ANTIMICROBIALS Flashcards

1
Q

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

A

NNRTI’s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the 2 neuraminidase inhibitors?

A

Zanamavir and Oseltamivir

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

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

A

IFN alpha

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What CMV drug must be coadministered with probenecid?

A

Cidofovir due to nephrotoxicity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the AE of zidovudine?

A

anemia (NRTI)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

This drug inhibits renal dehydropeptidase I to prevent breakdown of imipenem

A

cilastatin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

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

A

Penicillins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

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

A

Trimethoprim; Methotrexate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the major AE of chloroquine?

A

Retinopathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

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

A

First Generation (PEcK)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Which enzyme activates isoniazid to the active form?

A

Mycobacterial Catalase Peroxidase (KatG)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

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

A

oral penicillin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the MOA of griseofulvin?

A

Interferes with fungal microtubules and disrupts mitosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Which drugs block the conversion of lanosterol to ergosterol?

A

azoles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the 3 anti-staphylococcal penicillins?

A

Nafcillin, Oxacillin, and Dicloxacillin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

MOA of oseltamivir

A

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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What bugs are covered by second generation cephalosporins?

A

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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What drug inhibits HIV integrase

A

Raltegravir

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

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

A

Cephalosporins are overall less sensitive to beta lactamase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Which 2 antifungals affect membrane function?

A

Amphotericin B, Nystatin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Why are tetracyclines so effective against Chlamydia and Rickettsia?

A

They can accumulate intracellularly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
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)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
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.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What is famciclovir used for?

A

VZV; this drug is related to acylclovir

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

How do you treat tuberculous leprosy?

A

Dapsone and Rifampin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

MOA of ergosterol

A

Binds ergosterol to form membrane pores in fungi

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

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

A

Rheumatologic disorders

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What highly virulent bug is covered by ceftaroline?

A

MRSA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
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)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

2 antibiotic classes inhibiting 30 S

A

Aminoglycosides and tetracyclines

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

This antibiotic blocks peptidyltransferase at the 50S subunit

A

Chloramphenicol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What are the 4 AE of vancomycin?

A

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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What is the mechanism of resistance to tetracyclines?

A

Decreased uptake by cells or increased efflux by PLASMID ENCODED GENES

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Which antibiotics function by blocking DNA topoisomerase II and IV?

A

Fluoroquinolones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Which TB drug may cause optic neuropathy?

A

Ethambutol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

AE of macrolides (5)

A

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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

What are the 2 most serious side effects of amphotericin

A

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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

What is the MOA of aminoglycosides

A

Bind 30 S ribosome to inhibit formation of initiation complex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

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

A

Erythromycin ointment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

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

A

G-CSF and EPO

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

What do you use to treat onychomycosis?

A

Terbinafine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

What determines the half life of isoniazid?

A

whether the person is a fast or slow acetylator

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

What is the DOC for Leishmaniasis?

A

Sodium Stibogluconate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

How do you prophylax against meningitis?

A

Ciprofloxacin = adults; Rifampin = kids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Why do you avoid chloramphenicol in pregnancy?

A

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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

What must you co-administer with cidofovir?

A

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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Which antibiotic is best for anaerobes below the diaphragm?

A

Metronidazole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

Which antiviral inhibits IMP dehydrogenase?

A

Ribavirin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

What is used to Tx flukes such as Schistosomes?

A

Praziquantel

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

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

A

Serious gram negative infections

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

Why do you avoid aminoglycosides in pregnancy?

A

They are ototoxic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

Which ribosomal inhibitors can cause QT prolongation?

A

macrolides

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

What is IFN B used to TX?

A

Multiple Sclerosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

What are the AE of ribavirin (2)?

A

Hemolytic anemia and SEVERE TERATOGEN

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

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

A

Terbinafine and Naftifine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

How do you prevent red man syndrome?

A

Antihistamines and a slow infusion rate of vancomycin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

Which azole is best for candidal infections of all kinds?

A

Fluconazole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

Which tetracycline is best for a renally impaired patient?

A

Doxycycline because it is fecally excreted

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

What is the mechanism of resistance to penicillins?

A

Beta Lactamase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

This tetracycline is excreted fecally rather than renally

A

Doxycycline

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

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

A

Antihistone; it causes a lupus like syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

What is the mechanism of resistance to macrolides

A

methylation of the 23S rRNA binding site

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

What is the MOA of flucytosine? Used for?

A

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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

What is the MOA of chloroquine?

A

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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

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

A

Griseofulvin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

What is the MOA of macrolides?

A

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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

Which cephalosporin covers MRSA?

A

Ceftaroline

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

Why do infants on chloramphenicol get “Gray baby syndrome”

A

They lack liver UDP-glucuronyl transferase to glucuronidate it

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

What are the main 3 AE of protease inhibitors?

A

Hyperglycemia, GI intolerance, and Lipodystrophy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

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

A

Ethambutol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

Which 2 antifungals inhibit lanosterol synthesis?

A

Naftifine and Terbinafine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

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

A

Loop diuretics; Cephalosporins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

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

A

A) Isoniazid B) Azithromycin (when CD4

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

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

A

This is ribavirin (Chronic Hepatitis C and RSV)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

Why is cefazolin used prior to surgery?

A

To prevent staphylococcal wound infections

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

How do you prophylax against recurrent UTI’s?

A

TMP-SMX

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
78
Q

What do you use to treat NADPH oxidase deficiency?

A

IFN gamma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
79
Q

Major AE of rifampin

A

orange body fluids and hepatoxicity (induce CYP450)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
80
Q

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

A

Ritonavir

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
81
Q

Which antiviral should you use against HSV? VZV?

A

HSV = Acyclovir; VZV = Famciclovir

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
82
Q

What is the AE of raltegravir?

A

hypercholesterolemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
83
Q

What are suramin and melarsoprol used to treat?

A

Trypanosoma brucei

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
84
Q

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

A

Demeclocycline

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
85
Q

Why do you avoid clarithromycin in pregnancy?

A

Embryotoxic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
86
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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
87
Q

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

A

Corticosteroids (prednisone)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
88
Q

What are the AE of cephalosporins?

A

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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
89
Q

Aminoglycosides and tetracyclines both act on _____ S

A

30 S

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
90
Q

What is the mechanism of resistance to aminoglycosides?

A

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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
91
Q

What is valganciclovir?

A

Prodrug of ganciclovir with better oral bioavailability

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
92
Q

What are the 4 AE of aminoglycosides?

A

Nephrotoxicity, Neuromuscular blockade, Ototoxicity, and Teratogenic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
93
Q

Which ribosomal inhibitors can cause cholestatic hepatitis?

A

Macrolides

94
Q

Which monobactam prevents peptidoglycan crosslinking by binding to PBP3

A

Aztreonam

95
Q

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

A

Itraconazle

96
Q

What is the mechanism of resistance to the aminopenicillins?

A

Beta-lactamases (same as regular penicillins)

97
Q

Name 2 aminopenicillins

A

Ampicillin and Amoxicillin

98
Q

What are 3 AE of ampicillin?

A

Hypersensitivity, Ampicillin rash if underlying mono, and pseudomembranous colitis

99
Q

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

A

1) Suramin and Melarsoprol 2) Nifurtimox

100
Q

What is nifurtimox used to Tx?

A

Trypanosoma cruzi

101
Q

How do you treat lepromatous leprosy?

A

Dapson, Rifampin, and Clofazimine

102
Q

DOC for Trypanosoma brucei

A

Suramin and melarsoprol

103
Q

Why do you avoid tetracyclines in pregnancy?

A

Discolored teeth and inhibition of bone growth

104
Q

What can be treated with IFN alpha? (3)

A

HBV, HCV, and Kaposi

105
Q

What is the general rule for clindamycin and metronidazole?

A

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

106
Q

Name 3 CMV drugs

A

Ganciclovir, Foscarnet, and Cidofovir

107
Q

What is the MOA of cilastatin, always given with?

A

Inhibits renal dehydropeptidase I to prevent the breakdown of imipenem

108
Q

Which drugs potentiate the nephrotoxicity of aminoglycosides?

A

Cephalosporins

109
Q

Which azole is most likely to cause gynecomastia?

A

Ketoconazole by inhibiting testosterone synthesis

110
Q

MOA of trimethoprim

A

Inhibits dihydrofolate reductase

111
Q

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

A

cefazolin

112
Q

What is the MOA of tetracyclines?

A

Inhibit 30 S to prevent attachment of aminoacyl tRNA

113
Q

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

A

MRSA

114
Q

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

A

Clavulanic acid, inhibits beta lactamase

115
Q

Which protease inhibitor can cause hematuria?

A

Indinavir

116
Q

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

A

chloramphenicol

117
Q

Which antifungals inhibit ergosterol SYNTHESIS?

A

the conazoles

118
Q

Which bacteria is penicillin most effective for?

A

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

119
Q

What is triple therapy for H pylori?

A

Metronidazole, Clarithromycin and PPI’s

120
Q

What is the MOA of ethambutol? AE?

A

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

121
Q

What is the MOA of caspofungin and micafungin

A

inhibit cell wall synthesis by inhibiting synthesis of B-glucan

122
Q

MOA of metronidazole?

A

disulfiram like reaction, headache, and metallic taste

123
Q

MOA of zanamavir

A

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

124
Q

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

A

Cefazolin

125
Q

Which antifungals inhibit nucleic acid synthesis?

A

5-Flucytosine

126
Q

What is praziquantel used to Tx?

A

Flukes such as Schistosoma

127
Q

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

A

Pseudomonas and gram positives

128
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

129
Q

Which types of bugs can carbapenems be used against?

A

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

130
Q

Which CMV drug is a pyrophosphate analog?

A

Foscarnet

131
Q

Which aminopenicillin has the greatest oral bioavailability?

A

amOxicillin (greater Oral) than ampicillin

132
Q

What is the MOA of sulfa drugs?

A

They are PABA antimetabolites that inhibit dihydropteroate synthase

133
Q

In which tissue is griseofulvin most likely to deposit?

A

Keratin containing tissues

134
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)

135
Q

What is the most important AE of carbapenems?

A

Seizures! Use is therefore limited to serious drug rxns

136
Q

Which 2 antifungals affect cell wall synthesis?

A

Caspofungin and Anidulfungin

137
Q

Which type of antibiotics is aztreonam synergistic with?

A

aminoglycosides

138
Q

What inhibits the uptake of tetracyclines?

A

Divalent cations: milk, antacids, or iron

139
Q

What may relieve the bone marrow issues of trimethoprim?

A

Leucovorin = same as rescue for methotrexate (folinic acid)

140
Q

Which type of bugs can vancomycin be used against?

A

GRAM POSITIVE ONLY

141
Q

Name the 3 NNRTI’s

A

Nevirapine, Efavirenz, and Delavirdine

142
Q

Which 2 types of antibiotics cannot be taken with antacids?

A

Tetracyclines and Fluoroquinolones

143
Q

Which drugs all end in -navir?

A

Protease inhibitors

144
Q

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

A

3rd (ceftriaxone, cefotaxime, and ceftazidime)

145
Q

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

A

yes there is low cross-reactivity between the two

146
Q

What are the AE of penicillins (2)?

A

Hypersensitivity reactions and Hemolytic anemia

147
Q

How do you treat life-threatening malaria?

A

Quinidine (quinine in places outside US)

148
Q

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

A

Pyrazinamide; pyrazinoic aci

149
Q

What are 3 mechanisms of resistance to sulfa drugs?

A

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

150
Q

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

A

Primaquine

151
Q

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

A

Nystatin; Ergosterol

152
Q

What is the mechanism of resistance to ganciclovir?

A

mutated CMV DNA polymerase or viral kinase

153
Q

Which drugs are indicated for both influenza A and B?

A

Neuraminidase inhibitors = oseltamavir and zanamavir

154
Q

What bugs are covered by first generation cephalosporins?

A

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

155
Q

With which drugs are aminoglycosides synergistic? What problems arise?

A

Cephalosporins potentiate them but they also increase the risk for nephrotoxicity

156
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

157
Q

MOA of nystatin

A

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

158
Q

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

A

Second Generation (HEN PEcK)

159
Q

MOA of foscarnet

A

Pyrophosphate analog that inhibits CMV viral DNA polymerase

160
Q

Which antibiotic is best for anaerobes above the diaphragm?

A

Clindamycin

161
Q

What is the mechanism of resistance to acyclovir?

A

mutation of viral thymidine kinase

162
Q

Which 3rd generation cephalosporin is used against Pseudomonas?

A

Ceftazidime

163
Q

What are the AE of ganciclovir?

A

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

164
Q

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

A

Chloramphenicol, Macrolides, Clindamycin, Streptogramins, and Linezolid

165
Q

Name 2 antipseudomonals

A

Ticarcillin and Piperacillin

166
Q

Which drug is indicated to treat Hep C and RSV?

A

Ribavirin

167
Q

How are NNRTI’s different from NRTI’s?

A

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

168
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

169
Q

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

A

Beta lactamase inhibitors

170
Q

What is the mechanism of resistance to chloramphenicol?

A

Plasmid-encoded acetyltransferase that inactivates it

171
Q

Which electrolytes need to be supplemented when on amphotericin B?

A

K and Mg

172
Q

Which azole is best for chronic suppression of cryptococcal meningitis?

A

Fluconazole

173
Q

What are 3 beta-lactamase inhibitors?

A

Clavulanic acid, sulbactam, and tazobactam

174
Q

How can bacteria become resistant to fluoroquinolones?

A

mutation in DNA gyrase, plasmid mediated resistance, efflux pumps

175
Q

This TB drug blocks DNA dependent RNA polymerase

A

Rifampin

176
Q

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

A

TMP-SMX = Pneumocystis when CD4

177
Q

What is sodium stibogluconate used to Tx?

A

Leishmaniasis

178
Q

How do you prevent neurotoxicity in a patient on isoniazid?

A

Pyridoxine (B6)

179
Q

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

A

A) metronidazole B) Paramomycin

180
Q

Why do you avoid ribavirin in pregnancy?

A

Teratogenic

181
Q

Which aminoglycoside is commonly used for bowel surgery?

A

Neomycin

182
Q

Which drugs block mRNA synthesis?

A

Rifampin

183
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

184
Q

This TB drug blocks the synthesis of mycolic acid

A

Isoniazid

185
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

186
Q

What is the AE of flucytosine?

A

Bone Marrow Suppression

187
Q

Which NRTI does NOT have to be activated?

A

Tenofovir

188
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

189
Q

Why do you avoid griseofulvin in pregnancy?

A

Teratogenic

190
Q

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

A

Vancomycin (red man syndrome)

191
Q

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

A

Valganciclovir

192
Q

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

A

Macrolides but not telithromycin (a ketolide)

193
Q

What is used to treat VRE?

A

Streptogramins (quinupristin and dalfopristin)

194
Q

Which form of malaria is resistant to chloroquine?

A

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

195
Q

Why do you avoid fluoroquinolones in pregnancy?

A

Cartilage damage

196
Q

What is pyrimethamine used to treat?

A

Toxoplasmosis

197
Q

What is the MOA of aztreonam?

A

Monobactam that prevents peptidoglycan crosslinking by binding to PBP3

198
Q

What are ticarcillin and piperacillin used for?

A

Antipseudomonal penicillins

199
Q

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

A

Flucytosine

200
Q

Which gene encodes HIV-1 protease?

A

pol gene

201
Q

DOC for Trypanosoma cruzi

A

Nifurtimox

202
Q

What kind of bacteria are aminoglycosides most effective against?

A

gram negative

203
Q

What drug is impenem always adminstered with and why?

A

Cilastatin to decrease renal dehydropeptidase I? This would inactivate imipenem

204
Q

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

A

Does not have to be activated

205
Q

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

A

They have a bulky R group which sterically hinders them

206
Q

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

A

Carbapenems

207
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

208
Q

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

A

abnormal LFTs; used to treat onychomycosis

209
Q

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

A

aminoglycosides

210
Q

How do you prophylax against syphilis?

A

Benzathine penicillin G

211
Q

How can you reduce the nephrotoxicity of amphotericin B?

A

HYDRATE

212
Q

How do you prophylax against gonorrhea?

A

Ceftriaxone

213
Q

Which antifungal deposits in keratin-containing tissues?

A

Griseofulvin

214
Q

What is the common toxicity of all CMV drugs?

A

Nephrotoxicity

215
Q

Which drugs inhibit 50 S and prevent translocation?

A

Macrolides

216
Q

Which bacteria are not affected by aztreonam?

A

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

217
Q

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

A

Meropenem, it is not degraded in kidneys by dehydropeptidase I

218
Q

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

A

Tetracyclines

219
Q

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

A

Ampicillin (intrapartum)

220
Q

Which 30S inhibitors are bacteriostatic and bactericidal?

A

Bactericidal = aminoglycoside; Bacteriostatic = tetracyclines

221
Q

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

A

Caspofungin and Anidulfungin

222
Q

What is the MOA of raltegravir?

A

inhibits HIV integrase

223
Q

What is the MOA of ribavirin?

A

inhibits synthesis of guanine nucleotides by inhibiting IMP dehydrogenase

224
Q

What is the DOC for toxoplasmosis? Prophylaxis in AIDS?

A

Pyrimethamine; TMP-SMX when CD4 less than 100

225
Q

What are the AE of the penicillinase-resistant penicillins?

A

Hypersensitivity reactions and Interstitial nephritis

226
Q

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

A

clindamycin

227
Q

What molecule is truly a “quinolone”?

A

nalidixic acid –all others are FLUOROquinolones

228
Q

What are the penicillinase resistant penicillins?

A

Nafcillin, Oxacillin, and Dicloxacillin

229
Q

Why do you avoid sulfonamides in pregnancy?

A

Potential for kernicterus

230
Q

What kind of drugs are ampicillin and amoxicillin?

A

AMINOpenicillins