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M3 Pharm B3 > Anti-Infective Drugs 2 > Flashcards

Anti-Infective Drugs 2 Flashcards

1
Q

Antituberculous Drugs: Isoniazid (INH) MOA

A

Inhibition of mycolic acid synthesis (cell wall synthesis)

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2
Q

Antituberculous Drugs: Isoniazid (INH) low resistance

A

Deletion in INHA gene

Gene encoding acyl carrier protein (target)

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3
Q

Antituberculous Drugs: Isoniazid (INH) high resistance

A

Deletion in katG gene

Encode catalase enzymed needed for INH bioactivation

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4
Q

Antituberculous Drugs: Isoniazid (INH) Adverse effects (4)

A
  1. Hepatitis
  2. Neuritis
  3. Hemolysis in G6PD deficiency
  4. SLE in slow acetylators
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5
Q

Antituberculous Drugs: Isoniazid (INH) - Why is pyridoxine (Vit. B6) used with INH?

A

To help prevent numbness and tingling that occur secondary to isoniazid neuritis

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6
Q

Antituberculous Drugs: Rifampin MOA

A

Inhibits DNA-dependent RNA polymerase

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7
Q

Antituberculous Drugs: Rifampin Resistance

A

Mutation in polymerase enzyme

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8
Q

Antituberculous Drugs: Rifampin Adverse Effects (5)

A
  1. Red-orange discoloration of urine, sweat, and tears
  2. Proteinuria
  3. Flu-like symptoms
  4. Thrombocytopenia
  5. Induces p450
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9
Q

Antituberculous Drugs: Ethambutol MOA

A

Inhibits synthesis of Arabinogalactan (component of cell wall)

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10
Q

Antituberculous Drugs: Ethambutol Adverse effects (2)

A
  1. Loss of red green acuity

2. Retrobulbar neuritis

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11
Q

Antituberculous Drugs: Pyrazinamide MOA

A

Unknown

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12
Q

Antituberculous Drugs: Pyrazinamide Adverse Effects (3)

A
  1. Arthralgia due to hyperuricemia
  2. Hepatotoxicity
  3. Increase porphyrin synthesis
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13
Q

Antituberculous Drugs: Aminoglycosides MOA

A

Inhibit protein synthesis

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14
Q

Antituberculous Drugs: Aminoglycosides Adverse Effects (3)

A
  1. Hearing loss
  2. Ataxia
  3. Nephrotoxicity
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15
Q

Antituberculous Drugs: Aminoglycosides - Amikacin Side Effect (1)

A
  1. Nystagmus
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16
Q

Antituberculous Drugs: Aminoglycosides - Kanamycin (1)

A
  1. Electrolyte abnormalities
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17
Q

Antituberculous Drugs: Capreomycin is not what?

A

Not aminoglycosides

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18
Q

Antituberculous Drugs: Capreomycin Adverse Effects (2)

A
  1. Hearing loss

2. Ataxia

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19
Q

Antituberculous Drugs: Capreomycin Buzzword

A

No cross resistance with aminoglycosides

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20
Q

Antituberculous Drugs: Capreomycin Use

A

Used as 2nd line rx of resistant TB with aminosalicylic acid and cycloserine

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21
Q

Disseminated Mycobacterium Avium Complex (DMAC) Drug Combo

A

Azithromycin + Rifabutin + Ethambutol

Rifabutin: simular to rifampin

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22
Q

Disseminated Mycobacterium Avium Complex (DMAC) Drug Combo - Adverse Effect (5)

A
  1. Rashes
  2. GI effects
  3. Neutropenia
  4. Induces p450
  5. No hepatotoxicity
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23
Q

Clinical TB: Screening Test - Purified Protein Derived (PPD)

A

Screen Asymptomatic Population

+ve test: > 10 mm of induration (NOT erythema)

High risk: > 5mm with HIV +ve or close contact

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24
Q

If PPD +ve, do chest x-ray, and if chest x-ray is negative?

A

Rx: INH (isoniazid) alone for 6 months

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25
Q

If PPD +ve, do chest x-ray, and if chest x-ray is positive, do sputum cultures and if sputum culture is negative?

A

INH (isoniazid) alone for 6 months

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26
Q

If PPD +ve, do chest x-ray, and if positive, do sputum cultures and if sputum culture is positive?

A

Rx of 4 drugs

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27
Q

BCG immunization gives only?

A

3-4 mm induration

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28
Q

If after 10 years PPD is > 10 mm induration?

A

Don’t blame it on BCG

Follow protocol and do chest X-Ray

29
Q

Treating TB

A

4 drugs (INH-Rif-PZA-Ethamb) x 2 months + 2 drugs (INH-Rif) x 4 months = 6 months

30
Q

Treating TB: If HIB +ve?

A

Initial therapy stays the same then increase duration

4 drugs x 2 months + 2 drugs x 7 months = 9 months

31
Q

A 37 y/old prisoner, cough, fever, sputum, SOB lung infiltrate, sputum AFB +ve. Never do what and rx?

A

Never answer PPD in a case of TB

Rx: 4 drugs x 2 months + 2 drugs for 4 months

32
Q

Pregnant with +ve PPD: Answer Chest X-ray with lead Apron (2nd trimester) - If negative (3)

A

Wait until delivery

Then INH (isoniazid) alone

Why? INH is bad to the baby “teratogenic”

33
Q

Pregnant with +ve PPD: Answer Chest X-ray with lead Apron (2nd trimester) –> do sputum cultures and if culture is negative

A

INH (isoniazid) alone

34
Q

Pregnant with +ve PPD: Answer Chest X-ray with lead Apron (2nd trimester) –> do sputum cultures and if culture is positive

A

Rx 4 drugs

35
Q

Antiprotozoals: Giardiasis Defined

A

Giardia lamblia

Most common water born disease

Back-packer’s diarrhea

36
Q

Antiprotozoals: Giardiasis Rx

A

Metronidazole

37
Q

Antiprotozoals: Entamoeba Histolytrica Drug

A

Metronidazole

38
Q

Antiprotozoals: Asymptomatic/non-invasive Intestinal Amebiasis Drug

A

Diloxanide

39
Q

Antiprotozoals: Trichomoniasis Defined

A

Trichomnas vaginalis

40
Q

Antiprotozoals: Trichomoniasis Drug

A

Metronidazole

Gotta treat the partner

41
Q

Antiprotozoals: Leishmaniasis Defined

A

Leishmania Brasiliensis

American mucocutaneous leishmaniasis

42
Q

Antiprotozoals: Leishmaniasis Drug

A

Stibogluconate

43
Q

Antiprotozoals: Trypanosomiasis Name

A

Trypanosoma cruzi

44
Q

Antiprotozoals: American Trypanosomiasis (Chaga’s Disease) Drug

A

Nifurtimox

45
Q

Antiprotozoals: African Trypanosomiosis (Sleeping Sickness) Drug

A

Suramin + Melarsoprol

46
Q

Antiprotozoals: Toxoplasma Gondii Drug

A

Pyrimethamine + Sulfadiazine

47
Q

Antiprotozoals: Pneumocystosis Carinii (Pnemocystosis) Drugs (3)

A
  1. Trimethoprim-Sulphamethoxazle
  2. IV Pentamidine
  3. Atovaquone
48
Q

Malaria: Plasmodium Falciparum Drug

A

Chloroquine

49
Q

Malaria: Plasmodium Malariae Drug

A

Chloroquine

50
Q

Malaria: Plasmodium Vivax Drug

A

Chloroquine + Primaquine

51
Q

Malaria: Plasmodium Ovale Drug

A

Chloroquine + Primaquine

52
Q

Prophylaxis for chloroquine-SENsitive malaria: 1st line

A

Chloroquine +/- primaquine

53
Q

Prophylaxis for chloroquine-

SENsitive malaria: 2nd line

A

Pyrimethamine-sulfadozine

Hydroxychloroquine

54
Q

Prophylaxis for Chloroquine-RESISTant Malaria: 1st line

A

Mefloquine

55
Q

Prophylaxis for Chloroquine-RESISTant Malaria: 2nd line

A

Atovaquone-proquanil

Doxycycline

56
Q

Rx for Chloroquine-Resistant Malaria

A

Quinine +/- Doxycycline

57
Q

Antimalarial Adverse Effects: Chloroquine (3) and avoid in?

A
  1. Pruritis
  2. Ocular dysfunction
  3. Hemolysis

Avoid in psoriasis

58
Q

Antimalarial Adverse Effects: Mefloquine (2) and avoid in?

A
  1. Syncope
  2. Extrasystoles

Avoid in seizure and cardiac arrhythmias

59
Q

Antimalarial Adverse Effects: Primaquine (2) and avoid in?

A
  1. Neutropenia
  2. Hemolysis

Avoid in pregnancy, G6PD deficiency

60
Q

Antimalarial Adverse Effects: Quinine (3) and avoid in?

A
  1. Cinchonism
  2. CNS defects
  3. Hemolysis

Avoid in pregnancy

61
Q

Intestinal Nematodes (Worms): Mebendazole and Pyrantel MOA

A

Decrease glucose uptake and microtubular structure

62
Q

Tissue Nematodes: Drug

A

Ivermectin

63
Q

Cestodes (Tapeworms) & Trematodes (Flukes) Drug and MOA

A

Praziquantel

MOA: Increase Ca2+ influx

64
Q

Nematodes: Thiabendazole MOA

A

Inhibits fumarate reductase

65
Q

Nematodes: Dibucaine MOA

A

Inhibits Na+ permeability

66
Q

Nematodes: Piperzine MOA

A

Inhibits acetylcholine leading to muscle paralysis

67
Q

Leprostatic Drugs: Dapsone

A

Rx of leprosy and dermatitus herpitiformus

68
Q

Leprostatic Drugs: Thalidomide Use and Pregnancy Category

A

FDA approved Rx of erythema nodosum leprosum

FDA Pregnancy Category X

69
Q

Leprostatic Drugs: Thalidomide - Physicians should alert male and female patients in effective birth control methods because?

A

There’s a risk of phocomelia in the baby (absent arms and legs)

M3 Pharm B3 (10 decks)

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