gold usmle: anti-infective pharm

Question 1

Primaquine

Answer 1

Malaria profylaxis

5. Used for extraerythrocytic forms Plasmodium vivax or P. ovale

Question 2

Ciporfloxacin

Answer 2

Quinolone derivative

Question 3

Sulfonamides

Answer 3

PABA structural analogs

8. Inhibit Folic acid synthesis

Question 4

Tertacyclines, anuria & the exception

Answer 4

Should not be used in anuric pt due to production of (-) Nitrogen balance & ↑d BUN levels.
10. Doxycycline is the exception

Question 5

Ceftriazone

Answer 5

3rd generation cephalosporin

12. DOC for bacterial meningitis in kids (ie… HiB)
13. One dose txt of gonorrhea

Question 6

Hepatic coma DOC

Answer 6

Neomycin (aminoglycoside) – it supresses the normal flora = ↓g NH4 production = ↓g free
nitrogen levels in the bloodstream.

Question 7

Clavulanic acid

Answer 7

Irreversible (-)r of β lactamases, but ot of transpeptidase = use w/ a β lactamase sensitive
penicillin

Question 8

Piperacillin

Answer 8

Txt Pseudomonas aeruginosa & Klebsiella

17. Broad spectrum antibiotic

Question 9

Streptomycin (aminoglycoside)

Answer 9

Txt Mycobacterium tuberculosis

Question 10

Isoniazid

Answer 10

Most commonly used drug for TB.

20. Usually combined w/ Rifampin and/or Ethambutol
21. Pre Txt w/ Pyridoxine (Vit B6) can prevent peripheral neuritis‘

Question 11

Pyrantel Pamoate

Answer 11

Txt of Hookworm disease

23. Depolarizing NMJ (-)r

Question 12

Buy “AT” 30, “CELL” at 50

Answer 12

A = Aminoglycosides

25. T = Tetracyclines
26. C = Chloramphenicol
27. E = Erythromycin (macrolide)
28. L = Clindamycin
29. L = Lincomycin

Question 13

Cefoxitin

Answer 13

Txt intraabdominal infections (ie… w/ Bacteroides fragilis)

31. Traditional txt has been Clindamycin & Gentamycin

Question 14

Chloramphenicol

Answer 14

Broad spectrum antibiotic

33. Bone marrow depression (common) – Aplastic anemia (rare)
34. Gray baby syndrome (chloramphenicol cannot be conjugated)
35. DOC Typhoid Fever (symptomatic Salmonella infection)
36. DOC HiB meningitis in kids – especially resistant strain to ampicillin

Question 15

Nifurtimox

Answer 15

Txt trypanosomiasis

Question 16

Metronidazole

Answer 16

Txt Leishmaniasis & Amebiasis

39. Good for anaerobic bacteria = Bacteroides fragilis
40. DOC Trichomoniasis
41. DOC Giardia lamblia

Question 17

Txt P. carinii

Answer 17

TMP-SMX & Pentamidine

Question 18

Tetracycline

Answer 18

Txt of Brucellosis & Cholera

44. Txt Rocky Mountain Spotted Fever
45. Txt spirochete infections = Lyme disease (Borrelia burgdorferi)

Question 19

TMP-SMX

Answer 19

(-) dihydrofolate reductase activity

Question 20

Benzathine Penicillin G

Answer 20

Long duration of action = given once every 3-4 weeks for Txt of Syphilis

Question 21

Praziquantel

Answer 21

Txt Schistosomiasis (trematode [fluke] infections)

Question 22

Melarsoprol

Answer 22

Txt Trypanosomiasis that has neurological symptoms

Question 23

Stibogluconate

Answer 23

Txt Leishmaniasis

Question 24

Fluconazole

Answer 24

Txt fungal encephalitis

Question 25

Amphotericin B

Answer 25

Polyene antifingal

Question 26

Ketoconazole MOA

Answer 26

(-) fungal ergosterol synthesis = disrupts membrane

Question 27

Griseofulvin MOA

Answer 27

Accumulates in keratinized layers of the skin = used in dermatomycoses infections

Question 28

Mefloquine

Answer 28

Anti malarial | 56. Txt Chloroquine resistant strains = P. falciparum

Question 29

Chloroquine

Answer 29

Txt for Malaria when inside RBC

Question 30

Nifurtimox

Answer 30

DOC Chagas disease due to Trypanosoma cruzi

Question 31

Erythromycin

Answer 31

Used in pts allergic to penicillins

Question 32

Nystatin

Answer 32

Topical txt of superficial mycotic infections = Candidiasis

Question 33

Acyclovir

Answer 33

Guanine analog | 62. Txt Herpes infections

Question 34

Imipenem

Answer 34

Used w/ Cilastatin | 64. Can cause seizures

Question 35

Cefoperazone side effects

Answer 35

Bleeding due to vit K level alterations | 66. Contraindicated in pts w/ bleeding disorders

Question 36

Vancomycin

Answer 36

Used for MRSS (methicillin resistant Staph. Aureus) | 68. “Red neck”: due to histamine release causes facial flushing

Question 37

Meropenem

Answer 37

used w/ Cilastatin | 70. Does not cause seizures (cf w/ Imipenem)

Question 38

Nafcillin

Answer 38

Only penicillin that does not need dose adjustment in renal impairment

Question 39

Peripheral neuropathy

Answer 39

Seen w/ use of: | 73. Metronidazole – Isoniazid – Vincristine – ddI – AZT – Allopurinol

Question 40

Sulfonamides & newborns

Answer 40

Kernicterus can occur

Question 41

“O.N.E.” for gonorrhea

Answer 41

Fluoroquinolones used in a one dose deal for gonorrhea: 76. O = Ofloxacin 77. N = Norfloxacin 78. E = Enoxacin

Question 42

Ribavirin

Answer 42

Txt RSV (Respiratory Syncytial Virus)