Flashcards in PRE MCQ PAPER Deck (43):
Give examples of beta lactamase-resistant penicillns. (HINT: there's 5)
Name the 2 broad spectrum penicillins.
Name the 4 extended-spectrum penicillins.
What are carbapenamases resistant to? What is their MoA?
Resistant to typical beta lactamases
They bind to beta lactamase, acylating the enzyme - rendering it inactive
What are the 2 beta lactamase inhibitors? When/what are they used for?
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
What are the 6 uses of cephapholsporins? What are the 4 examples?
Against septicaemia, pneumonia, meningitis, biliary tract infections, UTIs, sinusitis
Examples = cefalexin, cefuroxime, cefotaxime, cefadroxil
What is bacitracin used to treat?
As an ointment to treat infections of the skin and eye by streptococci and staphylococci
What are the therapeutic uses of sulphonamides and trimethoprim?
Trimethoprim - UTIs
Co-trimoxazole - toxoplasmosis
With other drugs for opportunistic infections in AIDS pts
What are 2 macrolides? When are they usually used?
Erythromycin and Clarithromycin
- penicillin alternative
- used for community acquired LRTIs
What is the spectrum of activity of aminoglycosides?
Hospital acquired pneumonia
Resp and intra abdominal infections
What are tetracyclines used to treat?
First choice for rickettsial, mycoplasma and chalmydial infections, brucellosis, cholera, plague and lyme disease
Can be used in COPD or treating chronic acne.
What is the most commonly used fluoroquinolone currently?
For the following quinolones, state their uses (i) naladixic acid (ii) norfloxacin, cirpofloxacin (iii) motifloxacin, gatifloxacin, gemifloxacin
(ii) systemic infection
(iii) acute lower RTI
For lung cancer, what drug is used (i) If EGFR mutations present (ii) KRAS mutations present (iii) ALK rearrangement = 4% fusion?
(ii) no drug
For colorectal cancer what is the personalised treatment?
If there are no KRAS/NRAS mutations then cetuximab plus chemotherapy
For lung cancer, what drug is used if (i) BRAF mutations present (ii) KIT mutations present?
What drug is used in brain tumours (high grade glioblastomas) when there is a high percentage of MGMT promoter methylation?
For gastric tumours, what drug is used if GIST has KIT mutations present?
What 2 drugs are used in relation to anti-PD-1/PD-L1? Describe what they do
Nivolumab - anti PD-1 antibody used in melanoma and squamous NSCLC
Ipilimumab - anti-CTLA-4 antibody used in metastatic melanoma
What are the names of the 4 tri-azole drugs?
What is fluconazole used to treat?
What is itraconazole used to treat?
Treats a wide range of dermatophytes
What is (i) posaconazole (ii) voriconazole used to treat?
(i) invasive fungal infections unresponsive to treatment
(ii) used in life-threatening infections
What is flucytosine used to treat?
Systemic yeast and fungal infections
As an adjunct to amphotericin in cryptococcal or systemic condidiasis
What are the 2 polyenes?
Amphotericin and Nystatin
What is the clinical uses of (i) amphotericin (ii) nystatin?
(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
What are the 3 echinocandins? What are their clinical uses?
Adidulafungin, Capsofungin, Micafungin
- only capsofungin against aspergillus species
- all 3 against candida species
When is terbinafine used clincially?
dermatophyte infections of the nails
ringworm infections where oral therapy is appropriate
When is griseofulvin used clinically?
Dermatophyte infections of the skin, scalp, hair and nails where topical therapy has failed/inappropriate
What is the treatment of invasive candidiasis?
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
What is the treatment for superficial candidiasis?
Treated locally with miconazole
Widespread/intractable requires fluconazole
itraconazole for infectinons unresponsive to fluconazole
What is the treatment for aspergillosis?
Voriconazole = treatment of choice
Liposomal amphotericin when above cant be used
Then capsofungin, itraconazole or posaconazole for those intolerant of the above
What is the treatment for cryptococcal meningitis?
Amphotericin and Flucytosine by IV for 2 weeks
followed by oral fluconazole for 8 weeks/till cultures negative
What are the uses of aciclovir?
HSV and VZV
- genital herpes, herpes simplex labialis
- shingles, chickenpox in immunocompromised pts
ETC. (other herpes)
What is used to treat cytomegalovirus?
Ganciclovir and valganciclovir
What are the 2 RNA viruses?
Hep C virus
What are the 2 types of retroviruses?
Human T cell Leukaemia Virus
What are the 5 types of drugs used to treat retroviruses? Give an example for each.
1, RT inhibs
- NRTI = abacavir
- NNRTI = delaviridine
2. PR inhibs
3. Entry inhib
4. Fusion inhib
5. IN inhib
What is the MoA of (i) NRTI (ii) NNRTI?
(i) inhibit viral DNA synthesis by acting as a chain terminator
(ii) Binding induces conformational changes which inhibit the catalytic activity of RT
What is the use of (i) raltegravir (ii) dolutegravir (iii) elvitegravir?
(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
What is HAART?
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
What is used to treat influenza?
Oseltamivir - oral
Zanamivir - nasal spray