Block 3

Question 1

Pneumocystis jiroveci infection

Answer 1

Trimethoprim/sulfamethoxazole

Question 2

Mycobacterium avium complex infection

Answer 2

Clarithromycin plus ethambutol;
or Azithromycin (less drug interactions)

Question 3

Toxoplasmosis

Answer 3

Pyrimethamine/sulfadiazine plus folinic acid

Question 4

Cryptococcal meningitis

Answer 4

Amphotericin B/flucytosine

Fluconazole

Question 5

Cytomegalovirus infection

Answer 5

Valganciclovir (orally)
Ganciclovir (IV)
Foscarnet (resistant strains)

Question 6

Esophageal candidiasis or recurrent vaginal candidiasis

Answer 6

Fluconazole

Question 7

Herpes simplex infection

Answer 7

Acyclovir
Famciclovir
Valacyclovir
Foscarnet (resistant strains)

Question 8

Herpes zoster

Answer 8

Acyclovir
Famciclovir
Valacyclovir
Foscarnet (resistant strains)

Question 9

Ribavirin

Answer 9

Effective as aerosol for respiratory syncytial virus (RSV)

Question 10

palivizumab

Answer 10

prophylaxis against RSV

Question 11

Amantadine/Rimantadine

Answer 11

Block viral uncoating by blocking M2 protein channel
Influenza A
Anticholinergic

Question 12

Oseltamivir

Answer 12

First oral agent effective against all common influenza virus strains

Question 13

Zanamivir

Answer 13

Oral inhalation

Influenza A and B

Question 14

Viral Neuraminidase Inhibitors

Answer 14

Zanamivir

Oseltamivir

Question 15

Acyclovir

Answer 15

TK
Acyclovir TP is substrate
for viral polymerase
Crystalluria

Question 16

Valacyclovir & famcyclovir

Answer 16

effective against Acyclovir resistant strains but not effective in TK- strains

Question 17

Ganciclovir

Answer 17

Myelosuppression (25-40% of patients)& Mucositis →when too much then consider Foscarnet.

Teratogenic, carcinogenic in animals

Question 18

Foscarnet

Answer 18

Effective against ganciclovir-resistant CMV and acyclovir-resistant HSV
Nephrotoxic
Inhibits viral polymerases (DNA, RNA, RT)

Question 19

Cidofovir

Answer 19

Used IV for CMV retinitis

Question 20

Zidovudine/Azidothymidine

Answer 20

Thymidine analog (dideoxynucleoside)
Phosphorylated nonspecifically to a triphosphate that can inhibit HIV reverse transcriptase
Resistence occurs due to mutations in gene that code for RT

Bone marrow depression

Question 21

Nevirapine

Answer 21

NNRTI
Can be active against AZT-resistant HIV

Single dose can reduce vertical transmission by 50%

Causes severe, possibly life-threatening skin rash & abnormal LFT

CYP3A substrate and inducer

Question 22

Efavirenz–

Answer 22

Causes Insomnia & dysphoric dreams (in >50% patients)

Question 23

PRotease Inhibitors

Answer 23

Indinavir

Ritonavir

Question 24

Ritonavir

Answer 24

induces CYP1A2 & inhibits major CYP4503A4 & CYP4502D6.

Ritonavir used as a pharmacokinetic “booster” for other protease inhibitors; Because it blocks their metabolism