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PHARM SHELF AND BOARDS > ANTIMICROBIALS > Flashcards

ANTIMICROBIALS Flashcards

1
Q

The AE of which drug can be largely prevented by administration of histamines and a slow infusion rate?

A

Vancomycin (red man syndrome)

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1
Q

Which tetracycline is rarely used as an antibiotic but instead to act as a diuretic in SIADH?

A

Demeclocycline

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1
Q

What is the mechanism of resistance to tetracyclines?

A

Decreased uptake by cells or increased efflux by PLASMID ENCODED GENES

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1
Q

What autoantibodies may be found in the serum of a person on isoniazid?

A

Antihistone; it causes a lupus like syndrome

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1
Q

Which enzyme activates isoniazid to the active form?

A

Mycobacterial Catalase Peroxidase (KatG)

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1
Q

Which antifungal binds ergosterol but is only available topically? Which is used systemically?

A

Nystatin; Ergosterol

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2
Q

What is the mechanism of resistance to acyclovir?

A

mutation of viral thymidine kinase

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3
Q

The uptake of which type of antibiotics is inhibited by divalent cations?

A

Tetracyclines

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3
Q

Which drugs inhibit 50 S and prevent translocation?

A

Macrolides

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4
Q

Which type of antibiotics is aztreonam synergistic with?

A

aminoglycosides

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5
Q

What is nifurtimox used to Tx?

A

Trypanosoma cruzi

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6
Q

Which aminopenicillin has the greatest oral bioavailability?

A

amOxicillin (greater Oral) than ampicillin

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6
Q

Which carbapenem does not require coadministration of cilastatin? What does this mean?

A

Meropenem, it is not degraded in kidneys by dehydropeptidase I

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6
Q

MOA of oseltamivir

A

neuraminidase inhibitor that decreases release of influenza A and B viral progeny

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7
Q

What 2 types of HSV infections can you use acyclovir for? What is the benefit of valacyclovir?

A

mucocutaneous (i.e. genitals and cold sores) and encephalitis; better oral bioavailability

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8
Q

What do you use to treat NADPH oxidase deficiency?

A

IFN gamma

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9
Q

MOA of trimethoprim

A

Inhibits dihydrofolate reductase

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10
Q

How do you prevent postsurgical infection due to S. aureus?

A

Cefazolin

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10
Q

What can be treated with IFN alpha? (3)

A

HBV, HCV, and Kaposi

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11
Q

What cephalosporin is used prior to surgery to prevent S. aureus skin infections?

A

cefazolin

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12
Q

Why do you avoid chloramphenicol in pregnancy?

A

Gray Baby syndrome, baby has low levels of UDP glucuronyl transferase

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12
Q

MOA of foscarnet

A

Pyrophosphate analog that inhibits CMV viral DNA polymerase

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13
Q

Which drugs inhibit fungal cell wall synthesis by inhibiting B-glucan?

A

Caspofungin and Anidulfungin

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13
Q

What is the mechanism of resistance to ganciclovir?

A

mutated CMV DNA polymerase or viral kinase

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13
Q

In which circumstance could you use foscarnet in a ganciclovir resistant strain of CMV?

A

If the resistance is from lack of viral kinase. Foscarnet does not require viral kinase, however, if the resistance is from viral DNA pol then neither will work

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14
Q

What highly virulent bug is covered by ceftaroline?

A

MRSA

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14
Q

This antibiotic blocks peptidyltransferase at the 50S subunit

A

Chloramphenicol

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15
Q

What is pyrimethamine used to treat?

A

Toxoplasmosis

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15
Q

What is sodium stibogluconate used to Tx?

A

Leishmaniasis

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17
Q

What is the mechanism of resistance to penicillins?

A

Beta Lactamase

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17
Q

Why do you avoid fluoroquinolones in pregnancy?

A

Cartilage damage

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18
Q

Why do you avoid ribavirin in pregnancy?

A

Teratogenic

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19
Q

Which TB drug may cause optic neuropathy?

A

Ethambutol

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19
Q

MOA of zanamavir

A

neuraminidase inhibitor that decreases release of influenza A and B viral progeny

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20
Q

Which drugs are given as prophylaxis for A) Mycobacterium tuberculosis B) MAC and C) M. leprae?

A

A) Isoniazid B) Azithromycin (when CD4

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20
Q

What is Terbinafine? Terbutaline?

A

Terbinafine is an antifungal that inhibits squalene epoxidase and is used to Tx dermatophytes; Terbutaline is a B2 agonist used to relax the uterus

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21
Q

Which generation of cephalosporins covers gram positive bacteria and Proteus, E. coli, Klebsiella, Haemophilus, Enterobacter, and Neisseria?

A

Second Generation (HEN PEcK)

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22
Q

What inhibits the uptake of tetracyclines?

A

Divalent cations: milk, antacids, or iron

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22
Q

What is triple therapy for H pylori?

A

Metronidazole, Clarithromycin and PPI’s

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22
Q

Which 2 antifungals affect cell wall synthesis?

A

Caspofungin and Anidulfungin

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22
Q

Which antiviral inhibits IMP dehydrogenase?

A

Ribavirin

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22
Q

How can you reverse the bone marrow suppression caused by NRTI’s?

A

G-CSF and EPO

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22
Q

What kind of drugs are nevirapine, delavirdine, and efavirenz?

A

NNRTI’s

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23
Q

How do you prophylax against gonorrhea?

A

Ceftriaxone

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24
Q

What 7 bugs are covered by aminopenicillins that are not by penicillins?

A

Haemophilus influenzae b, E. coli, Listeria, Proteus, Salmonella, Shigella, and Enterococci (HELPSS kill enterococci)

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24
Q

How do you treat tuberculous leprosy?

A

Dapsone and Rifampin

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25
Q

What are 3 AE of ampicillin?

A

Hypersensitivity, Ampicillin rash if underlying mono, and pseudomembranous colitis

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25
Q

How do you prophylax against meningitis?

A

Ciprofloxacin = adults; Rifampin = kids

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25
Q

What is the MOA of raltegravir?

A

inhibits HIV integrase

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26
Q

What makes nafcillin, oxacillin, and dicloxacillin resistant to beta lactamases?

A

They have a bulky R group which sterically hinders them

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27
Q

MOA of metronidazole?

A

disulfiram like reaction, headache, and metallic taste

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28
Q

This TB drug blocks arabinosyltransferase and decreases carbohydrate polymerization of the cell wall

A

Ethambutol

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28
Q

Major AE of rifampin

A

orange body fluids and hepatoxicity (induce CYP450)

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29
Q

Which drug is used against cryptococcus and is converted to 5-FU by cytosine deaminase?

A

Flucytosine

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30
Q

What are the AE of penicillins (2)?

A

Hypersensitivity reactions and Hemolytic anemia

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30
Q

Aminoglycosides and tetracyclines both act on _____ S

A

30 S

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30
Q

What drug is used to treat Giardia in A) Non pregnant and B) Pregnant

A

A) metronidazole B) Paramomycin

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31
Q

Which antibiotic inhibits dihydrofolate reductase? Which drug also does this as an antineoplastic?

A

Trimethoprim; Methotrexate

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33
Q

Which antifungals inhibit nucleic acid synthesis?

A

5-Flucytosine

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34
Q

This tetracycline is excreted fecally rather than renally

A

Doxycycline

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34
Q

What is the antiviral that inhibits IMP dehydrogenase indicated for (2)?

A

This is ribavirin (Chronic Hepatitis C and RSV)

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35
Q

What molecule is truly a “quinolone”?

A

nalidixic acid –all others are FLUOROquinolones

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36
Q

Which 30S inhibitors are bacteriostatic and bactericidal?

A

Bactericidal = aminoglycoside; Bacteriostatic = tetracyclines

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38
Q

Which electrolytes need to be supplemented when on amphotericin B?

A

K and Mg

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40
Q

What is the difference between acyclovir and ganciclovir?

A

Not much really, both are guanosine analogs that are monophosphorylated by a viral kinase HOWEVER, ganciclovir is more effective against CMV and acyclovir is more effective against HSV

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40
Q

Name the 3 NNRTI’s

A

Nevirapine, Efavirenz, and Delavirdine

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41
Q

Which cephalosporin covers MRSA?

A

Ceftaroline

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43
Q

What other disorders can hydroxychloroquine be used for aside from malaria?

A

Rheumatologic disorders

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43
Q

What is special about tenofovir when compared to other NRTI’s?

A

Does not have to be activated

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44
Q

What may relieve the bone marrow issues of trimethoprim?

A

Leucovorin = same as rescue for methotrexate (folinic acid)

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44
Q

MOA of nystatin

A

Binds ergosterol to form membrane pores in fungi; unlike amphotericin B, only available topically because too toxic

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45
Q

How do you prophylax against syphilis?

A

Benzathine penicillin G

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46
Q

What determines the half life of isoniazid?

A

whether the person is a fast or slow acetylator

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48
Q

Which generation of cephalosporins covers gram positive bacteria and Proteus, E. coli, and Klebsiella?

A

First Generation (PEcK)

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49
Q

What is the MOA of aztreonam?

A

Monobactam that prevents peptidoglycan crosslinking by binding to PBP3

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49
Q

What must you co-administer with cidofovir?

A

It is nephrotoxic so it should be given probenicid and IV saline to decrease toxicity

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50
Q

What bugs are covered by first generation cephalosporins?

A

Gram positives and Proteus, E. coli, and Klebsiella (PeCK)

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51
Q

Which 3rd generation cephalosporin is used against Pseudomonas?

A

Ceftazidime

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53
Q

How do you prophylax against strep pharyngitis in a kid with Hx of rheumatic fever?

A

oral penicillin

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54
Q

What is the MOA of griseofulvin?

A

Interferes with fungal microtubules and disrupts mitosis

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56
Q

How do you prophylax against gonococcal and chlamydial conjunctivitis in a newborn?

A

Erythromycin ointment

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56
Q

What are the 2 most serious side effects of amphotericin

A

Nephrotoxicity and Arryhthmias (and the arrhythmias are ultimately due to the nephrotoxicity)

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57
Q

What is the mechanism of resistance to macrolides

A

methylation of the 23S rRNA binding site

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58
Q

Which type of bugs can vancomycin be used against?

A

GRAM POSITIVE ONLY

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59
Q

This TB drug blocks the synthesis of mycolic acid

A

Isoniazid

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59
Q

This TB drug blocks DNA dependent RNA polymerase

A

Rifampin

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60
Q

What drug inhibits HIV integrase

A

Raltegravir

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61
Q

Which antifungal drug interferes with microtubule function and may be carcinogenic?

A

Griseofulvin

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62
Q

MOA of ergosterol

A

Binds ergosterol to form membrane pores in fungi

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64
Q

Describe the full MOA of acyclovir

A

Gets into cells and is monophosporylated by viral thymidine kinase to the active form. This then functions as a guanosine analog and causes CHAIN TERMINATION (no 3’ OH)

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65
Q

Which type of beta-lactam have seizures as an AE?

A

Carbapenems

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66
Q

What bugs are covered by second generation cephalosporins?

A

Gram positives, Haemophilus, Enterobacter, Neisseria, Proteus, E. coli, Klebsiella (HEN PEcK)

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68
Q

What are the AE (6) of sulfonamides?

A

Hypersensitivity, hemolysis in G6PD, nephrotoxicity (tubulointerstitial nephritis), photosensitivity, KERNICTERUS, and displace drugs from albumin such as warfarin

69
Q

How do you prevent red man syndrome?

A

Antihistamines and a slow infusion rate of vancomycin

70
Q

What is the MOA of cilastatin, always given with?

A

Inhibits renal dehydropeptidase I to prevent the breakdown of imipenem

72
Q

Which beta-lactams may cause vitamin K deficiency? How would this manifest?

A

Cephalosporins, bleeding (loss of II, VII, IX, X, and proteins C and S)

73
Q

This TB drug has an unknown MOA but may acidify the intracellular environment by forming _____________

A

Pyrazinamide; pyrazinoic aci

74
Q

Which bactericidal antibiotics inhibit formation of the initiation complex and cause misreading of mRNA?

A

aminoglycosides

75
Q

Ototoxicity with aminoglycosides is potentiated with __________ while nephrotoxicity is potentiated with ______________

A

Loop diuretics; Cephalosporins

75
Q

Which type of anemia is formed by trimethoprim? What could you give to rescue?

A

Megaloblastic anemia (lack of folate); rescue with folinic acid (leucovorin) same as for methotrexate

76
Q

Which antibiotics function by blocking DNA topoisomerase II and IV?

A

Fluoroquinolones

77
Q

Which ribosomal inhibitor has a dose dependent risk of aplastic anemia?

A

chloramphenicol

79
Q

What is the MOA of aminoglycosides

A

Bind 30 S ribosome to inhibit formation of initiation complex

81
Q

What is the MOA of ribavirin?

A

inhibits synthesis of guanine nucleotides by inhibiting IMP dehydrogenase

82
Q

Which drug that treats anaerobes blocks peptide transfer at 50S?

A

clindamycin

82
Q

What is used to Tx flukes such as Schistosomes?

A

Praziquantel

83
Q

Which drugs all end in -navir?

A

Protease inhibitors

85
Q

Which 2 antifungals inhibit lanosterol synthesis?

A

Naftifine and Terbinafine

87
Q

Which protease inhibitor can cause hematuria?

A

Indinavir

88
Q

Which bacteria are not affected by aztreonam?

A

Gram positive and Anaerobes (Dr. Randolf: Aztreonam is the atom bomb of gram negatives)

89
Q

Which antibiotic is best for anaerobes above the diaphragm?

A

Clindamycin

90
Q

Which antibiotic is best for anaerobes below the diaphragm?

A

Metronidazole

92
Q

With which drugs are aminoglycosides synergistic? What problems arise?

A

Cephalosporins potentiate them but they also increase the risk for nephrotoxicity

93
Q

What is the major AE of chloroquine?

A

Retinopathy

94
Q

Methylation of the 23S rRNA binding site confers resistance to __________

A

Macrolides but not telithromycin (a ketolide)

94
Q

Which drug is indicated to treat Hep C and RSV?

A

Ribavirin

95
Q

DOC for Trypanosoma brucei

A

Suramin and melarsoprol

96
Q

What is the MOA of caspofungin and micafungin

A

inhibit cell wall synthesis by inhibiting synthesis of B-glucan

96
Q

What CMV drug must be coadministered with probenecid?

A

Cidofovir due to nephrotoxicity

97
Q

Which drugs are indicated for both influenza A and B?

A

Neuraminidase inhibitors = oseltamavir and zanamavir

98
Q

What is the mechanism of resistance to the aminopenicillins?

A

Beta-lactamases (same as regular penicillins)

99
Q

Why is cefazolin used prior to surgery?

A

To prevent staphylococcal wound infections

101
Q

Which gene encodes HIV-1 protease?

A

pol gene

102
Q

Which azole is best for chronic suppression of cryptococcal meningitis?

A

Fluconazole

104
Q

Why do you avoid tetracyclines in pregnancy?

A

Discolored teeth and inhibition of bone growth

106
Q

How do you prophylax against group B strep in a carrier pregnant female?

A

Ampicillin (intrapartum)

108
Q

Which types of bugs can carbapenems be used against?

A

Gram positive, Gram negative, and anaerobe = very wide spectrum but serious AE = seizures

110
Q

What are the AE of ganciclovir?

A

BONE MARROW AND KIDNEY (renal toxicity, leuko, neutro, thrombocytopenia)

111
Q

What is praziquantel used to Tx?

A

Flukes such as Schistosoma

113
Q

Which 2 types of antibiotics cannot be taken with antacids?

A

Tetracyclines and Fluoroquinolones

114
Q

Which medication would increase the likelihood of tendon rupture in a patient taking fluoroquinolones?

A

Corticosteroids (prednisone)

115
Q

What is the DOC for Leishmaniasis?

A

Sodium Stibogluconate

116
Q

AE of macrolides (5)

A

Motility issues, Arrhythmia (QT prolonged), Cholestatic hepatitis, Rash, eOsinophilia (MACRO)

117
Q

Why do you avoid sulfonamides in pregnancy?

A

Potential for kernicterus

118
Q

Name 2 antipseudomonals

A

Ticarcillin and Piperacillin

120
Q

What 5 types of drugs block protein synthesis at the 50 S ribosomal subunit?

A

Chloramphenicol, Macrolides, Clindamycin, Streptogramins, and Linezolid

121
Q

What are the penicillinase resistant penicillins?

A

Nafcillin, Oxacillin, and Dicloxacillin

123
Q

What are the main 3 AE of protease inhibitors?

A

Hyperglycemia, GI intolerance, and Lipodystrophy

125
Q

Which aminoglycoside is commonly used for bowel surgery?

A

Neomycin

126
Q

What kind of bugs are covered by 3rd generation cephalosporins?

A

Serious gram negative infections

127
Q

What kind of drugs are ampicillin and amoxicillin?

A

AMINOpenicillins

128
Q

Which azole is best for candidal infections of all kinds?

A

Fluconazole

129
Q

What is the mechanism of resistance to aminoglycosides?

A

transferase enzymes that inactivate the drug via acetylation, adenylation, or phosphorylation

130
Q

What drug is impenem always adminstered with and why?

A

Cilastatin to decrease renal dehydropeptidase I? This would inactivate imipenem

131
Q

Which monobactam prevents peptidoglycan crosslinking by binding to PBP3

A

Aztreonam

133
Q

What are the AE of cephalosporins?

A

Hypersensitivity, Vitamin K deficiency (bleeding), and increased nephrotoxicity of aminoglycosides

134
Q

What do you use to treat onychomycosis?

A

Terbinafine

136
Q

What are the 4 AE of vancomycin?

A

Nephrotoxicity, Ototoxicity, and Thrombophlebitis as well as Red Man Syndrome

136
Q

Which CMV drug is a pyrophosphate analog?

A

Foscarnet

137
Q

What 2 bugs can TMP-SMX prophylax against in an AIDS patient? Azithromycin?

A

TMP-SMX = Pneumocystis when CD4

138
Q

What are ticarcillin and piperacillin used for?

A

Antipseudomonal penicillins

139
Q

Name 2 aminopenicillins

A

Ampicillin and Amoxicillin

140
Q

What is the MOA of ethambutol? AE?

A

Blocks arabinosyltransferase which decreases carbohydrate polymerization of the cell wall; optic neuropathy

142
Q

How can bacteria become resistant to fluoroquinolones?

A

mutation in DNA gyrase, plasmid mediated resistance, efflux pumps

143
Q

What is the common toxicity of all CMV drugs?

A

Nephrotoxicity

144
Q

Which antiviral should you use against HSV? VZV?

A

HSV = Acyclovir; VZV = Famciclovir

144
Q

What is IFN B used to TX?

A

Multiple Sclerosis

145
Q

Which form of malaria is resistant to chloroquine?

A

P. falciparum–Tx with artemether/lumifantrine or atovaquone/proguanil

146
Q

What is the AE of flucytosine?

A

Bone Marrow Suppression

147
Q

What kind of bugs are covered by 4th generation cephalosporins?

A

Pseudomonas and gram positives

149
Q

Which drugs block the conversion of lanosterol to ergosterol?

A

azoles

151
Q

Compare the AE of penicillins to the penicillinase-resistant penicillins

A

Regular penicillins = hypersensitivity and hemolytic anemia whereas Penicillinase resistant ones are allergic rxns and interstitial nephritis

152
Q

Name 3 CMV drugs

A

Ganciclovir, Foscarnet, and Cidofovir

154
Q

What is the AE of zidovudine?

A

anemia (NRTI)

155
Q

Which azole is most likely to cause gynecomastia?

A

Ketoconazole by inhibiting testosterone synthesis

156
Q

Which drugs block mRNA synthesis?

A

Rifampin

158
Q

Why do you avoid clarithromycin in pregnancy?

A

Embryotoxic

160
Q

What drug is often co-administered with ticarcillin and piperacillin? Why?

A

Clavulanic acid, inhibits beta lactamase

161
Q

How do you treat life-threatening malaria?

A

Quinidine (quinine in places outside US)

162
Q

Which drug, related to ganciclovir, is a prodrug with better bioavailability?

A

Valganciclovir

164
Q

What is the mechanism of resistance to chloramphenicol?

A

Plasmid-encoded acetyltransferase that inactivates it

165
Q

Which bacteria is penicillin most effective for?

A

Gram positives but also some gram negatives and spirochetes (Syphilis)

166
Q

Why do you avoid griseofulvin in pregnancy?

A

Teratogenic

168
Q

What is the advantage of a cephalosporin over a penicillin regarding beta-lactamase?

A

Cephalosporins are overall less sensitive to beta lactamase

168
Q

What is the general rule for clindamycin and metronidazole?

A

Clindamycin = anaerobes above the diaphragm; Metronidazole = anaerobes below the diaphragm

169
Q

What is the AE of terbinafine? What is it used to treat?

A

abnormal LFTs; used to treat onychomycosis

170
Q

Why do you avoid aminoglycosides in pregnancy?

A

They are ototoxic

171
Q

What is famciclovir used for?

A

VZV; this drug is related to acylclovir

173
Q

Which drug is used to Tx the hypnozoites of Plasmodium vivax malaria?

A

Primaquine

175
Q

This drug inhibits renal dehydropeptidase I to prevent breakdown of imipenem

A

cilastatin

177
Q

Which 2 antifungals affect membrane function?

A

Amphotericin B, Nystatin

178
Q

What is used to treat VRE?

A

Streptogramins (quinupristin and dalfopristin)

179
Q

Which antifungals inhibit ergosterol SYNTHESIS?

A

the conazoles

180
Q

What kind of bacteria are aminoglycosides most effective against?

A

gram negative

181
Q

What are the 2 neuraminidase inhibitors?

A

Zanamavir and Oseltamivir

183
Q

What is the MOA of the azoles for antifungal therapy? How is it different from terbenafine?

A

Inhibition of the CYP450 that converts lanosterol to ergosterol; Terbenafine inhibits squalene epoxidase which converts squalene to lanosterol

184
Q

2 antibiotic classes inhibiting 30 S

A

Aminoglycosides and tetracyclines

185
Q

Which protease inhibitor is used to “boost” others by inhibiting cytochrome P450?

A

Ritonavir

187
Q

How do you treat lepromatous leprosy?

A

Dapson, Rifampin, and Clofazimine

189
Q

What are 3 beta-lactamase inhibitors?

A

Clavulanic acid, sulbactam, and tazobactam

190
Q

What is valganciclovir?

A

Prodrug of ganciclovir with better oral bioavailability

191
Q

What are 3 mechanisms of resistance to sulfa drugs?

A

Increased PABA production to outcompete, alteration of dihydropteroate synthase, or decreased uptake

192
Q

In which generation of cephalosporins do you lose gram positive coverage?

A

3rd (ceftriaxone, cefotaxime, and ceftazidime)

193
Q

What drug can be used to treat HBV, HCV, and Kaposi’s?

A

IFN alpha

194
Q

What are suramin and melarsoprol used to treat?

A

Trypanosoma brucei

194
Q

What is the MOA of chloroquine?

A

Blocks detoxification of heme to HEMOZOIN so heme accumulates and is toxic to plasmodia

195
Q

Which tetracycline is best for a renally impaired patient?

A

Doxycycline because it is fecally excreted

196
Q

How do you prophylax against endocarditis from surgery and dental procedures?

A

Penicillins

197
Q

What are the AE of the penicillinase-resistant penicillins?

A

Hypersensitivity reactions and Interstitial nephritis

199
Q

Why are tetracyclines so effective against Chlamydia and Rickettsia?

A

They can accumulate intracellularly

200
Q

What is the AE of raltegravir?

A

hypercholesterolemia

201
Q

Is it safe to give cephalosporins in a penicillin allergic patient?

A

yes there is low cross-reactivity between the two

202
Q

Which ribosomal inhibitors can cause QT prolongation?

A

macrolides

203
Q

DOC for 1) T. brucei 2) T. cruzi

A

1) Suramin and Melarsoprol 2) Nifurtimox

204
Q

What are the 3 anti-staphylococcal penicillins?

A

Nafcillin, Oxacillin, and Dicloxacillin

205
Q

Which bacteria can you NOT use the penicillinase resistant penicillins on?

A

MRSA

206
Q

What is the MOA of flucytosine? Used for?

A

blocks DNA and RNA synthesis by using cytosine deaminase to convert to 5 FU

207
Q

How do you prevent neurotoxicity in a patient on isoniazid?

A

Pyridoxine (B6)

208
Q

Which azole is best for Blastomyces, Coccidiodes, and Histoplasma?

A

Itraconazle

210
Q

Which antifungal deposits in keratin-containing tissues?

A

Griseofulvin

211
Q

What is the DOC for toxoplasmosis? Prophylaxis in AIDS?

A

Pyrimethamine; TMP-SMX when CD4 less than 100

212
Q

What are the AE of ribavirin (2)?

A

Hemolytic anemia and SEVERE TERATOGEN

213
Q

What is the most important AE of carbapenems?

A

Seizures! Use is therefore limited to serious drug rxns

214
Q

DOC for Trypanosoma cruzi

A

Nifurtimox

215
Q

What is the MOA of macrolides?

A

Bind to 23S rRNA at the 50S ribosome and prevent translocation

216
Q

What are sulbactam, tazobactam, and clavulanic acid used for?

A

Beta lactamase inhibitors

217
Q

How are NNRTI’s different from NRTI’s?

A

They bind to reverse transcriptase at a different site than the NRTI’s

218
Q

In which setting would you choose aztreonam over aminoglycosides? Can you give both?

A

In renal failure because aminoglycosides are nephrotoxic. However, the two are synergistic so can be given together under other circumstances.

219
Q

What is the MOA of sulfa drugs?

A

They are PABA antimetabolites that inhibit dihydropteroate synthase

220
Q

Which drugs inhibit squalene epoxidase and therefore prevent formation of lanosterol?

A

Terbinafine and Naftifine

221
Q

In which tissue is griseofulvin most likely to deposit?

A

Keratin containing tissues

222
Q

How do you prophylax against recurrent UTI’s?

A

TMP-SMX

223
Q

What are the 4 AE of aminoglycosides?

A

Nephrotoxicity, Neuromuscular blockade, Ototoxicity, and Teratogenic

224
Q

What is the MOA of tetracyclines?

A

Inhibit 30 S to prevent attachment of aminoacyl tRNA

225
Q

Why do infants on chloramphenicol get “Gray baby syndrome”

A

They lack liver UDP-glucuronyl transferase to glucuronidate it

226
Q

Which NRTI does NOT have to be activated?

A

Tenofovir

227
Q

Which drugs potentiate the nephrotoxicity of aminoglycosides?

A

Cephalosporins

228
Q

Which ribosomal inhibitors can cause cholestatic hepatitis?

A

Macrolides

229
Q

How can you reduce the nephrotoxicity of amphotericin B?

A

HYDRATE

230
Q

What is the utility of ritonavir vs. other protease inhibitors?

A

Ritonavir is used to boost the concentrations of others by inhibiting cytochrome P450

PHARM SHELF AND BOARDS (13 decks)

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