Immune Drugs (ABX, anti parasite)

Question 1

Iron lowers the absorption rate of these two antibiotics

Answer 1

Tetracycline & Doxycycline

Question 2

Anti-fungal that works by inhibiting the P450 system of mycoses. It may however have a small effect on humans as well therefore liver enzymes should be monitored. It is also contraindicated with warfarin use

Answer 2

Fluconazole

Question 3

What two antibiotics have antimicrobial activity against pneumocystis jiroveci

Answer 3

Sulfamethoxazole & Trimethoprim

Question 4

What antibiotic may cause pseudotumor cerebri

Answer 4

Tetracycline

Question 5

This antibiotic should not be used after expiration due to increased risk of hepatotoxicity and nephrotoxicity (Falconi’s syndrome)

Answer 5

Doxycycline

Question 6

These two antibiotics are contraindicated in individuals with G6PD deficiency.

Answer 6

Sulfamethoxazole & Trimethoprim

Question 7

This antibiotic increases the effects of warfarin and lithium. It should not be given in the first trimester of pregnancy or with lactation. It is also contraindicated in liver disease

Answer 7

Metronidazole

Question 8

This medication increases the risk of nephrotoxicity when taken with cephalosporins

Answer 8

Aminoglycosides

Question 9

This antibiotic works by inhibiting DNA gyrase.

It should not be given with aluminum or magnesium antacids because it creates insoluble salts with this antibiotic. It can reduce serum antibiotic levels by 90%

Answer 9

Ciprofloxacin

Question 10

This antibiotic can be given to beta-hemolytic streptococcus, Strep pyogenes, and MRSA. It is also used in impetigo (S.aureus)

Answer 10

Mupirocin

Question 11

May cause argyria (blue discolouration of the skin).

Answer 11

Silver nitrate

Question 12

This antibiotic has antimicrobial activity against mycobacterium and mycoplasma (walking pneumonia).

This antibiotic may decrease caffeine excretion therefore coffee abstinence is recommended

Answer 12

Ciprofloxacin

Question 13

You need to monitor methemoglobin levels while on this medication because it increases the methemoglobin (ferric-containing hemoglobin, as opposed to the standard ferrous-containing Hgb) levels in the blood that ultimately reduces oxygen delivery to the tissue.

Answer 13

Silver nitrate

Question 14

What antibiotic class is most likely to cause pseudomembranous colitis?

Answer 14

Cephalosporins

Question 15

This medication should be discontinued if seizures or paraesthesia begin; due to its neurotoxic adverse effects

Answer 15

Metronidazole

Question 16

This medication should not be used in mayasthenia gravis or SLE because it may exacerbate the respective conditions

Answer 16

Tetracyclines & Doxycycline

Question 17

This antibiotic reduces the absorption of iron and calcium. It is often used for moderately severe acne. It used to be indicated in many other infections but mass resistance has occurred

Answer 17

Tetracyclines (not doxycycline though)

Question 18

What antibiotic has unpredictable interactions with erythromycin, aminoglycosides, and chloramphenicol

Answer 18

Beta-lactams (Amoxicillin/Penicillin)

Question 19

This medication has a potentially fatal interaction with Astemizole and terfenadine. It also has a serious risk of toxicity when taken with digoxin, theophylline, cyclosporine, and bromocriptine.

Answer 19

Azithromycin

Question 20

This antimicrobial is bactericidal and may cause pseudomembranous colitis, hypoprothrombinemia, and vitamin K deficiency

Answer 20

Cephalexin

Question 21

What antibiotic classes have antimicrobial activity against spirochetes?

Answer 21

Macrolides, Beta-lactams, Tetracyclines

Question 22

Antimicrobial activity against haemophilus influenzae, E. coli, Listeria, proteus mirabilis, salmonella, shigella, and enterococci

Answer 22

Amoxicillin

Mnemonic = Amoxicillin HELPSS against enterococci

Question 23

i. ) Clinical Use
a. ) roundworm infection (ascariasis), tapeworm infection, hookworm infection, whipworm infection

ii. ) Mechanism
a. ) Destroys microtubules in parasitic worms

iii. ) Side Effects
a. ) This medication is not absorbed, therefore the medication is generally safe

iv. ) Contraindications
a. ) may be teratogenic

Answer 23

Mebendazole

Question 24

Used in oral candidiasis. This medication can be swished and swallowed. Systemically it is toxic but orally very little is absorbed.

Answer 24

Nystatin

Question 25

Guanosine (nucleoside) analog that inhibits viral DNA polymerase by chain termination. It works against HSV, VZV, EBV. This medication also potentiates Zidovudine in HIV treatment.

Answer 25

Acyclovir

Question 26

In what type of person is Zidovudine’s toxicity potentiated in?

Answer 26

Obese people

Question 27

i. ) Clinical Use
a. ) Rheumatoid Arthritis & Sjogren’s
b. ) Lupus
c. ) Malaria

ii. ) Mechanism
a. ) DMARD anti-inflammatory by blocking Toll-like receptors

iii. ) Side Effects
a. ) Nausea
b. ) Altered Eye pigmentation & Toxicity to the cornea/macula (toxicity is r/t dosage and length of time taking)
c. ) Anemia
d. ) Bleaching of hair
e. ) Blisters in mouth & eyes

iv. ) Contraindications
a. ) G6PD
b. ) Children
c. ) Pregnancy & Lactation

Answer 27

Hydroxychloroquine

Question 28

Inhibits squalene epoxidase in trichophyton & candida species of fungi. It is used to treat dermatophytoses, especially onychomycosis

Answer 28

Terbinafine

Question 29

Used for anaerobic respiratory infections (Clostridium, bacteroides), aspiration pneumonia, and abscesses. It can also be applied topically for acne, and given orally in some cases of MRSA

Answer 29

Clindamycin

Question 30

This anti-fungal agent may cause Steven-Johnson Syndrome, pancytopenia, visual disturbances, vertigo, and hepatic failure.

Answer 30

Terbinafine

Question 31

3rd generation cephalosporin used in acute appendicitis, otitis media, and respiratory infections such as community pneumonia and strep throat

Answer 31

Cefidinir

Question 32

i. ) Clinical Use
a. ) Chronic Hepatitis B & C (minimally effective in HepC genotype 1b)
b. ) Kaposi’s sarcoma
c. ) Renal Cell carcinoma
d. ) Esophageal or Colorectal Cancer (given with 5-FU)
e. ) Metastatic Malignant Melanoma

ii. ) Mechanism
a. ) Antiviral - inhibiting protein synthesis & inducing apoptosis in host cells

iii. ) Side Effects
a. ) Mild Bone Marrow Suppression
b. ) Hair Loss & Sexual Dysfunction
c. ) Depression & Insomnia
d. ) Debilitating Fatigue

iv. ) Contraindications
a. ) Pregnancy
b. ) Renal insufficiency
c. ) Hypothyroidism
d. ) Thrombocytopenia
e. ) Organ transplant, Diabetes, Autoimmune diseases

Answer 32

Interferon-alpha

Question 33

This topical agent should not be applied to the breast if breastfeeding because it is a neurotoxin if ingested

Answer 33

Permethrin

Question 34

A medication that inhibits TNF-alpha, which long-term may result in reactivation of latent infections or (rarely) cause lymphoma.

Answer 34

Adalimumab

Question 35

A medication that can be given concomitantly with methotrexate in RA, that nearly doubles the response rate

Answer 35

Adalimumab

Question 36

This anti-fungal is used as a single dose for vaginal candidiasis. It may cause gynecomastia in men and can be used to treat hypercortisolemia.

Answer 36

Fluconazole

Question 37

Often used in diaper rash this medication has the same mechanism of action as amphotericin B (binds to ergosterol?

Answer 37

Nystatin

Question 38

i. ) Clinical Use
a. ) HIV/AIDS and prevent transmission to fetus
b. ) Post-exposure prophylaxis

ii. ) Mechanism
a. ) Nucleoside analog that inhibits reverse transcriptase

iii. ) Side Effects
a. ) Neutropenia from bone marrow suppression (80%)
b. ) Peripheral Neuropathy
c. ) Myalgia and muscle wasting
d. ) Encephalitis & Seizures

iv. ) Contraindications
a. ) Bone marrow failure
b. ) Myositis
c. ) Caution with obesity (may increase toxicity)

Answer 38

Zidovudine