Antimicrobials IV

Question 1

prophylaxis for TB

Answer 1

isoniazid

Question 2

tx for TB

Answer 2

RIPE

rifampin
isoniazid
pyrazinamide
ethambutol

Question 3

prophylaxis for MAI

Answer 3

azithromycin

rifabutin

Question 4

tx of MAI

Answer 4

more drug resistant than TB

azithromycin or clarithromycin and ethambutol

add rifabutin or cipro

Question 5

tx of m. leprae tuberculoid form

Answer 5

long term tx - dapsone and rifampin

Question 6

tx of m. leprae lepromatous form

Answer 6

long term tx - dapsone and rifampin

add clofazimine

Question 7

rifampin

Answer 7

rifamycin

Question 8

rifabutin

Answer 8

rifamycin

Question 9

rifamycin

Answer 9

inhibit DNA dependent RNA polymerase

Question 10

rifampin in leprosy tx

Answer 10

delays resistance to dapsone

Question 11

adverse of rifampin

Answer 11

increase P450

orange body fluids

Question 12

rifabutin vs. rifampin

Answer 12

rifabutin favored in HIV patient - due to less P450 activation

Question 13

resistance rifamycins

Answer 13

mutation reduce drug binding RNA polymerase

Question 14

isoniazid

Answer 14

inhibit synthesis mycolic acid

Question 15

to activate isoniazid

Answer 15

require bacterial catalase-peroxidase (KatG gene)

Question 16

adverse isoniazid

Answer 16

neurotoxic
hepatotoxic
prevent neurotoxic - vit B6 - pyridoxine

Question 17

prevent neurotoxicity of isoniazid

Answer 17

vit B6 - pyridoxine

Question 18

resistance to isoniazid

Answer 18

mutation to underexpression of KatG

Question 19

pyrazinamide

Answer 19

prodrug - converted to active compound pyrazinoic acid

Question 20

adverse pyrazinamide

Answer 20

hyperuricemia

hepatotoxicity

Question 21

ethambutol

Answer 21

decreased carb polymerization of mycobacterium cell wall - block arabinosyltransferase

Question 22

adverse ethambutol

Answer 22

optic neuropathy
-red-green color blindness

“eye” thambutol

Question 23

prophylaxis for pt at risk for endocarditis with dental or surgical procedure

Answer 23

amoxicillin

Question 24

prophylaxis for exposure to gonorrhea

Answer 24

ceftriaxone

Question 25

prophylaxis for recurrent UTIs

Answer 25

TMP-SMX

Question 26

prophylaxis for exposure to meningoccal drugs

Answer 26

ceftriaxone ciprofloxacin rifampin

Question 27

prophylaxis pregnant women group B strep positive

Answer 27

PCN G

Question 28

prophylaxis prevent gonococcal conjunctivitis in newborn

Answer 28

erythromycin ointment

Question 29

prophylaxis prevent post surgery infection from staph aureus

Answer 29

cefazolin

Question 30

prophylaxis strep pharyngitis in child with prior rheumatic fever

Answer 30

benzathine PCN G - or oral PCN V

Question 31

prophylaxis exposure to syphilis

Answer 31

benzathine PCN G

Question 32

prophylaxis for pneumo jirovecii

Answer 32

CD4 less than 200 TMP-SMX

Question 33

prophylaxis for pneumo jirovecii and toxoplasmosis

Answer 33

CD4 less than 100 TMP-SMX

Question 34

prophylaxis for mycobacterium avium complex

Answer 34

CD4 less than 50 azithromycin

Question 35

tx of MRSA

Answer 35

``` vancomycin daptomycin linezolid tigecycline ceftaroline ```

Question 36

tx of VRE

Answer 36

linezolid | streptogramins - quinupristin, dalfopristin

Question 37

tx of multidrug-resistant pseudomonas

Answer 37

polymyxin B and E (colistin)

Question 38

tx of multidrug resistant acinetobacter baumannii

Answer 38

polymyxin B and E (colistin)

Question 39

amphotericin B

Answer 39

binds ergosterol form membrane pore - leakage of electrolytes

Question 40

adverse amphotericin B

Answer 40

``` fever/chills hypotension nephrotoxic arrhythmia anemia IV phlebitis ```

Question 41

decrease nephrotoxicity of amphotericin B

Answer 41

hydration

Question 42

tx cryptococcus meningitis

Answer 42

amphotericin B with/without flucytosine

Question 43

tx blastomyces

Answer 43

amphotericin B

Question 44

tx histoplasma

Answer 44

amphotericin B

Question 45

tx candida

Answer 45

amphotericin B

Question 46

tx mucor

Answer 46

amphotericin B

Question 47

supplement with amphotericin B

Answer 47

K and Mg because of altered renal tubule permeability