Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

PPP Spring > FINAL🎃 > Flashcards

FINAL🎃 Flashcards

1
Q

What does each stage of hemostasis target?

Primary
Secondary
Fibrinolysis

A 
Primary = platelets
Secondary = clotting factors
Fibrinolysis = plasmin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What drugs are antiplatelets?

..there are 6

A 
PAR1 blockers
PDE inhibitors
COX inhibitors
P2Y12 inhibitors
SSRIs
GP2b3a inhibitors
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the MOA of Vorapaxar?

AEs?

A

PAR-1 blocker: reversible inhibition of platelet thrombin R’s

AEs: rarely used…

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

What is the MOA, uses, and AEs of dipyridamole and cilostazol?

A

PDE inhibitors: raise cAMP, resulting in vasodilation, inhibition of platelet activation

Uses: tx thrombocytosis (leukemia)

AEs: inhibit megakaryocyte development + dec. platelet #

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

What is the MOA, AEs, and use of aspirin?

A

Irreversibly inhibits COX 1 + 2

AEs: inc. bleeding risk
Use: anti-thrombotic

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

What’s the MOA, AEs, use of nonselective NSAIDs?

A

Reversible inhibit COX 1 + 2
BLOCK ASA BINDING SITE

AE: inc bleeding risk; dec. efficacy of ASA
Use: NOT used as anti-thrombotic

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

What’s the MOA, AEs of selective NSAIDs?

A

Reversible inhibit COX2&raquo_space; 1

AE: inc. clotting risk

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

What do P2Y12 inhibitors do?

A

Block ADP (for platelet activation)

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

What is another name for irreversible P2Y12 inhibitors?

A

Irreversible = thienopyridines

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

What’s the MOA/interactions for Clopidogrel?

A

Irreversible P2Y12 inhibitor
PRODRUG - 2 STEP PROCESS = SLOWEST ONSET

DDI: omeprazole

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

What’s MOA/interaction of prasugrel?

A

Irreversible P2Y12 inhibitor
PRODRUG - 1 STEP = FASTER ONSET

DDI: fewer

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

What are the MOA/limitations of Ticagrelor?

A

Reversible P2Y12 inhibitor - active drug/metabolite

Requires BID dosing
MAX 81mg ASA

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

What are the MOA/limitations of Cangrelor?

A

Reversible P2Y12 inhibitor - drug active
FASTEST on/off

Interferes w/ thienopyridines
IV ONLY
$$$

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

What’s the MOA/AE/use of SSRIs?

A

Inhibit platelet activation by serotonin

AE: inc. risk of bleeds
NOT used as anti-thrombotic

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

What does GP2b3a do?

A

Helps platelets bind vWF and fibrinogen to stick to each other or vessel wall

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

What are MOA/elimination/onset of Abciximab?

A

GP2b3a inhibitor: persistent binding to receptor (host AB’s may dec. efficacy)

Elimination: proteolytic
effect up to 7 DAYs
$$$

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

What are MOA/elimination/onset of Eptifibatide?

A

GP2b3a reversible inhibitor (not immunogenic)

Elimination: renal
Effect 4-8 hours
$$

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

What are MOA/elimination/onset of Tirofiban?

A

GP2b3a reversible inhibitor (not immunogenic)

Elimination: renal
Effect 4-8 hours
$

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

What’s the MOA/admin/elimination/titration of DABIGATRAN?

A 
direct thrombin (CF II) inhibitors 
PO - BID
Elimination: renal (t1/2: 12-17 hrs)
NOT titration but may inc. PTT/INR
NO effect on anti-Xa
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is the reversal agent for DABIGATRAN?

A

Idarucizumab

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

What’s the MOA/admin/elimination/titration of BIVALIRUDIN?

A 
Direct thrombin (CF II) inhibitor 
IV - continuous
Elimination: proteolytic (t1/2 = 25 min)
Titration w/ PTT (may inc. INR)
NO effect on anti-Xa
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What’s the MOA/admin/elimination/titration of Argatroban?

A 
Direct thrombin (CFII) inhibitor
IV - continuous
Elimination: hepatic (t1/2 = 40-50 min)
Titrated w/ PTT (may inc. INR)
NO effect on anti-Xa
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is the reversal agent for factor Xa inhibitors?

A

Andexanet alfa

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

What’s the MOA/admin/elimination/titration of Rivaroxaban?

A 
Factor Xa inhibitor - PO/ qD or BID
Elimination: hepatic (t1/2 = 5-9 hrs)
NOT titrated (but may inc. PTT, INR, anti-Xa)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
What's the MOA/admin/elimination/titration of Apixaban?
``` Factor Xa inhibitor - PO/ BID Elimination: hepatic (t1/2 = 12 hrs) NOT titrated (may inc PTT, INR, anti-Xa) ```
26
What's the MOA/admin/elimination/titration of EDOXABAN?
``` Factor Xa inhibitor - PO/ qD Elimination: renal + hepatic (t1/2 = 10-14 hrs) NOT titrated (may inc. PTT, INR, anti-Xa) ``` **LESS EFFECTIVE IF CrCL > 95**
27
What does Anti-thrombin (ATIII) do?
Made by liver, circulates in blood and inhibits CFs by binding in stable 1:1 complex Inhibits Xa unbound to platelets and IIa unbound to fibrin
28
What's the MOA/AE/elimination/admin of unfractionated heparin (UFH)?
Allosteric activation of ATIII - complex formed w/ thrombin + Xa IV or SQ Elimination: reticuloendothelial system (macs, ECs) = no renal adjustment AEs: HIT; osteopenia (prolonged use)
29
What is the reversal agent for UFH?
Protamine
30
How is UFH monitored?
PTT
31
What's the MOA/AE/elimination/admin of Enoxaparin, Dalteparin?
LMWH: more uniform mixture that binds Xa >> IIa Elimination: renal QD or BID AE: lower HIT
32
What's the reversal agent for LMWH?
Protamine
33
What's the MOA/AE/elimination/admin of fondaparinux?
``` Stimulates ATIII to inhibit Xa only QD dosing (longest t1/2) SQ Elimination: renal AE: does NOT cause HIT ```
34
How is fondaparinux monitored?
Anti-Xa
35
What's the MOA/AE of Warfarin?
inhibits VKOR: dec. vitamin K and prevents activation of CFs AEs: skin necrosis "purple toe syndrome" Teratogenic, genetic variability
36
Describe what happens in days 1 and beyond on warfarin
Day 1: liver makes fewer CFs, but those already in circulation unaffected Day 2-4: INR beings inc. - if protein S/C depleted = hyperCOAGUABLE Days >5: anticoagulation
37
What are the t1/2s of CF depletion under warfarin?
VII = 4-6 hrs *greatest effect on INR* ``` C = 8 hrs S = 30 hrs X = 48 hrs II = 72 hrs ```
38
What are DDIs associated with warfarin
CYP inducers = dec. INR = inc. clotting (Carbamazepine, phenytoin, rifampin, phenobarbital, CHRONIC EtOH) CYP inhibitors = inc. INR = inc. bleeding (Amiodarone, fluconazole, acute EtOH) Antiplatelets/anticoagulants = no change INR ; inc. bleeding
39
What are disease interactions with warfarin?
Sensitive: hyperthyroidism, decompensated HF, liver disease, malnourishment, low albumin, low body weight Resistant: hypOthyroidism, high body weight
40
What's the MOA and use of citrate?
Dec. Ca (required for CFs to localize to membrane) Use: anticoagulation of stored blood/blood circuits
41
What is the MOA/use/half-life of alteplase?
Fibrinolytic: binds fibrin and converts plasminogen to plasmin in order to break up clot Use: acute ischemic stroke SHORT t1/2
42
What is the MOA/use/half-life of tenecteplase?
Fibrinolytic: more specific binding to fibrin and more resistant to plasminogen activator inhibitor (PAI-I) Use: MI Longer t1/2 = SINGLE BOLUS
43
What's the MOA/use of desmopressin (DDAVP)?
Binds V2 R's to trigger release of stored vWF in order to activate platelets Use: tx bleeding
44
Distinguish b/w single vs. multiple vs. blood products for coagulopathy
Single factor products = hemophilias Multiple = bleeding (warfarin) Blood products = (liver failure) contain factors AND fibrinogen
45
What is the MOA/use of aminocaproic acid, tranexamic acid?
Anti-fibrinolytics: competitively inhibit plasmin/plasminogen Use: control bleeding (surgical, dental, trauma)
46
What are the irreversible inhibitors (antiplatelets)?
Aspirin Clopidogrel Prasugrel Abciximab
47
Describe acute management for ischemic stroke
THROMBOLYTICS (for re-perfusion) Other: + secondary prophylaxis (anti-platelets, warfarin, direct oral anticoagulants- DOACs) + control BP (nicardipine, beta blockers, hydralazine, NTP) + avoid hypErglycemia
48
What's the thrombolytic/fibrinolytic used for ischemic stroke?
Alteplase
49
For secondary prophylaxis, what can patients take if allergic to aspirin?
P2Y12 inhibitors
50
What's the MOA/AE for nicardipine?
DHP-CCB prevents release of internal Ca stores so heart muscle doesn't respond to signal = vasodilation *IV 1st line for BP CONTROL IN STROKE* AE: headache, peripheral edema, hypOtension, tachycardia, N/V, flushing
51
Whats AE/DDI for beta blockers?
Angina, bronchospasm, insomnia/depression/fatigue/ dec. HDL and inc. TG DDI: other AV blocking or anti-HTN agents
52
Differentiate MOA of Esmolol vs. Labetalol
(For stroke) Esmolol: beta1 selective = dec. BP/HR Labetalol: beta1/2, alpha1, partial beta2 agonist = dec. BP/HR and arterial vasodilation (alpha, beta2)
53
What's the MOA/AEs for hydralazine?
Directly relaxes arteriolar smooth muscle; may dec. calcium to dec. contraction; vasodilation AE: headache, hypotension, fluid retention, palpitations, tachycardia *DRUG-INDUCED LUPUS SYNDROME* ..typically resolves w/ DC
54
What's the MOA/AE/caution for nitroprusside (NTP)?
NO will activate guanylate cycylase to inc. cGMP in vascular smooth muscle = venous/arteriolar dilation = dec. AL/BP AE: hypotension, CN toxicity, thiocyanite toxicity (tinnitus, tremor) **RISK WITH RENAL DISEASE**
55
What products can be given for life threatening/serious bleeding?
Vitamin K Prothrombin complex concentrates (PCC) = Kcentra Fresh frozen plasma (FFP) *blood group specific* Idarucizumab
56
What BBW is associated with vitamin K?
IV admin = risk of anaphylaxis
57
What AEs are associated with idarucizumab?
Hypokalemia, delirium, constipation, pyrexia hypersensitivity, thrombosis
58
What can be given for subarachnoid hemorrhage?
Aminocaproic acid | Nimodopine
59
What is the MOA/AE of aminocaproic acid?
Blocks plasmin:fibrin interaction to inhibit fibrinolysis AE: hypOtension, bradycardia, myopathy
60
What's the MOA/AE of nimodopine?
DHP-CCB = arterial vasodilation AE: hypotension, headache, flushing, edema, nausea, sinus bradycardia
61
Which beta lactams are not renally eliminated and therefore do not need dose adjustments?
Nafcillin Oxacillin Ceftriaxone
62
What cephalosporins pass BBB and can be used to treat meningitis?
Cefuroxime Ceftriaxone Cefotaxime Ceftazidine
63
What cephalosporins can be used to tx anaerobic (B. Fragilis) infections?
Cefoxitin | Cefotetan
64
What PCN is not impaired by food when administered?
Amoxicillin
65
What AEs associated with PCNs?
+Hypersensitivity: skin rash, fever, joint swelling, pruritis, leukopenia, anaphylaxis +GI: D (killed flora)
66
What does Ceftaroline treat and not treat?
Only beta lactam to tx MRSA | Does NOT treat pseudomonas
67
What AEs are associated with CSNs?
Hypersensitivity, GI distress, Intolerance to EtOH (Cefotetan inhibits ADH) Potentially nephrotoxic (mainly 1st gen)
68
Which CSNs could be used for surgical prophylaxis?
1st gen = Cefazolin, cephalexin
69
How is aztreonam administered?
IV Use if allergic to PCN or CSN
70
Which carbapenem is coadministered with cilastatin?
Imipenem
71
What AEs are associated with Carbapenems?
GI, hypersensitivity, CNS: seizures (imipenem)
72
What AEs are associated with vancomycin?
Hypersensitivity "RED MAN SYNDROME" - cx by histamine | Ototoxicity (mainly when combined w/ aminoglycosides)
73
What is daptomycin used to treat?
VRE, MRSA, VRSA **NOT used in pneumonia - inactivated by surfactant**
74
What AEs/DDI associated with daptomycin?
AE: musculoskeletal (pain/weakness) DDI: HMG-CoA reductase inhibitors - statins - since known to cx myopathy
75
What is telavancin used for?
VRE, MRSA, VRSA
76
What AEs are associated with telavancin?
GI, CNS: insomnia, headache ◼️Nephrotoxic ◼️Teratogenic
77
What's AEs/CI/interactions of aminoglycosides?
Nephrotoxic, ototoxicity, neuromuscular blockade (could lead to respiratory paralysis @high doses) CI: renal disease, hearing impairment, pregnancy DDI: other ototoxic/nephrotoxic drugs
78
What are aminoglycosides used for?
Gram negative AEROBES | + beta lactam = activity vs. gram+
79
What are oxazolidinones used for?
Gram+ RESERVED FOR: VRSA, VRE, MRSA
80
What's AEs/CI/interactions of oxazolidinones?
GI distress, Mitochondrial toxicity: - hematologic: BM suppression - otic/peripheral neuropathy DDI: Linezolid w/ SSRIs or tyramine-containing foods (since competitive MAO inhibitor)
81
What are tetracyclines used for?
``` Acne (gram+) Odd: -brucella -mycoplasma pneumoniae -chlamydia ssp (STD, pneumonia) -rickettsia ssp (Typhus, Rocky) -borrelia burgdorferi (Lyme) -Treponema pallidum (syphillis) ``` Tigecycline can be used vs. VRE/MRSA
82
What's AEs/CI/interactions of tetracyclines?
NO dose adjustments for: doxy and tigecycline AEs: bone/teeth, GI distress (C. Diff risk), phototoxicity DDIs: do NOT take with food, dairy, antacids, Ca/Mg/Fe CI: pregnancy, children
83
What protein synthesis inhibitors can pass BBB?
Chloramphenicol
84
What protein synthesis inhibitors can be used vs. anaerobes?
Tetracycline Chloramphenicol Clindamycin
85
What protein synthesis inhibitors can be used to tx MRSA/VRSA/VRE?
Oxazolidinones = available PO! Tigecycline Streptogramins
86
What is chloramphenicol active against?
Gram +/- aerobes AND anaerobes
87
What does chloramphenicol need to be dose adjusted for?
Liver dysfunction | Neonate
88
What's AEs/CI/interactions of chloramphenicol?
Hematologic: aplastic anemia, BM suppression Gray Baby syndrome Hypersensitivity DDIs: potent CYP inhibitor = inc. warfarin, phenytoin, phenobarbital
89
What are macrolides active against?
Strep pneumo (1st line) Legionella penumoniae Mycobacterium Avium (MAC): infects immunocompromised Atypical: mycoplasma pneumonia, chlamydia Campylobacter (diarrhea)
90
What's AEs/CI/interactions of macrolides?
GI (inc. gut motility), hepatotoxicity, cardiac toxicity (QT prolongation) DDI: CYP/PgP inhibitors except azithromycin
91
What's clindamycin active against?
Gram + drug of CHOICE for anaerobes "above diaphragm" (aspiration pneumonia, lung abscess) (Combined with others for anaerobic coverage)
92
What's AEs/CI/interactions of clindamycin?
GI: N/V/D, C-diff's Pseudomembranous colitis Hypersensitivity: rash, fever, agranulocytosis
93
What are streptogramins used to tx?
Gram+ | Reserved for: VRSA, MRSA, VRE (e. Faecium)
94
What's AEs/CI/interactions of streptogramins?
Pain @infusion site; arthalgia/myalgia DDI: potent CYP inhibitor
95
What subunit does each protein synthesis inhibitor act on?
Buy AT 30 = aminoglycosides, tetracyclines CELL for 50 = chloramphenicol, erythromycin, linezolid, lincosamide (clindamycin)
96
What ABX inhibit DNA replication?
Folic acid synthesis inhibitors = TMP/SMX Quinolone Metronidazole
97
What is the MOA of TMP/SMX?
Sulfonamides inhibit PABA => DHF enzyme (dihydropteroate synthase) Trimethoprim inhibits DHF => THF enzyme (DHF reductase - also in humans!)
98
What is TMP/SMX active against?
Gram+: S. Aureus H__PEK NO anaerobic Fungi: pneumocystis jiroveci
99
What's AEs/CI/interactions of TMP/SMX?
GI, dermatologic (SJS, photodermatitis), hematologic (leukopenia, hemolytic anemia, kernicterus), crystallization of urine, hyperkalemia DDI: CYP inhibitor (warfarin); drugs that cx hyperkalemia (ACEIs) or spare K+ CI: pregnancy, infants
100
What is the MOA of quinolone?
Inhibit topoisomerase II in bacteria ``` Gram- = "DNA gyrase" gram+ = Topo IV ```
101
What quinolone does not need to be dose adjusted for renal failure?
Moxifloxacin
102
What is 1st gen quinolone and their activity?
Nofloxacin HNPEK + CApES
103
What is 2nd gen quinolone and activity?
Ciprofloxacin, Ofloxacin Gram+, intestinal (shigella, campylobacter, salmonella) HNPEK + CAPES
104
What is 3rd gen quinolones and activity?
Levofloxacin, Moxifloxacin, Gemifloxacin Gram+ AEROBES, anaerobes (b. Fragillis), atypical HNPEK + CApES
105
Which quinolones are best for anaerobic activity?
Moxifloxacin | Gemifloxacin
106
What's CI/interactions of quinolones?
``` CI: pregnancy, children, tendinitis Myasthenia gravis (since they have neuromuscular blocking activity) ``` DDIs: other drugs that cause QT prolongation **multivalent cations: take 2 hrs before or 4 AFTER**
107
What AEs associated with quinolones?
GI, CNS stimulation (dizziness, insomnia, seizures) Dermatologic: phototoxicity, rash Musculoskeletal: damage to growing cartilage Cardiac: QT prolongation (blocks K channels)
108
What's the MOA of Metronidazole?
PRODRUG - requires reduction of nitro group by anaerobic bacteria Crosses BBB!
109
What does metronidazole have activity against?
(Anaerobes) Gram+ = clostridium Gram- = bacteroides, fusobacterium, prevotella (Protozoa) Giardia, trichomonas, entamoeba
110
What's AEs/CI/interactions of metronidazole?
GI (N/V/D, metallic taste, FURRY TONGUE from yeast overgrowth) * disulfiram reaction* * peripheral neuropathy* DDI: EtOH, warfarin CI: pregnancy, seizures, alcoholism
111
What is a CCR5 inhibitor to tx HIV?
Maraviroc
112
What is a fusion inhibitor to treat HIV?
Enfuviritide
113
Which NRTI is an exception for renal adjustment?
Tenofavir alefenamide (TAF)
114
Which NRTI requires allele screening?
Abacavir | For sensitivity reaction risk
115
Which NNRTIs can be given on empty stomach vs. food?
Empty: efavirenz Food required: etravirine, rilpivirine
116
What drugs are boosters for HIV?
Ritonavir | Cobicistat
117
What drugs are NRTIs?
``` Didanosine Zidovudine Lamivudine Abacavir Tenofovir Emtricitabine ```
118
Which NRTIs have once daily dosing?
Tenofavir | Emtricitabine
119
What's the MOA of NRTIs?
Competitively inhibit nucleotide binding to reverse transcriptase = termination of DNA chain
120
What drugs are NNRTIs? "-vir"
Efavirenz Nevirapine Etravirine Rilpivirine
121
What's the MOA of NNRTIs?
Bind to reverse transcriptase to cause a conformational change and disrupt the catalytic center of the RT
122
What drugs are INSTIs? "-tegra"
Raltegravir Elvitegravir Dolutegravir
123
What's the MOA of INSTIs?
Interfere with the integration of viral DNA into host DNA
124
What drugs are protease inhibitors (PI)? "-navir"
Atazanavir Darunavir Ritonavir Lopinavir
125
Which PI is used only as a "booster"?
Ritonavir
126
What's the MOA of PIs?
Block proteolytic cleavage of protein precursors that are necessary for the production of infectious particles
127
What are tx regimens for HIV therapy?
2 NRTIs + _____ (1 NNRTI/PI/INSTI)
128
Differentiate between NRTIs with significant vs. minimal mitochondrial toxicity
Significant: didanosine, zidovudine | Minimal: LATE Lamivudine, abacavir, tenofavir, emtricitabine
129
What NRTI has renal/bone toxicities
Tenofavir | New version has less
130
What are class AEs for NRTIs?
Mitochondrial toxicity PLAN (Pancreatitis, lactic acidosis, anemia, neuropathy)
131
What are NRTI class interactions?
FE were compared to others.. (no CYP)
132
What are class AEs for NNRTIs?
Rash, hepatotoxic (inc. LFTs)
133
Which (and what) drug is associated with CNS symptoms of (NNRTIs)
Efavirenz = vivid nightmares, stoned feeling, TERATOGENIC
134
What are NNRTI class interactions?
CYP3A4 inducers (except rilpivirine)
135
What are the INSTI class AEs?
Very well tolerated ✔️ | GI
136
Which HIV drugs are generally used with a booster?
Protease inhibitors | Atazanavir, darunavir, lopinavir
137
What are PI class AEs?
Lipodystrophy (less with atazanavir) Hyperlipidemia Hyperglycemia Fat redistribution = "protease pouch" Hepatotoxicity (inc. LFTs)
138
Which PI can cause unconjugated hyperbilirubinemia ?
Atazanavir
139
What PI class interactions are there?
CYP - they are all inhibitors
140
What's the MOA of polyenes (amphotericin B)?
Interact with ergosterol in fungal membrane to form artificial pores
141
What's the clinical use for amphotericin B?
DOC for severe infections by aspergillus, candida, cryptococcus, histoplasma
142
What AEs are associated with amphotericin B?
Infusion related Nephrotoxic (administer with saline) Hypokalemia, hypomagnesemia
143
What's the MOA and AEs of 5-FC?
Penetrates cell wall; deaminated to 5-FU to inhibit DNA/RNA synthesis AE: Hematologic toxicity (anemia, leukopenia, thrombocytopenia)
144
What's the activity for 5-FC?
(+ AmpB) | Cryptococus
145
What's the MOA/AEs of the azoles?
Azoles inhibit Lanasterol Terbinafine inhibits squalen epoxidase AE: N/V hepatotoxicity
146
What are specific AEs for azoles? Fluconazole, Itraconazole, Voriconazole, Posaconazole, Isavuconazole
``` Fluconazole = GI Itraconazole = rarely used due to cardiac AEs Voriconazole = visual disturbances Posaconazole = well tolerated/ GI Isavuconazole = GI ```
147
What are the MOA/AEs of echinocandins? "-fungins"
Inhibit beta-glucan synthase enzyme (* not in humans) AE: minor, some histamine release (=> flushing, headache, urticaria, pruritis)
148
What's the spectrum of activity of micafungin?
Candida (yeast) | Aspergillus (mold)
149
Compare activities of fluconazole vs. Voriconazole vs. Posaconazole
``` Flu = candida, cryptococcus Voriconazole = candida, cryptococcus, aspergillus Posa = candida, cryptococcus, aspergillus, mucormycosis ```
150
What species are the flat worms?
Trematodes (flukes) | Cestodes
151
What species are the roundworms (nematodes)?
Ascariasis Hookworm Pinworm
152
ANTIMALARIALS | What's the MOA of quinine and quinidine?
Quinine = PO; quinidine = IV Block heme to hemoglobin = buildup of heme Blocks trophozoite stage to schizone/gametocytes
153
What's AEs/CI/interactions of quinine, quinidine?
GI, cardiac (QT prolong), CINCHONISM (tinnitus, disturbed vision, dizziness), HEMATOLOGIC (quinine: acute hemolytic anemia if G6PD def.) DDI: CYP/PgP inhibitor CI: G6PD deficiency (quinine only)
154
Which drug classes can be used for malaria?
Quinolone derivatives Artemisinin + derivatives Antifolates ABX
155
What's the MOA of chloroquine and hydroxychloroquine?
Inhibit heme polymerase activity - toxic buildup
156
What's AEs/CI/interactions of chloroquine, hydroxychloroquine?
GI (n/v/d), cardiac (QT prolong), PRURITIS, VISUAL DISTURBANCES *SAFE in PREGNANCY* CI: psoriasis, ocular disease
157
What are the MOA/AEs/CI for mefloquine?
Similar to quinine GI (n/v/d), cardiac (QT prolong), CNS: vivid dreams, anxiety, HA, psychosis, seizures CI: ◼️epilepsy, psychosis, schizophrenia, depression, anxiety
158
What's the MOA/AE/CI/DDI of primaquine?
Generates reactive oxygen species? (Active vs. hepatic stage) GI, cardiac, hematologic: hemolysis/hemolytic anemia (counsel patients to look for dark/blood-colored urine!!!) CI: G6PD def, pregnancy DDIs: CYP inducer = caution with warfarin
159
What's the MOA/AEs/CI of artesunate, artemether, dihydroartemisinin?
Bind iron, breakdown peroxide to make free radicals that damage parasite GI (n/v/d), CNS = dizziness CI: 1st tri pregnancy, kids <5kg
160
What's the MOA/AE/CI of atovaquone-proguanil?
(Antifolate) Atovaquone: disrupts NT synthesis; proguanil = DHFR inhibitor GI (n/v/d, abdominal pain), mild/reversible inc. of liver enzymes CI: pregnancy
161
What ABX can be used to tx malaria?
Tetracycline, doxycycline, clindamycin
162
How is complicated malaria tx?
1st: quinidine + ABX Artesunate if quinidine unavailable, then switch to PO regimen
163
How is uncomplicated/non-falciparum malaria tx?
P. Malariae: chloroquine/hydroxychloroquine P.ovale/P.vivix: cholorquine/hydroxychloroquine + Primaquine (if not G6PD def.)
164
How is uncomplicated/falciparum malaria tx?
Chloro ✅: chloroquine/hydroxychloroquine Chloro ❌: Atovaquone-Proguanil OR ARtemether OR quinine +ABX OR mefloquine Mefloquine❌: atovaquone-proguanil OR arthemether OR quinine+ABX
165
Describe antimalaria prophylaxis tx
Chloro✅: chloroquine/hydroxychloroquine chloro❌: atovaquone-proguanil OR doxy OR mefloquine areas w/ P.vivax: primaquine anti-relapse Tx: primaquine
166
What drugs are used to tx entamoeba hystolytica/amebiasis?
Metronidazole or Tinidazole (systemic) | Paromycin or Iodoquinol (luminal)
167
What's the tinidazole?
Similar to metronidazole (prodrug that will eventually generate free radicals and disrupt DNA to cause cell death)
168
What's the MOA/AE of paromycin?
Aminoglycosides - binds 30S to interfere with initiation complex and inhibit protein synthesis AE: GI (n/v/d), rash (rare) *SAFER in PREGNANCY*
169
What's the MOA/AE of iodoquinol? Hint: 🎀
..?.. effective vs. organisms in bowel lumen AE: GI (mild diarrhea - take with meal), ENLARGEMENT OF THYROID
170
What drugs are used to tx giardia lamblia/giardiasis?
Metronidazole Tinidazole Niazoxanide Paromycin
171
What's the MOA/AE of nitazoxamide?
??? (May interfere with e- transfer rxn) AE: GI (diarrhea, abdominal pain)
172
What are tx for nematodes/roundworms? | Ascaris lumbricoides, Necator americans/hookworm, enterobius vermicularis/pinworm
Albendazole | Pyrantel pamoate
173
Which nematode can cause anemia?
Hookworm
174
Which nematode can cause pruritis in perianal region?
Pinworm
175
What's the MOA/AE/CI of albendazole?
Starves the worm - interferes with MT synthesis and glucose uptake AE: GI (long term use can inc. liver enzymes) CI: pregnancy, liver disease
176
What's MOA/AE of pyrantel pamoate?
Neuromusuclar blocking agent causes inc. in ACh and inhibition of AChE = paralysis AE: GI, dizziness, inc. liver enzymes
177
What's the MOA/AE/CI for ivermectin?
Paralyzes worm: binds with gated chloride channels GI (diarrhea), pruritis CI: pregnancy
178
What can ivermectin only be used to tx?
Ascariasis and hookworm
179
What can be used to treat flatworms (trematodes, cestodes)
Praziquantel
180
What is used to treat cysticercosis (invasive cestodes from taenia solium which infects pigs)?
Praziquantel + surgery Anticonvulsant + corticosteroid Albendazole
181
What's the MOA/AE of praziquantel?
Inc. permeability to Ca (variant channel in parasites) = contraction/paralysis GI (n/v/d), CNS (headache, dizziness), pruritis
182
What do cephalosporins NOT work on?
LAME Listeria Atypicals MRSA (except for Ceftaroline) Enterococci
183
What tx can be given for community-acquired pneumonia (CAP)?
Macrolide Tetracycline Fluoroquinolone (LEVOFLOXACIN) *discouraged b/c of resistance*
184
What should be administered for children with CAP?
(S. Pneumo common cx) Preferred: Amox Rash from PCN: cephalosporin

PPP Spring (9 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions