Antimicrobial III

Question 1

types of fungal infections (locations)

Answer 1

superficial, pulmonary, CNS, systemic

Question 2

parental med for fungal mengitis

Answer 2

amphotericin B

Question 3

superficial anti-fungal agent Dr. Dodge <3

Answer 3

Fluconazole

Question 4

What are some toxicities of amphotericin B?

Answer 4

renal, fever/chills, anemia, hypotension crisis, thrombophlebitis

Question 5

This form of ampho B is less toxic, particularly renal

Answer 5

Lipsomal

Question 6

This is used with ampho B, you can use a lower does of ampho B however it is more limited to crytopcoccus and candida

Answer 6

flucytosine

Question 7

T/F: Azoles are tetratogenic

Answer 7

T

Question 8

What are other risks for azoles?

Answer 8

drug interactions, decrease steroid hormone production

Question 9

Great tx for fungal meningitis, least potent azole, oral/IV, vaginal yeast infections, hepatic toxicity is rare

Answer 9

fluconazole

Question 10

This is a strong inhibitor of gonadal and adrenal steroids and CANNOT be given with ampho B

Answer 10

Ketoconazole

Question 11

This is a derivative of ketoconazole; indicated in candida septicemia and invasive aspergillosis

Answer 11

Voriconazole

Question 12

This type of herpes results in severe infections in immunocompromised pt

Answer 12

herpes simplex

Question 13

Two popular anti-human herpes virus agents

Answer 13

acyclovir, valacyclovir

Question 14

CMV complications in immunocompromised pt

Answer 14

retinitis, encephalitis

Question 15

Anti-CMV agent

Answer 15

ganciclovir

Question 16

Anti-hepatitis agents

Answer 16

interferon alfa-2a, ribavirin, ledipasvir+sofosbuvir

Question 17

Interferon toxicities

Answer 17

neuropsychiatric, flu-like sx, marrow suppression, hepatic toxicity

Question 18

New standard of care for Hep C Tx

Answer 18

ledipasvir + Sofosbuvir

Question 19

Prophylactic agents against influenza A need in first 24-48 hrs

Answer 19

amantadine, rimantadine

Question 20

Anti-flu agents that are neuraminidase inhibitors start within 48 hrs

Answer 20

zanamivir, oseltamivir

Question 21

This NI is dangerous in pt with severe asthma or COPD

Answer 21

zanamivir

Question 22

What are the 5 classes of HIV meds?

Answer 22

1. nucleoside/tide reverse transcriptase inhibitors NRTIs
2. nonnucleoside RT inhibitors (NNRTIs)
3. protease inhibitors
4. fusion inhibitors
5. integrase inhibitor

Question 23

NRTI agent

Answer 23

Zidovudine

Question 24

NRTI toxicities

Answer 24

bone marrow tox, drug interactions

Question 25

NNRTIs agent

Answer 25

efavirenz

Question 26

NNRTI toxicity

Answer 26

epidermal reactions- TEN, SJS

Question 27

Protease inhibitor agent

Answer 27

saquinavir

Question 28

Protease inhibitor toxicity

Answer 28

drug interactions, hyperglycemia and hyperlipidemia

Question 29

When do you initiate HIV therapy?

Answer 29

at time of first dx

Question 30

Key HIV tx strategy (HAART)

Answer 30

highly active anti-retroviral therapy

Question 31

T/F people can be genetically immune to HIV

Answer 31

True

Question 32

5 common medical protozoa

Answer 32

entamoeba histolytica, giardia lambia, toxoplasmosis gondii, trichomonas vaginalis, plasmodium species

Question 33

amebic colitis (dysentery) is treated with ____.

Answer 33

metronidazole

Question 34

T/F giardiasis is not responsive to metronidazole

Answer 34

F

Question 35

This protozoan in cats can pass ova of this via there poop and pee.

Answer 35

Toxoplasmosis gondii

Question 36

T/F if you are NOT immunocompromised Toxoplasmosis gondii can affect you.

Answer 36

F

Question 37

IF a pregnant women is exposed to Toxoplasmosis gondii, what can happen

Answer 37

there can be significant levels in the blood stream and it can effect the fetus causing congenital malformations -CNS

Question 38

Tx for Toxoplasmosis gondii involves ___

Answer 38

plasmodium inhibitor, broad spectrum ABX (more than one agent)

Question 39

Least common vaginal infection

Answer 39

trichomonas vaginalis

Question 40

Tx of trichomonas vaginalis

Answer 40

single dose (2g) of metronidazole

Question 41

Issue with metronidazole

Answer 41

disulfiram (antabuse)- like reaction possible

Question 42

Metronidazole indications

Answer 42

protozoal, anaerobic infections, bacterial vaginosis

Question 43

lethal malaria bug

Answer 43

plasmodium falciparum

Question 44

what drugs are used to tx malaria

Answer 44

Chloroquine (depending), artemisinin

Question 45

Most concerning side effects of Chloroquine?

Answer 45

QT (ekg) changes, retinal toxicity, visual disturbances, hemolysis in G6PD deficient individuals

Question 46

What is the current standard tx for P. falciparum infections?

Answer 46

Artemisinin based combo therapy

Question 47

Good drug useful for pinworms?

Answer 47

albendazone