ID 19

Question 1

griseofulvin uses

Answer 1

1) oral treatment of superficial infections

2) inhibits growth of dermatophytes (tinea, ringworm)

Question 2

other griseofulvin AE

Answer 2

metabolizes Warfarin

Question 3

permethrin MOA

Answer 3

blocks sodium channels (*thus neurotoxic)

Question 4

malathion mechanism

Answer 4

acetylcholisterase inhibitor

Question 5

lindane mechanism

Answer 5

blocks GABA channels (*thus neurotoxic)

Question 6

chloroquine MOA

Answer 6

blocks detoxification of heme into hemozoin –> heme accumulates and is toxic to plasmodia

Question 7

resistance to chloroquine?

Answer 7

membrane pump that decreases intracellular concentration of drug.

Question 8

only drug you can’t use chloroquine for?

Answer 8

p falciparum

Question 9

p falciparum treatment options

Answer 9

1) artemether/lumefantrine

2) atovaquone/proguanil

Question 10

life-threatening malaria treatment

Answer 10

artesunate

*quinidine in US (quinine elsewhere)

Question 11

chloroquine AE’s

Answer 11

retinopathy

pruritus (especially in dark-skinned individuals)

Question 12

drug like oseltamivir…

Answer 12

zanamivir

Question 13

oseltamivir/zanamivir uses

Answer 13

treatment and prevention of both influenza A and B

Question 14

Why do acyclovir/valacyclovir have few adverse effects in uninfected cells?

Answer 14

not phosphorylated

Question 15

acyclovir/valacyclovir usage caveat

Answer 15

no effect on latent forms of HSV and VZV

Question 16

difference between valacyclovir and acyclovir?

Answer 16

valacyclovir is a prodrug of acyclovir that has better oral bioavailability

Question 17

acyclovir/valacyclovir MOA of resistance

Answer 17

mutated viral thymidine kinase

Question 18

acyclovir/valacyclovir AE’s

Answer 18

1) Obstructive crystalline nephropathy

2) ARF

Question 19

Ganciclovir MOA

Answer 19

5-monophosphate formed by a CMV viral kinase. Guanosine analog. Triphosphate formed by cellular kinase. Preferentially inhibits viral DNA polymerase.

Question 20

ganciclovir prodrug

Answer 20

valganciclovir, better oral bioavailability.

Question 21

ganciclovir MOA of resistance

Answer 21

mutated viral kinase

Question 22

Foscarnet MOA

Answer 22

Viral DNA/RNA polymerase inhibitor and HIV reverse transcriptase inhibitor.
*binds to pyrophosphate-binding site of enzyme (pyrophosphate analog)

Question 23

foscarnet vs. ganciclovir/acyclovir

Answer 23

foscarnet doesn’t require kinase activation.

Question 24

foscarnet uses

Answer 24

1) CMV retinitis in immunocompromised patients when ganciclovir fails
2) acyclovir-resistant HSV

Question 25

foscarnet AE's

Answer 25

1) nephrotoxicity 2) electrolyte abnormalities (hypo or hypercalcemia, hypo or hyperphosphatemia, hypokalemia, hypomagnesemia) 3) seizures

Question 26

MOA of resistance with foscarnet

Answer 26

mutated DNA polymerase

Question 27

Cidofovir and phosphorylation?

Answer 27

doesn't require phosphorylatoin

Question 28

cidofovir MOA

Answer 28

inhibits viral DNA polymerase

Question 29

cidofovir pharmacokinetics

Answer 29

long half-life

Question 30

cidofovir uses

Answer 30

1) CMV retinitis in immunocompromised patients | 2) acyclovir-resistant HSV

Question 31

cidofovir AE's

Answer 31

nephrotoxic

Question 32

how to reduce cidofovir toxicity?

Answer 32

coadminster with probenecid and IV saline

Question 33

HAART composition

Answer 33

2 NRTIs + integrase inhibitor

Question 34

NRTIs

Answer 34

``` Abacavir (ABC) Didanosine (ddl) Emtricitabine (FTC) Lamivudine (3TC) Stavudine Tenofovir (TDF) Zidovudine (ZDV, formerly AZT) ```

Question 35

NRTI MOA

Answer 35

competitively inhibit nucleotide binding to reverse transcriptase and terminate DNA chain (lack a 3' OH group)

Question 36

What is unique about Tenofovir?

Answer 36

nucleo"T"ide, unlike nucleoside, and needs to be phosphorylated.

Question 37

NRTI AE's

Answer 37

1) bone marrow suppression (reverse with G-CSF and ego) 2) peripheral neuropathy 3) lactic acidosis (nucleosides) 4) anemia (ZDV) 5) pancreatitis (didanosine)

Question 38

thing to remember about abacavir

Answer 38

contraindicated if patient has a HLA-B5701 mutation

Question 39

NNRTIs

Answer 39

Delaviridine Efavirenz Nevirapine

Question 40

NNRTI mechanism

Answer 40

bind reverse transcriptase at site different from NRTIs. | *no phosphorylation required.

Question 41

NNRTI AE's

Answer 41

1) rash 2) hepatotoxic 3) efavirenz -- vivid dreams + CNS symptoms 4) delavirdine and efavirenz contraindicated in pregnancy

Question 42

protease inhibitors

Answer 42

all the -navirs

Question 43

protease inhibitor that's a CYP-45O inhibitor...

Answer 43

ritonavir

Question 44

protease inhibitor AE's

Answer 44

Hyperglycemia GI intolerance (nausea, diarrhea) lipodystrophy (Cushing-like syndrome Nephropathy, hematuria (indinavir)

Question 45

protease inhibitor contraindicaion

Answer 45

rifampin (potent CYP/UGT inducer) that can decrease concentration.

Question 46

integrase inhibitors

Answer 46

raltegravir elvitegravir dolutegravir

Question 47

integrase inhibitor AE

Answer 47

increase creatine kinase

Question 48

enfuvurtide AE

Answer 48

skin reaction at injection sites

Question 49

enfuvirtide MOA

Answer 49

Binds gp41, inhibiting viral entry

Question 50

maraviroc MOA

Answer 50

binds CCR-5 on surface of T cells/monocytes inhibiting interaction with gp120