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INTERNSHIP > Anti-Infectives > Flashcards

Anti-Infectives Flashcards

1
Q

Name 8 classes of anti-infectives

A
  1. Antibacterials
  2. Antifungals
  3. Antivirals
  4. Antivirals for Hepatitis B
  5. Antivirals for Hepatitis C
  6. Antiretrovirals
  7. Antiprotozoals
  8. Anthelminthics
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2
Q

Name 12 classes of antibacterials

A
  1. Aminoglycosides
  2. Carbapenems
  3. Cephalosporins
  4. Glycopeptides
  5. Lincosamides
  6. Macrolides
  7. Penicillins
  8. Quinolones
  9. Rifamycins
  10. Tetracyclines
  11. Antimycobacterials
  12. Other antibacterials
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3
Q

Name 5 aminoglycosides

A
  1. Amikacin
  2. Gentamicin
  3. Paromomycin
  4. Streptomycin
  5. Tobramycin
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4
Q

Name 3 carbapenems

A
  1. Ertapenem
  2. Imipenem with cilastatin
  3. Meropenem
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5
Q

Name 12 cephalosporins

A
  1. cefaclor
  2. cefaLEXin
  3. cefaZOLin
  4. cefEPIME
  5. cefOTAXIME
  6. cefOXITIN
  7. ceftAROLine
  8. cefTAZIDIME
  9. cefTAZIDIME with avibactam
  10. ceftolozane with tazobactam
  11. cefTRIAXONE
  12. cefuroxime
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6
Q

Name 2 glycopeptides

A
  1. teicoplanin
  2. vancomycin
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7
Q

Name 2 lincosamides

A
  1. clindamycin
  2. linCOMYCIN
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8
Q

Name 4 macrolides

A
  1. aziTHROMYCIN
  2. cLARITHROMYcin
  3. ERYthromycin
  4. roxithromycin
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9
Q

Name 10 penicillins

A
  1. amoxicillin
  2. amoxicillin with clavulanic acid
  3. ampicillin
  4. benzathine benzylpenicillin
  5. benzylpenicillin
  6. dicloxacillin
  7. flucloxacillin
  8. phenoxymethylpenicillin
  9. piperacillin with tazobactam
  10. procaine benzylpenicillin
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10
Q

Name 5 quinolones

A
  1. ciPROFLOXAcin
  2. levofloxacin
  3. mOXifloxacin
  4. NORfloxacin
  5. ofloxacin
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11
Q

Name 3 rifamycins

A
  1. rifabutin
  2. rifaMPICin
  3. rifaXIMin
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12
Q

Name 4 Tetracyclines

A
  1. demeclocycline
  2. doxycycline
  3. minocycline
  4. tetracycline
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13
Q

Name 10 antimycobacterials

A
  1. capreomycin
  2. clofazimine
  3. cyclosERINE
  4. dapsone
  5. ethambutol
  6. isoniazid
  7. pyrazinamide
  8. rifabutin
  9. rifaMPICin
  10. streptomycin
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14
Q

Name 14 miscellaneous antibacterials

A
  1. aztreonam
  2. colistin
  3. daPTomycin
  4. fidaxomicin
  5. fosfomycin
  6. linEZOLID
  7. methenamine hippurate
  8. metronidazole
  9. nitrofurantoin
  10. sodium fusidate
  11. sulfaDiazine
  12. tigecycline
  13. trimETHOPRIM
  14. trimETHOPRIM with sulfamethoxazole
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15
Q

Name 3 classes of antifungals

A
  1. azoles
  2. echinocandins
  3. other antifungals
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16
Q

Name 7 azole antifungals

A
  1. fluconazole
  2. isavuconazole
  3. itraconazole
  4. ketoconazole
  5. miconazole
  6. posaconazole
  7. voriconazole
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17
Q

Name 3 echinocandins

A
  1. anidulafungin
  2. caspofungin
  3. micafungin
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18
Q

Name 6 miscellaneous antifungals

A
  1. amphotericin B
  2. flucytosine
  3. griseofulvin
  4. nystatin
  5. pentamidine
  6. terbinafine
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19
Q

Name 3 classes of general antivirals

A
  1. guanine analogues
  2. neuraminidase inhibitors
  3. other antivirals
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20
Q

Name 5 guanine analogues

A
  1. aciclovir
  2. famciclovir
  3. ganciclovir
  4. valAciclovir
  5. valGANciclovir
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21
Q

Name 3 neuraminidase inhibitors

A
  1. oseltamivir
  2. peramivir
  3. zanamivir
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22
Q

Name 11 miscellaneous antivirals

A
  1. amantadine
  2. casirivimab and imdevimab
  3. cidofovir
  4. foscarnet
  5. letermovir
  6. molnupiravir
  7. nirmatrelvir and ritonavir
  8. palivizumab
  9. remdesivir
  10. sotrovimab
  11. tixagevimab and cilgavimab
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23
Q

Name 5 antivirals for Hepatitis B

A
  1. adefovir
  2. entecavir
  3. lamiVUDine
  4. peginterferon alfentanila-2a
  5. tenofovir
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24
Q

Name 6 antivirals for Hepatitis C

A
  1. glecaprevir with pibrentasvir
  2. ledipasvir with sofosbuvir
  3. ribavirin
  4. sofosbuvir
  5. sofosbuvir with velpatasvir
  6. sofosbuvir with velpatasvir and voxilaprevir
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25
Q

Name 5 classes of antiretrovirals

A
  1. nucleoside reverse transcriptase inhibitors
  2. non-nucleoside reverse transcriptase inhibitors
  3. HIV-protease inhibitors
  4. integrase inhibitors
  5. other antiretrovirals
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26
Q

Name 9 nucleoside reverse transcriptase inhibitors

A
  1. abacavir
  2. abacavir with lamiVUDine
  3. abacavir with lamiVUDine and zidovudine
  4. emtricitabine
  5. emtricitabine with rilpivirine and tenofovir alafenamide
  6. emtricitabine with tenofovir alafenamide
  7. lamiVUDine
  8. lamiVUDine with zidovudine
  9. zidovudine
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27
Q

Name 4 non-nucleoside reverse transcriptase inhibitors

A
  1. efavirenz
  2. etravirine
  3. nevirapine
  4. rilpivirine
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28
Q

Name 8 HIV-protease inhibitors

A
  1. atazanavir
  2. atazanavir with cobicistat
  3. darunavir
  4. darunavir with cobicistat
  5. darunavir with cobicistat, emtricitabine and tenofovir alafenamide
  6. fosamprenavir
  7. lopinavir with ritonavir
  8. ritonavir
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29
Q

Name 9 integrase inhibitors

A
  1. bictegravir
  2. cabotegravir
  3. cabotegravir and rilpivirine
  4. dolutegravir
  5. dolutegravir with abacavir and lamivudine
  6. dolutegravir with lamivudine
  7. dolutegravir with rilpivirine
  8. elvitegravir
  9. raltegravir
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30
Q

Name 2 classes of antiprotozoals

A
  1. Antimalarials
  2. Other antiprotozoals
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31
Q

Name 11 antimalarials

A
  1. artemether with lumefantrine
  2. artesunate
  3. atovaquone with proguanil
  4. chloroquine
  5. clindamycin
  6. doxycycline
  7. hydroxychloroquine
  8. mefloquine
  9. primaquine
  10. quinine
  11. tafenoquine
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32
Q

Name 4 miscellaneous antiprotozoals

A
  1. atovaquone
  2. metronidazole
  3. paromomycin
  4. pyrimethamine
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33
Q

Name 2 classes of anthelminthics

A
  1. benzimidazoles
  2. other anthelmintics
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34
Q

Name 2 benzimidazoles

A
  1. albendazole
  2. mebendazole
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35
Q

Name 3 miscellaneous anthelminthics

A
  1. ivermectin
  2. praziquantel
  3. pyrantel
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36
Q

Describe how trimethoprim may effect creatinine clearance.

A

Trimethoprim is known to cause reversible increases in serum creatinine, reportedly by inhibiting its renal tubular secretion, without causing a change in the glomerular filtration rate.

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37
Q

What is a combination of amoxicillin, gentamicin and metronidazole known as, and what is its purpose?

A

This is known as ‘triple therapy’ and is used to provide coverage against Gram-positive, Gram-negative and anaerobic bacteria.

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38
Q

What is the first line treatment option for mild-to-moderate hospital-acquired pneumonia?

A

Amoxicillin/clavulanic acid (oral, or IV if oral is inappropriate).

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39
Q

What is the first line treatment option for severe hospital-acquired pneumonia?

A

Piperacillin/tazobactam plus gentamicin.

40
Q

What is a particularly good resource for the dosing of antibiotics in renal impairment?

A

eTG

41
Q

What is the drug class of aciclovir?

A

Guanine analogue antiviral

42
Q

What is the mechanism of action of guanine analogue antivirals?

A

Following phosphorylation by viral and cellular enzymes, guanine analogues inhibit viral DNA polymerase and DNA synthesis.

43
Q

What are 4 indications of aciclovir?

A
  1. Treatment and prevention of herpes simplex infections
  2. Shingles (varicella zoster virus reactivation)
  3. Acute chickenpox (varicella zoster) in immunocompromised patients
  4. Herpetic eye infections
44
Q

What is a recommended Cautionary Advisory Label with oral aciclovir?

A

Label D (although some products contain more dosage units than required for treatment of one episode)

45
Q

What should patients expect when using aciclovir?

A

This medicine does not cure genital herpes or cold sores, or reduce the risk of transmitting the infection to other people

46
Q

How should patients take aciclovir?

A

Take doses at regular intervals. If they have to take 5 doses per day, take a dose every 4 hours during waking hours

47
Q

How should patients use aciclovir dispersible tablets?

A

Disperse the tablets in at least 50 mL of water, or swallow whole with water.

48
Q

What are 4 common side effects associated with aciclovir?

A
  1. Nausea
  2. Vomiting
  3. Diarrhoea
  4. Headaches
49
Q

What is a side effect associated with aciclovir cream?

A

If applied to the mucous membranes (such as in the mouth, eye or vagina), it can cause localised irritation

50
Q

How should patients use aciclovir for episodic treatment?

A

For episodic treatment, start taking the tablets as soon as they notice symptoms (such as tingling, itching or burning)

51
Q

What is a practice point you should always mention to patients who are taking aciclovir?

A

It is important to drink plenty of fluids (at least 1.5 to 2 litres daily) while taking this medicine (especially at high doses)

52
Q

What are 12 rare (and potentially severe) side effects of aciclovir?

A
  1. Dizziness
  2. Anorexia
  3. Confusion
  4. Hallucinations
  5. Insomnia
  6. Rashes
  7. Taste disturbances
  8. Tremor
  9. Arthralgia
  10. Blood dyscrasias
  11. Angioedema
  12. Anaphylaxis
53
Q

Describe the use of aciclovir in pregnancy.

A

Aciclovir is in pregnancy category B3. It should be used with caution in the first trimester; but can be used in the second and third trimesters. Patients should seek advice from an infectious diseases specialist. Topical application is safe.

54
Q

Describe the use of aciclovir in breastfeeding.

A

Aciclovir is safe to use in breastfeeding. The dose received by an infant is likely to be lower than doses used in neonates.

55
Q

Describe the use of aciclovir in elderly patients.

A

There is an increased risk of neurological adverse effects (such as confusion, hallucinations, and seizures) when aciclovir is used in the elderly. Consider using an alternative antiviral agent.

56
Q

Why is it important for patients to drink plenty of water while taking aciclovir?

A

To reduce the risk of crystal formation in the urine.

57
Q

How should CNS adverse effects be interpreted with aciclovir?

A

CNS adverse effects may be a sign of an inappropriately high dose with respect to the patient’s renal function

58
Q

What is the standard adult dose range for oral aciclovir?

A

200 to 800 mg up to FIVE times daily, depending on the condition being treated

59
Q

What is the standard adult dose range for IV aciclovir?

A

5 to 10 mg/kg over 1 hour, administered every EIGHT hours

60
Q

What is the standard dosage for aciclovir from birth (at term) to 3 months of age for herpes simplex?

A

20 mg/kg IV every EIGHT hours. After the IV course is completed, consider giving oral aciclovir, 300 mg/m2 THREE times daily for 6 months (may red recurrence of skin lesions and improve neurodevelopmental outcome in those with CNS disease).

61
Q

What is the standard IV dosage for aciclovir for patients aged 3 months to 12 years for herpes simplex (non-encephalitis)?

A

250 mg/m2 (or 10 mg/kg) every EIGHT hours

62
Q

What is the standard oral dosage for aciclovir for patients aged 3 months to 12 years for herpes simplex (non-encephalitis)?

A

10 mg/kg (maximum 400 mg) FIVE times daily for 5 to 7 days

63
Q

What is the standard IV dosage for aciclovir for patients aged 3 months to 12 years for herpes simplex encephalitis?

A

250 to 500 mg/m2 (or 10 to 20 mg/kg) every EIGHT hours

64
Q

What is the standard oral dosage for aciclovir for patients aged 3 months to 12 years for chickenpox/shingles?

A

20 mg/kg (maximum 800 mg) FOUR or FIVE times daily

65
Q

What is the standard IV dosage for aciclovir for patients aged 3 months to 12 years for severe chickenpox/shingles?

A

250 to 500 mg/m2 every EIGHT hours

66
Q

What is a contraindication for the use of aciclovir?

A

Allergy to aciclovir or valaciclovir

67
Q

What is a neurological precaution associated with aciclovir?

A

There is an increased risk of reversible encephalopathic changes (such as seizures, hallucinations) with IV aciclovir in patients with neurological abnormalities

68
Q

What is the standard oral dosage of aciclovir for primary and recurrent genital herpes simplex in adults with a creatinine clearance of 10 to 25 mL per minute?

A

200 mg every SIX to EIGHT hours.

69
Q

What is the standard oral dosage of aciclovir for primary and recurrent genital herpes simplex in adults with a creatinine clearance of <10 mL per minute?

A

200 mg every 12 hours.

70
Q

What is the standard oral dosage of aciclovir for shingles in adults with a creatinine clearance of 10 to 25 mL per minute?

A

800 mg every EIGHT hours

71
Q

What is the standard oral dosage of aciclovir for shingles in adults with a creatinine clearance of <10 mL per minute

A

800 mg every 12 hours

72
Q

What is the standard IV dosage of aciclovir in adults with a creatinine clearance of 26 to 50 mL per minute?

A

5 to 10 mg/kg every 12 hours

73
Q

What is the standard IV dosage of aciclovir in adults with a creatinine clearance of 10 to 25 mL per minute?

A

5 to 10 mg/kg every 24 hours

74
Q

What is the standard IV dosage of aciclovir in adults with a creatinine clearance of <10 mL per minute?

A

2.5 to 5 mg/kg every 24 hours and after haemodialysis

75
Q

What is a practical consideration with IV aciclovir?

A

Avoid extravasation as injection is alkaline (pH 11)

76
Q

What is the main pathway of elimination of aciclovir ?

A

Its elimination is 40 to 70% unchanged in the urine.

77
Q

Describe the pharmacokinetics of valAciclovir.

A

valAciclovir is converted in the liver to aciclovir and achieves plasma concentrations 2 to 4 times that of equivalent oral doses of aciclovir; valaciclovir 4 to 8 g daily is comparable to IV aciclovir 15 to 30 mg/kg daily.

78
Q

Describe the pharmacokinetics of valGANciclovir.

A

valGANciclovir is converted to ganciclovir in the intestinal wall and liver; ganciclovir concentrations from oral valganciclovir are similar to those from IV ganciclovir.

79
Q

In what 3 formulations if aciclovir available as?

A
  1. Tablets
  2. IV
  3. Topical
80
Q

In what formulation is famciclovir available in?

A

Tablets

81
Q

How do guanine analogue antivirals compare in their use for shingles?

A

Early treatment with aciclovir, famciclovir or valaciclovir reduces the duration of acute pain, although aciclovir seems less effective than famciclovir or valaciclovir. Evidence for reducing the risk or duration of post-herpetic neuralgia is conflicting.

82
Q

How do guanine analogue antivirals compare in their use for herpes simplex infections?

A

Aciclovir, famciclovir and valaciclovir can all be used to treat these infections. Unlike genital infections, orolabial infections are not usually treated or suppressed unless they are severe, or the patient is immunocompromised as treatment benefits are modest. There is little evidence and no long-term data for the use of famciclovir to suppress orolabial or genital herpes infections in HIV patients.

83
Q

How do guanine analogue antivirals compare in their use for herpes simplex and varicella zoster infections?

A

Famciclovir and valaciclovir are preferred to aciclovir for herpes simplex and varicella zoster virus infections due to better oral bioavailability and greater convenience (taken 2 or 3 times daily, while aciclovir is taken 5 times daily).

84
Q

How do guanine analogue antivirals compare in their use for cytomegalovirus disease?

A

Ganciclovir is used to treat CMV disease in immunocompromised patients, while valganciclovir is used for CMV retinitis and to prevent CMV disease after transplants; valaciclovir is also used for the latter indication.

85
Q

In what formulation is valaciclovir available in?

A

Tablets

86
Q

In what 2 formulations is valganciclovir available in?

A
  1. Tablets
  2. Oral liquid
87
Q

In what 2 formulations is ganciclovir available in?

A
  1. IV
  2. Intravitreal implant (available via the SAS).
88
Q

Name 9 penicillins.

A
  1. Amoxicillin ± clavulanic acid
  2. Ampicillin
  3. Benzathine benzylpenicillin
  4. Benzylpenicillin
  5. Dicloxacillin
  6. Flucloxacillin
  7. Phenoxymethylpenicillin
  8. Piperacillin with tazobactam
  9. Procaine benzylpenicillin
89
Q
  1. Amoxicillin ± clavulanic acid
  2. Ampicillin
  3. Benzathine benzylpenicillin
  4. Benzylpenicillin
  5. Dicloxacillin
  6. Flucloxacillin
  7. Phenoxymethylpenicillin
  8. Piperacillin with tazobactam
  9. Procaine benzylpenicillin
A

This is known as ‘triple therapy’ and is used to provide coverage against Gram-positive, Gram-negative and anaerobic bacteria.

90
Q

What is the main anaerobic bacteria covered by metronidazole which is not covered by amoxicillin/clavulanic acid?

A

Clostridium Difficile

91
Q

What is the main anaerobic bacteria covered by metronidazole which is not covered by amoxicillin/clavulanic acid?

A

Clostridium Difficile

92
Q

Describe the role of renal function in trimETHOPRIM dosing.

A

trimETHOPRIM is contraindicated in severe renal impairment as it is renally-cleared and accumulation may lead to hyperkalaemia, especially when used concurrently with other drugs that cause potassium retention (such as ACE inhibitors).

93
Q

What is the active ingredient in Plaquenil?

A

Hydroxychloroquine

94
Q

What is the active ingredient in Plaquenil?

A

Hydroxychloroquine

95
Q

What is the active ingredient in Plaquenil?

A

Hydroxychloroquine

INTERNSHIP (189 decks)

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