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M3 Pharm B3 > Anti-Infective Drugs 2 > Flashcards

Anti-Infective Drugs 2 Flashcards

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1
Q

Antituberculous Drugs: Isoniazid (INH) MOA

A

Inhibition of mycolic acid synthesis (cell wall synthesis)

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2
Q

Antituberculous Drugs: Isoniazid (INH) low resistance

A

Deletion in INHA gene

Gene encoding acyl carrier protein (target)

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3
Q

Antituberculous Drugs: Isoniazid (INH) high resistance

A

Deletion in katG gene

Encode catalase enzymed needed for INH bioactivation

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4
Q

Antituberculous Drugs: Isoniazid (INH) Adverse effects (4)

A
  1. Hepatitis
  2. Neuritis
  3. Hemolysis in G6PD deficiency
  4. SLE in slow acetylators
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5
Q

Antituberculous Drugs: Isoniazid (INH) - Why is pyridoxine (Vit. B6) used with INH?

A

To help prevent numbness and tingling that occur secondary to isoniazid neuritis

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6
Q

Antituberculous Drugs: Rifampin MOA

A

Inhibits DNA-dependent RNA polymerase

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7
Q

Antituberculous Drugs: Rifampin Resistance

A

Mutation in polymerase enzyme

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8
Q

Antituberculous Drugs: Rifampin Adverse Effects (5)

A
  1. Red-orange discoloration of urine, sweat, and tears
  2. Proteinuria
  3. Flu-like symptoms
  4. Thrombocytopenia
  5. Induces p450
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9
Q

Antituberculous Drugs: Ethambutol MOA

A

Inhibits synthesis of Arabinogalactan (component of cell wall)

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10
Q

Antituberculous Drugs: Ethambutol Adverse effects (2)

A
  1. Loss of red green acuity

2. Retrobulbar neuritis

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11
Q

Antituberculous Drugs: Pyrazinamide MOA

A

Unknown

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12
Q

Antituberculous Drugs: Pyrazinamide Adverse Effects (3)

A
  1. Arthralgia due to hyperuricemia
  2. Hepatotoxicity
  3. Increase porphyrin synthesis
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13
Q

Antituberculous Drugs: Aminoglycosides MOA

A

Inhibit protein synthesis

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14
Q

Antituberculous Drugs: Aminoglycosides Adverse Effects (3)

A
  1. Hearing loss
  2. Ataxia
  3. Nephrotoxicity
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15
Q

Antituberculous Drugs: Aminoglycosides - Amikacin Side Effect (1)

A
  1. Nystagmus
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16
Q

Antituberculous Drugs: Aminoglycosides - Kanamycin (1)

A
  1. Electrolyte abnormalities
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17
Q

Antituberculous Drugs: Capreomycin is not what?

A

Not aminoglycosides

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18
Q

Antituberculous Drugs: Capreomycin Adverse Effects (2)

A
  1. Hearing loss

2. Ataxia

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19
Q

Antituberculous Drugs: Capreomycin Buzzword

A

No cross resistance with aminoglycosides

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20
Q

Antituberculous Drugs: Capreomycin Use

A

Used as 2nd line rx of resistant TB with aminosalicylic acid and cycloserine

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21
Q

Disseminated Mycobacterium Avium Complex (DMAC) Drug Combo

A

Azithromycin + Rifabutin + Ethambutol

Rifabutin: simular to rifampin

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22
Q

Disseminated Mycobacterium Avium Complex (DMAC) Drug Combo - Adverse Effect (5)

A
  1. Rashes
  2. GI effects
  3. Neutropenia
  4. Induces p450
  5. No hepatotoxicity
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23
Q

Clinical TB: Screening Test - Purified Protein Derived (PPD)

A

Screen Asymptomatic Population

+ve test: > 10 mm of induration (NOT erythema)

High risk: > 5mm with HIV +ve or close contact

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24
Q

If PPD +ve, do chest x-ray, and if chest x-ray is negative?

A

Rx: INH (isoniazid) alone for 6 months

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25
If PPD +ve, do chest x-ray, and if chest x-ray is positive, do sputum cultures and if sputum culture is negative?
INH (isoniazid) alone for 6 months
26
If PPD +ve, do chest x-ray, and if positive, do sputum cultures and if sputum culture is positive?
Rx of 4 drugs
27
BCG immunization gives only?
3-4 mm induration
28
If after 10 years PPD is > 10 mm induration?
Don't blame it on BCG Follow protocol and do chest X-Ray
29
Treating TB
4 drugs (INH-Rif-PZA-Ethamb) x 2 months + 2 drugs (INH-Rif) x 4 months = 6 months
30
Treating TB: If HIB +ve?
Initial therapy stays the same then increase duration 4 drugs x 2 months + 2 drugs x 7 months = 9 months
31
A 37 y/old prisoner, cough, fever, sputum, SOB lung infiltrate, sputum AFB +ve. Never do what and rx?
Never answer PPD in a case of TB Rx: 4 drugs x 2 months + 2 drugs for 4 months
32
Pregnant with +ve PPD: Answer Chest X-ray with lead Apron (2nd trimester) - If negative (3)
Wait until delivery Then INH (isoniazid) alone Why? INH is bad to the baby "teratogenic"
33
Pregnant with +ve PPD: Answer Chest X-ray with lead Apron (2nd trimester) --> do sputum cultures and if culture is negative
INH (isoniazid) alone
34
Pregnant with +ve PPD: Answer Chest X-ray with lead Apron (2nd trimester) --> do sputum cultures and if culture is positive
Rx 4 drugs
35
Antiprotozoals: Giardiasis Defined
Giardia lamblia Most common water born disease Back-packer's diarrhea
36
Antiprotozoals: Giardiasis Rx
Metronidazole
37
Antiprotozoals: Entamoeba Histolytrica Drug
Metronidazole
38
Antiprotozoals: Asymptomatic/non-invasive Intestinal Amebiasis Drug
Diloxanide
39
Antiprotozoals: Trichomoniasis Defined
Trichomnas vaginalis
40
Antiprotozoals: Trichomoniasis Drug
Metronidazole Gotta treat the partner
41
Antiprotozoals: Leishmaniasis Defined
Leishmania Brasiliensis American mucocutaneous leishmaniasis
42
Antiprotozoals: Leishmaniasis Drug
Stibogluconate
43
Antiprotozoals: Trypanosomiasis Name
Trypanosoma cruzi
44
Antiprotozoals: American Trypanosomiasis (Chaga's Disease) Drug
Nifurtimox
45
Antiprotozoals: African Trypanosomiosis (Sleeping Sickness) Drug
Suramin + Melarsoprol
46
Antiprotozoals: Toxoplasma Gondii Drug
Pyrimethamine + Sulfadiazine
47
Antiprotozoals: Pneumocystosis Carinii (Pnemocystosis) Drugs (3)
1. Trimethoprim-Sulphamethoxazle 2. IV Pentamidine 3. Atovaquone
48
Malaria: Plasmodium Falciparum Drug
Chloroquine
49
Malaria: Plasmodium Malariae Drug
Chloroquine
50
Malaria: Plasmodium Vivax Drug
Chloroquine + Primaquine
51
Malaria: Plasmodium Ovale Drug
Chloroquine + Primaquine
52
Prophylaxis for chloroquine-SENsitive malaria: 1st line
Chloroquine +/- primaquine
53
Prophylaxis for chloroquine- | SENsitive malaria: 2nd line
Pyrimethamine-sulfadozine Hydroxychloroquine
54
Prophylaxis for Chloroquine-RESISTant Malaria: 1st line
Mefloquine
55
Prophylaxis for Chloroquine-RESISTant Malaria: 2nd line
Atovaquone-proquanil Doxycycline
56
Rx for Chloroquine-Resistant Malaria
Quinine +/- Doxycycline
57
Antimalarial Adverse Effects: Chloroquine (3) and avoid in?
1. Pruritis 2. Ocular dysfunction 3. Hemolysis Avoid in psoriasis
58
Antimalarial Adverse Effects: Mefloquine (2) and avoid in?
1. Syncope 2. Extrasystoles Avoid in seizure and cardiac arrhythmias
59
Antimalarial Adverse Effects: Primaquine (2) and avoid in?
1. Neutropenia 2. Hemolysis Avoid in pregnancy, G6PD deficiency
60
Antimalarial Adverse Effects: Quinine (3) and avoid in?
1. Cinchonism 2. CNS defects 3. Hemolysis Avoid in pregnancy
61
Intestinal Nematodes (Worms): Mebendazole and Pyrantel MOA
Decrease glucose uptake and microtubular structure
62
Tissue Nematodes: Drug
Ivermectin
63
Cestodes (Tapeworms) & Trematodes (Flukes) Drug and MOA
Praziquantel MOA: Increase Ca2+ influx
64
Nematodes: Thiabendazole MOA
Inhibits fumarate reductase
65
Nematodes: Dibucaine MOA
Inhibits Na+ permeability
66
Nematodes: Piperzine MOA
Inhibits acetylcholine leading to muscle paralysis
67
Leprostatic Drugs: Dapsone
Rx of leprosy and dermatitus herpitiformus
68
Leprostatic Drugs: Thalidomide Use and Pregnancy Category
FDA approved Rx of erythema nodosum leprosum FDA Pregnancy Category X
69
Leprostatic Drugs: Thalidomide - Physicians should alert male and female patients in effective birth control methods because?
There's a risk of phocomelia in the baby (absent arms and legs)

M3 Pharm B3 (10 decks)

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