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Flashcards in Exam 2 Deck (123):
1

Metronidazole? And Tinidazole

How does it work? 

What is it good at fighting against?

AE?

What are its three functions of killing?

Amebicide 

Does a ton of things, it kills trophozoites but not cysts by causeing DNA damage. 

Good for kill Clostridium

Kills: Amebiasis, Giardiasis, Trichomoniasis

Dry mouth, nausea, metallic taste

Amebicidal, bactericidal, Trichomonicidal

2

What does daptomycin do?

Effects against? can cause?

  • Binds to the cell wall of gram positive causing death 
  • Effective againsts MRSA, VRE (Vanco-resistant)
  • Allergic pneumonitis 

 

3

Entecavir and Lamivudine are?

Nucleoside RTI Treat HBV

4

Telaprevir, Simeprevir and Boceprevir are all? What do they so?

HCV NS3/4A protease inhibitors Inhibit replication by blocking the proteolytic activity of HCV protease NS3/4A

5

Immunocompromised patients?

Pneumonia

P. Jiroveci 

6

Vancomycin is only active against?

Binds to d-___d-___

Drug of choice for?

Can cause?

  • Gram positive 
  • Binds to d-Ala-d-Ala preventing elongation
  • Drug of choice for MRSA
  • Time dependent killing
  • Redman syndrome

7

Block dihydropteroate synthase

Sulfonamides 

8

STDs there are 5 bacterial STDs and diseases to go with them

A image thumb
9

Why are mycobacteria (like TB) difficult to treat?

  1. Slow growth or become dormant to evade
  2. intracellular pathogens cannot be reached by immune factors (Ab,C) and drugs 
  3. lipid rich cell wall of the bacteria is impermeable to many agents 
  4. Incredibly good at aquiring resistance to drugs 

10

Macrolides?

Clari, Azithro, Erythro

11

Using ABXs can cause? 

Medical devices can also cause _____ invasion

_____ is a major cause of fungal sepsis and septic shock (HTN, tachycardia) 

 

Thrush

candidiasis invasion

Candidemia

12

How is gonorrhea transmitted?

  • Transmission generally requires contact of epithelial surfaces
  • Gonorrhea also crosses amniotic membranes
  • Humans are the only natural hosts

13

WHAT IS THIS?

Q image thumb

Yeast 

14

Oxazolidinones?

MOA

GOOD for?

AE?

Resistnace?

Linezolid

  • Inhibits proteins synth by preventing formation of the ribosome complex
  • Good for MSSA, MRSA, VRE entero faecium 
  • Hematologic AE: Thrombocytopenia myelosuppression
  • Different from other protein synth inhibitors

 

15

Hepatitis B is a ____ virus _____

dsDNA virus hepadnavirus

16

Cyclic Lipopeptide?

Daptomycin

17

Respiratory Infections: Acute bronchitis

What is it?

Bronchitis causes similar symptoms as? But doesnt demonstrate what?

  • Acute inflammation or infection of the airways or bronchi
  • Symptoms like pneumonia but doesnt demonstrate pulmonary consolidation and chest infiltrates 

18

Interferon alfa-2a

Interferon alfa-2a or 2b act similarly to endogenous IFN-α to inhibit viral replication and cleave single-stranded viral RNA.

19

Name the quinolines

What are there adverse effects and how do they work?

Chloroquine, Mefloquine, Quinine, Primaquine

  • Hematologic abnormalities, hemolysis, prolonged QT, hypotension
  • Quinine can cause cinchonism, tinnitus, headache, nausea, dizziness, flushing, visual disturbances

20

B-lactams consist of Penicillin, Lactamase inhibitors, cephalosporins and Cephamycins, Carbapenems, Monobactams

What is there MOA?

Cross link is usually formed by transpeptidase but B-lactams inhibit this

Also known as PBP

21

What are the 6 bacteria types?

  1. True Bacteria
  2. Filamentous Bacteria
  3. Spirochetes
  4. Mycoplasmas
  5. Rickettsia
  6. Chlamydia

22

Tenofovir and Adefovir are both?

Nucleotide reverse transcriptase inhibitors

23

Scabies?

Carcoptes scabei

24

Entecavir is the most ___ so far?

potent

25

What are other pathogens associated with urethritis?

  • Trichomonas vaginalis, herpes simplex virus, Ureaplasma urealyticum, and Mycoplasma

26

Kill sexual stages and prevent transmission to mosquitos?

Gametocides

27

What are the common side effects of Entecavir?

Diarrhea, Headache, Fatigue, chills, vomit, anorexia

28

Ribavirin?

IMP dehydrogenase inhibitor, crucial in making RNA including viral RNA

29

Amino glycosides. 3 main things

 

  1. Irreversible inhbitors of protein synthesis, Block the initiation complex
  2. Miscoding of amino acids
  3. Block of translocation on mRNA

30

Bacterial Sepsis? Associated with?

ARDS, DIC, Hemodynamic effects and renal failure.

31

Miroorganism/human relationship

Mutual relationship - Normal Flora - Relationship can be breached by injury + Leave their normal sites and cause infection elsewhere

32

Hepatitis can be A-?

G

33

Lincosamides?

Derivative of the?

Good for? 

what type of bacteria

Resistance?

Clindamycin 

  • Of Lincomycin
  • skin and soft tissue infections cause by strep and staph
  • Same as macrolides 
    • Impaired influx or increase efflux 

      Production of esterases that hydrolyze macrolide lincosamide and streptogramin, MLS type B

      Modification of the ribosomal binding site by mutation or by macrolide inducible or constitutive methylase

34

Flatworms examples?

  • Neuro Cysticerosis
  • Schistosomiasis blood flukes?

35

What is the oldest and highly effective antimalarial blood schizonticide?

Quinolines

36

Problems and adverse effects of HCV protease inhibitors?

Resistance to both drugs has been demonstrated in HCV isolated from cell cultures and during clinical studies • Skin rash (in some case systemic symptoms-> fatal)

37

B-lactams are _____ dependent and they are not active against?

Time dependent, not active against MRSA

38

Eliminate developing or dormant liver forms?

Tissue schizonticides

39

Act as erythrocytic parasites?

Blood schizonticides

40

Telaprevir, Simeprevir and Boceprevir should always be used in combination with?

Ribavirin and Interferon alfa-2b

41

Respiratory infections: Pneumonia

Community acquired

Pneumococcal pneumonia (strepto pneumoniae)

Mycoplasm in young 

42

Bacteremia or septicemia

  • Presence of bacteria in the blood due to a failure of the body’s defense mechanisms
  •  Usually caused by gram-negative bacteria
  •  Toxins released in the blood cause the release of vasoactive peptides and cytokines that produce widespread vasodilation

43

What is a UTI ?

what are the 3 type?

  • UTI is inflammation of the urinary epithelium following invasion and colonization by some pathogen within the urinary tract
  • Complicated
  • Uncomplicated
  • Persistent

44

Blocks Dihydrofolate reductase

Pyrimidines 

45

Macrolides are used for?

Check for interactions with?

Respiratory infection, Avium, Chlamydia

P450 interaction 

 

46

Nongonococcal or nonspecific urethritis

  •  Nonreportable STI
  •  Syndrome caused most commonly by Chlamydia trachomatis

47

What are the common pathogens that cause UTIs?

  • E.Coli 
  • Staphylococcus saprophyticus
  • Enterobacter spp

48

Isoniazid is responsible for? 

MOA?

Cell wall inhibition of mycobacteria it inhibits mycolic acid synthesis 

49

Oral fungistatic used for dermatophytosis

 

Griseofulvin

50

Explain how Pneumococcal Pneumonia gets in and infects the body?

A image thumb
51

Disease caused by fungi?

Fungi that invade the skin, hair, or nails? They are specifically called?

Deep fungal infections are ____ threatening

 

 

mycoses

dermatophytes, tineas (ringworm)

life threatening

 

52

Oral and topical fungicidal that blocks ergosterol synthesis at an earlier step than azoles

Terbinafine

53

What is pentamidine?

What is it used in? 

Whats else?

  • Used in african Trypanosomiasis - Sleeping sickness
  • Leishmaniasis
  • Its highly toxic

54

Staphylococcus aureus is?

Gram positive bacterial sepsis.

55

How to Entecavir work?

It slows the progression of chronic hepatitis B infection and improves liver inflammation and fibrosis caused by HBV

56

HBV causes?

Cirrhosis and hepatocellular carcinoma

57

Sexually transmitted parasitic infection? 

Only one gone over in class

What does it stick to and damage?

Trichomoniasis

  • Adheres to and damages squamous epithelial cells 
  • coexists with gonorrhea 

58

Sulfonamides are good for? 

Generally use as? 

Adverse effects?

  • Uncomplicated UTIs
  • Hematopoietic disturbances
  • interacts with warfarin

 

59

HBV relies on what type of transcription?

Reverse transcription RNA--->DNA

60

Tetracyclines?

Tetra, Doxy, Tige all cycline

61

First, Second, Third, Fourth generation cephalosporins gone over in class?

  1. Cephalexin, Cefazolin
  2. Cefprozil, Cefuroxime
  3. Ceftriaxone, Cefotaxime
  4. Cefepime 

 

62

Bacterial virulence and infectivity.

Bacteria must have iron to multiply (Siderophores) - Presence of polysaccharide capsules - Supression of complement activation - Bacterial proliforation rates can surpass protective response.

63

Sexually transmitted Urogenital Infections

Gonorrhea 

Cause by what species?

What type of bacteria are they? 

 

  • Caused by microorganisms of the species Neisseria gonorrhoeae
  • Aerobic, non–spore-forming, gram-negative, diplococcus
  • Presence of pili helps the microorganisms attach themselves to the epithelial cells of mucous membranes

64

Sofosbuvir is?

HCV RNA polymerase NtRTI inhibitor

65

A fungal infection is also referred to as?

Mycosis

66

Artemisinin is a? 

How does it work?

Antimalarial medication

  • Its a sesquinterpene lactone endoperoxide

67

GI infections? 

_____ seen with dysentery

One other pathogen 

  • Shigellosis
  • Campylobacter enteriris (Travelers Di)

68

HBV is spread by?

Sexual contact, perinatal

69

Ivermectin?

MOA?

Used in?

Antihelminthic

  • Causes paralysis by intensifying GABA-mediated transmission of signals in peripheral nerves crazy
  • Onchocerciasis: River blindness 
  • Microfilaria
  • Ectoparasites such as scabies

70

What is sofosbuvirs MOA?

Sofosbuvir blocks the NS5B RNA-dependent RNA polymerase of HCV

71

Albendazole?

MOA? 

Used for? 

Antihelminthic

  • Inhibits the polymerization of microtubules 
  • Intestinal parasites: Cysticercosis, Acariasis, Enterobiasis (pinworm)
  • Hydatid disease (Echinococcus via dogs)
  • Neurocysticercosis

 

72

Examples of Nematodes?

  • Hookworm disease
  • Ascariasis 
  • Enterobiasis
  • Filariasis-Riverblindness, Loa loa, Lymphatic (can live there)

73

Streptogramins?

Rapidly ____ for most susceptible organisms ____ , _____ and ____ but not?

Resistance?

 

  • Quinupristin-dalfopristin in 30:70
  • bactericidal for MSSA, MRSA, and VRE
    • but not Entero Faecalis
    • slow with Entero Faesium 
  • Same as macrolide

 

74

Types of lice?

  • Pediculus Humanus Capitis
  • Corporis
  • pubis crabs bro

75

Cephalosporin and Cephamycin what is their purpose?

What are some adverse rxns?

Increase gram negative coverage 

Allergy, methylthiotetrazole containing cephs can cause bleeding and disulfiram like rxns

76

What can lice transmit?

As a result causes?

Rickettsia promazekii

Louseborne typhus

77

Fosfomycin?

MOA?

Used to treat?

Same as?

 

  • Inhibits the bacterial wall synthesis by inhibiting the synthesis of the cell wall building blocks
  • Primarily used for uncomplicated lower UTI
  • Same as Nitrofurantoin

78

What is cystitis? Pertaining to UTIs

What are the symptoms?

How do you treat?

 

  • Cystitis is an inflammation of the bladder
  • Frequency, dysuria(hurts to pee), urgency, and lower abdominal and/or suprapubic pain
  • Antimicrobial therapy, increased fluid intake, avoidance of bladder irritants, and urinary analgesics

79

How to fungal infections invade and evade destruction

 

  • Intracellular survival (switch from yeast to more virulent)
  • Inhibit phagocytosis
  • Antigenic Variation
  • Immune suppression 
  • Tissue damage by triggering inflammatory response

80

Viral Hepatitis

Is a viral disease that causes inflammation of the liver

81

Pneumonia Port of Entry 

  • Aspiration of oropharyngeal secretions 
  • Inhalation of aerosols
  • From blood bacteremia 

82

Nosocomial Infection? 

Pneumonia 

Staph aureus, Kleb pneumoniae, P. Aeroginosa 

83

Hepatitis?

An inflammation of the liver from any cause

84

Interactions of HCV protease inhibitor drugs?

Act as inhibitors and substrates of CYP3A4 (boceprevir>telaprevir>simeprevir) • Also inhibitors and substrates of efflux transporter P-glycoprotein • Watch for interactions with other drugs that undergo same metabolism

85

How can bacteria be resistant to B-lactams and their derivatives? Theres 4 

  1. Inactivation by amidases, B-lactamase, or carbapenamases
  2. Modification of PBP
  3. Imparied drug penetration to target PBPs
  4. Anitbiotic Efflux 

86

Filamentous fungi growth as multinucleate, branching hyphae (branching), ringworm is a common one. Also these are more pathogenic

MOLds 

87

Respiratory Infections TB or Mycobacterium Avium complex 

TB has the ___ death toll of any infectious pathogen 

POA:?

TB---?

MAC in what type of patient?

How to detect TB?

  • Highest death toll
  • Airborne transmission 
  • Mycobacterium tuberculosis
  • MAC in immunocompromised patients 

 

Detected

  • Tubercle formation 
  • Caseous necrosis
  • Positive tuberculin skin test (PPD)

88

Infections from species Neisseria gonorrhoeae can result in?

  • Disseminated gonococcal infection (CGI)  
  • Perihepatitis 
  • Ophthalmia neonatorum

89

Macrolide resistance? 3 ways 

  1. Impaired influx or increase efflux 
  2. Production of esterases that hydrolyze macrolide lincosamide and streptogramin, MLS type B
  3. Modification of the ribosomal binding site by mutation or by macrolide inducible or constitutive methylase

90

Binds to ergosterol in the fungal cell membrane forming pores 

  • Broad spectrum with good activity against candida, cryptococcus

Adverse effects?

Amphotericin B

AE: Infusion related rxns, nephrotoxicity. 

91

Carbapenems are not active against? 

Impenem is administered with? 

Good choice for?

  • Klebsiella pneumoniae 
  • And carbapenemase producing strains 
  • administered with a renal dehydropeptidase, cilastatin
  • Good for nosocomial infections and B-lactamase producing GN strains 

92

What is the life cycle of HCV?

- Viral entry into the cells - Replication of the HCV genome depends on NS5B RNA replicase which subsequently converts genomic (t) RNA into (-) and back to (+) RNA - The messenger RNAs formed during the replicative cycle of HCV are translated to viral precursor proteins that are then cleaved by virus-encoded protease NS3/4A into mature structural and functional protein

93

Chlamydial infections 

Trachoma?

 

Leading cause of preventable blindness 

 

94

Monobactams?

Limited to?

No activity againsts? _____ and _____

  • Aztreonam
  • Limited to aerobic GN rods (including P aeruginosa) 
  • No activity against GP, or anaerobes 

95

What are the B-lactam inhibitors?

What do they do? 

Clavulanic Acid, Sulbactam, Tazobactam 

Protected hydrolyzed penicillins from inactivation. Extend Spectrum of the penicillin to strains that would otherwise be inactive. 

96

Adverse effects of Fluoroquinolones?

How do they work?

  • Prolonged QT
  • Neuropathy
  • Cartilage degradation, Achilles tendon
  • Should be avoided during pregnancy 

They block bacterial DNA synthesis by inhibiting bacterial topoisomerase II (DNA gyrase) and Topo IV

97

Amebiasis

Most important?

Causes? 

Can cause what type of liver disease?

  • most important parasitic disease 
  • Causes dysentary as a result of cytotox. on colonic epithelial
  • Can also cause amebic liver disease

98

Rifamycin is a? 

What is its MOA?

 

 

Antimycobacterial Drug that inhibits the synthesis of RNA by targeting RNA polymerase 

99

What generation cephalosporin/cephamycin can cross the BBB?

3rd and 4th 

  • Ceftriaxone, Cefotaxime
  • Cefepime

 

100

Respiratory Infection: Acute epiglottitis

Most common in?

WHat happens how serious?

What bacteria causes it?

Symptoms?

Treatment?

  • Children
  • Severe rapid progressive, life threatening infection of the epiglottis and surrounding area
  • Usually cause by Haemophilus influenzae type B
    • Incidence decreased by HIB vaccine
  • High fever, sore throat, inspiratory stridor, sever respiratory distress
  • Emergency airway and antibiotics 

101

Fluoroquinolones?

One is specific for upper and lower respiratory tract infections?

 

Ciprofloxacin, Levofloxacin, floxacin 

Levofloxacin

102

Fungal Infections 

  • Eukaryotic Cells with _____ walls
  • Can grow as molds or yeasts
  • ______ can be both 
  • Resistant to ________ wall
  • Pathogenicity?

 

  • Rigid cell walls
  • Candida albicans 
  • bacterial cell wall inhibitors 
  • Can adapt to a wide variety of temperatures, digest keratin, low oxygen, they also suppress the immune systems defense

103

HCV virus type

Single stranded RNA flaviviridae (Like dengue, yellow fever)

104

Inhibition of protein synthesis by targeting the 30S ribosomal subunit. 

Used as an Anti what?

Antimycobacterial 

Streptomycin

105

Combination of sulfonamide with timethoprim is?

Synergistic becasue it blocks the process in two different steps. 

106

Polyene macrolide like amphotericin B 

is too toxic for parenternal admin and only used topically

 

Nystatin

107

Nucleoside Analog

Blocks DNA and RNA polymerization

Treats Cryptococcus associated meningitis 

AE?

Flucytosine

Bone marrow toxicity with anemia, leukopenia, and thrombocytopenia

108

Acute viral Hepatitis?

Inflammation of the liver that begins suddenly and lasts a few weeks

109

HCV can cause chronic?

Infection, cirrhosis and carcinoma

110

Syphillis 

Primary ___

Secondary ___

Tertiary ____ 

Latent ____

Congenital____

  •  primary: appearance of a chancre (painless ulcers on genitals)
  •  secondary: mucocutaneous eruptions widespread hematogenous and lymphatic spread
  •  tertiary: cardiovascular syphilis, neurosyphilis
  •  latent syphilis: asymptomatic but potential recurrent infections
  • congenital

111

Maturatio of TB

Cellular ______?

-

_____ granuloma

______

Granuloma

Necrotic Granuloma

Cavity 

112

Inhibits fungal wall synthesis, good for invasive candidiasis

Fungin

113

Grow as ovoid or spherical, single cells multiply by budding and division

(Histoplasma)

Yeast

114

Complications of chronic HBV include?

Cirrhosis- scarring of the liver 2) Decompensated cirrhosis - Increase in portal HTN - Splenomegaly - Encephalopathy - Jaundice 3) Hepatic Carcinoma

115

Block ergosterol synthesis from lanosterol 

broad spectrum for candida, C neoformans, endemic mycoses 

Metabolized by CYP3A4

Azoles

116

Tetracyclines are good for treating?

Resistance? 3 ways 

 

  • Rickettsia Mycoplasma, Chlamydia, Plasmodium
  1. Impaired influx or increased efflux
  2. Productin of proteins that interfere with tetracylcine
  3. Enzymatic inactivation 

117

The most common cause of water borne disease in the US?

Giardiasis 

118

Terbinafine and Azoles both block synthesis of?

Ergosterol 

119

Aminoglycosides?

______ dependent killing?

_____ killing with cell wall ___ in endocarditis

Good for?

AE?

Amikacin, Gentamicin, Tobramycin

  • Cocentration dependent killing
  • Synergisitc with cell wall inhibitors
  • Nephro and ototoxicity 

 

120

Staphylococcus aureus infections

Commensal bacteria and _____ pathogen?

Super antigens?

Children? SSSS? others?

Hospital? 

SOFT PAINS?

  • Opportunistic pathogen 
  • Enterotoxin and toxic shock syndrome toxin 1 (TSST-1)
    • Cause immune overactivation ---> Toxic shock and food poisoning 
  • Impetigo and Staph scalded skin syndrome (SSSS)
  • Most common cause of food borne outbreaks 
  • Skin infection, Osteomyelitis, Food poisoning, Toxic shock syndrome, Pneumonia, Acute Endocarditis, Infective arthritis, Necrotizing fasciitis, Sepsis

121

Bacteria can produce endotoxins and exotoxins whats the difference?

Endo- lipopolysaccharides contained in the cell walls of gram negative organisms. Pyrogenic effects Exo- Enzymes released during growth causing specific responses - Immunogenic - Antitoxin production.

122

Chronic viral hepatitis?

Irreversible inflammatory disease of the liver a leading cause of death

123

What are the antimilarial drugs?

How are these administered?

  • Quinolines
  • Atovaquone
  • Artemisinins

Either prophylactically or as definite therapy