26. Anti Fungal, Anti Influenza, Anti TB

Question 1

Drug:
Description: newest azole, inhibits CYP450, oral or IV, broadest spectrum, activity against candida & aspergillus, mucormycosis*, salvage therapy for aspergillosis use, prophylaxis during induction of chemo for leukemia and in allogenic bone marrow transplant patients with graft vs host disease

Answer 1

Posaconazole

Question 2

Drug:
Description: inhibits synthesis of beta 1/3 glucan at fungal cell wall by inhibiting glucan syynthase; thus disrupting fungal cell wall leading to fungal cell death…covers disseminated and mucocutaneous candidal infections, empiric anti fungal therapy during febrile neutropenia (replaced by amphoteracin B), used in invasive aspergillosis only as salvage therapy when amphoteracin doesnt work

Answer 2

Caspofungin

Echinocandin-GI effects and flushing

Question 3

Drug:
Description: inhibits synthesis of beta 1/3 glucan at fungal cell wall by inhibiting glucan syynthase; thus disrupting fungal cell wall leading to fungal cell death. treats mucocutaneous candidiasis, candidiemia, prophylaxis of candidal infections in bone marrow transplant patients

Answer 3

Micafungin

Echinocandin-GI effects and flushing

Question 4

Drug:
Description: inhibits synthesis of beta 1/3 glucan at fungal cell wall by inhibiting glucan syynthase; thus disrupting fungal cell wall leading to fungal cell death. Treats esophageal candidiasis and invasive cnadidiasis, including candidemia

Answer 4

Anidulafungin

Echinocandin-GI effects and flushing

Question 5

Drug:
Description: competitive inhibitor of viral neuraminidase, binds to enzymes active site, halting spread of infection. may have hallucinations, delirium and abnormal behavior. oral admin, prodrug created by hepatic esterases, SE: nausea, vomitting, HA, fatigue diarrhea

Answer 5

Oseltamivir

Question 6

Drug:
Description: competitive inhibitor of viral neuraminidase, binds to enzymes active site, halting spread of infection. may have hallucinations, delirium and abnormal behavior. admin directly to respiratory tract via inhalation.. SE: cough, bronchospasm, nasal/throat discomfort, not for airway disease patients

Answer 6

Zanamivir

Question 7

Drug:
Description: competitive inhibitor of viral neuraminidase, binds to enzymes active site, halting spread of infection. may have hallucinations, delirium and abnormal behavior. admin via IV dose for acute uncomplicated influenza in adults, SE: diarrhea and skin or HS reactions

Answer 7

Peramivir

Question 8

Drug: (2)
Description: Blokc M2 proton ion channel of virus particle and inhibit uncoating of viran RNA in infected host preventing replication. For influenza A, orally, SE: nausea, anorexia, nervousness, insomnia, light headed, birth defects reported after exposure during preg

Answer 8

Amantadine

Rimantadine

Question 9

Anemia and leukopenia can be seen in? (antifung)

Answer 9

flucytosine

Question 10

Fever and muscle spasms can be seen in? (fung)

Answer 10

amphotericin B

Question 11

What adverse effect is associated with most azoles?

Answer 11

Minor upset GI symptoms

Question 12

All of the other -azoles are triazoles (oral) while which -azole is an amidizide (topical), which is different from the rest?

Answer 12

Ketoconazole

Question 13

What is the first, and second line treatment for invasive aspergillus?

Answer 13

1. voriconazole

2. Caspofungin

Question 14

What is the only azole which is oral only, and has variable asoprtion (topical)?

Answer 14

ketoconazole

Question 15

Amantadine are only selective for type A influenza while zanamivir and oseltamivir are selective for?

Answer 15

BOTH A/B

Question 16

Which neuraminidase inhibitor is has a oral bioavailiblty of less than 5%?(inhaled powder)

Answer 16

Zanamivir

Question 17

TB: isoniazid and rifampin are most active, 9 month admin will cure 95% cases, adding pyrazinamide drops its to 6months. Ethambutolol is added to provide additional coverage to iosoniazid and rifampin, which together have a resisitance of?

Answer 17

1%

isoniazid has a 10% resistance

Question 18

Caspofungin/Micafungin treat both mucocutaneous and disseminated candidiasis while anidulafungin treats?

Answer 18

esophageal