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MOD II > Final > Flashcards

Final Flashcards

1
Q

What MOAs are specific for bacterial cell wall inhibitors?

A

Transpeptidse inhibitor, Binds D-ala-D-ala, and MurA inhibitors.

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2
Q

What class of antibacterials has the MOA of transpeptidase inhibitors?

A

Beta-lactams

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3
Q

What are some examples of Beta-lactams?

A

Penicillins, Cephalosporins, Carbapenems, and Monobactams.

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4
Q

What class of antibacterials has the MOA of binding D-ala-D-ala?

A

Glycopeptides

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5
Q

What are some examples of glycopeptides?

A

Vancomycin

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6
Q

What is an example of an antibacterial that has the the MOA of being a MurA inhibitor (inhibits the synthesis of N-acetylmuramic acid, N-Am, residues)?

A

Fosfomycin

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7
Q

What classes of antibacterials are cell membrane inhibitors?

A

Lipopeptides and Polymyxins

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8
Q

What is an example of a lipopeptide?

A

Daptomycin

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9
Q

What is are some examples of polymixins?

A

Polymixin B and Polymixin E (colistin).

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10
Q

What are some classes of antibacterial DNA synthesis inhibitors?

A

Fluroquinolones, Nitroimidazoles, and Nitrofurantoin which does not have a class.

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11
Q

What is the MOA of fluroquinolones?

A

Topoisomerase inhibitor.

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12
Q

What is the MOA of nitroimidazoles?

A

Generates radical species which damage DNA and/or cellular machinery.

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13
Q

What are some examples of nitroimidazoles?

A

Metronidazole and tinidazole.

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13
Q

What is the MOA of nitrofurantoin?

A

It is a reactive intermediate.

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14
Q

What classes of antibacterials are protein synthesis inhibitors, specifically 50s inhibitors?

A

Macrolides, lincosamides, oxazolidinones, streptogramins, and Chloramphenical, which does not have a class.

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15
Q

What classes of antibacterials are protein synthesis inhibitors, specifically 30s inhibitors?

A

Tetracyclines and aminoglycosides.

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16
Q

What are some examples of macrolides?

A

Azithromycin, erythromycin, and claritheomycin

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17
Q

What is an example of a lincosamide?

A

Clindamycin

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18
Q

What are some examples of oxazolidinones?

A

Linezolid and tedizolid

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19
Q

What is an example of a streptogramin?

A

Quinupristin-dalfopristine

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20
Q

What are some examples of tetracyclines?

A

Doxycycline, tetracycline, minocycline, and tigecycline.

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21
Q

What are some examples of aminoglycosides?

A

Gentamicin, tobramycin, amikacin, and streptomycin.

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22
Q

What two classes of antibacterials are antimetabolites/antifolates?

A

Sulfonamides and Dihydropyrimidine.

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23
Q

What is the MOA of sulfonamides?

A

Dihydropteroate synthesis inhibitor.

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24
Q

What is the MOA of dihydropyrimidines?

A

Dihyrdrofolate reductase inhibitor

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25
Q

What is an example of a sulfonamide?

A

Sulfamethoxazole

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26
Q

What is an example of a dihydropyrimidine?

A

Trimethoprim

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27
Q

What are some examples of antimycobacterials?

A

Rifamycin class, Isoniazid, Pyrazineamide, and Ethambutol.

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28
Q

What is the MOA of rifamycins?

A

DNA-dependent RNA synthesis inhibitor.

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29
Q

What are some examples of Rifamycins?

A

Rifampin, Rifapentine, and Rifabutin

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30
Q

What is the MOA of isoiazid?

A

Mycolic acid synthesis inhibitor.

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31
Q

What is the MOA of pyrazinemide?

A

Cell membrane synthesis inhibitor.

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32
Q

What is the MOA of ethambutol?

A

Cell was synthesis inhibitor.

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33
Q

What drug name/class has the side effect of hypersensitivity?

A

Beta-lactams and Trimethoprim-sulfamethoxazole

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34
Q

What drug name/class has the side effect of nephrotoxicity?

A

Vancomysin, Polymyxins, Aminoglycosides, and Trimethoprim-sulfamethoxazole.

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35
Q

What drug name/class has the side effect of ototoxicity?

A

Vancomycin and Aminoglycosides

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36
Q

What drug name/class has the side effect of rhinitis/pharyngitis?

A

Fosfomycin

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37
Q

What drug name/class has the side effect of myopathy?

A

Daptomycin

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38
Q

What drug name/class has the side effect of neurotoxicity?

A

Polymyxins

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39
Q

What drug name/class has the side effect of photosensitivity?

A

Fluoroquinolones, Tetracyclines, Trimethoprim-sulfamethoxazole.

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40
Q

What drug name/class has the side effect of QTc prolongation?

A

Fluoroquinolones and Macrolides

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41
Q

What drug name/class has the side effect of tendinitis and tendon rupture?

A

Fluoroquinolones.

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42
Q

What drug name/class has the side effect of needing to be avoided in pregnancy?

A

Fluoroquinolones, Aminoglycosides, Tetracycline, Trimethoprim-sulfamethoxazole.

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43
Q

What drug name/class has the side effect of needing to be avoided with alcohol?

A

Nitroimidazoles

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44
Q

What drug name/class has the side effect of peripheral neuropathy?

A

Fluoroquinolones, Oxazolidinones, and Isoniazid.

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45
Q

What drug name/class has the side effect of pulmonary fibrosis?

A

Nitrofurantoin

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46
Q

What drug name/class has the side effect of C. difficile pseudomembranous colitis?

A

Clindamycin

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47
Q

What drug name/class has the side effect of Serotonin Syndrome?

A

Oxazolidinones

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48
Q

What drug name/class has the side effect of myelosuppression?

A

Oxazolidinones and Trimethoprim-sulfamethoxazole.

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49
Q

What drug name/class has the side effect of gray baby syndrome?

A

Chloramphenical

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50
Q

What drug name/class has the side effect of neuromuscular blockade, which is avoided in myasthenia gravis?

A

Aminoglycosides

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51
Q

What drug name/class has the side effect of hepatotoxicity?

A

Rifamycins, Isoniazid, and Pyrazinamide.

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52
Q

What drug name/class has the side effect of optic neuropathy (red-green colorblindness)?

A

Ethambutol

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53
Q

What drug name/class has the side effect of orange-tan discoloration?

A

Rifamycins

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54
Q

What drug name/class has the side effect of seizures?

A

Isoniazid

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55
Q

What are some examples of fluroquinolones?

A

Ciprofloxacin, moxifloxacin, and levofloxacin.

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55
Q

What drug name/class has the side effect of needing to be avoided in patients with G6PD deficiency?

A

Sulfonamides, Dapsone, and Nitrofurantoin

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56
Q

What is an example of a Lanosterol Synthesis Inhibitor/Squalene Epoxidase Inhibitor?

A

Terbinafine

57
Q

What is the MOA of Terbinafine?

A

Squalene epoxidase inhibitor; squalene epoxidase converts squalene to lanosterol, which is eventually converted by 14-a-sterol demethylase to ergosterol (major component of cell membranes).

58
Q

What are some adverse effects of Terbinafine?

A

Hepatotoxicity
Taste and smell disturbances
Hypersensitivity reactions
Thrombotic microangiography (hemolytic anemia, thrombocytopenia, blood clots in small arteries/capillaries).

59
Q

What are some examples of an Ergosterol Synthesis Inhibitor/14-a-sterol Demethylase Inhibitor?

A

Clotrimazole, micronazole, ketoconazole, econazole, itraconazole, fluconazole, voriconazole, posaconazole, and isavuconazole.

60
Q

What is the MOA of the antifungal class ending in “-conazole?”

A

14-a-sterol demethylase inhibitor; 14-a-sterol demethylase (CYP450) converts lanosterol to ergosterol.

61
Q

What are some adverse effects of the antifungal class ending in “-conazole?”

A

Hepatotoxicity
Drug-drug interactions (CYP inhibitors)
Arrythemias (QTc prolongation)
Inhibits testosterone synthesis leading to gynecomastia (ketoconazole).

62
Q

What antifungal class is a cell wall synthesis inhibitor?

A

Echinocandins

63
Q

What are some examples of echinocandins?

A

Capsofungin, anidulfungin, micafungin.

64
Q

What is the MOA for echinocandins?

A

1,3-B-D-glucan synthesis inhibitor; inhibits the formation of 1,3-B-D-glucan which is a major fungal cell wall inhibitor.

65
Q

What are some side effects of echinocandins?

A

GI discomfort
Flushing (histamine related)

66
Q

What antifungal class are cell membrane inhibitors?

A

Polyenes

67
Q

What are some examples of polyenes?

A

Amphotericin and nystatin

68
Q

What is the MOA of polyenes?

A

Disrupts cell membranes; sequesters ergosterol which disrupts the membrane structure, leading to cell death.

Amphotericin “tears” holes in membranes.

69
Q

What are some adverse effects of Polyenes?

A

“amphoTERRIBLE”
- Infusion related reactions
- Fever, chills, hypotension (“shake and bake”)
- Nephrotoxicity
- Hypokalmeia, jypomagnesemia, arrhythmias

Hydration and liposomal formulations of amphotericin reduce toxicity.

Nystatin: only given topically to treat candida infections of the mouth and diaper region.

70
Q

What is an antifungal example of a nucleic acid synthesis inhibitor?

A

Flucytosine (5-fluorocytosine)

71
Q

What is the MOA of Flucytosine?

A

DNA synthesis inhibitor; transported by cytosine permease into fungal cells, converted to 5-FU which is inserted into RNA and inhibits cell growth. Also inhibits thymidylate synthase.

72
Q

What are the adverse effects of Flucytosine?

A

Bone marrow suppression
GI discomfort

73
Q

What is an antifungal that is a microtubule inhibitor?

A

Griseofulvin

74
Q

What is the MOA of Griseofulvin?

A

Microtubule assembly inhibitor; inhibits fungal cell mitosis at metaphase.

75
Q

What are some adverse effects of Griseofulvin?

A

Teratogenic
Carcinogenic
Confusion, headaches
CYP inducer
Disulfiram like reaction

76
Q

What MOA do Albendazole, Mebendazole, and Triclabendazole have?

A

Disrupts cytoplasmic microtubules and glucose uptake leading to decreased ATP production.

77
Q

What MOA do Benznidazole, Fexinidazole, Metronidazole, and Nifurtimox have?

A

Generates radical species which damage DNA and/or cellular machinery.

78
Q

What MOA does Ivermectin have?

A

Paralytic; increases chloride influx via opening glutamate-gated chloride ion channels).

79
Q

What MOA does Permethrin have?

A

Paralytic; inhibits sodium influx.

80
Q

What MOA does praziquantel have?

A

Paralytic; increases calcium influx which leads to strong contractions followed by paralysis and detachment.

81
Q

What MOA does Eflornithine have?

A

Ornithine decarboxylase inhibitor (OD is needed to synthesize polyamines).

82
Q

What MOA does Duethylcarbamzine have?

A

Immobilizes microfilariae, alters their surface structure, and displaces them from tissues; INC susceptibility to host.

83
Q

What MOA does Melarsoprol have?

A

Trypanothione reductase and pyruvate kinase inhibitor leading to a lack of defense against oxidative stress.

84
Q

What MOA does Miltefosine have?

A

Interferes with cell membrane phospholipids, inhibits cytochrome c oxidase, and induces apoptosis-like cell death.

85
Q

What MOA does Pentamidine have?

A

Interferes with RNA/DNA phospholipids and protein synthesis.

86
Q

What MOA does Suramin have?

A

Inhibits glycoloysis.

87
Q

What MOA does Paromomycin have?

A

30s subunit inhibitor (aminoglycoside).

88
Q

What is the best treatment for HSV/VZV?

A
  • Acyclovir (prodrug is valacyclovir)
  • Peniclovir (prodrug is famciclovir)
89
Q

What MOA does acyclovir/peniclovir have?

A

Viral DNA polymerase inhibitor

90
Q

What are some side effects of Acyclovir/peniclovir?

A

GI discomfort
AKI (obstructive crystalline nephropathy)
Neurotoxicity (headache, behavioral changes, convulsions, and trauma)

91
Q

What resistance mechanisms do acyclovir and peniclovir have?

A
  • Reduced thymidine kinase concentrations
  • Binding site alterations
92
Q

What is the best treatment for non-resistant CMV?

A

Ganciclovir (prodrug is valganciclovir)

93
Q

What is the MOA of Ganciclovir?

A

Viral DNA polymerase inhibitor.

94
Q

What are some adverse effects of Ganciclovir?

A

Bone marrow suppression (leukopenia, neutropenia, and thrombocytopenia)
AKI (obstructive crystalline nephropathy)
Neurotoxicity

95
Q

What resistance mechanisms does Ganciclovir have?

A
  • Reduced thymidine kinase and/or viral phosphotransferase concentrations
  • Binding site alterations
96
Q

What is the best treatment for ganciclovir resistant CMV?

A

Cidofovir

97
Q

What is the MOA of Cidofovir?

A

Viral DNA polymerase inhibitor

98
Q

What are some adverse effects of Cidofovir?

A

Nephrotoxicity

99
Q

What resistance mechanisms does Cidofovir have?

A

Binding site alterations.

100
Q

What is the best treatment for ganciclovir/cidofovir resistant CMV?

A

Foscarnet (pyrophosphate analog)

101
Q

What is the MOA of Foscarnet?

A

Viral DNA/RNA synthesis inhibitor and is also an HIV reverse transcriptase inhibitor.

102
Q

What are some adverse effects of Foscarnet?

A

Nephrotoxicity
Electrolyte disturbances
Neurotoxicity

103
Q

What resistance mechanisms does Foscarnet have?

A

Binding site alterations.

104
Q

What MOA does Enfuvirtide have?

A

gp41 inhibitor

105
Q

What MOA does Maraviroc have?

A

CCR5 antagonist

106
Q

What MOA does Fostemsavir have?

A

gp120 inhibitor; binds gp120 before the conformational change.

107
Q

What MOA does Ibalizumab have?

A

gp120 inhibitar; binds gp120 after the conformational change.

108
Q

What are some examples of HIV entry/fusion inhibitors?

A

Enfuvirtide, Maraviroc, Fostemsavir, and Ibalizumab

109
Q

What are some examples of HIV reverse transcriptase inhibitors (RTI), specifically nucleoside (NRTI)?

A

Older: Didanosine, Stavudine, Zidovudine
Newer: Abacavir, Emtricitabine, and Lamivudine
NucleoTide: Tenofovir disoproxil fumarate and Tenofovir alafenamide.

110
Q

What are some examples of HIV reverse transcriptase inhibitors (RTI), specifically non-nucleoside (NNRTIs)?

A

Doravirine, Efavirenz, Etravirine, Nevirapine, and Rilpivirine

111
Q

What are some examples of HIV integrase inhibitors (INSTI)?

A

Cabotegravir, Raltegravir, Elvitegravir, Dolutegravir, and Bictegravir.

112
Q

What are some examples of HIV protease inhibitors (PIs)?

A

Atazanavir, Darunavir, Fosamprenavir, Indinavir, Lopinavir, Nelfinavir, Saquinavir, and Tipranavir.

113
Q

What treatment regimens are used to treat HIV?

A

Common: Two NRTIs and INSTI
Other: Two NRTIs + NNRTI and two NRTIs + (PI+PK)

114
Q

What is the common regimen for post-exposure prophylaxis?

A

Tenofovir, Emtricitabine, and Raltegravir.

115
Q

What is the common regimen for pre-exposure prophylaxis?

A

Tenofovir and Emtricitabine

116
Q

What are the HIV agent(s) of concern for bone mineral density loss?

A

Tenofovir

117
Q

What are the HIV agent(s) of concern for renal effects/urolithiasis?

A

Tenofovir

118
Q

What are the HIV agent(s) of concern for pancreatitis?

A

Didanosine

119
Q

What are the HIV agent(s) of concern for bone marrow suppression (anemia, neutropenia)?

A

Zidovudine

120
Q

What are the HIV agent(s) of concern for lactic acidosis?

A

Zidovudine, Stavudine, Didanosine

121
Q

What are the HIV agent(s) of concern for hepatotoxicity?

A

Zidovudine, Protease inhibitors (PIs)

122
Q

What are the HIV agent(s) of concern for dyslipidemia?

A

Zidovudine and PIs

123
Q

What are the HIV agent(s) of concern for lipohypertrophy (fat trunk)?

A

PIs, Integrase inhibitors, and NNRTIs (most with efavirenz).

124
Q

What are the HIV agent(s) of concern for weight gain?

A

Integrase inhibitors

125
Q

What are the HIV agent(s) of concern for psychiatric effects?

A

Integrase inhibitors and NNRTIs (most with efavirenz)

126
Q

What are the HIV agent(s) of concern for Stevens-Johnson Syndrome (SJS)/Toxic Epidermal Necrosis (TEN)?

A

NNRTIs (most with nevirapine)

127
Q

What are the HIV agent(s) of concern for hypersensitivity reactions (excluding SJS)?

A

Abacavir (avoid if patient is HLA-B*5701 positive) or Nevirapine

128
Q

What are the HIV agent(s) of concern for myocardial infarction?

A

Abacavir

129
Q

What drug(s) should be used for HBV without HIV co-infection?

A

Interferon alfa-2b, peginterferon alfa-2a, adefovir, and entecavir.

130
Q

What drug(s) should be used for HBV with HIV co-infection?

A

NRTIs: Tenofovir, Lamivudine, and Emtricitabine

2 NRTIs + one of either INSTI, NNRTI, or PI-PK.

131
Q

What HCV drugs are NS3/4A proteases, which cleave viral polyproteins?

A

Glecaprevir, Simeprevir, Paritaprevir, and Grazoprevir

132
Q

What HCV drugs are NS5A protein inhibitors?

A

Pibrentasvir, Velpatasvir, Ledipasvir, and Daclarasvir.

133
Q

What HCV drugs are NS5B RNA polymerase inhibitors?

A

Sofosbuvir and Dasabuvir

134
Q

What Influenza drugs are neuraminidase inhibitors?

A

Oseltamivir (oral), Zanamivir (nasal), and Peramivir (IV)

135
Q

What Influenze drugs are “cap-snatching” inhibitors?

A

Baloxavir (oral)

136
Q

What are the indications for use of neuraminidase inhibitors in Influenza treatment?

A

Treatment and pre-exposure prophylaxis.

137
Q

What are the indications for use of “cap-snatching” inhibitors in Influenza treatment?

A

Treatment and post-exposure prophylaxis.

138
Q

What are some adverse effects of Influenza drugs?

A

GI discomfort
Neuropsychiatric events
Wheezing/bronchospasm (zanamivir)

139
Q

What drug is used to treat RSV?

A

Palivizumab

140
Q

What is the MOA of Palivizumab?

A

Inhibits viral entry

141
Q

What are some adverse effects of Palivizumab?

A

Injection site reactions
Rash
Increased liver function tests

MOD II (1 decks)

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