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antimicrobials II Flashcards

1
Q

TB prophylaxis

A

Isonizaid

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2
Q

TB Tx

A 
RIPE
Rifampin
Isoniazid
Pyranxinamdie
Ethambutal
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3
Q

MAI prophylaxis

A

azithromycin

rifabutin

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4
Q

MAI Tx

A

more drug resistent then TB
azithromycin or clartithromycin + ethambutol
add rifabutin or ciprofloxacin

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5
Q

M. leprae Tx

A

long-term w/dapsone and rifampin for tuberculoid form

add clofazimine for lepromatous form

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6
Q

what blocks mycolic acid synthesis

A

Isoniazid

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7
Q

what blocks arabinoglycan synthesis

A

ethmbutol

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8
Q

what blocks DNA-dependent RNA polymerase?

A

ribambutin

rifampin

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9
Q

what works intracellularly via unclear MOA

A

pyrazinamide

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10
Q

rifamycins

A

rifampin

rifabutin

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11
Q

rifamycins MOA

A

inhibit DNA-dependent RNA polymerase

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12
Q

rifamycins uses

A

TB
delay resistance to dapsone in leprosy
meningococcal prophylaxis and H. influenza prophylaxis in exposed kids

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13
Q

rifamycins ADRs

A

minor hepatotoxicity and DDIs (increase P-450)
orange body fluids
rifabutin > rifampin in HIV pts

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14
Q

rifamycins resistance

A

mutations reduce drug binding to RNA

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15
Q

rifampins acronym

A 
4Rs:
RNA polymerase inhibitor
Ramps up P-450
Red/orange body fluids
Rapid resistance if used alone
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16
Q

isoniazid MOA

A

decrease synthesis or mycolic acids

bacterial catalase peroxidase (KatG) needed to convert INH to active metabolite

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17
Q

isoniazid uses

A

TB
only agent that can be used solo
strongly affected by acetylation rates

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18
Q

isoniazid ADRs

A

INH: Injures Neurons and Hepatocytes
neurotoxic
hepatotoxic
pyridoxine (B6) can prevent neurotoxicity

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19
Q

isoniazid resistance

A

mutations leading to underexpression of KatG

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20
Q

pyrazinamide MOA

A

unknown, prpdrug

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21
Q

pyrazinamide uses

A

TB

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22
Q

pyrazinamide ADRs

A

hyperuricemia

hepatotoxic

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23
Q

ethambutol MOA

A

decreaes carbohydrate polymerization of mycobacterium cell wall by blocking arabinoxyltransferase

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24
Q

ethambutol uses

A

TB

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25
Q

ethambutal ADRs

A 
optic neuropathy (red-green color blindness)
pronounce eye-thambutal
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26
Q

high risk for endocarditis and undergoing surgical or dental procedures prophylaxis

A

amoxicillin

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27
Q

exposure to gonorrhea prophylaxis

A

ceftriaxone

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28
Q

recurrent UTIs prophylaxis

A

TMP-SMX

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29
Q

exposure to meningococcal prophylaxis

A

ceftriaxone
cipro
rifampin

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30
Q

prego w/grp B strep

A

Penicillin G

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31
Q

prevention of gonococcal conjunctivitis in newborn

A

erthyromycin ointment

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32
Q

prevention of postsurgical S. aureus

A

Cefazolin

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33
Q

prevention of strep pharyngitis in kid w/prior rheumatic fever

A

bezathine penicillin G

PO penicillin V

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34
Q

exposure to syphilis

A

bezathine penicillin G

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35
Q

prophylaxis when CD4

A

TMP-SMX for pneumocystis pneumonia

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36
Q

prophylaxis when CD4

A

TMP-SMX for pneumocystis pneumonia and toxo

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37
Q

prophylaxis wheN CD4

A

azithromycin or clarithromycin for MAI

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38
Q

Tx MRSA

A 
Vanco
daptomycin
linezolid
tigecycline
ceftaroline
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39
Q

Tx VRE

A

linexolid

streptogramins

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40
Q

Tx multi drug resistant P. aeruginosa

A

Polymyxins B and E (colistin)

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41
Q

Tx multi drug resistant acinetobacter baumannii

A

polymyxins B and E (colistin)

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42
Q

lanosterol synthesis inhibitor

A

terbineafine

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43
Q

ergosterol synthesis inhibitors

A

-azole

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44
Q

cell wall synthesis inhibitors

A

echinocandins

-fungin

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45
Q

forms membrane pores

A

polyens:

  • amphotercin B
  • Nystatin
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46
Q

nucleic acid synthesis inhibitors

A

flucystosine

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47
Q

amphotericin B MOA

A

binds ergosterol and forms pores

amphoTERicin -> tears holes

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48
Q

amphotericin B uses

A 
serious systemic mycoses
cryptococcus 
blastomyces
histoplasma 
candida
mucor
intrathecally for fungal menigitis 
must supplement K and Mg d/t altered renal tubule permeability
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49
Q

amphotericin B ADRs

A 
aka amphoterrible 
fever/chills (shake and bake)
hypotension
nephrotoxic (overhydrate to prevent)
arrrhythmias
anemia
IV phlebitis
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50
Q

Nystatin MOA

A

same as amphotericin B

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51
Q

nystatin uses

A

too toxic for systemic use
swish and swallow for oral candidasis
topical for diaper rash or vaginal candisasis

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52
Q

flucytosine MOA

A

inhibits DNA and RNA biosythesis by conversion to 5-FU by cytosine deaminase

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53
Q

flucytosine use

A

systemic fungal infections

combo w/amphotercin B

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54
Q

flucytosine ADRs

A

bone marrow suppression

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55
Q

azoles MOA

A

inhibit ergosterol

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56
Q

azoles uses

A

local and less serious systemic mycoses
fluconazole- chronic suppression of crypto and candidasis in AIDs and candidasis in anyone
itraconazole- blasto, coccidioides, histo
clotrimazole and micronazole for topical fungal infections

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57
Q

azole ADRs

A

testesterone synthesis inhibitons

liver dysfnx

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58
Q

terbinafine MOA

A

inhibits fungal squalen epoxidase

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59
Q

terbinafine uses

A

dermatophytoses (especially onychomycosis)

60
Q

terbinafine ADRs

A

GI
HA
hepatotoxic
tast disturbance

61
Q

echinocandins MOA

A

inhibit cell wall synthesis by blocking beta-glucan

62
Q

echinocandins use

A

invasive aspergillosis, Candida

63
Q

echinocandins ADRs

A

GI

flushing d/t histamine release

64
Q

griseofulvin MOA

A

interferes w/microtubule fnx

deposits in keratin tissues

65
Q

griseofulvin uses

A

oral Tx of superficial infections

inhibits growth of dermatophytes

66
Q

griseofulvin ADRs

A 
teratogenic
carcinogenic
confusion
HA
increase P-450 and warfarin meta
67
Q

antiprotoxoan therapy

A 
pyrimethamine
sramin
melarsoprol
nifurtimox
sodium stibogluconate
68
Q

Tx toxo

A

pyrimethamine

69
Q

Tx trypanosoma brucei

A

suramin and melarsoprol

70
Q

Tx T cruzi

A

nifurtimox

71
Q

Tx leishmaniasis

A

sodium stibugluconate

72
Q

anti-mite/louse Tx

A

permethrin
malathion
lindane

73
Q

chloroquine MOA

A

blocks detox of heme -> hemozoin -> heme accumlates toxic to plasmodia

74
Q

chloroquine uses

A

Tx of plasmodial species other then p. falciparum (too resistant)

75
Q

chloroquine ADRs

A

retinopathy

pruitis

76
Q

Tx of falciparum

A

artemther/lumefantrine
or
atovaquone/proguanil

77
Q

Tx of life threatening malaria

A

US- quinidine

elsewhere- quinine

78
Q

viral attachment inhibitors

79
Q

viral penetration inhibitors

A

enfuvirtide

80
Q

integrase inhibitors

A

raltegravir

81
Q

protease inhibitors

A

-navir

navir (never) tease a protease

82
Q

reverse transcriptase inhibitors

A

NRTIs

NNRTIS

83
Q

NRTIs

A 
abacavir (ABC)
didanosine (ddl)
emtrictabine (FTC)
lamivudine (3TC)
stavudine (d4T)
tenofovir (TDF)
zidovudine (ZDV/AZT)
84
Q

NNRTIs

A

delavirdine
efacirenx
nevirapine

85
Q

protein synthesis inhibitors

A

interferon alpha (HBV, HCV)

86
Q

uncoating antivirals

A

amantadine
rimantadine
no longer used for influenza d/t resistance

87
Q

nucleic acid synthesis inhibitors

A

guanosine analogs
viral DNA polymerase inhibitors
guanine nucleotide synthesis

88
Q

guanosine analogs

A

acylcovir (HSV, VZV)

ganciclovir (CMV)

89
Q

viral DNA polymerase inhibitors

A

cidofovir (HSV)

foscarnet (CMV)

90
Q

guanine nucleotide synthesis

A

ribavirin (RSV, HCV)

91
Q

block release of viral progeny

A

neuroamindase inhibitors
-osteromivir
-zanamivir
influenza A and B

92
Q

osteomivir, zanamivir MOA

A

inhibit neuroamidase decrease progeny release

93
Q

osteomivir, zanamivir uses

A

Tx and prevent influenza A and B

94
Q

acyclovir, famciclovir, valacyclovir MOA

A

guanosine anaglogs

preferentially inhibit DNA polymerase by chain termination

95
Q

acyclovir, famciclovir, valacyclovir uses

A

active HSV, VZV (no effect on latent)

weak against EBV, nothing against CMV

96
Q

acyclovir, famciclovir, valacyclovir ADRs

A

obstructive crystaline nephropathy and acute renal failure if not hydrated

97
Q

acyclovir, famciclovir, valacyclovir resistance

A

viral mutated thymidine kinase

98
Q

ganciclovir MOA

A

guanosine analog

inhibits viral DNA polymerase by chain termination

99
Q

ganciclovir uses

100
Q

ganciclovir ADRs

A

pancytopenia

renal toxicity

101
Q

gancicilovir resistance

A

mutated viral kinase

102
Q

foscarnet MOA

A

viral DNA/RNA pilymerase inhibitor and HIV reverse transcriptase inhibitor

103
Q

foscarnet uses

A

CMV retinitis when ganciclovir fails

acyclovir resistance HSV

104
Q

foscarnet ADRs

A

nephrotoxic, electrolyte abnormalities -> seizures

105
Q

foscarnet resistance

A

mutated DNA polymerase

106
Q

cidofovir MOA

A

preferentially inhibits viral DNA polymerase
does NOT require phosphorylation by viral kinase
long half-life

107
Q

cidofovir use

A

CMV retinitis

acyclovir resistance HSV

108
Q

cidofovir ADRs

A

nephrotoxic

coadminister probenecid and IV saline

109
Q

HIV Tx

A 
3 drugs:
2 NRTIS and 1 of:
NNRTI
or
Protease inhibitor
or integrase inhibitor
110
Q

protease inhibitors MOA

A

prevent HIV-protease (pol gene) virus cannot mature

ritonavir boosts other drugs by inhibiting P-450

111
Q

protease inhibitor ADRs

A 
hyperglycemia
GI
lipodystrophy
nephropathy
hematuria
112
Q

protease inhibitors DDI

A

cannot combo w/rifampin

113
Q

NRTIs MOA

A

competitively inhibit nucleotide binding reverse transcriptase and terminate DNA chian
Tenovir is a nuceloTide, the others are nucleosides

114
Q

NRTI uses

A

use 2 for HIV therapy

ZVD (old AZT) used during prego to prevent transmission

115
Q

NRTIs ADRs

A 
bone marrow supression (give G-CSF and EPO) 
peripheral neuropathy 
lactic acidosis
anemia
pancreatitis
116
Q

NNRTIs MOA

A

bind reverse transcriptase at different site then NRTIs

DO NOT require phosphorylation

117
Q

NNRTI ADRs

A

rash
hepatotoxic
vivid dreams and CNS symptoms are common w/efavirenz
CI in prego

118
Q

raltegravir MOA

A

inhibits HIV genome integration

119
Q

raltegravir ADRs

A

increased creatine kinase

120
Q

fusion inhibitors

A

enfuvirtide- binds gp41 inhibiting viral entry

marviroc- binds CCR-5

121
Q

fusion inhibitors ADRs

A

skin rxn at injection site

122
Q

interferon alpha use

A 
chronic HBV, HCV
kaposi sarcoma
hairy cell leukemia
condyloma acuminatum
RCC
malignant melanoma
123
Q

interferon beta use

124
Q

interferon gamma use

A

chronic granulomatous disease

125
Q

interferon ADRs

A

neutropenia and myopathy

126
Q

Hep C therapy

A

ribavirin
simeprevir
sofobuvir

127
Q

ribavirin MOA

A

inhibits synthesis of guanine nucleotides by competitvely inhibiting inosine monophosphate dehydrogenase

128
Q

ribavirin use

A

chronic HCV

RSV (palivizumab preferred in kids)

129
Q

ribavirin ADRs

A

hemolytic anemia

severe teratogen

130
Q

simeprevir MOA

A

HCV protease inhibitor

prevents viral replication

131
Q

simeprevir use

A

chronic HCV in combo w/ribavirin and peginterferon alpha

do not use as monotherapy

132
Q

simeprevir ADRs

A

photosensitivity

rash

133
Q

sofobuvir MOA

A

inhibits HCV RNA dependent RNA polymerase, chain terminator

134
Q

sofobuvir uses

A

chronic HCV in combo with ribavirin +/- perinterferon

do not use as monotherpay

135
Q

sofobuvir ADRs

A

fatigue
HA
nausea

136
Q

what cleansing processes destroy spores?

A

autoclave
hydrogen peroxide
iodine and idophors (maybe)

137
Q

Abx CI in prego

A 
SAFe Children Take Really Good Care
sulfonamides
aminoglycosides
fluoroquinolones
clarithromycin
tetracyclines
ribavirin
griseofulvin
chloroamphenicol
138
Q

sulfonamides in prego

A

kernicterus

139
Q

aminoglycosides in prego

140
Q

fluoroquinolones in prego

A

cartilage damage

141
Q

clarithromycin in prego

A

embyrotoxic

142
Q

tetracyclines in prego

A

discolored teeth

inhibition of bone growth

143
Q

ribavirin in prego

A

teratogenic

144
Q

grisesfulcin in prego

A

teratogenic

145
Q

chloramphenicol in prego

A

gray baby syndrome

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