leading to cell lysis.
p.29
Aminoglycosides and Macrolides
Name a key characteristic of macrolides.
They are effective against atypical pathogens.
p.11
Adverse Effects of Antimicrobials
What is a serious potential adverse effect of Cephalosporins?
Nephrotoxicity, especially in patients with pre-existing kidney issues.
p.19
Antimicrobial Resistance Strategies
What types of infections require a trough level of 15 - 20 mg/L?
Complicated S. aureus infections such as bacteremia, endocarditis, osteomyelitis, meningitis, and hospital-acquired pneumonia.
p.55
Antimicrobial Resistance Strategies
What is recommended to reduce the use of high-risk antibiotics for Clostridium difficile infection?
Antibiotic stewardship interventions.
p.3
Antimicrobial Resistance Strategies
What is a key strategy to combat antimicrobial resistance?
Patient education on using antimicrobials.
p.9
Specific Antibiotic Classes: Penicillins, Cephalosporins, Carbapenems
What is the primary focus of the study on cephalosporins?
The relative activity of various cephalosporins against selected bacteria.
p.20
Mechanisms of Action of Antibiotics
Is Linezolid bacteriostatic or bactericidal?
It is bacteriostatic against Enterococci and Staphylococci, and bactericidal against Streptococci.
p.29
Aminoglycosides and Macrolides
What types of infections are macrolides indicated for?
Respiratory tract infections caused by atypical bacteria.
p.20
Specific Antibiotic Classes: Penicillins, Cephalosporins, Carbapenems
Which bacteria is Linezolid effective against?
Enterococci, Staphylococci, and Streptococci.
p.37
Fluoroquinolones and Trimethoprim-Sulfamethoxazole
What does TMP-SMX stand for?
Trimethoprim-Sulfamethoxazole.
p.56
Antimicrobial Resistance Strategies
What is a recommended strategy for the use of oral antibiotics?
Implement programs to increase appropriate use of oral antibiotics for initial therapy.
p.53
Antimicrobial Resistance Strategies
What is the primary goal of antimicrobial stewardship?
To achieve good stewardship in the use of antimicrobials.
p.39
Mechanisms of Action of Antibiotics
Which antibiotics inhibit bacterial protein synthesis?
Clindamycin and Chloramphenicol.
p.35
Adverse Effects of Antimicrobials
What are some serious adverse events linked to fluoroquinolones?
Rupture of tendon, tendinitis, peripheral neuropathy, seizure, and cardiac arrest.
p.52
Antimicrobial Resistance Strategies
What factors should be considered when selecting antimicrobial therapy?
Optimal drug, dose, and duration.
p.40
Specific Antibiotic Classes: Penicillins, Cephalosporins, Carbapenems
What is the role of Chloramphenicol in treating anaerobic infections?
It inhibits protein synthesis in susceptible bacteria.
p.59
Vancomycin and Linezolid
Which antibiotic(s) is a nephrotoxic agent requiring frequent monitoring of renal function?
Aminoglycosides and vancomycin.
p.31
Mechanisms of Action of Antibiotics
What is the primary mechanism of action of fluoroquinolones?
They inhibit bacterial DNA gyrase (topoisomerase type II) activity.
p.11
Adverse Effects of Antimicrobials
Can Cephalosporins cause allergic reactions?
Yes, they can cause allergic reactions in some patients.
p.51
Antimicrobial Resistance Strategies
What practice involves optimizing the use of antimicrobials?
Antimicrobial stewardship.
p.56
Antimicrobial Resistance Strategies
What is a guideline for antibiotic therapy duration?
Reduce antibiotic therapy to the shortest effective duration.
p.23
Adverse Effects of Antimicrobials
What are common adverse events associated with Linezolid?
GI issues like diarrhea, nausea, vomiting, and headache (occurring in less than 10% of patients).
p.53
Antimicrobial Resistance Strategies
What type of collaboration is important for effective antimicrobial stewardship?
Administrative collaboration.
p.7
Overview of Antimicrobials
What does 'waterydiwheakillbac.in' imply?
It seems to refer to a watery discharge that may kill bacteria; clarification needed.
p.45
Adverse Effects of Antimicrobials
What are some side effects of Paxlovid®?
Distorted sense of taste, diarrhea, hypertension, and myalgia.
p.27
Therapeutic Drug Monitoring
Is peak monitoring required for Gentamicin/Tobramycin?
No, peak is not monitored.
p.51
Antimicrobial Resistance Strategies
What is an important component of infection control to combat antimicrobial resistance?
Active infection control programs.
p.60
Antimicrobial Resistance Strategies
Who are the members of antimicrobial stewardship?
Members typically include physicians, pharmacists, microbiologists, infection control specialists, and nursing staff.
p.60
Antimicrobial Resistance Strategies
What are the recommended strategies in antimicrobial stewardship?
Strategies include appropriate prescribing, education, monitoring of antimicrobial use, and implementing guidelines.
p.55
Antimicrobial Resistance Strategies
What type of monitoring is recommended for aminoglycosides in hospitals?
Pharmacokinetic monitoring and adjustment programs.
p.40
Specific Antibiotic Classes: Penicillins, Cephalosporins, Carbapenems
What is Clindamycin used for?
It is effective against anaerobic bacteria.
p.3
Antimicrobial Resistance Strategies
What is a risk associated with self-medication of antimicrobials?
It can lead to inappropriate use and increased resistance.
p.8
Adverse Effects of Antimicrobials
What should be considered if a patient has a history of penicillin hypersensitivity?
There is a risk of cross-reactivity with cephalosporins, which may lead to allergic reactions including anaphylaxis.
p.22
Vancomycin and Linezolid
What type of pneumonia is classified as community-acquired?
Community-acquired pneumonia.
p.37
Fluoroquinolones and Trimethoprim-Sulfamethoxazole
What is one common indication for using TMP-SMX?
Urinary tract infections (UTIs).
p.47
Antifungals, Antivirals, and COVID-19 Management
What are some common side effects of Molnupiravir?
Diarrhea, nausea, and dizziness.
p.17
Overview of Antimicrobials
What does 'grmtv' likely stand for?
'Grmtv' likely refers to 'grammar' or a related term.
p.4
Mechanisms of Action of Antibiotics
What is the mechanism of action (MOA) of penicillins?
They interfere with the biosynthesis of the peptidoglycan structure, leading to cell lysis.
p.39
Mechanisms of Action of Antibiotics
What is the mechanism of action of Clindamycin and Chloramphenicol?
They inhibit bacterial protein synthesis by binding to the bacterial 50S ribosomal subunit.
p.20
Mechanisms of Action of Antibiotics
What is the mechanism of action (MOA) of Linezolid?
It binds to the 50S subunit of ribosomal RNA, inhibiting the bacterial translation process.
p.30
Adverse Effects of Antimicrobials
What are common adverse events associated with Erythromycin?
Epigastric distress, allergic reactions, cholestatic hepatitis.
p.19
Patient Education on Antimicrobials
When should a blood sample be collected for therapeutic drug monitoring?
Before the dose (pre-dose level).
p.15
Specific Antibiotic Classes: Penicillins, Cephalosporins, Carbapenems
How does the spectrum of Ertapenem compare to imipenem and meropenem?
Similar, but with limited activity against Pseudomonas aeruginosa and Acinetobacter spp.
p.24
Mechanisms of Action of Antibiotics
How do aminoglycosides affect protein synthesis?
They interfere with the reading of the genetic code, thus inhibiting protein synthesis.
p.27
Therapeutic Drug Monitoring
Is peak monitoring required for Amikacin?
No, peak is not monitored.
p.15
Specific Antibiotic Classes: Penicillins, Cephalosporins, Carbapenems
What type of infections is Ertapenem indicated for?
Community-acquired infections caused by mixed aerobic-anaerobic species.
p.12
Specific Antibiotic Classes: Penicillins, Cephalosporins, Carbapenems
What are the two main types of Carbapenems mentioned?
Imipenem-cilastatin and Meropenem.
p.60
Antimicrobial Resistance Strategies
What are the aims of antimicrobial stewardship?
To optimize the use of antimicrobials, improve patient outcomes, reduce resistance, and minimize adverse effects.
p.55
Antimicrobial Resistance Strategies
Which antibiotics are associated with a high risk of Clostridium difficile infection?
Clindamycin, fluoroquinolones, cephalosporins, penicillins, and macrolides.
p.52
Antimicrobial Resistance Strategies
What is the primary goal of antimicrobial stewardship?
Maximizing therapeutic impact of antibiotics while minimizing toxicity and development of resistance.
p.36
Fluoroquinolones and Trimethoprim-Sulfamethoxazole
What does Sulfamethoxazole (SMX) compete with in the production of dihydrofolate?
Para-aminobenzoic acid (PABA).
p.52
Antimicrobial Resistance Strategies
When should antimicrobial therapy be prescribed?
Only when beneficial to a patient.
p.36
Fluoroquinolones and Trimethoprim-Sulfamethoxazole
What is the role of Trimethoprim (TMP) in folate synthesis?
Inhibits the conversion of dihydrofolic acid to tetrahydrofolic acid.
p.7
Overview of Antimicrobials
What does 'Gblockedresp' suggest?
It likely refers to blocked respiratory pathways.
p.47
Antifungals, Antivirals, and COVID-19 Management
What is the dosage regimen for Molnupiravir?
800 mg (four 200 mg capsules) taken orally every 12 hours for 5 days.
p.41
Adverse Effects of Antimicrobials
What form of Metronidazole can be used topically?
Topical gel or cream for skin conditions.
p.53
Antimicrobial Resistance Strategies
How does information technology contribute to antimicrobial stewardship?
By providing tools and data to support stewardship efforts.
p.37
Fluoroquinolones and Trimethoprim-Sulfamethoxazole
What type of infections can TMP-SMX treat?
Bacterial infections, including skin and soft tissue infections.
p.26
Adverse Effects of Antimicrobials
What is the relationship between trough levels and ototoxicity?
Ototoxicity relates to trough level.
p.43
Antifungals, Antivirals, and COVID-19 Management
Which antivirals are used for Herpes?
Acyclovir and valaciclovir.
p.42
Antifungals, Antivirals, and COVID-19 Management
What is the spectrum of activity for echinocandins?
Candida, Aspergillus, Cryptococcus, Histoplasma, Zygomycetes.
p.42
Adverse Effects of Antimicrobials
What are common adverse events associated with Amphotericin B?
GI distress, nephrotoxicity, infusion reaction, phlebitis, anemia.
p.2
Fluoroquinolones and Trimethoprim-Sulfamethoxazole
What are Fluoroquinolones commonly used to treat?
Urinary tract infections and respiratory infections.
p.31
Mechanisms of Action of Antibiotics
What effect do fluoroquinolones have on bacterial DNA?
They cause conformational changes in bacterial DNA.
p.39
Mechanisms of Action of Antibiotics
What is the mechanism of action of Metronidazole?
It is reduced to metabolites that damage bacterial DNA.
p.48
Antifungals, Antivirals, and COVID-19 Management
What is the mechanism of action (MOA) of Remdesivir?
Nucleotide RNA polymerase inhibitor.
p.3
Patient Education on Antimicrobials
What is a common misconception patients have about antimicrobials?
That they are effective against viral infections.
p.23
Adverse Effects of Antimicrobials
What gastrointestinal issues can occur with Linezolid use?
Diarrhea, nausea, and vomiting.
p.53
Antimicrobial Resistance Strategies
What can supplement core strategies in antimicrobial stewardship?
Supplement to core strategies.
p.3
Patient Education on Antimicrobials
What precautions should be taken when using antibiotics?
Follow the prescribed dosage and duration.
p.52
Antimicrobial Resistance Strategies
What is a key consideration regarding patient safety in antimicrobial stewardship?
Minimizing toxicity to the patient.
p.45
Antifungals, Antivirals, and COVID-19 Management
What is a potential concern when using Ritonavir?
It has potential drug-drug interactions with many medications.
p.30
Adverse Effects of Antimicrobials
What is a risk of ototoxicity associated with Macrolides?
High doses can lead to ototoxicity.
p.18
Adverse Effects of Antimicrobials
What enhances the risk of nephrotoxicity and ototoxicity when using vancomycin?
Concurrent use with aminoglycosides.
p.2
Specific Antibiotic Classes: Penicillins, Cephalosporins, Carbapenems
What is Linezolid primarily used to treat?
Infections caused by resistant Gram-positive bacteria.
p.43
Adverse Effects of Antimicrobials
What are some adverse effects of antivirals?
GI distress, headache, rash, and nephrotoxicity.
p.12
Mechanisms of Action of Antibiotics
What is the mechanism of action (MOA) of Carbapenems?
They impair cell wall synthesis by binding to bacterial penicillin-binding proteins.
p.56
Antimicrobial Resistance Strategies
What should be done to facilitate the transition from IV to oral antibiotics?
Implement timely transition programs for patients.
p.35
Adverse Effects of Antimicrobials
What are common adverse events associated with fluoroquinolones?
Photosensitivity, diarrhea, nausea, dizziness, headache, and insomnia.
p.48
Antifungals, Antivirals, and COVID-19 Management
In which patients is Remdesivir indicated?
For severe patients on supplemental oxygen.
p.47
Antifungals, Antivirals, and COVID-19 Management
What is the mechanism of action (MOA) of Molnupiravir?
It is a prodrug with antiviral activity that induces viral error catastrophe.
p.22
Vancomycin and Linezolid
What type of infections can Linezolid be used for besides pneumonia?
Skin and soft tissue infections.
p.45
Antifungals, Antivirals, and COVID-19 Management
What is the mechanism of action (MOA) of Nirmatrelvir and Ritonavir?
They inhibit the processing of polyprotein precursors, preventing viral replication.
p.48
Antifungals, Antivirals, and COVID-19 Management
What is the subsequent dosing schedule for Remdesivir after day 1?
100 mg QD for 4 to 9 days.
p.44
Overview of Antimicrobials
What are common symptoms of COVID-19?
Fever, fatigue, dry cough, difficulty breathing, body aches, nasal congestion.
p.17
Overview of Antimicrobials
What could the letter 'e' signify in this context?
'E' could represent an example or a specific element related to grammar.
p.50
Antimicrobial Resistance Strategies
What can resistant bacteria cause?
Infections with few effective antimicrobials available for treatment.
p.50
Patient Education on Antimicrobials
Why is adherence to antibiotic treatment necessary?
To cure infection and prevent the emergence of bacterial resistance.
p.54
Overview of Antimicrobials
What is the role of a Clinical Pharmacist in infection management?
They manage medication therapy related to infections.
p.54
Overview of Antimicrobials
What is the role of an Information System Specialist in infectious disease management?
They manage data systems related to infection tracking.
p.2
Aminoglycosides and Macrolides
What is the role of Macrolides in antibiotic therapy?
They are used to treat respiratory tract infections and some skin infections.
p.28
Mechanisms of Action of Antibiotics
What is the mechanism of action (MOA) of macrolides?
Inhibits RNA-dependent protein synthesis by reversibly binding to the 50S ribosomal subunit.
p.11
Adverse Effects of Antimicrobials
What are common adverse effects of Cephalosporins?
Allergic reactions, gastrointestinal disturbances, and potential nephrotoxicity.
p.22
Vancomycin and Linezolid
Which types of Staphylococcus aureus infections can be treated with Linezolid?
Methicillin-sensitive and methicillin-resistant Staphylococcus aureus infections.
p.7
Overview of Antimicrobials
What does 'Movitor' refer to in the context of respiratory health?
It appears to be a misspelling or abbreviation; clarification needed.
p.7
Overview of Antimicrobials
What is indicated by 'Swenmgotlipsllnngs'?
It seems to be a misspelling; clarification needed.
p.32
Overview of Antimicrobials
What role does MPO play in the immune response?
It contributes to the body's defense against infections by generating reactive oxygen species.
p.50
Patient Education on Antimicrobials
What is a common misconception about antibiotics?
They can only treat bacterial infections.
p.3
Antimicrobial Resistance Strategies
Why is adherence to treatment important in antimicrobial therapy?
To ensure effectiveness and reduce the risk of resistance.
p.50
Patient Education on Antimicrobials
Can antibiotics treat viral infections?
No, they cannot treat viral infections.
p.44
Overview of Antimicrobials
What are some complications associated with COVID-19?
Pneumonia, acute respiratory distress syndrome, septic shock, multiorgan failure.
p.52
Antimicrobial Resistance Strategies
How should antimicrobial stewardship impact resistance development?
It should have minimal impact on subsequent resistance.
p.43
Mechanisms of Action of Antibiotics
How do deoxynucleoside analogues work?
They inhibit DNA polymerase and DNA replication.
p.21
Vancomycin and Linezolid
What are the available routes of administration for Linezolid?
IV (intravenous) and PO (oral).
p.51
Antimicrobial Resistance Strategies
What is one strategy to combat antimicrobial resistance?
Surveillance for resistance.
p.11
Adverse Effects of Antimicrobials
What gastrointestinal disturbances can occur with Cephalosporin use?
Nausea, vomiting, and diarrhea.
p.32
Overview of Antimicrobials
What is the primary function of myeloperoxidase (MPO)?
To produce hypochlorous acid from hydrogen peroxide and chloride ions, which helps in microbial killing.
p.41
Adverse Effects of Antimicrobials
What is a common adverse effect of Clindamycin?
Diarrhea, which can lead to Clostridium difficile infection.
p.41
Adverse Effects of Antimicrobials
What should be avoided while taking Metronidazole?
Alcohol, due to the risk of disulfiram-like reactions.
p.23
Adverse Effects of Antimicrobials
What are some serious adverse events linked to Linezolid?
Liver toxicity, lactic acidosis, Clostridium difficile diarrhea, myelosuppression, and peripheral neuropathy.
p.29
Aminoglycosides and Macrolides
Can macrolides be used for skin infections?
Yes, they can be indicated for certain skin infections.
p.52
Antimicrobial Resistance Strategies
What is the importance of targeting therapy?
To address the desired pathogen(s).
p.15
Specific Antibiotic Classes: Penicillins, Cephalosporins, Carbapenems
Is Ertapenem active against Enterococci?
No, it is not active against Enterococci.
p.42
Antifungals, Antivirals, and COVID-19 Management
What routes of administration are available for azoles?
PO (oral), IV (intravenous), topical.
p.42
Adverse Effects of Antimicrobials
What are common adverse events associated with azoles?
GI distress, hepatotoxicity, cardiac toxicity, infusion reaction.
p.56
Antimicrobial Resistance Strategies
How should antibiotic costs be measured?
Based on prescriptions or administrations instead of purchasing data.
p.55
Antimicrobial Resistance Strategies
What is the purpose of preauthorization and/or prospective audit and feedback?
To enhance antibiotic stewardship and reduce inappropriate antibiotic use.
p.40
Specific Antibiotic Classes: Penicillins, Cephalosporins, Carbapenems
How does Metronidazole work against anaerobic bacteria?
It disrupts DNA synthesis in anaerobic organisms.
p.59
Vancomycin and Linezolid
Which antibiotic(s) require therapeutic drug monitoring?
Vancomycin and aminoglycosides.
p.48
Adverse Effects of Antimicrobials
What are some adverse events associated with Remdesivir?
Increased liver enzymes, renal impairment, infusion reaction, nausea.
p.22
Vancomycin and Linezolid
Which bacteria is susceptible to penicillin that can be treated with Linezolid?
Penicillin-susceptible Streptococcus pneumoniae.
p.37
Fluoroquinolones and Trimethoprim-Sulfamethoxazole
Can TMP-SMX be used for respiratory infections?
Yes, it is indicated for certain respiratory infections.
p.50
Antimicrobial Resistance Strategies
What can unnecessary use of antimicrobials promote?
Resistance in normal flora in the body.
p.37
Fluoroquinolones and Trimethoprim-Sulfamethoxazole
Is TMP-SMX effective against Pneumocystis jirovecii pneumonia?
Yes, it is used for prophylaxis and treatment.
p.37
Fluoroquinolones and Trimethoprim-Sulfamethoxazole
What is a common use of TMP-SMX in immunocompromised patients?
Prevention of opportunistic infections.
p.43
Antifungals, Antivirals, and COVID-19 Management
What are examples of antivirals used for Influenza?
Oseltamivir and zanamivir.
p.2
Aminoglycosides and Macrolides
What type of infections are Aminoglycosides typically used for?
Serious infections caused by Gram-negative bacteria.
p.2
Fluoroquinolones and Trimethoprim-Sulfamethoxazole
What is Trimethoprim-sulfamethoxazole used for?
To treat a variety of bacterial infections, including urinary tract infections.
p.17
Overview of Antimicrobials
What is the significance of the number 17 in the context of grammar?
It may refer to a specific rule, concept, or example in grammar studies.
p.24
Mechanisms of Action of Antibiotics
What do aminoglycosides irreversibly bind to?
The 30S ribosomal subunit of bacterial messenger RNA.
p.41
Adverse Effects of Antimicrobials
What is a potential effect of Metronidazole contamination?
Gastrointestinal disturbances.
p.44
Overview of Antimicrobials
How is COVID-19 diagnosed?
Detection of SARS-CoV-2 RNA.
p.16
Mechanisms of Action of Antibiotics
Is Vancomycin bactericidal or bacteriostatic?
Bactericidal; may be bacteriostatic against enterococci.
p.54
Overview of Antimicrobials
What role does a Clinical Microbiologist play in the infectious disease team?
They study microorganisms to understand infections.
p.42
Mechanisms of Action of Antibiotics
What is the mechanism of action of echinocandins?
Inhibit fungal cell wall glucan synthesis.
p.43
Adverse Effects of Antimicrobials
What specific adverse effect can occur with inhaled antivirals?
Nasal and throat discomfort, bronchospasm.
p.2
Antifungals, Antivirals, and COVID-19 Management
What is the purpose of antivirals?
To treat viral infections.
p.7
Overview of Antimicrobials
What is the significance of 'nfectiovsiteg.no maltuora'?
It appears to be a misspelling; clarification needed.
p.7
Overview of Antimicrobials
What does 'tbalance' refer to?
It likely refers to maintaining balance in the body, possibly in relation to infection.
p.16
Mechanisms of Action of Antibiotics
How does Vancomycin inhibit bacterial growth?
By inhibiting bacterial peptidoglycan polymerase and transpeptidation, thus blocking peptidoglycan biosynthesis.
p.54
Overview of Antimicrobials
Who is a member of the infectious disease team that specializes in diagnosing and treating infections?
Infectious disease physician.
p.42
Mechanisms of Action of Antibiotics
What is the mechanism of action of Amphotericin B?
Binds to membrane ergosterol, causing leakage of cellular contents.
p.42
Antifungals, Antivirals, and COVID-19 Management
What is the spectrum of activity for azoles?
Candida, Aspergillus, Cryptococcus, Histoplasma.
p.43
Patient Education on Antimicrobials
What are common routes of administration for antivirals?
PO (oral), IV (intravenous), and topical.
p.23
Adverse Effects of Antimicrobials
What serious gastrointestinal infection can be caused by Linezolid?
Clostridium difficile diarrhea.
p.18
Adverse Effects of Antimicrobials
What are the potential adverse effects of vancomycin?
Nephrotoxicity and ototoxicity.
p.50
Adverse Effects of Antimicrobials
What should you do if adverse events occur while taking antibiotics?
Seek medical advice from a doctor or pharmacist.
p.18
Adverse Effects of Antimicrobials
What happens at high doses of vancomycin?
Increased risk of 'Red-man' syndrome.
p.54
Overview of Antimicrobials
Who is responsible for infection control in a healthcare setting?
Infection control professional (Nurse).
p.54
Overview of Antimicrobials
What does a Hospital Epidemiologist do?
They study and prevent the spread of infections within hospitals.
p.24
Mechanisms of Action of Antibiotics
What is the significance of the term '24 gramte' in relation to aminoglycosides?
It appears to be a typographical error; please clarify the intended meaning.
p.42
Antifungals, Antivirals, and COVID-19 Management
What are examples of azole antifungals?
Fluconazole and itraconazole.
p.2
Antifungals, Antivirals, and COVID-19 Management
How is COVID-19 managed in terms of antiviral treatment?
Through specific antiviral medications and supportive care.
p.42
Mechanisms of Action of Antibiotics
What is the mechanism of action (MOA) of azoles?
Inhibit fungal cell membrane ergosterol synthesis.
p.43
Mechanisms of Action of Antibiotics
What is the mechanism of action of antivirals for Influenza?
Inhibit viral neuraminidase to prevent viral release from host cell.
p.43
Mechanisms of Action of Antibiotics
What is the action of nucleos/tide analogues?
They inhibit reverse transcriptase and DNA replication.
