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Step 1 Exam > Antimicrobials - First Aid > Flashcards

Antimicrobials - First Aid Flashcards

1
Q

Penicillin G and V (prototype Beta-lactams) MOA

A

Bind penicillin-binding proteins to block transpeptidase cross-linking of peptidoglycan.

They also activate autolytic enzymes.

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2
Q

Penicillin G and V Use

A
  • mostly for gram-positive organisms

- also for N. meningitidis and T. pallidum

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3
Q

Penicillin G, V are bactericidal for…

A

gram-positive cocci and rods, gram-negative cocci and spirochetes.

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4
Q

Toxicity of Penicillin G, V

A

HSRs and hemolytic anemia

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5
Q

Resistance to Penicillin G, V

A

penicillinase in bacteria (a type of beta-lactamase) cleaves the beta-lactam ring

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6
Q

Ampicillin/Amoxicillin MOA

A

same as penicillin

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7
Q

Ampicillin/Amoxicillin Use

A

extended spectrum penicillins

  • H. influenzae
  • E. coli
  • Listeria
  • Proteus
  • Salmonella
  • Shigella
  • enterococci
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8
Q

Ampicillin/Amoxicillin Toxicity

A
  • HSRs
  • rash
  • pseudomembranous colitis
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9
Q

Ampicillin/Amoxicillin Resistance

A

-penicillinase

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10
Q

Oxacillin, Nafcillin, Dicloxacillin MOA

A

same as penicillin; penicillinase resistant because bulky R group blocks access of beta-lactamase

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11
Q

Oxacillin, Nafcillin, Dicloxacillin Use

A

S. aureus (narrow spectrum)

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12
Q

Oxacillin, Nafcillin, Dicloxacillin Toxicity

A

HSRs, interstitial nephritis

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13
Q

MRSA is resistant because of….

A

altered PBP target site.

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14
Q

Ticarcillin, Piperacillin MOA

A

same as penicillin

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15
Q

Ticarcillin, Piperacillin Use

A

extended spectrum; Pseudomonas and gram-negative rods

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16
Q

Beta-lactamse inhibitors are often…

A

added to penicillin antibiotics to protect the antibiotic from destruction by beta-lactamase.

(Clavulanic Acid, Sulbactam, Tazobactam)

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17
Q

Cephalosporins MOA

A

Beta-lactam drugs that inhibit cell wall synthesis but are less suceptible to penicillinases; bactericidal

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18
Q

Organisms typically not covered by cephalosporins are…

A

LAME:

  • Listeria
  • Atypicals
  • MRSA
  • Enterococci

(Exception: ceftaroline covers MRSA)

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19
Q

1st generation Cephalosporins Use

A

Cefazolin, Cephalexin

  • gram positive cocci
  • Proteus
  • E. coli
  • Klebsiella
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20
Q

Cefazolin is used prior to…

A

surgery to prevent S. aureus wound infections.

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21
Q

2nd generation Cephalosposrins Use

A

Cefoxitin, Cefaclor, Cefuroxime

  • gram positive cocci
  • H. influenza
  • Enterobacter
  • Neisseria
  • Proteus
  • E. coli
  • Klebsiella
  • Serratia
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22
Q

3rd genreation Cephalosporins Use

A

Ceftriaxone, Cefotaxime, Ceftazidime
-serious gram negative infections resistant to other beta-lactams
(Ceftriaxone for Neisseria and Ceftazidime for Pseudomonas)

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23
Q

4th generation Cephalosporins Use

A

Cefepime

-increased activity against pseudomonas and gram-positives

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24
Q

5th generation Cephalosporins Use

A

Ceftaroline

  • broad gram positive and negative coverage
  • including MRSA
  • does NOT cover pseudomonas
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25
Q

Cephalosporins toxicity

A
  • HSRs
  • vitamin K deficiency
  • increased nephrotoxicity of aminoglycosides
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26
Q

Aztreonam MOA

A

a monobactam; resistant to beta-lactamases; prevents peptidoglycan cross-linking by binding to PBP3

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27
Q

Aztreonam Use

A

gram-negative rods only; for penicillin allergic pts and those with renal insufficiency who cannot tolerate aminoglycosides

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28
Q

Carbapenems (4)

A
  1. Imipenem
  2. Meropenem
  3. Ertapenem
  4. Doripenem
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29
Q

Carpabenem (Imipenem) MOA

A

broad-spectrum, beta-lactamase reistant; always admisistered with Cilastatin (inhibitor of renal dehydropeptidase I) to decrease inactivation of the drug in the renal tubules

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30
Q

Clinical use of carbapenems

A
  • gram positive cocci
  • gram negative rods
  • anaerobes
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31
Q

Toxicity

A

GI distress, rash, CNS toxicity (seizures) - limits use

Meropenem has decreased risk of seizures

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32
Q

Vancomycin MOA

A

inhibits cell wall peptidoglycan formation by binding D-ala-D-ala portion of cell wall precurors; bactericidal

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33
Q

Use of Vancomycin

A

gram positive only (serious, multidrug resistant organisms including MRSA, enterococci and C. diff)

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34
Q

Toxicity of Vancomycin

A
  • Red Man Syndrome
  • Nephrotoxicity
  • Ototoxicity
  • Thrombophlebitis
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35
Q

Mechanism of resistance to Vancomycin

A

-amino acid modification of D-ala-D-ala to D-ala-D-lac

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36
Q

Protein synthesis inhibitors specifically target…

A

the smaller bacterial ribosome (70S (30S+50S)) leaving the human ribosome (80S) unaffected.

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37
Q

30S Inhibitors

A

Aminoglycosides (bactericidal)

Tetracyclines (bacteriostatic)

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38
Q

50S Inhibitors

A

Chloramphenicol, Clindamycin (bacteriostatic)
Erythromycin (macrolides - bacteriostatic)
Linezolid

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39
Q

Aminoglycosides (5)

A
  1. Gentamicin
  2. Neomycin
  3. Amikacin
  4. Tobramycin
  5. Streptomycin
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40
Q

Aminoglycosides MOA

A

inhibit formation of initiation complex and cause misreading of mRNA; also block translocation

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41
Q

Aminoglycosides are ineffective against…

A

anaerobes bc they require O2 for uptake.

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42
Q

Aminoglycosides Use

A
  • severe gram-negative rod infections

- neomycin for bowel surgery

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43
Q

Aminoglycosides Toxicity

A
  • Nephrotoxicity (esp. with cephalosporins)
  • Neuromuscular blockade
  • Ototoxicity (esp. with loop diuretics)
  • Teratogen
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44
Q

Aminoglycosides resistance

A

bacterial transferase enyzmes inactivate the drug by acetylation, phosphorylation or adenylation

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45
Q

Tetracyclines (3)

A
  1. Tetracycline
  2. Doxycycline
  3. Minocycline
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46
Q

MOA of Tetracyclines

A

bind to 30S and prevent attachment of aminoacyl-tRNA

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47
Q

Doxycycline is eliminated…

A

fecally and can be used in pts with renal failure.

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48
Q

Tetracyclines should not be taken with…

A

milk, antacids or iron-containing preps because divalent cations inhibit its absorption in the gut.

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49
Q

Clinical use of tetracyclines

A
  • Borrelia
  • M. pneumoniae
  • Rickettsia and Chlamydia (bc it can accumulate intracellularly)
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50
Q

Toxicity of Tetracycline

A
  • GI
  • discoloration of teeth-
  • inhibition of bone growth
  • photosensitivity

(contraindicated in pregnancy)

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51
Q

Resistance to Tetracycline

A

decreased uptake or increased efflux out of bacterial cells by plasmid-encoded transport pumps

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52
Q

Macrolides (3)

A
  1. Azithromycin
  2. Clarithromycine
  3. Erythromycine
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53
Q

Macrolides MOA

A

inhibit protein synthesis by blocking translocation; binds to the 23S rRNA of the 50S ribosomal subunit

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54
Q

Macrolides Use

A
  • atypical pneumonias
  • STDs (Chlamydia)
  • gram-positive cocci (strep infxns in pts allergic to penicillin)
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55
Q

Toxicity of Macrolides

A
  • GI motility issues
  • Arrhythmia (prolonged QT)
  • acute cholestatic hepatitis
  • rash
  • eosinophilia
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56
Q

Macrolides increase the concentration of…

A

theophyllines and oral anticoagulants.

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57
Q

Resistance to Macrolides

A

methylation of 23S rRNA binding site prevents binding of drug

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58
Q

Chloramphenicol Mechanism

A

blocks peptidyltransferase at 50S ribosomal subunit; bacteriostatic

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59
Q

Chloramphenicol Use

A

Meningitis

Rocky Mountain Spotted Fever

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60
Q

Toxicity of Chloramphenicol

A
  • anemia (dose dependent)
  • aplastic anemia (dose independent)
  • gray baby syndrome
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61
Q

Chloramphenicol causes gray baby syndrome in premature infants because…

A

they lack liver UDP-glucuronyl transferase.

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62
Q

Chloramphenicol resistance

A

plasmid-encoded acetyltransferase inactivates the drug

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63
Q

Clindamycin MOA

A

blocks peptide transfer (translocation) at 50S ribosomal subunit; bacteriostatic

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64
Q

Clindamycin Use

A
  • anaerobic infxns (Bacteroides, C. perfringens) in aspiration pneumonia
  • lung abscesses
  • oral infxns
  • Group A Strep
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65
Q

Clindamycin Toxicity

A
  • pseudomembranous colitis
  • fever
  • diarrhea
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66
Q

Treat anaerobes above the diaphragm with…

A

Clindamycin and below the diaphragm with Metronidazole.

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67
Q

Sulfonamides (3)

A
  1. Sulfamethoxazole (SMX)
  2. Sulfisoxazole
  3. Sulfadiazine
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68
Q

Sulfonamides MOA

A
  • inhibits folate synthesis

- para-aminobenzoic acid (PABA) antimetabolites inhibit dihydropteroate synthase; bacteriostatic

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69
Q

Sulfonamides Use

A
  • gram positive
  • gram negative
  • Nocardia
  • Chlamydia
  • simple UTI
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70
Q

Toxicity of Sulfonamides

A
  • HSRs
  • hemolysis if G6PD deficient
  • tubulointerstitial nephritis
  • photosensitivity
  • kernicterus in infants
  • displaces other drugs from albumin (warfarin)
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71
Q

Resistance to Sulfonamides

A
  • altered enzyme (bacterial dihydropteroate synthase)
  • decreased uptake
  • increased PABA synthesis
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72
Q

Trimethoprim MOA

A

inhibits bacterial dihydrofolate reductase; bacteriostatic

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73
Q

Trimethoprim Use

A

in combo with sulfonamides causing sequential block of folate synthesis; UTIs, Shigella, Salmonella, Pneumocystis jirovecii, pneumonia tx/prophylasis, toxoplasmosis prophylaxis

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74
Q

Trimethoprim Toxicity

A
  • megaloblastic anemia
  • leukopenia
  • granulocytopenia
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75
Q

Fluoroquinolones (9)

A
  1. Ciprofloxacin
  2. Norofloxacin
  3. Levofloxacin
  4. Ofloxacin
  5. Sparfloxacin
  6. Moxifloxacin
  7. Gemifloxacin
  8. Enoxacin
  9. Nalidixic Acid (a quinolone)
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76
Q

MOA of Fluoroquinolones

A

inhibit DNA gyrase (topoisomerase II) and topoisomerase IV; bactericidal

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77
Q

Use of Fluoroquinolones

A

gram-negative rods of urinary and GI tracts (including pseudomonas), Neisseria

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78
Q

Fluoroquinolones Toxicity

A
  • superinfections
  • tendonitis
  • tendon rupture (in people over 60 and people taking prednisone)
  • leg cramps
  • QT prolonagation
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79
Q

Fluoroquinolones are contraindicated in…

A

pregnant women, nursing mothers, and children under 18 due to risk of cartilage defect.

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80
Q

Resistance to Fluoroquinolones

A

chromosome-encoded mutation in DNA gyrase, plasma-mediated reissitance, efflux pumps

81
Q

Metronidazole MOA

A

forms free radical toxic metabolites in the bacterial cell taht damage DNA; bactericidal; antiprotozoal

82
Q

Metronidazole Use

A 
Giardia
Entamoeba
Trichomonas
Gardnerella
Anaerobes
H. pylori (w/ a proton pump inhibitor and clarithromycin)
83
Q

Metronidazole Toxicity

A

Disulfiram like rxn (flushing, tachycardia, hyoptension)

84
Q

Mycobacterium tuberculosis prophylaxis

A

Isoniazid

85
Q

Mycobacterium tuberculosis treatment

A

Rifampin
Isoniazid
Pyrazinamide
Ethambutol

86
Q

Mycobacterium avium-intracellulare prophylaxis

A

Azithromycin

Rifabutin

87
Q

Mycobacterium avium-intracellulare treatment

A
  • more drug resistant than M. tuberculosis

- Azithromycin or Clarithromycin + Ethambutol

88
Q

Mycobacterium leprae treatment

A

long-term treatment with dapsone and rifampin for tuberculoid form; add clofazimine for lepromatous form

89
Q

Isoniazid MOA

A

decreased synthesis of mycolic acids; bacterial catalase-peroxidase needed to convert INH to the active metabolite

90
Q

Isoniazid Use

A

M. tuberculosis

91
Q

Toxicity of Isoniazid

A

-neurotoxicity, hepatotoxicity

B6 can prevent the neurotoxicity

92
Q

Rifampin, Rifabutin MOA

A

inhibits DNA-dependent RNA polymerase

93
Q

Use of Rifampin, Rifabutin Use

A

M. tuberculosis; delays resistance to dapsone when used for leprosy; used for meningococcal prophylaxis and prophylaxis in contacts of kids w/ Hib

94
Q

Toxicity of Rifampin, Rifabutin

A

-orange body fluids
-hepatotoxicity/drug interaction
(Rifabutin favored in pts with HIV due to less CYP450 stimulation.)

95
Q

Pyrazinamide MOA

A

thought to acidify intracellular environment via conversion to pyrazinoic acid; effective in acidic pH of phagolysosomes where TB engulfed by macrophages is found

96
Q

Pyrazinamide Use

A

M. tuberculosis

97
Q

Toxicity of Pyrazinamide

A

Hyperuricemia, hepatotoxicity

98
Q

Ethambutol MOA

A

decreased carbohydrate polymerization of mycobacterium cell wall by blocking arabinosyltransferase

99
Q

Ethambutol Use

A

M. tuberculosis

100
Q

Ethambutol toxicity

A

optic neuropathy (red-green color blindness)

101
Q

Prophylaxis for endocarditis with surgical or dental procedures

A

Penicillins

102
Q

Prophylaxis for gonorrhea

A

Ceftriaxone

103
Q

Prophylaxis for recurrent UTIs

A

TMP-SMX

104
Q

Prophylaxis for meningococcal infxn

A

Ciprofloxacin

Rifampin for children

105
Q

Prophylaxis for pregnant women carrying group B strep

A

Ampicillin

106
Q

Prevention of gonococcal or chlamydial conjunctivitis in the newborn

A

erythromycin ointment

107
Q

Prevention of postsurgical infxn due to S. aureus

A

Cefazolin

108
Q

Prophylaxis of strep pharyngitis in a child with prior rheumatic fever

A

oral penicillin

109
Q

Prophylaxis for syphilis

A

benzathine penicillin G

110
Q

Prophylaxis of Pneumocystis pneumonia in HIV pts with CD4<200

A

TMP-SMX

111
Q

Prophylaxis of Pneumocystis pneumonia and toxoplasmosis in HIV pts with CD4 < 100

A

TMP-SMX

112
Q

Prophylaxis of M. avium in HIV pts with CD4 < 50

A

Azithromycin

113
Q

MRSA treatments

A
  • vancomycin
  • daptomycin
  • linezolid (can cause serotonin syndrome)
  • tigecycline
  • ceftaroline
114
Q

VRE treatments

A
  • linezolid

- streptogramins (quinupristin/dalfopristin)

115
Q

Amphotericin B MOA

A

binds ergosterol (unique to fungi); forms membrane pores that allows leakage of electrolytes

116
Q

Amphotericin B Use

A
  • Cryptococcus
  • Blastomyces
  • Coccidioides
  • Histoplasma
  • Candida
  • Mucor

(give supplemental K+ and Mg2+ bc of altered renal tubule permeability)

117
Q

Amphotericin B toxicity

A
  • fevers/chills
  • nephrotoxicity
  • arrhythmias
  • anemia
  • IV phlebitis
118
Q

Nystatin MOA

A

same as amphotericin B; topical form only!

119
Q

Nystatin Use

A

“swish and swallow” for oral candidiasis; topical for diaper rash or vaginal candidiasis

120
Q

Azoles (6)

A
  1. Fluconazole
  2. Ketoconazole
  3. Clotrimazole
  4. Miconazole
  5. Itraconazole
  6. Voriconazole
121
Q

Azoles MOA

A

inhibit fungal sterol synthesis by inhibiting the CYP450 that converts lanosterol to ergosterol

122
Q

Azoles Use

A

local/less serious systemic mycoses

  • Fluconazole for chronic suppression of cryptococcal meningitis in AIDS pts and candidal infections of all types
  • Itraconazole for Blasto, Cocci, and Histo
  • Clotrimazole/Miconazole for topical fungal infxns
123
Q

Azoles toxicity

A

-testosterone synthesis inhibition (gyencomastia, esp. w/ ketoconazole), liver dysfunction (inhibits CYP450)

124
Q

Flucytosine MOA

A

inhibits DNA and RNA biosynthesis by conversion to 5-FU by cytosine deaminase

125
Q

Use of Flucytosine

A

systemic funcgal infections (esp. meningitis caused by Crypto) in combo w/ amphotericin B

126
Q

Toxicity of flucytosine

A

bone marrow suppression

127
Q

Echinocandins (3)

A
  1. Caspofungin
  2. Micafungin
  3. Anidulafungin
128
Q

Echinocandins MOA

A

inhibits cell wall synthesis by inhibiting synthesis of beta-glucan

129
Q

Use of Echinocandins

A

invasive aspergillosis, Candida

130
Q

Terbinafine MOA

A

inhibits the fungal enzyme squalene epoxidase

131
Q

Terbinafine Use

A

dermatophytoses (esp onychomycosis)

132
Q

Griseofulvin MOA

A

interferes w/ microtubule fxn; disrupts mitosis; deposits keratin-containing tissues

133
Q

Use of Griseofulvin

A

oral treatment of superficial infections; inhibits growth of dermatophytes (tinea, ringworm)

134
Q

Griseofulvin toxicity

A

teratogenic, carcinogenic, confusion, headaches, increased P450 and warfarin metabolism

135
Q

Toxoplasmosis tx

A

pyrimethamine

136
Q

Trypanosoma brucei tx

A

Suramin and Meelarsoprol

137
Q

T. cruzi tx

A

Nifurtimox

138
Q

Leishmaniasis tx

A

Sodium Stibogluconate

139
Q

Chloroquine MOA

A

blocks detoxification of heme into hemozoin; heme accumulates and is toxic to plasmodia

140
Q

Chloroquine Use

A

treatment of plasmodial species other than P. falciparum (resistance to P. falciparum due to membrane pump that decreases intracellular concentration of the drug)

141
Q

Treat P. falciparum with…

A

artemether/lumefantrine or atovaquone/proguanil.

142
Q

For life-threatening malaria, use…

A

quinidine or artesunate.

143
Q

Toxicity of chloroquine

A

retinopathy

pruritis

144
Q

Antihelminthic therapy (5)

A
  1. Mebendazole
  2. Pyrantel pamoate
  3. Ivermectin
  4. Diethylcarbamazine
  5. Praziquantel

(immobilize helminths)

145
Q

Treatment for flukes (trematodes) such as Schistosoma

A

Praziquantel

146
Q

Zanamivir, Oseltamivir MOA

A

inhibit influenza neuraminidase leading to decreased release of progeny virus

147
Q

Zanamivir, Oseltamivir Use

A

treatment/prevention of influenza A and B

148
Q

Ribavirin MOA

A

inhibits synthesis of guanine nucleotides by competitively inhibiting inosine monophosphate dehydrogenase

149
Q

Ribavirin Use

A

RSV, chronic hep C

150
Q

Ribavirin toxicity

A
  • hemolytic anemia

- severe teratogen

151
Q

Acyclovir, Famciclovir, Valacyclovir MOA

A

guanosine analog; triphosphate formed by cellular enzymes; preferentially inhibits DNA polymerase by chain termination

152
Q

Acyclovir, Famciclovir and Valacyclovir have few adverse effects because…

A

they are monophosphorylated by HSV/VZV thymidine kinase and not phosphorylated in uninfected cells.

153
Q

Use of Acyclovir, Famciclovir and Valacyclovir

A

HSV and VZV
-HSV induced mucocutaneous/genital lesions and encephalitis
-prophylaxis in immunocompromised
-

154
Q

Acyclovir, Famciclovir and Valacyclovir have no effect on..

A

latent forms of HSV and VZV.

155
Q

Toxicity of Acyclovir, Famciclovir and Valacyclovir

A

obstructive crystalline nephropathy and acute renal failure

156
Q

Mechanism of resistance to Acyclovir, Famciclovir and Valacyclovir

A

mutated viral thymidine kinase

157
Q

Ganciclovir MOA

A

5’ monophosphate formed by a CMV viral kinase; guanosine analog; triphosphate formed by cellular kinases; preferentially inhibits viral DNA polymerase

158
Q

Use of Ganciclovir

A

CMV, esp. in immunocompromised pts

159
Q

Toxicity of Ganciclovir

A

leukopenia, neutropenia, thrombocytopenia, renal toxicity

160
Q

Resistance to Ganciclovir

A

mutated CMV DNA polymerase or lack of viral kinase

161
Q

Foscarnet MOA

A

viral DNA polymerase inhibitor that binds to the pyrophosphate-binding site of the enzyme; does not require activation by viral kinase

162
Q

Foscarnet Use

A

CMV retinitis in immunocompromised pts when ganciclovir fails; acyclovir resistant HSV

163
Q

Toxicity of Foscarnet

A

Nephrotoxicity

164
Q

Resistance to Foscarnet

A

mutated DNA polymerase

165
Q

Cidofovir MOA

A

preferentially inhibits viral DNA polymerase; does not require phosphorylation by viral kinase

166
Q

Use of Cidofovir

A

CMV retinitis in immunocompromised pts; acyclovir-resistant HSV

167
Q

Toxicity of Cidofovir

A

nephrotoxicity (administer with probenecid and IV saline to decrease toxicity)

168
Q

Highly Active Antiretroviral Therapy (HAART) is initiated when…

A

pts present with an AIDs defining illness, low CD4 cell counts (<500), or a high viral load.

169
Q

HAART regimen consists of..

A

3 drugs to preven resistance:

  • 2 nucleoside reverse transcriptase inhibitors
  • 1 non-nucleoside reverse transcriptase inhibitor OR 1 protease inhibitor OR 1 integrase inhibitor
170
Q

Protease Inhibitors (7)

A
  1. Atazanavir
  2. Darunavir
  3. Fosamprenavir
  4. Indinavir
  5. Lopinavir
  6. Ritonavir
  7. Saquinavir

(Navir tease a protease)

171
Q

The assembly of HIV virions depends on…

A

HIV-1 protease (pol gene) which cleaves the polypeptide products of HIV mRNA into their functional parts. Thus, protease inhibitors prevent maturation of new viruses.

172
Q

Ritonavir can boost…

A

other drug concentrations by inhibiting CYP450.

173
Q

Toxicity of protease inhibitors

A

hyperglycemia, lipodystrophy, nephropathy, hematuria

174
Q

NRTIs (nucleoside reverse transcriptase inhibitors) (7)

A
  1. Abacavir
  2. Didanosine
  3. Emtricitabine
  4. Lamivudine
  5. Stavudine
  6. Tenofovir
  7. Zidovudine

(Have you dined (vudine) w/ my nuclear (nucleoside) family?)

175
Q

NRTIs MOA

A

competitively inhibit nucleotide binding to reverse transcriptase and terminate the DNA chain

176
Q

NRTIs need to be…

A

phosphorylated to be active (except for tenofovir which is a nucleotide).

177
Q

Zidovudine is used for…

A

general prophylaxis and during pregnancy to decrease risk of fetal transmission.

178
Q

Toxicity of NRTIs

A

bone marrow suppression (give G-CSF and EPO), neuropathy, lactic acidosis, anemia (ZDV), pancreatitis (didanosine)

179
Q

NNRTIs (non-nucleoside reverse transcriptase inhibitors) (3)

A
  1. Efavirenz
  2. Nevirapine
  3. Delavirdine
180
Q

NNRTIs MOA

A

bind to reverse transcriptase at a site different from NRTIs; do not require phosphorylation for activation

181
Q

Toxicity of NNRTIs

A
  • rash, hepatotoxicity

- vivid dreams and CNS symptoms (Efavirenz)

182
Q

Delavirdine and Efavirenz are contraindicated in…

A

pregnancy.

183
Q

Raltegravir MOA

A

inhibits HIV genome integration into host cell chromosome by reversibly inhibiting HIV integrase

184
Q

Raltegravir Toxicity

A

hypercholesterolemia

185
Q

Fusion inhibitors

A

Enfuvirtide

Maraviroc

186
Q

Enfuvirtide MOA

A

binds gp41, inhibiting viral entry

187
Q

Maraviroc MOA

A

binds CCR-5 on surface of T cells/monocytes inhibiting interaction with gp120

188
Q

Interferons MOA

A

glycoproteins normally synthesized by virus-infected cells, exhibiting a wide range of antiviral and antitumoral properties

189
Q

Use of INF-alpha

A

chronic Hep B/C, Kaposi sarcoma, hairy cell leukemia, condyloma acuminatum, RCC and malignant melanoma

190
Q

Use of IFN-beta

A

MS

191
Q

Use of IFN-gamma

A

CGD

192
Q

Toxicity of interferons

A

neutropenia

myopathy

193
Q

Antibiotics to avoid in pregnancy

A 
SAFe Children Take Really Good Care
Sulfonamides
Aminoglycosides
Fluoroquinolones
Clarithromycin
Tetracyclines
Ribavirin
Griseofulvin
Chloramphenicol
194
Q

Sulfonamides teratogenecity

A

Kernicterus

195
Q

Aminoglycosides teratogenecity

A

ototoxicity

196
Q

Fluoroquinolones teratogenecity

A

cartilage damage

197
Q

Clarithromycin teratogenecity

A

embryotoxic

198
Q

Tetracyclines teratogenecity

A

discolored teeth, inhibition of bone growth

Step 1 Exam (32 decks)

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