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ID Exam 5 Flashcards

1
Q

Fluconazole (Diflucan) is 1st line for which infections?

A
  1. invasive candidiasis (albicans, parapsilosis, lusitaniae)
  2. coccidiodes
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2
Q

Itraconazole (Sporanox) is 1st line for which infections?

A
  1. Histoplasmosis
  2. Blastomyces
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3
Q

Amphotericin B adverse effects

A
  1. Nephrotoxicity (can use pre- and post-infusion saline hydration to offset)
  2. Electrolyte imbalances: hypokalemia, hypomagnesemia
  3. Anemia
  4. Infusion reactions (can pretreat w/ APAP, antihistamines)
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4
Q

Amphotericin B dose for severe, disseminated infection

A

3-5mg/kg/day

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5
Q

Flucytosine adverse effects

A
  1. Bone marrow suppression
  2. GI: N/V/D - take with food
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6
Q

Common adverse effect of all -azoles, except for which one?

A

QTc prolongation
Except for isavuconazole (Cresemba)

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7
Q

Voriconazole (Vfend) adverse effects

A
  1. Visual disturbances - blurred vision, hallucinations, etc.
  2. Increased LFTs
  3. Phototoxic skin reactions
  4. Periostitis
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8
Q

Itraconazole (Sporanox) serum trough goal

A

> 0.5-1 ug/mL

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9
Q

Itraconazole (Sporanox) dose - histo and blasto

A

200mg PO TID x 3 days

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10
Q

Absorption following oral adminstration of which -azole is dependent on gastric pH?

A

Itraconazole

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11
Q

NRTIs adverse effects

A

Mitochondrial toxicity: anemia, granulocytopenia, myopathy, peripheral neuropathy, pancreatitis

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12
Q

Voriconazole (Vfend) is 1st line for which infection?

A

Aspergillus

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13
Q

All NRTIs should be renally dosed except for which one?

A

Abacavir

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14
Q

NNRTIs adverse effects

A

rash - risk of SJS

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15
Q

PI adverse effects

A

GI intolerance - N/V/D
Insulin resistance
Lipodystrophy

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16
Q

INSTIs adverse effects

A

weight gain

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17
Q

What adverse effect is unique to isavuconazole (Cresemba)?

A

QTc shortening

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18
Q

Which IV formulations of -azoles contain cyclodextrin and should therefore be renally dosed?

A

Posaconazole (Noxafil)
Voriconazole (Vfend)

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19
Q

Febrile neutropenia - empiric tx options

A
  1. cefepime 2g
  2. ceftazidime 2g
  3. Zosyn 4.5g
  4. Imipenem 500mg
  5. meropenem 1g
20
Q

What 2 drugs make up Truvada?

A

Tenofovir disoproxil fumarate (TDF)
Emtricitabine (FTC)

21
Q

What 2 drugs make up Descovy?

A

Tenofovir alefenamide (TAF)
Emtricitabine (FTC)

22
Q

What 2 drugs make up Dovato?

A

Dolutegravir
Lamivudine

23
Q

What 3 drugs make up Biktarvy?

A

TAF
FTC
Bictegravir

24
Q

If a patient has been on cabotegravir for HIV PrEP, what kind of ART should they be started on if they get HIV?

A

PI-based regimen

25
Isoniazid (Nydrazid) MOA
Inhibits InhA in the FASII system -> bacteria cannot synthesize mycolic acid -> detective cell wall
26
Isoniazid reversal agent
Pyridoxine (Vitamin B6)
27
What enzyme activates isoniazid?
KatG
28
Isoniazid toxicities
1. Hepatitis 2. Peripheral neuropathy
29
Metabolism of isoniazid by which enzyme leads to toxic metabolites?
CYP 2EI
30
Pyrazinamide (Aldinamide) toxicities
1. Joint pain 2. Hepatitis - most common cause of hepatitis in 4-drug TB regimen
31
Ethambutol toxicities
OPTIC NEURITIS - if tx not d/c then irreversible!!
32
Rifampin (Rifadin) toxicities
Orange bodily fluids Many CYP interactions
33
What is the most effective 1st line agent for the treatment of TB?
Rifampin (Rifadin)
34
Which protease inhibitors are boosted with ritonavir and cobicistat?
Atazanavir Darunavir
35
Pyrazinamide (Aldinamide) is activated by what enzyme?
pncA
36
Pyrazinamide (Aldinamide) MOA
inhibition of panD which leads to inhibition of CoA system
37
Ethambutol MOA
inhibits mycobacterial arabinosyl transferases -> arabinan buildup -> formation of arabinogalactan (cell wall component) is inhibited
38
Artemisinin MOA
endoperoxide bridge activated by heme-iron, forms free radicals that alkylate parasitic protein
39
Which plasmodium species requires anti-relapse treatment due to dormant liver stage (hypnozoites)?
P. vivax P. ovale
40
Criteria for severe malaria
1. Hgb < 7 2. Acidosis 3. Parasitemia > 5% 4. ARDS 5. Shock 6. AKI 7. Impaired consciousness
41
Which antimalarial drugs require G6PD testing prior to starting?
Primaquine Tafenoquine
42
Which antimalarial drugs should be avoided with psychiatric disorders?
Mefloquine Tafenoquine
43
Diagnostic standard for malaria
Giesma-stained blood smear Thin: species ID Thick: parasite density
44
What is the drug of choice for pinworms?
Albendazole
45
Benzimidazoles MOA
binds to tubules (they cap the tubule), inhibits formation of microtubules
46
Aspergillosis prophylaxis
Posaconazole 300mg IV or PO

P3 Therapeutics (21 decks)

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