Pharm Test 3 (Final)

Front 1

Characteristics of tumor cells (5)?

Back 1

1.derive from our cells (normal)
2. Aberrant (abnormal)
3. Clonal (from 1 cell)
4. Hyperproliferative: no controls
5. Can be metastatic

Front 2

Cancer is ___highest cause of death?

what % of people develop cancer?

Back 2

second

30%

Front 3

etiology for cancer?

contributing factors?

Back 3

80% unknown.

viruses, environmental, radiation, life style

Front 4

what percentage of tumors has tx been effective on mortality?

Back 4

less than 20%

Front 5

Grade vs stage?

Back 5

Grade: histology (biopsy) or blood smear
stage: whole organ level (single mass or metastasis)

Front 6

failure of chemotherapy usually do to ?

Back 6

80% due to resistance

Front 7

types of chemotherapy resistance?

Back 7

single agent: resist build to only 1 agent
multidrug resist: to many

Front 8

Combination chemo is based on?

Back 8

side effects of drugs (most are myelosuppressive at 28 days so cycle 1 month)

Front 9

Why do combination chemo?

Back 9

overcome resistance
enhance anti-tumor effect
rescue normal cells

Front 10

CR for chemo is? PR?

Back 10

Complete response: no disease left
Partial: greater than 50% size reduction

Front 11

what are teh 3 major classes of chemotherapeutic agents?

Back 11

1. Alkylating agents
2.Antimetabolites
3 Plant alkaloids

Front 12

Alkylating agents do?

Back 12

bind covalenty to dna (stop cell growth)

Front 13

alkylating agents derived from?

Back 13

chemical war fare agents

Front 14

alkylating agents exs?

Back 14

Cyclophosphamide
carmustine

Front 15

Antimetabolites do?

Back 15

block biosynthesis/use of cellular metabolites

Front 16

how do antimetabolites differ from alkylating agents?

Back 16

better for slower growing tumors

Front 17

exs of antimetabolites ?

Back 17

methotrexate and 5-fluorouracil

Front 18

Plant alkaloids exs?

Back 18

vincas: vinblasting, vinorelbine, vindesine
taxenes

Front 19

how do the vincas work?

Back 19

arrest cell division by stoping mitotic spindle

Front 20

how do taxenes work?

Back 20

stabilize microtubules to inhibit mitotic spindle assembly (stop cell division)

Front 21

what are the 3 major toxicities of chemotherapeutic agents?

Back 21

1. myelosuppression (bone marrow)
2. dermatologic
3. GI

Front 22

dose limiting is due to

Back 22

myelosuppression (b/c makes pts susceptible to infections

Front 23

Dermatologic toxicity ex is?

Back 23

alopecia (hair loss)
2. extravasation necrosis: if administered outside vein, tissue dies
3. oral mucositis

Front 24

how treat oral mucosits?

Back 24

saline/bicarbonate rinse
2. mucosal coating
3. lubricating agents
topical anesthetics
5. film forming agents

Front 25

types of nausea and vomiting? time/cause?

Back 25

acute: within minutes of drug injection
chronic: hours/days
anticipatory: smells, colors, places, etc.

Front 26

subdivisions of chemotherapeutic agents are?

Back 26

anti cancer and anti infective

Front 27

disinfectant vs antiseptic?

Back 27

dis: remove microbes
anti: skin use

Front 28

Selective toxicity is? is related to?

Back 28

harms only invading microbe

mechanism of action

Front 29

drugs that attack cell walls?

Back 29

penecillin
cephalosporins
vancomycin

Front 30

drugs that attack protein synthesi/

Back 30

macrolides
tetracycline
clindamycin

Front 31

drugs that destroy cell membrane function?

Back 31

fungal membranes: polyene, azole

Front 32

altered nucleic acid synthesis?

Back 32

fluoroquinolones
sulfonamides and trimethoprim (thymidine synthesis)

Front 33

metronidazole does?

Back 33

is metabolized by anaerobic bacteria or amebas (metabolite kills organism)

Front 34

antibiotic-associated colitis is ex of?

Back 34

overgrowth of non-susceptible organisms

Front 35

antibacterial spectrum is?

Back 35

type of bacteria that a drug is usually effective against

Front 36

extended spectrum drugs means?

Back 36

intermediate between narrow spectrum and broad spectrum

Front 37

exs of narrow spectrum antibiotics?
Extended?
broad?

Back 37

pen g and v
amoxicillin and cephalexin
tetracyclines, sulfonamides, ciprofloxacin

Front 38

drugs for anaerobic bacteria

Back 38

clindamycin and metronidazole

Front 39

exs of problem bacteria?

what does "problem" mean?

Back 39

m. tuberculosis
s. aureus
pseudomonas aeruginosa

resist normal antibiotics

Front 40

MIC is?

Back 40

minimum inhibitory concentration: amount to achieve inhibition

Front 41

what are the drug types that inhibit cell wall synthesis?

Back 41

Pens, cephalosporins, (Beta lactam antibiotics)

Front 42

what is clavulanic acid?

Back 42

a beta lactamase inhibitor given with amoxicillin to increase its effectiveness

Front 43

Macrolide antibiotics do? first drug of this type was?

Back 43

inhibit 50 s ribosome

erythromycin

Front 44

are they broad or narrow spectrum?

Back 44

extended spectrum

Front 45

Most widely used macrolide?

another ex?

Back 45

azithromycin

clarithromycin

Front 46

Tetracyclines MOA?

ex?

Back 46

inhibit bacterial protein synthesis (30 s)

dyxycycline

Front 47

adverse effects of tetracyclines?

Back 47

high concentrations in skin and salive
deposite with Ca in teeth and bones.

Front 48

tetracycline absorption can be prevented by?

Back 48

dairy, antacids

Front 49

MOA of fluoroquinolones?

cidal or static?

Back 49

altered nucleic acid metabolism (inhibit DNA gyrase) (bacterialcidal)

Front 50

Ex of fluoroquinolones?

Back 50

ciprofloxacin, levofloxacin (improved against gram+)

Front 51

MOA of Sulfonamides and trimethoprim?

Back 51

inhibit bacterial folic acid synthesis and recycling

Front 52

why is trimethoprim included?

Back 52

adminstered with sulfamethoxazole (effects the same pathway)

Front 53

Why fungi are important even though not as common?

Back 53

b/c candida is 4th most common cause of hospital-acquired bloodstream infections

Front 54

most common fungal pathogens effecting humans?

Back 54

A. fumigatus
C. albicans
C. glabrata, parasilosis, tropicalis, krusei,
cryptococcus neoformans

Front 55

Fungal drugs discussed? MOA?

Back 55

amphotericin B: binds ergosterol (in cell wall)
Azoles: inhibit ergosterol biosynthesis

Front 56

downside to amphotericin B?

Back 56

IV, side effects: kidney

Front 57

ex of azole ?

Back 57

fluconazole (oral med)

Front 58

how do antivirals usually work?

Back 58

attack early stages of viral DNA replication with antiviral nucleoside analogs

Front 59

ex. of antivirals?

Back 59

acyclovir: herpes
Zidovudine: reverse transcriptase inhibitors

Front 60

most common antiparasitic drug?

Back 60

metronidazole

Front 61

gut parasites?

intestinal parasite common in USA?

Back 61

round/flat worms

pinworm

Front 62

drugs for malaria?

Back 62

chloroquine
Mefloquine (for chloroquine resistant strains)
some sulfa drugs (folic acid inhibition)

Front 63

what are the types of oral infections?

Back 63

1. chronic
2. Chronic-subacute with acute exacerbations
3. Intensely acute

Front 64

ex. of chronic infection?

Back 64

periodontisis

Front 65

ex of chronic-subacute infections?

Back 65

percoronitis, periodontal abscess

Front 66

ex of intensely acute infections?

Back 66

necrotizing gingivitis, pa abscess, cellulitis,

Front 67

how many microbes usually in orofacial infections?

Back 67

2-8 (polymicrobial)

Front 68

why do orofacial pathogens become pathogenic?

Back 68

local variables change

Front 69

orofacial infections have ___ onset?

can usually be treated with?

Back 69

rapid (so quick cure too)

incision and drainage (not antibiotics)

Front 70

why not just use antibiotics instead of incision and drainage?

Back 70

1. antibiotics do not diffuse well in infected areas
2. inactive antibiotics by pH
3. abscess microbes not alwasy dividing (low metabolic state)
4. high levels of antibiotic inhibitors

Front 71

periodontal abscesses are due to

Back 71

breakdown of periodontum within gingival wall of pocket (purulence accumulation)

Front 72

predominant microflora in periodontal abscess?

Back 72

74% anaerobes
67% gram - rods

Front 73

what are the beta lactam antibiotics reserved for hospital aquired infections (serious ones)

Back 73

cabapenems, monobactams

Front 74

penicillins effect better gram ___?

what % of bacteria from mouth are sensitive to one of the penicillins?

Back 74

+.

90%

Front 75

Pen G is good b/c?

downside?

Back 75

most active form

narrow spectrum, not stable in acid (not orally admin), short half life

Front 76

how overcome short half life of Pen g?

Back 76

Procain and benzathine pen G are insoluble salts. IM injection

Front 77

what is Pen V?

Back 77

same as G, but stable in acid

Front 78

Penicillinase-resistant Penicillins aka?

exs?

Back 78

anti-staphylococcal penicillins

best is Dicloxacillin for oral
cloxacillin, oxacillin, nafcillin, methicillin

Front 79

penicillinase resistant pens are ___spectrum?

Back 79

narrow

Front 80

exs of extended spectrum penicillins?

which is prototype and which is better taken orally?

Back 80

ampicillin and amoxicillin

ampicillin

Front 81

broad spectrum penicillins exs?

Back 81

piperacillin and mezlocillin. not used b/c not orally effective

Front 82

beta-lactamase inhibitors exs?

Back 82

clavulanic acid

Front 83

what are the initial drugs of choice in orofacial infections?

Back 83

Pen V and amoxicillin

Front 84

when use parental pen G?

Back 84

sever infection
oral route compromised

Front 85

how do pen allergies manifest?

Back 85

maculopapular or urticarial skin reactions

Front 86

which types of allergic reactions are most life threatening?

Back 86

immediate: seconds to 1 hour after exposure

Front 87

what is an accelerated allergic reaction?

Back 87

urticaria and angioedema 1-72 hrs post exposure

Front 88

most common cause of antibiotic induced diarrhea/colitis?

Back 88

amoxicillin

Front 89

NSAIDS and penicillins? and probenecid?

Back 89

both increase half life of penicillins by decreasing renal excretion

Front 90

what is different about cephalosporins?

Back 90

more diverse group (2 spots for substitutions)

Front 91

how are cephalosporins grouped?

Back 91

4 generations

Front 92

first generation cephalosporins are?
exs or oral and parenteral drugs?

Back 92

older, extended spectrum antibiotics
oral: cephalexin
Parenteral: cefazolin

Front 93

uses of first generation cephalosporins?

Back 93

tx staphlococcal and streptococcal infections
surgical and endocarditis prophylaxis

Front 94

how do 2nd generation cephalosporins differ from 1st?

Back 94

more stable against beta lactamases (thus increased activity)

Front 95

major use of 2nd gen cephalosporins?

Back 95

tx respiratory infections

Front 96

third generation cephalosporins are ___ spectrum?
differ by?

Back 96

broad

used against gram - (improbed antibacterial effects), resistant to most beta lactamases

Front 97

3rd generation cephalosporins used for?

Back 97

serious gram - infections
meningitis, pneumonia, gonorrhea, sepsis

Front 98

4th generation cephalosporins differ by?

ex?

Back 98

more resistant to beta lactamases, more active against gram + bacteria.

cefepime

Front 99

cephalosporins uses in dentistry?

Back 99

against orofacial pathogens but not oral anaerobes

Front 100

cephalosporins adverse effects?

Back 100

cross allergy with penicillins (rare that is serious or has anaphylaxis)

Front 101

drug interactions of cephalosporins?

Back 101

antacids decrease plama concentration

Front 102

ex of carbapenems?

Back 102

meropenem, ertapenem, imipenem (ME I)

Front 103

carbapenems ___ spectrum?
beta lactamases effect by?
pregnancy rating?

Back 103

wide
not hydrolyzed by most
b or c

Front 104

carbapenems can raise serum levels of ?

can cause?

Back 104

liver transaminases

colitis, skin rash

Front 105

first carbapenem?

Back 105

imipenim/cilastatin

Front 106

imipenem is metabolized in?

Back 106

kidney (but found to be toxic to kidney)

Front 107

why are meropenem and ertapenem not administered with cilistatin?

Back 107

not nephrotoxic

Front 108

ex of monobactams?

Back 108

aztreonam

Front 109

aztreonam spectrum?

Back 109

narrow (gram -)

Front 110

drugs used if oral infection is mix of gram + and -?

Back 110

amoxicillin or ampicillin (if beta lactamase producer, add in clavulanic acid)

Front 111

most important glycopeptide antibiotic?

does?

Back 111

vancomycin

cell wall inhibition

Front 112

vancomycin spectrum?

Back 112

narrow, gram +

Front 113

uses of vancomycin?

Back 113

for resistant strains

Front 114

vancomycin is given?

Back 114

IV (not well absorbed)

Front 115

adverse effects of vancomycin are?

Back 115

pain at injection site, histamine release (from high blood levels), nephrotoxicity
ototoxicity, skin rash (red man syndrome)

Front 116

what drugs bind the 50s subunite?

Back 116

macrolides, lincomycin, clindamycin, chloramphenicol

Front 117

exs of macrolides?

aka?

Back 117

erythromycin, clarithromycin, azithromycin

large ring antibiotics

Front 118

are macrolides cidal or static
spectrum?

Back 118

static

extended (effective especially for gram +)

Front 119

absorption of macrolides?

Back 119

via salts derivatives b/c by themselves are not acid stable

Front 120

adverse effects of erythromycin?

Back 120

10-20% get GI symptoms
reversible liver injury (occasionally)
Deafness
torsades de points (long QT interval) arrythmias
metabolized in liver, drug interactions (inhibits their metabolism)

Front 121

how does clarithromycin differ from erythromycin?

Back 121

same spectrum,
longer half life, acid stability, better absorption

Front 122

Azithromycin differs b/c has ?

how differ?

Back 122

additional nitrogen atom in ring

spectrum includes more gram - than erythromycin

Front 123

azithromycin distribution?

Back 123

more in tissues very quickly so little in blood (so longer half life,68 hrs)

Front 124

macrolides in dentistry?

Back 124

against acute orofacial infections (if beta lactam allergy)
not good against gram -
endocarditis (clari, azithromycin)

Front 125

most common mechanism of bacterial resistance for macrolides?

Back 125

erythromycin resistant methylase:

Front 126

when take erythromycin?

Back 126

1 hr before
2 hrs after meal

Front 127

what is done to macrolides to increase absorption?

Back 127

salts, enteric coating

Front 128

erythro and clarithro and azithro excreted by?

Back 128

urine
azi: bile

Front 129

max adult does of macrolides?
if renal impaired?

Back 129

4g/day
1.5g/day

Front 130

macrolide drug interactions?

Back 130

inhibit metabolism of other drugs
can decrease cardiac glycoside metabolism
if co administration with oral contraceptive, can increase hepatic cholestasis likelihood

Front 131

contraindications of macrolides?

Back 131

pts with allergies
pts with history of cholestatic hepatitis
pts taking other drugs that together can lead to torsades de pointe

Front 132

exs of lincosamides?

Back 132

lincomycin and clindamycin

Front 133

clindamycin differs from loncomycin by?

Back 133

is chlorinated, giving increased antimicrobial potency and better absorption from GI

Front 134

lincosamides spectrum

Back 134

narrow: gram + but good against anaerobes (static)

Front 135

lincosamides metabolized in?
excreted in?
taken via?

Back 135

liver
biles and urine
oral

Front 136

adverse effects of lincosamides?

Back 136

may mild GI
metallic taste sensation

Front 137

clindamycin is drug most often associated with ?

Back 137

antibiotic associated colitis

Front 138

contraindications for lincosamides?

Back 138

do not co administer with neuromuscular blocking drugs

Front 139

dental indications for clindamycin?

Back 139

purulent osteitis (bacteroides infections)
if conditions do not respond to other drugs
prophylaxis in pts allergic to pen

Front 140

Tetracyclines effect?

Back 140

30s ribosome subunit

Front 141

what do the tetracycline derivatives differ by?

Back 141

duration/rate of excretion/metabolism

Front 142

tetracycline derivatives:
short acting
medium
long acting?

Back 142

short: tetracycline
Med: methacycline
long: doxycycline

Front 143

tetracycline spectrum?

static of cidal?

Back 143

broad (includes rickettsia)

static?

Front 144

used for?

Back 144

tx of serious nosocmial infections for highly resitant strains (although there are resistant forms of tetracycline)
maleria

Front 145

tetracycline distribution?

Back 145

high in skin and saliva, well distributed
can deposite in developing teeth and bones

Front 146

absorption of tetracycline? % absorbed?

prevented by?

Back 146

incompletely absorbed (doxy better)
tetra: 60-80
doxy: 95-100%

dairy, antacids

Front 147

tetracyclines metabolized by? excreted by?

Back 147

met: liver
exc: kidney

Front 148

Adverse reaction and contraindications to tetracyclines?

Back 148

C. albicans superinfections,
phototoxicity
GI difficulties
do not take before 8
pregnancy (preg D)/breast feeding

Front 149

drug interactions for tetracyclines?

Back 149

reduce efficacy of cell wall inhibitors
reduce insulin requirements
increase serum blood levels of digoxin
increase coumarin effects

Front 150

tetracyclines used in dentistry for?

Back 150

alternative to pens,
acute necrotizing ulcerative gingivitis,
perio disease

Front 151

aminoglycosides act on?

static or cidal?

Back 151

30s subunit (some act on both)

cidal

Front 152

ex of an aminoglycoside?

Back 152

gentamicin

Front 153

Gentamicin is used for?

Back 153

serious infections by gram -s.

Front 154

gentamicin spectrum?

Back 154

extended

Front 155

absorption of aminoglocosides?
excretion?

Back 155

not orally
in urine

Front 156

adveres effects of aminoglycosides?

Back 156

8th CN toxicity, (hearing and vestibular function of innner ear)
toxic to kidney

Front 157

chlorampheniol does?

Back 157

inhibits bacterial protein synthesis
first discovered!

Front 158

absorption of chloramphenicol?

Back 158

complete orally and crosses BBB (use for meningitis)

Front 159

why is chloramphenicol not used?

Back 159

anemia, "grey baby syndrome",
not used in orofacial infections

Front 160

mupirocin is a ?

used for?

Back 160

topical antibiotic that inhibits Bacterial RNA/protein synthesis.
impetigo, or nasal cavity to control staph infections

Front 161

streptogramins are like/do?

Back 161

macrolides (block protein synthesis

Front 162

oxazolidinones are?

Back 162

newest

Front 163

classes of drugs that inhibit bacterial NA sythesis?

Back 163

Quinolones
Sulfonamides and trimethoprim

Front 164

Quinolones exs?

Back 164

older ones for UTI: nalidixic acid, cinoxacin
Fluoroquinolones; ciprofloxacin, levofloxacin

Front 165

what do fluoroquinolones do?

Back 165

inhibit dna gyrase.

Front 166

how does levofloxacin differ from ciprofloxacin?

Back 166

improved against gram+

Front 167

quinolones spectrum?

Back 167

gen 1: limited
gen 2: broad spectrum
gen 3: better when broader spectrum needed
gen 4: broad, plus anaerobes

Front 168

absorption of quinolones?
half-life?
excretion?

Back 168

good orally
long half-lives (gen 3,4)
kidneys

Front 169

Adverse effects of quinolones?

Back 169

mild. cartilage damage if growing (do not take under 18 yrs)
intereacts with antacids, phototoxicity, arrythmias,

Front 170

sulfonamides are derived from ?

Back 170

p-aminobenenesulfonamide

Front 171

solubility of sulfonamides?

Back 171

low, especially in low pH (they are weak acids)

Front 172

how do sulfonamides work

Back 172

inhibit dihydropteroate synthetase (stop folic acid synthesis)

Front 173

trimethoprim does?

Back 173

inhibits step in folic acid synthesis

Front 174

what does folic acid do?

Back 174

used for synthesis step in nucleotide synthesis

Front 175

sulfonamides used to tx?

Back 175

respiratory, urinary and GI infections
(nothing orally)

Front 176

absorption of sulfonamides?
metabolized by?
excreted by?

Back 176

penetrate CNS !
liver
kidney

Front 177

side effects of sulfonamides?

Back 177

GI problems:8%
3-5% skin rash

Front 178

drug interactions of sulfonamides?

Back 178

can increase oral anticoagulants
stuff with PABA (sunscreens, health foods) contraindicated

Front 179

how does metronidazole work?

Back 179

metabolized by bacteroides to products that damage NA
(also for protozoans)

Front 180

if someone is at rist for mycobacterial infection, first step is?

Back 180

prophylaxis, preventative

Front 181

first line anti-tubicular drugs (less toxic) ex?

Back 181

isoniazid

Front 182

Isoniazid is used for?

Back 182

prophylaxis and tx

Front 183

isoniazid does?

Back 183

inhigits synthesis of mycolic acids in cell wall, bactericidal (only against active bacteria)

Front 184

side effects?

Back 184

older pts: hepatic damage
nervous system toxicity (prevent by b6 vitamin)

Front 185

second line antitubicular drugs?

aka?

Back 185

capreomycin and cycloserine

retreatment agents

Front 186

downsides to capreomycin and cycloserine?

Back 186

cap: injection
cyclo:1% of pts psychosis (must be monitored for CNS effects)

Front 187

what is MAC?

what is it?

Back 187

mycobacterium avium complex

for pts with AIDS, is clarithromycin, or azithromycind plus rifabutin to treat tb infection by m. avium

Front 188

what heart conditions warrant prophylaxis for IE?

Back 188

Prosthetic valve, previous IE, congential heart disease (CHD), repaired heart with prosthetic material/devise, repaired CHD with residual defects, transplants with valvulopathy

Front 189

malaria is caused by?

most dangerous cause?

Back 189

4 species of plasmodia

p. falciparum

Front 190

how get malaria/ stages?

Back 190

infected bite: sporozoites into blood-->liver-->tissue schizont which then rupture and merozoites enter circulation enter erythrocytes and begin cycle again

Front 191

antimalarial drugs active against?

aka?

Back 191

erythrocytic forms

schizontocides

Front 192

what does malaria rely on in humans?

Back 192

proteins form erythrocytes. (this is what the schizontocides probably interfiere with

Front 193

how does the accumulation of p. falciparum and p. malariae differ from ovale and vivax?

Back 193

falciparum and malariae leave no residual merozoites in the liver and thus cannot have recurrent episodes later on

Front 194

what is the drug of choice to tx liver for malaria?

Back 194

primaquine

Front 195

drug to tx malaria in the blood?

Back 195

chloroquine

Front 196

chloroquine absorptions?

excreted by? half life?

Back 196

good orally. accumulates in liver

kidneys. 7 days

Front 197

side effects of chloroquine?

Back 197

at prophylaxis levels, none.
dizzy, headache, GI upset/vomit, skin rashes, itching and blurring of vision
at high doses, can cause retinopathy *bulls eye), lupus like skin, cardiovascular toxicity

Front 198

chloroquine effects on body tissues?

Back 198

relaxes smooth muscle, antiarrhythmic, antiinflammatory action

Front 199

what is the chloroquine drug that is save during pregnancy?

Back 199

chloroquine phosphate

Front 200

Mefloquine is for?

half life?

Back 200

strains of P. falciparum ( a single dose can be curative)

14 days (efective levels for up to 30 days)

Front 201

mefloquine side effects?

Back 201

GI upset, sometimes serious psychiatric effects

Front 202

quinine is used for?

absorption? half life?

Back 202

erythrocytic forms

orally (half life of less than 5 hours)

Front 203

quinine as IV?

Back 203

can be, but hazardous due to cardiotoxid effects,

Front 204

toxicity with quinine causes?

Back 204

cinchonism: headache, etc

Front 205

atovaquone is good as a ?

Back 205

blood schizotocide: inhibits electron transport

Front 206

Proquanil does?

Back 206

inhibits plasmodial dihydrofolate reductaase activity

Front 207

what is artimesinin for?

Back 207

erythrocitic stages of P. vivax/falciparum

Front 208

Halofantrine is for?

Back 208

blood schizontocide (alternative to quinine)

Front 209

what are the antimarlarials for exoerythrocytic forms (outside blood)?
(kill liver forms)

Back 209

primaquine, pyrimethamine, sulfonamides, tetracyclines

Front 210

What is the prototype of the 8-aminoquinoline compouds?

Back 210

primaquine

Front 211

Primaquine absorption?

Back 211

rapidly absorbed orally and then rapidly converted to quinone

Front 212

primaquine does?

Back 212

interfere with ubiquinone in mitochondria

Front 213

downside to primaquine?

Back 213

hemolytic anemia, methemoglobinemia (with persons with glucose 6 p dehydrogenase deficiencies)