Pharm Fall 2010 Test 2

Front 1

MOA of quinolones

Back 1

Inhibit DNA gyrase

Front 2

MOA of penicillin

Back 2

Block cell wall synthesis by inhibiting peptidoglycan cross-linkage

Front 3

Drug used for MRSA

Back 3

Vancomycin

Front 4

Vancomycin MOA

Back 4

Blocks peptidoglycan synthesis

Front 5

Type of resistance found with vancomycin

Back 5

Point mutation

Front 6

Meningitis prophylaxis in exposed patients

Back 6

Rifampin

Front 7

Technique used to diagnose perianal itching, and the drug used to treat it

Back 7

"Scotch tape technique and mebendazole

Front 8

Two toxicities of aminoglycosides

Back 8

nephro and ototoxicity

Front 9

DOC for Legionnaires' disease

Back 9

Erythromycin

Front 10

MOA of sulfonamides

Back 10

Inhibit dihydropteroate synthase

Front 11

Penicillins active against penicillinase secreting bacteria

Back 11

Methicillin, nafcillin, and dicloxacillin

Front 12

Cheap wide spectrum antibiotic DOC for otitis media

Back 12

Amoxicillin

Front 13

Class of antibiotics that have 10% cross sensitivity with penicillins

Back 13

Cephalosporins

Front 14

PCN active against pseudomonas

Back 14

Carbenicillin, piperacillin and ticarcillin

Front 15

Antibiotic causing red-man syndrome, and prevention

Back 15

Vancomycin, infusion at a slow rate and antihistamines

Front 16

Drug causes teeth discoloration

Back 16

Tetracycline

Front 17

MOA of tetracycline

Back 17

Decreases protein synthesis by inhibiting 30S ribosome

Front 18

Drug that causes gray baby syndrome and aplastic anemia

Back 18

Chloramphenicol

Front 19

Drug notorious for causing pseudomembranous colitis

Back 19

Clindamycin

Front 20

DOC for tx of pseudomembranous colitis

Back 20

Metronidazole

Front 21

Treatment of resistant pseudomembranous colitis

Back 21

ORAL vancomycin

Front 22

Anemia caused by trimethoprim

Back 22

Megaloblastic anemia

Front 23

Reason fluoroquinolones are contraindicated in children and pregnancy

Back 23

Cartilage damage

Front 24

DOC for giardia, bacterial vaginosis, pseudomembranous colitis, and trichomonas

Back 24

Metronidazole

Front 25

Treatment for TB patients (think RIPE)

Back 25

Rifampin, Isoniazid, Pyrazinamide, and Ethambutol

Front 26

Metronidazole SE if given with alcohol

Back 26

Disulfiram-like reaction

Front 27

Common side effect of Rifampin

Back 27

Red urine discoloration

Front 28

MOA of nystatin

Back 28

Bind ergosterol in fungal cell membrane

Front 29

Neurotoxicity with isoniazid (INH) prevented by

Back 29

Administration of Vit. B6 (pyridoxine)

Front 30

Toxicity of amphotericin

Back 30

Nephrotoxicity

Front 31

SE seen only in men with administration of ketoconazole

Back 31

Gynecomastia

Front 32

Topical DOC in impetigo

Back 32

Topical mupirocin (Bactroban)

Front 33

DOC for influenza A

Back 33

Amantadine

Front 34

DOC for RSV

Back 34

Ribavirin

Front 35

DOC for CMV retinitis

Back 35

Ganciclovir

Front 36

SE for ganciclovir

Back 36

Neutro, leuko and thrombocytopenia

Front 37

Anti-viral agents associated with Stephen Johnson syndrome

Back 37

Nevirapine, amprenavir

Front 38

HIV antiviral class known to have severe drug interactions by causing inhibition of metabolism

Back 38

Protease inhibitors

Front 39

Antivirals that are teratogens

Back 39

Delavirdine, efavirenz, and ribavirin

Front 40

Antivirals associated with neutropenia

Back 40

Ganciclovir, zidovudine, saquinavir, and interferon

Front 41

HIV med used to reduce transmission during birth

Back 41

AZT (zidovudine)

Front 42

Drug used for African sleeping sickness

Back 42

Suramin

Front 43

Drug used in Chagas disease

Back 43

Nifurtimox

Front 44

Cephalosporins able to cross the BBB

Back 44

Cefuroxime (2nd) generation and Cefixime (3rd) generation

Front 45

Drug used for N. gonorrhea in females

Back 45

Ceftriaxone

Front 46

Cephalosporin causes kernicterus in neonates

Back 46

Ceftriaxone or cefuroxime

Front 47

SE of INH

Back 47

Peripheral neuritis and hepatitis

Front 48

Aminoglycoside that is least ototoxic

Back 48

Streptomycin

Front 49

Drug used in exoerythrocytic cycle of malaria

Back 49

Primaquine

Front 50

Oral antibiotic of choice for moderate inflammatory acne

Back 50

Minocycline

Front 51

Drug of choice for leprosy

Back 51

Dapsone, rifampin and clofazimine combination

Front 52

DOC for herpes and its MOA

Back 52

Acyclovir; incorporated into viral DNA and chain termination

Front 53

Anti-microbials that cause hemolysis in G6PD-deficient patients

Back 53

Sulfonamides

Front 54

MOA of erythromycin

Back 54

Inhibition of protein synthesis at the 50s subunit of ribosome

Front 55

Anti-biotic frequently used for chronic UTI prophylaxis

Back 55

sulfamethoxazole/ trimethoprim

Front 56

Lactam that can be used in PCN allergic patients

Back 56

Aztreonam

Front 57

SE of imipenem

Back 57

Seizures

Front 58

Anti-viral with a dose limiting toxicity of pancreatitis

Back 58

Didanosine

Front 59

chapter 46 TMP/SMX/fluorquinolones

Front 60

sulfanomides are structurally similar to what chemical compound

Back 60

PABA (p-aminobenzoic acid)

Front 61

name the short, intermediate, and long acting sulfonamides

Back 61

sulfisoxazole, sulfamethoxazole, sulfadoxine respectively

Front 62

trimethoprim is structurally similar to what chemical compund?

Back 62

folic acid

Front 63

MOA of sulfonamides

Back 63

competitive inhibitor of dihydropteroate synthase

Front 64

MOA of trimethoprim

Back 64

selective inhibition of dihydrofolate reductase

Front 65

common mechanism of resistance to trimethoprim

Back 65

production of dihydrofolate reductase w/ lower afinity for the drug

Front 66

what is the importanc of folic acid?

Back 66

it is required for the synthesis of purines

Front 67

sulfonamides used for burn infections

Back 67

mafenide or silver sulfasalazine

Front 68

DOC for toxoplasmosis

Back 68

sulfadiazine + pyrimethamine

Front 69

DOC for p. pneumonia infection in immunocompromised pts?

Back 69

TMP-SMX

Front 70

DOC for nocardiosis

Back 70

TMP-SMX

Front 71

SE of sulfonamides

Back 71

allergic reaction, polyarteritis nodosa, Stevens-Johnsons syndrome, NVD, granulocytopenia, thrombocytopenia, aplastic anemia, hemolysis in pts w/ glucose-6-phosphate dehydrogenase deficency, crystalluria and hematuria from precipitation at low pH, transient increase in warfarin and methotrexate plasma lvls, risk of kernicterus of neonate if used in the 3rd trimester of pregnancy

Front 72

SE of trimethoprim

Back 72

Megaloblastic anemia, leukopenia, granulocytopenia

Front 73

used to aleviate side effects for therapy

Back 73

folinic acid

Front 74

name the fluoroquinolones

Back 74

norfloxacin, ciprofloxacin, ofloxacin, levofloxacin, gatifloxacin, gemifloxacin, moxifloxicin

Front 75

renal excretion of fluroquinolones can be blocked by what?

Back 75

probenecid

Front 76

MOA of fluroquinolones

Back 76

inhibition of topoisomerase II (DNA gyrase) especially in gram negative bacteria, and topoisomerase IV especially in gram positive bacteria

Front 77

SE of fluroquinolones

Back 77

rash, headache, dizzyness, insomnia, abnormal LFTs, phototoxicity, tendinitis, opportunistic infection by C. albicans, not recommended for children or in pregnancy because of cartilage problems

Front 78

SE of newer fluoroqunolones (gemifloxacin, levofloxacin, moxifloxacin)

Back 78

QTc prolongation

Front 79

antiviral drugs which blocks viral penitration and uncoating

Back 79

amantadine, rimantadine

Front 80

antiviral drugs which inhibit viral DNA polymerase

Back 80

acyclovir, foscarnet, gancyclovir

Front 81

antiviral drugs which inhibit viral RNA polymerases

Back 81

foscarnet, ribavirin

Front 82

antiviral drug which inhibits viral reverse transcriptase

Back 82

zidovudine, didanosine, zalctibine, lamivudine, stavudine, nevirapine, delavirdine, efavirenz

Front 83

antiviral drugs which inhibit viral aspartate protease (inhibit viral protein synthesis and processing)

Back 83

indinavir, ritonavir, saquinavir, nelfinavir

Front 84

antiviral drugs which inhibit viral neuraminidase (inhibit viral assembly and release)

Back 84

zanamivir, oseltamivir

Front 85

antiviral drug which is phosphorylated by viral thymidine kinase (TK)

Back 85

acyclovir

Front 86

acyclovir is used for the Tx of what?

Back 86

HSV, VSV

Front 87

SE of acyclovir

Back 87

not hematotoxic, SE include crystalluria

Front 88

drug used for prophylaxis of CMV infection

Back 88

ganciclovir

Front 89

ganciclovir has activity against what infections

Front 90

SE of ganciclovir

Back 90

hepatotoxicity, bonemarrow supression, seizures in overdose

Front 91

drug used for TK- HSV (HSV strains which lack thymidine kinase)

Back 91

foscarnet

Front 92

SE of foscarnet

Back 92

not hepatotoxic and will not cause bone marrow supression, nephrotoxicity, hypocalcemia (tremors, seizures), do not use with pentamidine

Front 93

foscarnet is used for what infections

Back 93

CMV, HSV, VSV?

Front 94

what is HAART?

Back 94

highly active anti-retroviral therapy; use of a combination of three drugs from the classes NRTI, NNRTI, and PI (usually 2NRTIs + PI)

Front 95

what is the difference between NRTIs and NNRTIs, and so are not myelosuppressive, they bind to a different site than the NRTIs

Back 95

NNRTIs do not require metabolic activation

Front 96

what is reverse transcriptase?

Back 96

RNA dependant DNA polymerase

Front 97

drug interactions of AZT (zidovudine)

Back 97

drug levels of ZDV are increased by azoles and cimetidine (inhibitors of P450), indomethacin and probenecid (decrease renal clearance), and TMP-SMX (additive meyleosupressive effect) ; drug levels are descrease by rifampin (inducers of P450)

Front 98

SE of AZT (ZVD)

Back 98

hematotoxicity, headache, myalgia, myopathy, peripheral neuropathy, lactic acidosis

Front 99

difference between AZT and newer NRTIs?

Back 99

newer NRTIs have less bone marrow supressing effects

Front 100

SE of didanosine (DDI)?

Back 100

Pancreatitis, peripheral neuropathy, hyperuricemia, liver dysfunction

Front 101

SE of zalcitabine (DDC)

Back 101

peripheral neuropathy, Pancreatitis, neutropenia (don't give with DDI)

Front 102

why shouldn't you use AZT with stavudine (D4T)?

Back 102

D4T is an AZT analog, and they compete for the same binding site

Front 103

what is the least toxic of the NRTIs?

Back 103

lamivudine (3TC), but it is very weakly effective on HIV so should be used only in combination with other drugs

Front 104

what NRTI can also be used for HBV infection?

Back 104

lamivudine (3TC)

Front 105

what is the mechanism of resistance to protease inhibitors?

Back 105

mutations in the pol gene

Front 106

SE of indinavir

Back 106

nephrolithiasis (maintain hydration), GI distress, thrombocytopenia, inhibition of P450(3A4)

Front 107

SE of ritonavir

Back 107

major drug interactions: induces CYP1A2, and inhibits CYP3A4 and CYP2D6, as well as disordered lipid and carbohydrate metabolism, asthenia and paresthesias

Front 108

MOA of enfurvitide

Back 108

fusion inhibitor- binds gp41

Front 109

what is the MOA, uses, and SE of amantadine?

Back 109

blocks attachment, penetration, and uncoating of influenza A virus, SE: atropine-like effects (antimuscarinic)

Front 110

MOA, use, and SE of zanamivir and oseltamivir

Back 110

inhibit influenzae A and B neuraminidases (prevent budding), N&V, nasal and throat irritations (zanamivir)

Front 111

MOA, use, and SE of ribavirin

Back 111

inhibits the synthesis of purines and viral RNA polymerase and end-capping, use: usually RSV, but also influenzae A and B, lassa fever, hantavirus, HCV (w/interferon alpha), SE: hematotoxic, teratogenic, respiratory irritaton

Front 112

drugs which are used for HBV, HCV, HDV, Kaposi sarcoma, CML, multiple myeloma, renal carcinoma, and MS

Back 112

interferons

Front 113

what is the primary drug Tx for CMV

Back 113

ganciclovir or valganciclovir

Front 114

what is the primary drug Tx for HSV and VSV

Back 114

acyclovir

Front 115

what is the primary drug Tx for HBV

Back 115

INF-a or lamivudine

Front 116

what is the primary drug Tx for HCV

Back 116

INF-a

Front 117

what is the primary drug Tx for influenza A

Back 117

oseltamivir

Front 118

what is the primary drig Tx for influenza B

Back 118

oseltamivir

Front 119

is the amount of time above the MIC important for aminoglycosides?

Back 119

no

Front 120

how are amino glycosides administered and why

Back 120

IV or IM because they are not absorbed oraly

Front 121

elimination of aminoglycosides is via what mechanism?

Back 121

glomerular filtration

Front 122

MOA of aminoglycosides

Back 122

bind to 30s subunit and block formation of the initiation complex, cause misreading of mRNA, and inhibit translocation

Front 123

major mechanism of resistance to aminoglycosides?

Back 123

plasmid mediated inactivating enzymes (group tansferases)

Front 124

aminoglycosides work better on aerobes or anareobes?

Back 124

areobes because penitration is partially oxygen dependant

Front 125

amino glycosides restricted to topical or oral uses?

Back 125

neomycin and kanamycin

Front 126

aminoglycoside -like drug used for the Tx of penicillin allergic gonorhea pts

Back 126

spectinomycin

Front 127

SE of amino glycosides

Back 127

ototoxicity (contraindicated in pregnancy), nephrotoxicity, neuromuscular blockade (reversable by Ca + neostigmine)

Front 128

most nephrotoxic aminoglycosides

Back 128

gentamicin and tobramycin

Front 129

amino glycosides used systemically

Back 129

gentamicin, amikacin, netilmicin, tobramycin

Front 130

pharm 47 antimycobacterial

Front 131

MOA of INH

Back 131

structural cogener of B6 (pyridoxine), inhibits mycolic acids (compenents of mycobacterial cell walls)

Front 132

what TB drug is usually given for prophylaxis of TB

Back 132

INH

Front 133

neurotoxic effects of INH can be elieviated by adminitering what?

Back 133

B6 (pyridoxine)

Front 134

what genetic disorder is associated with hemolysis when taking INH?

Back 134

pts w/ glucose-6-phosphate dehydrogenase deffiency

Front 135

MOA of rifampin

Back 135

inhibition of DNA-dependant RNA polymerase

Front 136

major SE of rifampin

Back 136

induction of drug metabolizing liver enzymes, increasing the elimination of anticonvulsants, contraceptives, cyclosporine, ketoconazole, methadone, terbinafine, and warfarin

Front 137

MOA of ethambutol

Back 137

inhibition of arabinosyl transferase (arabinogalactan is a component of the mycobaterial cell wall)

Front 138

SE of ethambutol

Back 138

visual disturbances

Front 139

SE of pyrazinamide

Back 139

polyarthralgia, porphyria, hepatic dysfuntion, should not be used in pregnancy

Front 140

drug Tx for TB when INH resistance is suspected

Back 140

rifampin + pyrazinamide + ethambutol or streptomycin

Front 141

multi drug resistant TB can be treated with what drugs (based on susceptability)

Back 141

amikacin, ciprofloxacin, ofloxacin, ethionamide, p-aminosalicylic acid (rarely)

Front 142

usual drug Tx for M. leprae

Back 142

Dapsone, rifampin and clofazimine combination

Front 143

prophylaxis of MAC in AIDS pts w/ CD4 <50

Back 143

clarythromycin or azithromycin with or without rifabutin