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Pharmacology > Antifungals, Antimalarials, Antivirals > Flashcards

Antifungals, Antimalarials, Antivirals Flashcards

1
Q

what is the drug used for latent and active TB, inhibits mycolic acid in bacteria, disrupting the cell wall

A

Isoniazid

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2
Q

Coverage isoniazid

A

m. tuberculosis

m. kansasii (at high conc)

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3
Q

cross-resistance possible between isoniazid and ______ (drug)

A

ethionamide

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4
Q

isoniazid Adverse effects?

A

hepatitis, peripheral neuropathy, CNS effects, hypersensitivity

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5
Q

in treating ACTIVE TB, drug-susceptible drugs require ___ months of treatment, while multi-drug resistance requires _____

A

6 months

2 + years

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6
Q

WHAT TWO factors do you look at when assessing HIV?

A

CD4 and viral load

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7
Q

does isoniazid enter the CSF?

A

yes

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8
Q

where does metabolism occur for isoniazid?

A

liver

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9
Q

What is Rifampin, Rifabutin, Rifapentine used for?

A

TB and HIV

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10
Q

Which Rifamycin is has greater activity, and longer 1/2 life, used to treat Latent TB

A

Rifapentine

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11
Q

Which drug to NEVER USE FOR MONOTHERAPY for treating TB?

A

Rifampin

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12
Q

Which Antifungal has a LOW therapeutic index, but is best drug of choice for treating several life-threatening mycoses?

A

Ampho B

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13
Q

Does the administration (IV) for ampho B need to be slow or fast?

A

SLOW - insoluble in water

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14
Q

Ampho B is insoluble in water - what are the 2 preparations of it?

A
  • Mixed with sodium deoxycholate

- Lipid preparation - only for salvage therapy if can’t tolerate other kind

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15
Q

Does Ampho B cross the CSF?

A

no

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16
Q

Azotemia can occur in which anifungal?

A

Ampho B - infuse with normal saline and lipid-based ampho B to avoid this.

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17
Q

Flucytosine is combined with which other antifungal?

A

Ampho B

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18
Q

Which antifungal is converted to 5-FU in the fungal cell?

A

Flucytosine

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19
Q

What is flucytosine’s coverage?

A

systemic mycoses, meningitis caused by c. albicans, c. neoformans, cryptococcosis

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20
Q

Resistance is increasing, especially for immunocompromised with this type of antifungal

A

Triazoles (fluconazole, itraconazole, posaconazole…)

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21
Q

Fluconazole is limited to yeasts and fungi. It has no coverage against ______

A

aspergillosis or zygomycosis

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22
Q

Fluconazole is the drug of choice for treatment of what?

A

induction therapy of treating Cryptococcus neoformans, candida, coccidioidomycosis

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23
Q

Which antifungal is used for prophylaxis in bone marrow transplant?

A

Fluconazole

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24
Q

Which is the LEAST active (worst coverage) of the Triazoles

A

Fluconazole

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25
Does Itraconazole reach the CSF?
no
26
Which triazole has the BROADEST coverage?
Posaconazole
27
Which triazole has the longest 1/2 life?
Posaconazole
28
Which types of drugs interact with posaconazole, and decreases its absorption?
Drugs that affect gastric pH - PPI/H2 blockers
29
This triazole has a TON of interactions and contraindicated medications
Voriconazole
30
What are the Echinocandins?
Capsofungin Micafungin Anidulafungin
31
What is Capsofungin used FIRST LINE for treating?
``` invasive candidiasis (2nd line for aspergillus when ampho B or azoles don't work) ```
32
True or False: you need to adjust capsofungin for RENAL dysfunction but not for HEPATIC dysfunction
FALSE - adjust only for hepatic dysfunction
33
Anidulafungin is First line treatment for which type of infection?
invasive fandidasis
34
Micafungin is prophylaxis of invasive candida for those undergoing which procedure?
hematopoietic stem cell transplantation
35
Which Echinocandin can be used in severe hepatic (liver) disfunction?
Anidulafungin
36
Terbinafine, Naftifine, and Butenafine are what type of CUTANEOUS antifungals?
Squalene epoxidase inhibitors
37
Which type of antifungal is drug of choice for fungal infection of the NAILS?
PO Terbinafine (also used for the scalp - tinea capitis)
38
Does topical terbinafine have a slow or fast 1/2 life?
SLOW - 200-400 hours
39
This cutaneous antifungal requires MONTHS duration of use in order to see results?
Griseofulvin
40
Griseofulvin concentrates/distributes where?
skin, hair, nails, adipose
41
Griseofulvin CONTRAINDICATIONS?
Pregnancy | Porphyria
42
Nystatin is commonly used as powder and cream. what administration is NOT OK and why?
IV - toxic when absorbed systemically
43
Oseltamivir | Zanamavir
Neuraminidase inhibitors
44
when do you administer neuraminidase inhibitors?
PRIOR to flu exposure (48 hours)
45
which neuraminidase inhibitor is safe for pregnancy
Oseltamivir
46
What is ribavirin used for?
severe RSV and chronic HepC (when in combo with interferon alpha)
47
is Ribavirin ok to use in pregnancy?
NO caution in infants too
48
Of the hepatitis infections A, B, C, D, E, the most common are A,B,C. Which 2 are there treatments available for?
hepatitis B and C
49
This antiviral class comes in alpha, beta, and gamma forms
Interferons
50
Interferons are used to treat which viral infection?
HBV
51
Treatment of Chronic hepatitis C USED TO BE interferon + ribavirin, but NOW it is _____
direct-acting antivirals
52
``` Simeprevir Sofosbuvir Simeprivir + sofosbuvir Sofosbuvir + Ledipasvir Ombitasvir + paritaprevir + ritonavir + dasabuvir ```
Direct-acting antiviral agents (2nd generation) | used in treating hep c
53
what is Acyclovir and Valacyclovir used to treat?
Herpes simplex 1/2, Varicella-zoster, EBV
54
Cidofovir used to treat _____?
Cytomegalovirus in patients with AIDS
55
CONTRAINDICATION of using Cidofovir
Renal impairment, and caution with renal dysfunction
56
Foscarnet treats what?
it is an antiviral, treats CMV retinitis in immunocompromised
57
Which 5 classes of drugs treats HIV?
NRTIs, NNRTIs, Protease inhibitors, Entry inhibitors, Integrase inhibitors
58
Which NRTI is best to use if renal impairment, because it is metabolized in the liver?
Abacavir
59
``` Zidovudine Stavudine Lamivudine Didanosine Tenofovir Emtricitavine Abacavir ```
NRTIs (HIV treatment)
60
Nevirapine Efavirenz Etavirine Rilpivirine
NNRTIs (HIV treatment)
61
``` Ritonavir Saquinavir Indinavir Nelfinavir Fosamprenavir Lopinavir Atazanavir Tipranavir Darunavir ```
Protease inhibitors (HIV treatment)
62
Which severe AE do you need to be aware of when using Tenofovir to treat HBV?
fanconi's syndrome, decreased bone density
63
during which phase of herpes (cold sore) must you treat with acyclovir or valaciclovir?
Acute phase | NO EFFECT DURING LATENT stage
64
Trifluridine Coverage?
antiviral - treats HSV1, HSV2, vaccinia virus (eye infections)
65
Why is trifluridine only available topically?
TOXIC SYSTEMICALLY! use topically in eye
66
which protease inhibitor can you NOT use PPI/H2 blockers, as they cause in increase in bilirubin/jaundice?
Atazinavir
67
Using this class of of HIV meds chronically can lead to fat redistribution around abdomen and neck
Protease inhibitors
68
Ampho B does not cross CSF, vitreous humor, or amniotic fluid, but IT DOES CROSS what?
placenta!
69
What is the drug of choice for aspergillus (Triazole)
Voriconazole
70
This antifungal replaces Ampho B for drug of choice for treating invasive aspergillus
Voriconazole
71
Which Cutaneous antifungal treatment DOES NOT COVER candidiasis
tolnaftate
72
Tolnaftate MOA
stunts fungal growth
73
Griseofulvin MOA
disruption of fungal mitosis
74
most common causes of cutaneous fungals
trichophyton microsporum epidermophytin
75
Which antigungal is used in prophylaxis for stem cell transplantation
micafungin
76
which "male" medications do you need to MAKE SURE TO wash your hands after use for risk of harming children/pregnancy women
Testosterone supplements & 5-alpha reductase
77
Which 2nd line TB medication has Adverse effects that are mainly CNS related - lethargy, suicidal thoughts, anxiety!
Cycloserine
78
Newest TB drug, used for treating MDR-TB
Bedaquiline
79
Bedaquiline AE
QT prolongation
80
which antimacrolide therapy's MOA is inhibition of folate synthesis
Dapsone
81
primaquine only works in the erythrocytic or exoerythrocytic form?
exoerythrocytic
82
first line treatment for invasive candidiasis?
echinocandins
83
first line treatment for invasive aspergillosis
voriconazole
84
which 2 medications used to treat nematodes are CONTRAINDICATED in pregnancy?
ivermectin | Mebendazole
85
which antihelmetic drug is used for lung/blood/intestinal/liver worms?
praziquantel
86
coverage of choice for c. neoformans AFTER induction therapy with ampho B and flucytosine?
fluconazole
87
of the Triazoles, which DOES NOT cross into the CSF?
Itraconazole
88
which triazole has AEs that include visual and auditory hallucinations?
voriconazole
89
why is Voriconazole tough to administer?
SO MANY CONTRAINDICATIONS AND INTERACTIONS
90
TOP 3 TREATMENT options for invasive aspergillosis
Ampho B + flucytosine --> Voriconazole --> Capsofungin
91
first line treatment for invasive candidiasis?
echinocandins: capsofungin, Anidulafungin, micafungin
92
which echinocandin DOES NOT require a loading dose when initiating?
micafungin | also used as prophylaxis in stem cell transplants
93
nystatin coverage?
cutaneous/oral candida oropharyngeal/cutaneous candidiasis NO TINEAs
94
Treatment for Latent TB
isoniazid + Rifapentine for 9 months
95
Due to rifampin's risk of liver failure, which patients to BE CAREFUL in?
alcoholics elderly liver failure
96
which of the 4 first-line treatments for active TB can be discontinued after 2 months of a 6 month regimen?
pyrazinamide
97
what 2 meds are used to treat leprosy?
Dapsone | Clofazimine
98
Clofazimine MOA (leprosy)
phenazine dye generates toxins | can cause brown/pink discoloration of skin

Pharmacology (12 decks)

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