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Flashcards in PRE MCQ PAPER Deck (43)
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1
Q

Give examples of beta lactamase-resistant penicillns. (HINT: there’s 5)

A
methicillin
oxacillin
cloxacillin
dicloxacillin
nafcillin
2
Q

Name the 2 broad spectrum penicillins.

A

Ampicillin

Amoxicillin

3
Q

Name the 4 extended-spectrum penicillins.

A

carbenicillin
ticaracillin
azlocillin
piperacillin

4
Q

What are carbapenamases resistant to? What is their MoA?

A

Resistant to typical beta lactamases

They bind to beta lactamase, acylating the enzyme - rendering it inactive

5
Q

What are the 2 beta lactamase inhibitors? When/what are they used for?

A

CLAVULANIC ACID and SALBACTAM

  • inhibit class A beta lactamase
  • can be administered alongside a beta lactam antibiotic instead of using a beta lactamase resistant antibiotic
6
Q

What are the 6 uses of cephapholsporins? What are the 4 examples?

A

Against septicaemia, pneumonia, meningitis, biliary tract infections, UTIs, sinusitis
Examples = cefalexin, cefuroxime, cefotaxime, cefadroxil

7
Q

What is bacitracin used to treat?

A

As an ointment to treat infections of the skin and eye by streptococci and staphylococci

8
Q

What are the therapeutic uses of sulphonamides and trimethoprim?

A

Trimethoprim - UTIs
Co-trimoxazole - toxoplasmosis
With other drugs for opportunistic infections in AIDS pts

9
Q

What are 2 macrolides? When are they usually used?

A

Erythromycin and Clarithromycin

  • penicillin alternative
  • used for community acquired LRTIs
10
Q

What is the spectrum of activity of aminoglycosides?

A

septicaemia
serious UTIs
Hospital acquired pneumonia
Resp and intra abdominal infections

11
Q

What are tetracyclines used to treat?

A

First choice for rickettsial, mycoplasma and chalmydial infections, brucellosis, cholera, plague and lyme disease
Can be used in COPD or treating chronic acne.

12
Q

What is the most commonly used fluoroquinolone currently?

A

Ciprofloxacin

13
Q

For the following quinolones, state their uses (i) naladixic acid (ii) norfloxacin, cirpofloxacin (iii) motifloxacin, gatifloxacin, gemifloxacin

A

(i) UTI
(ii) systemic infection
(iii) acute lower RTI

14
Q

For lung cancer, what drug is used (i) If EGFR mutations present (ii) KRAS mutations present (iii) ALK rearrangement = 4% fusion?

A

(i) erlotinib
(ii) no drug
(iii) crizotinib

15
Q

For colorectal cancer what is the personalised treatment?

A

If there are no KRAS/NRAS mutations then cetuximab plus chemotherapy

16
Q

For lung cancer, what drug is used if (i) BRAF mutations present (ii) KIT mutations present?

A

(i) vermurafenib

(ii) imatinib

17
Q

What drug is used in brain tumours (high grade glioblastomas) when there is a high percentage of MGMT promoter methylation?

A

Temozolomide

18
Q

For gastric tumours, what drug is used if GIST has KIT mutations present?

A

Imatinib

19
Q

What 2 drugs are used in relation to anti-PD-1/PD-L1? Describe what they do

A

Nivolumab - anti PD-1 antibody used in melanoma and squamous NSCLC
Ipilimumab - anti-CTLA-4 antibody used in metastatic melanoma

20
Q

What are the names of the 4 tri-azole drugs?

A
  1. fluconazole
  2. itraconazole
  3. posaconazole
  4. voriconazole
21
Q

What is fluconazole used to treat?

A

Fungal meningitis

Candiduria

22
Q

What is itraconazole used to treat?

A

Treats a wide range of dermatophytes

23
Q

What is (i) posaconazole (ii) voriconazole used to treat?

A

(i) invasive fungal infections unresponsive to treatment

(ii) used in life-threatening infections

24
Q

What is flucytosine used to treat?

A

Systemic yeast and fungal infections

As an adjunct to amphotericin in cryptococcal or systemic condidiasis

25
Q

What are the 2 polyenes?

A

Amphotericin and Nystatin

26
Q

What is the clinical uses of (i) amphotericin (ii) nystatin?

A

(i) IV for systemic fungal infections as active against most fungi and yeasts
- usually given in lipid formulation as it is significantly less toxic
(ii) oral, oropharyngeal and perioral infections

27
Q

What are the 3 echinocandins? What are their clinical uses?

A

Adidulafungin, Capsofungin, Micafungin

  • only capsofungin against aspergillus species
  • all 3 against candida species
28
Q

When is terbinafine used clincially?

A

dermatophyte infections of the nails

ringworm infections where oral therapy is appropriate

29
Q

When is griseofulvin used clinically?

A

Dermatophyte infections of the skin, scalp, hair and nails where topical therapy has failed/inappropriate

30
Q

What is the treatment of invasive candidiasis?

A

Echinocandin can be used

  • FLUCONAZOLE in candida albicans who haven’t received an ‘azole’ recently
  • AMPHOTERICIN when the above cannot be used
  • VORICONAZOLE pts intoletant of above or those with fluconazole resistant candida
31
Q

What is the treatment for superficial candidiasis?

A

Treated locally with miconazole
Widespread/intractable requires fluconazole
itraconazole for infectinons unresponsive to fluconazole

32
Q

What is the treatment for aspergillosis?

A

Voriconazole = treatment of choice
Liposomal amphotericin when above cant be used
Then capsofungin, itraconazole or posaconazole for those intolerant of the above

33
Q

What is the treatment for cryptococcal meningitis?

A

Amphotericin and Flucytosine by IV for 2 weeks

followed by oral fluconazole for 8 weeks/till cultures negative

34
Q

What are the uses of aciclovir?

A

HSV and VZV
- genital herpes, herpes simplex labialis
- shingles, chickenpox in immunocompromised pts
ETC. (other herpes)

35
Q

What is used to treat cytomegalovirus?

A

Ganciclovir and valganciclovir

36
Q

What are the 2 RNA viruses?

A

Influenza

Hep C virus

37
Q

What are the 2 types of retroviruses?

A

HIV

Human T cell Leukaemia Virus

38
Q

What are the 5 types of drugs used to treat retroviruses? Give an example for each.

A

1, RT inhibs

  • NRTI = abacavir
  • NNRTI = delaviridine
    2. PR inhibs
  • atanzavir
    3. Entry inhib
  • maraviroc
    4. Fusion inhib
  • Enfuvitide
    5. IN inhib
  • raltegravir
39
Q

What is the MoA of (i) NRTI (ii) NNRTI?

A

(i) inhibit viral DNA synthesis by acting as a chain terminator
(ii) Binding induces conformational changes which inhibit the catalytic activity of RT

40
Q

What is the use of (i) raltegravir (ii) dolutegravir (iii) elvitegravir?

A

(i) pts with HIV resistant to other HAART regimens
(ii) Add on to concurrent HAART therapy
(iii) used for pts starting HIv treatment for 1st time

41
Q

What is HAART?

A

Highly active anti-retroviral therapy

  • combo of 3 or 4 different drugs
  • usually 2 NRTIs with a NNRTI, PI or most recently an IN inhibitor
42
Q

What is used to treat influenza?

A

Amantadine
Rimantidine
Oseltamivir - oral
Zanamivir - nasal spray

43
Q

What drugs are used for the treatment of Hep C?

A

ribavirin
peginterferon alpha
simeprevir, ledipasvir and sofosbuvir
protease inhibitors (telaprivir, boceprivir, paritaprevir)