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Pharmacology > Block 3- 6/10 > Flashcards

Block 3- 6/10 Flashcards

1
Q

metronidazole acts on what organisms

A

protozoa and anaerobic bacteria

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2
Q

is metronidazole luminal, systemic, or mixed acting

A

mixed

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3
Q

what are 3 adverse effects of metronidazole

A

peripheral neuropathy
seizures
disulfiram like reaction

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4
Q

what drug can be used for E. histolytica, H. pylori, B. fragilis, and C. diff

A

metronidazole

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5
Q

what is the main drug used for giardia

A

metronidazole

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6
Q

what is the main difference between metronidazole and tinidazole

A

tinidazole is longer acting with less severe effects than metronidazole

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7
Q

what are the 2 main adverse effects of iodoquinol

A

nausea/vomiting
optic neuritis

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8
Q

what can iodoquinol be used to treat

A

giardia

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9
Q

what is the mechanism of action of nitazoxanide

A

inhibits pyruvate ferredoxin oxidoreductase for electron transport

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10
Q

chloroquine, when used with metronidazole and paromomycin or iodoquinol, can be used to treat __

A

amoebic liver disease

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11
Q

what is the mechanism of action of ementine

A

blocks AA chain elongation

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12
Q

what is the main adverse effect of ementine

A

cardiotoxicity

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13
Q

what are the 3 main uses of ementine

A

severe intestinal amebiasis
severe hepatic amebiasis
severe extraintestinal amebiasis

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14
Q

ementine should be avoided in patients with __ and __

A

heart arrythmias
heart failure

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15
Q

what is the drug of choice for asymptomatic protozoal cyst carriers

A

paromomycin or iodoquinol

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16
Q

what is the drug of choice for mild-severe intestinal amoebiasis

A

metronidazole or tinidazole with paromomycin or iodoquinol

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17
Q

what is the drug of choice for amebic liver abscess

A

metronidazole or tinidazole with chloroquine and paromomycin

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18
Q

in early E. african T. brucei infection, what is the drug of choice

A

pentamidine or suramin

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19
Q

what is an adverse reaction of pentamidine

A

renal dysfunction

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20
Q

what is the drug of choice for late stage E. african T. brucei infection

A

melarsoprol

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21
Q

what is an adverse effect of melarsoprol

A

fatal reactive encephalopathy

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22
Q

what drug is used for either early or late infection of W. african T. brucei

A

Flexinidazole

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23
Q

what drug is used in late stage W. african T. brucei infection

A

melarsoprol

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24
Q

what is the drug of choice for T. cruzi infection

A

nifurtimox or benznidazole

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25
Q

what is the mechanism of action of nifurtimox or benznidazole

A

formation of free radicals and inhibition of trypanothione reductase and DNA synthesis

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26
Q

what are the 2 main toxic effects of nifurtimox and benznidazole

A

abdominal pain/nausea/vomiting
neurological reactions (paresthesia, polyneuritis, seizures)

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27
Q

what are the 3 classifications of antifungals

A

antibiotics
antimetabolites
azoles

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28
Q

amphotericin B is what class of antifungal

A

antibiotic

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29
Q

what is the mechanism of action of amphotericin B

A

binds to ergosterol, creates pores, causes leakage of cell contents

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30
Q

is amphotericin B fungicidal or fungistatic

A

fungicidal

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31
Q

what is the main toxicity of amphotericin B

A

nephrotoxicity

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32
Q

what can be done to decrease the nephrotoxicity of amphotericin B

A

liposomal preparation
give normal saline prior to administration
slow IV infusion

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33
Q

__ can occur with prolonged use of amphotericin B

A

anemia

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34
Q

what is the effect of IV infusion of amphotericin B

A

release of histamine

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35
Q

amphotericin B is the drug of choice for what infections

A

coccidiomycosis
blastomyces
histoplasmosis

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36
Q

amphotericin B is an anti__

A

fungal

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37
Q

flucytosine is what class of antifungal

A

antimetabolite

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38
Q

flucytosine is an anti__

A

metabolite

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39
Q

what is the mechanism of action of flucytosine

A

inhibition of thymidylate synthase, inhibiting DNA synthesis

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40
Q

is flucytosine able to cross the BBB

A

yes

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41
Q

is flucytosine fungistatic or fungicidal

A

fungistatic

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42
Q

what is the main adverse effect of flucytosine

A

it has a narrow therapeutic range

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43
Q

flucytosine is often combined with __ to allow for pore producing, enhancing the ability for 5-fluorouracil to get into fungal cells

A

amphotericin B

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44
Q

what is the mechanism of action for ketoconazole

A

inhibits demethylase–>leakage of cell contents

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45
Q

ketaconazole is an anti__

A

fungal

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46
Q

drug resistance to ketoconazole can develop due to the gene __ in C. albicans

A

ERG11

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47
Q

is ketoconazole better absorbed on an empty or full stomach

A

empty

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48
Q

what are the 2 main adverse effects of ketoconazole

A

disulfiram like reaction
blockage of androgen receptors (gynecomastia, decreased libido, impotence, menstrual irregularity)

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49
Q

ketoconazole should not be combined with what drug

A

amphotericin B

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50
Q

what is the mechanism of all azole drugs for fungal infections

A

inhibition of demethylase–>leakage of cell contents

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51
Q

what are the 2 main advantages to fluconazole usage

A

CSF permeability
wide therapeutic index

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52
Q

what is used to treat cryptococcal meningitis

A

fluconazole

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53
Q

what drug is used to prevent candidemia in ICU patients

A

fluconazole

54
Q

is itraconazole a broad or narrow spectrum drug

A

broad

55
Q

what are the 2 main adverse effects of fluconazole

A

hepatotoxicity
should be avoided in pregnancy

56
Q

itraconazole is the drug of choice for what infections

A

histoplasmosis
blastomycosis
sporothichosis

57
Q

what is the main adverse effect of voriconazole

A

visual disturbances

58
Q

what is voriconazole used to treat

A

invasive aspergillosis

59
Q

what is the main adverse effect of posaconazole

A

hyperaldosteronism–>hypertension and hypokalemia

60
Q

what is the main use of posaconazole

A

prophylactic for fungal infection in chemotherapy

61
Q

echinocandins are anti__

A

fungal

62
Q

echinocandins have the suffix -___

A

fungin

63
Q

what is the mechanism of action of echinocandins

A

inhibition of glucan synthesis–>fungal cell lysis

64
Q

how can resistance be developed against echinocandins

A

AA changes in Fks subunit of glucan synthase

65
Q

are echinocandins fungistatic or fungicidal

A

fungicidal

66
Q

what fungal drug class is relatively free of any drug-drug interactions

A

echinocandins (capsofungin, micafungin)

67
Q

what are 3 main uses of capsofungin

A

disseminated and mucocutaneous candida infections
empirical treatment in febrile neutropenia and stem cell transplants
salvage therapy in invasive aspergillosis

68
Q

echinocandins such as capsofungin should be avoided in patients with __

A

liver disease

69
Q

what are the 2 main superficial fungal infection drugs

A

griseofulvin
terbinafine

70
Q

what is the mechanism of actions of griseofulvin

A

prevention of infection of new hair/skin/hairs by preventing microtubule formation–>inhibition of mitosis

71
Q

what superficial fungal infection drug requires prolonged therapy

A

griseofulvin

72
Q

what is an adverse effect of griseofulvin

A

disulfiram like reaction

73
Q

what is the mechanism of action of terbinafine

A

inhibition of squalene epoxidase and ergosterol synthesis
–>accumulation of toxic squalene

74
Q

what are the 2 main adverse effects of terbinafine

A

GI distress
hepatotoxicity

75
Q

griseofulvin is an anti__

A

fungal

76
Q

terbinafine is an anti__

A

fungal

77
Q

what is terbinafine used for

A

dermatophytosis

78
Q

what drug is used for onychomycosis of nails

A

terbinafine

79
Q

albendazole is an anti__

A

helminthic

80
Q

what is the mechanism of action of albendazole

A

inhibition of assembly of tubulin /microtubules
inhibition of glucose uptake

81
Q

what is the distribution of albendazole

A

to bile and CSF

82
Q

what are the main adverse effects of albendazole

A

at high dose–>hepatitis and hematologic toxicity
avoid in pregnancy

83
Q

what are the uses of albendazole

A

ascariasis (roundworm)
pinworm (enterobius vermicularis)
hookworm (nector americanus and ancyclostoma duodenal)
whipworm (trichuris trichuria)
hydatid cyst
cysticerosis
neurocysticerosis
prophylaxis for filariasis

84
Q

pyrantel palmoate is an anti__

A

helmintic

85
Q

what is the mechanism of action of pyrantel palmoate

A

enhances ACh release and inhibits AChE
inhibits neuromuscular transmission

86
Q

what is pyrantel palmoate used for

A

roundworm

87
Q

what are the main adverse effects of piperazine citrate

A

urticaria
bronchospasm
muscle incoordination

88
Q

piperazine citrate should be avoided in patients with __

A

seizure disorder
hepatic dysfunction
renal dysfunction
pregnancy

89
Q

ivermectin is an anti__

A

helminth

90
Q

what is the mechanism of action of ivermectin

A

enhances glutamate mediated transmission of Cl- influx

91
Q

what is ivermectin used for

A

onchocerciasis
strongyloidasis

92
Q

what are the adverse effects of ivermectin

A

Mazotti like reaction
avoid in pregnancy and meningitis

93
Q

what is the Mazotti like reaction caused by ivermectin

A

allergic reaction to dying microfilariae leads to fever, HA, weakness, lymphadenitis, lymphedema, edt

94
Q

diethylcarbamazine (DEC) is commonly combined with what other drug

A

albendazole

95
Q

diethylcarbamazine (DEC) is an anti__

A

helminth

96
Q

what is the mechanism of action of diethylcarbamazine (DEC)

A

immobilize microfilariae
modify surface area proteins and displace them from tissue

97
Q

what is diethylcarbamazine (DEC) used for

A

lymphatic filariasis
tropical eosinophilis

98
Q

what is diethylcarbamazine (DEC) used for

A

lymphatic filariasis
tropical eosinophilia

99
Q

praziquantel is an anti__

A

helminth

100
Q

what is the mechanism of action of praziquantel

A

increases calcium permeability in trematodes and cestodes

101
Q

what is praziquantel used for

A

flukes
cestodes (tapeworms)

102
Q

praziquantel should be avoided in patients with __

A

pregnancy

103
Q

sodium stibogluconate is an anti__

A

helminth

104
Q

what is the mechanism of action of sodium stibogluconate

A

inhibition of glycolysis

105
Q

what is sodium stibogluconate used for

A

cutaneous, visceral, and mucocutaneous leishmania

106
Q

what are the adverse effects of sodium stibogluconate

A

cardiac arrythmias
renal, hepatic, and cardiac toxicity
GI effects

107
Q

what drug is used specifically for visceral leishmania

A

amphotericin B

108
Q

what drug is used in combination with amphotericin B for specifically cutaneous leishmania

A

paromomycin

109
Q

what is the first choice of drug for P. falciparum infection

A

chloroquine

110
Q

what drug is used for chloroquine resistant P. falciparum

A

quinine or mefloquine

111
Q

what drug is used for multidrug resistant P. falciparum

A

artemisinin

112
Q

what drug is used for severe, complicated multidrug resistant P. falciparum

A

artemisinin

113
Q

what drug is used for P. malariae

A

chloroquine

114
Q

what drug is used for clinical cure of P. ovale and vivax

A

chloroquine

115
Q

what drug is used for chloroquine resistant P. vivax and ovale

A

mefloquine

116
Q

what drug is used for radial (blood and tissue) cure of P. vivax and ovale

A

primaquine and tafenoquine

117
Q

what drug is used for malaria in the pregant

A

melfloquine

118
Q

__ is the main drug choice for malaria but if the area is resistant, __ is used

A

main= chloroquine
chloroquine resistant= mefloquine

119
Q

what malaria drug can be used for both prophylaxis and treatment

A

atovaquone-proguanil

120
Q

what is the mechanism of action of chloroquine

A

inhibits heme polymerase–>accumulation of heme which is toxic to parasites at the erythrocytic stage

121
Q

chloroquine has a high affinity for __ and __

A

RBC
melanin

122
Q

what malaria drug is able to cross the placenta

A

chloroquine

123
Q

what are the adverse effects of chloroquine

A

cinchonism (vertigo and tinnitus)
pruritus
visual disturbances
EKG changes
discoloration of nail beds and mucous membranes

124
Q

chronic use of chloroquine can lead to __

A

retinopathy

125
Q

__ along with artesunate is the drug of choice for severe P. falciparum infection

A

quinine

126
Q

what are the adverse effects of quinine

A

cinchonism (tinnitus and vertigo)
hypoglycemia
hypotension

127
Q

what are the toxic effects of mefloquine

A

hallucinations
seizures

128
Q

mefloquine should be avoided in patients with what pre-existing conditions

A

seizures
cardiac conduction defects
psychiatric disorders

129
Q

what is the mechanism of action of pyrimethamine sulfadoxine

A

pyrimethamine inhibits DHFR
sulfadoxine inhibits dihydrofolate synthase

130
Q

what is the adverse effect of pyrimethamine +sulfadoxine (FANSIDAR)

A

megaloblastic anemia

131
Q

what is the main adverse effect of artemisinin

A

delayed hemolysis

Pharmacology (16 decks)

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