Pharm Final

Question 1

Entamoeba Histolytica- Amebiasis

Answer 1

DOC: Metronidazole + Luminal Amebicide (invasive) OR Luminal Amebicide alone (asymptomatic)

Question 2

Giardia Lamblia

Answer 2

DOC: Metronidazole

Question 3

Trichomonas Vaginalis

Answer 3

DOC: Metronidazole

Question 4

Toxoplasma gondii

Answer 4

DOC: Pyrimethamine + Sulfadiazine + Folinic acid

Question 5

Pneumocystis jrovecii

Answer 5

DOC: Trimethoprim + Sulfamethoxazole + Folinic acid

Question 6

Alternates to treat Pneumocystosis if intolerant to Bactrim

Answer 6

Pentamidine (but not used often d/t toxicity)

Atavoquone + Proguanil (Malarone)

Question 7

Roundworm (nematode)

Answer 7

DOC: 
Albendazole,
Mebendazole, or 
Pyrantel Pamoate
(species dependent)

Question 8

Flukes (trematodes)

Answer 8

DOC: Praziquantel

Question 9

Tapeworms (cestodes)

Answer 9

DOC: Praziquantel

Question 10

Alternate tx for Roundworms (nematodes)

Answer 10

Ivermectin

Question 11

Alternate tx for Tapeworms (cestodes)

Answer 11

Albendazole

Question 12

Drugs that cause myelosuppression (decrease in RBC and WBC/ leukopenia, neutropenia, anemia)

Answer 12

Ganciclovir/valganciclovir (CMV)
Ribavirin (RSV)
Zidovudine (HIV)

Question 13

Side effects of all NRTI (nucleotide reverse transcriptase inhibitors)

Answer 13

Lactic Acidosis & Hepatotoxicity (liver)

Higher risk if pt is obese, previous liver disease, or chronic use

Question 14

Ritonavir

Answer 14

“BOOST” increases the bioavailability of other Protease Inhibitors

Do not use with Saquinavir (QT) and avoid in combo with Metronidazole and Cephalosporins bc this contains ethanol
(dilsulfuram liker rxn)

Question 15

Darunavir

Answer 15

DOC for Protease Inhibitor class

do not use if Sulfa allergy

Question 16

Atazenavir

Answer 16

2nd DOC for Protease Inhibitor class if Sulfa allergy

less body fat distribution issues

Question 17

Saquanavir

Answer 17

alternate Protease Inhibitor

QT problem

Question 18

Lopinavir/RItonavir

Answer 18

alternate Protease Inhibitor

Question 19

Indinavir

Answer 19

alternate Protease Inhibitor

SE: nephrolithiasis, hyperbilirubinemia (Agressive hydration recommended!!)

Question 20

Tipranavir

Answer 20

Reserved for treatment experienced HIV pts . that have resistance to other Protease Inhibitors

SE: increased risk for intracranial hemorrhage (avoid w/head trauma), Do not use if Sulfa allergy, Hepatotoxicity risk

Question 21

Mechanism of Rifampin, Rifabutin, and Rifapentine

Answer 21

inhibits RNA polymerase

Question 22

Mechanism of Isoniazid

Answer 22

inhibits biosynthesis of Mycolic Acid

Question 23

Mechanism of Pyrazinamide

Answer 23

unknown, but active at Acidic pH

Question 24

Mechanism of Ethambutol

Answer 24

inhibits Arabinosyl transferase involved in synthesis of Arabinogalactan
(static)

Question 25

Mechanism of Streptomycin (an aminoglycoside)

Answer 25

30S, Cidal

Question 26

Mechanism of Dapsone

Answer 26

compete with PABA in Folic Acid pathway, interfere w/nutrition of M. Leprae

Question 27

Blood Schizonticide DOC for Malaria

Answer 27

Chloroquine (if no resistance)

Question 28

If Chloroquine resistant, Blood Schizonticide tx

Answer 28

Choice 1 & 2 are equally recommended: 1. Artesunate + Atovoquone/Proguanil 2. Artemether + Lumefantrine

Question 29

Mechanism of Chloroquine

Answer 29

concentrated w/in plasmodium in RBC. may interfere with Lysosomal degradation of hemoglobin

Question 30

Mechanism of Artemisins: Artesunate and Artemether

Answer 30

unknown ALWAYS in combo with other drugs: 1 of the following 4 1. Atovoquine/proguanil 2. Lumefantrine 3. Mefloquine 4. Sulfadoxine-pyremethamine

Question 31

Atovaquine + Proguanil mechanism

Answer 31

Atovaquine- interferes with mitochondrial electron transport, ATP, and Pyrimidine synthesis Proguanil- prodrug: converted to Cycloguanil (mutagenesis in pregnant mice) which is a DHF reductase inhibitor . cant do DHF --> THF

Question 32

Malarial drugs used for Terminal prophylaxis (anti-relapse)

Answer 32

the tissue forms that treat dormant liver- Vivax and Ovale: Primaquine and Tafenoquine!

Question 33

Mechanism of Azoles

Answer 33

block biosynthesis of Ergosterol, a sterol needed for cell membrane stability

Question 34

Mechanism of Amphotericin B

Answer 34

forms pores in cell membrane with Ergosterol, leading to leakage of cellular components

Question 35

Mechanism of Echinocandins

Answer 35

disrupt function of beta 1,3 Glucan synthase complex