Pharmacology -- Antimicrobials

Question 1

Primaquine

Answer 1

Malaria prophylaxis

Used for extraerythrocytic forms Plasmodium vivax or P. ovale

Question 2

Ciprofloxacin

Answer 2

Quinolone derivative
Both gam + and - coverage
Disrupts DNA gyrases: topo II and IV.

Question 3

Tetracyclines, anuria and “the exception”

Answer 3

Tetracyclines contraindicated in anuric pt. due to production of (-)Nitrogen balance and Inc BUN levels.
Doxycycline is the exception

Question 4

Ceftriaxone

Answer 4

3rd gen cephalosporin
DOC for bacterial meningitis in kids (e.g. HiB)
one dose tx for gonorrhea

Question 5

Hepatic coma DOC

Answer 5

Neomycin (aminoglycoside)– supresses normal flora= Dec NH4 prod.= Dec free nitrogen levels in blood stream

Question 6

Clavulanic acid

Answer 6

Irreversible inhibitor of Beta-lactamases, but not transpeptidase
combined w beta-lac sensitive penicillins
usually amoxacillin (Augmentin) or ticercillin (Timentin)

Question 7

Piperacillin

Answer 7

Tx: Pseudomonas & Klebsiella
Broad spec Abx, ureidopenicillin
usually combined w/ tazobactam

Question 8

Streptomycin

Answer 8

Tx: Mycobacterium Tuberculosis

-aminoglycoside – protein synth inhib by bind to 30 s subunit

Question 9

Isoniazid

Answer 9

Most commonly used drug for TB
Usually combined w Rifampin and/or Ethambutol
Pre-tx w pyridoxine (Vit B6) can prevent peripheral neuritis

Question 10

Pyrantel Pamoate

Answer 10

Tx: Hookworm
Depolarizing NMJ inhibitor–causing sudden contraction, followed by paralysis, of helminths. worm to “lose its grip” on intestine

Question 11

Buy “AT” 30, “CELL” at 50

Answer 11

A=aminoglycosides
T=tetracyclines
30= 30S ribosomal subunit
C=chloramphenicol
E= Erythromycin (macrolide)
L= clindamycin
L= lincomycin
50=50S subunit

Question 12

Cefotoxin

Answer 12

Tx: intraabdominal infections (e.g. w Bacteroides fragilis)

Tradition tx has ben clindamycin & gentamycin

Question 13

Chloramphenicol

Answer 13

Broad spec Abx
Bone marrow suppression (common)- aplastic anemia (rare)
Gray baby syndrome (choram. can’t be conjugated)
DOC Typhoid fever (symptomatic salmonella infect.)
DOC HiB meningitis in kids– esp. strain resistant to ampicillin

Question 14

Nifurtimox

Answer 14

Tx: trypanosomiasis

an antiparasitic

Question 15

Metronidazole

Answer 15

Tx: Leishmaniasis & Amebiasis
God for anaerobic bacteria e.g. B. fragilis, C. Diff
DOC Trichomoniasis
DOC Giardia lambia

Question 16

Txt P. Carinii

Answer 16

TMP-SMX & Pentamidine

Question 17

Tetracycline

Answer 17

Tx: Brucellosis & Cholera, Rocky Mountain Spotted Fever, spirochete infections like Lyme disease (Borrelia burgdorferia)
-30S protein synth inhibition

Question 18

TMP-SMX

Answer 18

Anti-dyhydrofolate reductase activity
sulfonamide abx combo– inhibit successive steps in folate synth
trade: bactrim

Question 19

Benzathine Penicillin G

Answer 19

Long duration of action…given every 3-4 weeks for tx of syphilis

Question 20

Praziquantel

Answer 20

Tx: schistosomiasis (flukes/trematodes)

Question 21

Melarsoprol

Answer 21

Tx trypanosomiasis w/ neurological sx

i.e. when “sleeping sickness” signs have already started

Question 22

Stibogluconate

Answer 22

Tx: Leishmaniasis

Question 23

Fluconazole

Answer 23

Tx: fungal encephalitis
mech: inhibits fungal cytochrome P450 enzyme 14α-demethylase
block conversion of lanosterol to ergosterol

Question 24

Amphotericin B

Answer 24

Ployene antifungal… binds ergosterol

“ampho-terrible” …severe side effects

Question 25

Ketoconazole MOA

Answer 25

Inhibits fungal ergosterol synth= disrupts membrane

Question 26

Griseofulvin MOA

Answer 26

accumulates in keratinized layers of skin= used in dermatomycoses infections

Question 27

Mefloquine

Answer 27

Anti-malarial | Tx: chloroquine resistant strains= P. falciparum

Question 28

Chloroquine

Answer 28

tx: malaria when inside RBC

Question 29

Nifurtimox

Answer 29

DOC Chagas disease due to T. cruzi

Question 30

Erythromycin

Answer 30

Used in pt.s allergic to penicillin | Macrolide- blocks aminoacyl translocation, prevents tRNA from moving from A--P site at the A site of rRNA complex

Question 31

Nystatin

Answer 31

Topical tx of superficial mycotic infection, e.g. candidiasis

Question 32

Acyclovir

Answer 32

Guinine analog | Tx: Herpes infections (HSV1, 2, VZV, EBV)

Question 33

Imipenem

Answer 33

Carbapenem--Broad spec beta-lactam Abx Used w Cilastatin Can cause seizures

Question 34

Cefoperazone side effects

Answer 34

Bleeding due to vit K level alterations contraindicated in pts w/ bleeding d/os (third gen cephalosporin)

Question 35

Vancomycin

Answer 35

Used for MRSA | "red neck" due to histamine release --> facial flushing

Question 36

Meropenem

Answer 36

Use w/ cilastatins | Doesn't cause seizures (unlike Imipenem)

Question 37

Nafcillin

Answer 37

Only penicillin that does not need dose adjustment in renal impairment

Question 38

Peripheral neuropathy

Answer 38

Seen w use of: metronidazole, isoniazid, vincristine, ddI, AZT, allopurinol (gout tx)

Question 39

Sulfonamides & newborns

Answer 39

Kernicterus can occur (neuro)

Question 40

"O.N.E." for gonorrhea

Answer 40

Fluroquinolones used in a one dose deal for gonorrhea: O= Oflaxacin N= Norfloxacin E= Enoxacin

Question 41

Ribavirin

Answer 41

Tx RSV