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Microbiology First Aid USMLE Step 1 > Micro Pharm > Flashcards

Micro Pharm Flashcards

1
Q

Binds PBPs, inhibit transpeptidation, activate autolytic enzymes

A

Penicillins (G and V) mechanism of action?

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2
Q

Gram positive bacteria

A

Penicillins (general) uses?

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3
Q

Hypersensitivity, dose adjustment in renal impairment

A

Penicillins (general) side effects?

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4
Q

Beta lactamase sensitive. Narrow spectrum (g+), Treponema pallidum.

A

Penicillin V uses?

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5
Q

Hypersensitivity, dose adjustment in renal impairment. Jarisch-Herxheimer reaction (fervers, chills, rigor hypotension) with syphillis treatment.

A

Penicillin V side effects?

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6
Q

Bactericidal. Binds PBPs, inhibit transpeptidation, activate autolytic enzymes.

A

Methicillin, Nafcillin, Dicloxacillin, Amoxicillin, Ampicillin, Ticarcillin, Pipercillin, Azlocillin, Carbenicillin

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7
Q

Beta lactamase RESISTANT. Very narrow spectrum, methicillin SENSITIVE S. aureus (MSSA).

A

Methicillin, Nafcillin, Dicloxacillin uses?

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8
Q

Hypersensitivity, dose adjustment in renal impairment. Interstitial nephritis.

A

Methicillin, Amoxicillin

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9
Q

Hypersensitivity, dose adjustment in LIVER impairment.

A

Nafcillin, Dicloxacillin side effects?

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10
Q

Hypersensitivity, dose adjustment in LIVER impairment.

A

Dicloxacillin side effects?

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11
Q

Beta lactamase sensitive. Broad spectrum, Haemophilus, E.coli, Listeria, Proteus, Salmonella, Shigella

A

Amoxicillin, Ampicillin uses?

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12
Q

Hypersensitivity, dose adjustment in renal impairment. Rash with viral infection, pseudomembranous colitis

A

Ampicillin side effects?

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13
Q

Beta lactamase sensitive. Extended spectrum, Pseudomonas aeruginosa. Gram negative anaerobes (Bacteriodes fragilis).

A

Ticarcillin, Piperacillin, Azlocillin, Carbenicillin

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14
Q

Hypersensitivity, dose adjustment in renal impairment.

A

Ticarcillin, Piperacillin, Azlocillin, Carbenicillin side effects?

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15
Q

Inhibits beta-lactamase/penicillinase

A

Clavulanic acid, Tazobactam, Sulbactam mechanism of action?

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16
Q

Combine with ampicillin/amoxicillin or antipseudomonals to protect the antibiotic from destruction by Beta-lactamase (penicillinase)

A

Clavulanic acid, Tazobactam, Sulbactam uses?

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17
Q

Beta-lactam drugs that inhibit cell wall synthesis but are less susceptible to penicillinases. Bactericidal.

A

Cephalosporins (general)

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18
Q
  • Hypersensitivity, dose adjustment in renal impairment, vitamin K deficiency.
  • Low reactivity with penicillins and increased nephrotoxicity of amino glycosides.
A

Cephalosporins (general) side effects?

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19
Q

Used for: Gram Positive Cocci, PEcK (Proteus mirabilis, E. coli, Klebsiella pneumoniae.)
- One of these was used prior to surgery to precent S. Aureus wound infections.

A

1st Gen: Cefazolin, cephalexin

- Cefazolin

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20
Q

Used for: Gram positive Cocci HEN PEcKS (Haemophilus influenzae, Enterobacter aerogenes, Neisseria spp., Proteus mirabilis, E. coli, Klebsiella pneumoniae, Serratia marascens.)
- Greater Spectrum of Gram pos

A

2nd Gen: Cefoxitin, cefaclor, cefuroxime

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21
Q

Used for: Serious Gram negative infections resistant to other Beta-lactams. Sepsis and meningitis (crosses BBB.)

A

3rd gen: Ceftriaxone, cefotaxime, ceftazidime

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22
Q

Used for: increased activity against Pseudomonas and gram positive organisms.

A

4th gen: Cefepime

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23
Q

2nd gen: HEN PEcKS (Haemophilus influenzae, Enterobacter aerogenes, Neisseria spp., Proteus mirabilis, E. coli, Klebsiella pneumoniae, Serratia marascens.)

A

Cefamandole, cefotetan uses?

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24
Q

Disulfiram like effects, hypersensitivity, dose adjustment in renal impairment.

A

Cefamandole, cefotetan side effects?

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25
Q

3rd gen that doesn’t cross BBB (too lipid soluble)

A

Cefoperazone uses?

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26
Q

Disulfiram like effects, hypersensitivity, dose adjustment in LIVER impairment.

A

Cefoperazone

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27
Q

A Monobactam resistant to Beta-lactamases that prevents peptidoglycan cross-linking by binding to PBP3.
- Synergistic with aminoglycosides and no cross allergenicity with penicillins.

A

Aztreonam mechanism of action?

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28
Q

Used For: Gram negative rods only: Klebsiella, Pseudomonas, Serratia.

  • For penicillin-allergic pts and those with renal insufficiency who cannot tolerate amino glycosides.
  • Usually nontoxic, occasional GI upset.
A

Aztreonam

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29
Q

Broad-spectrum, Beta-lactamase-resistant carbapenem. Always used with cilastatin (inhibitor of renal dehydropeptidase I) to decrease inactivation of drug in renal tubules..

A

Imipenem

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30
Q

MUST BE USED WITH CILASTATIN. Broad spectrum G+ cocci and G- rods and anaerobes. Wide spectrum but limited use due to life-threatening infections.

A

Imipenem uses?

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31
Q

SE: GI distress, skin rash, and SEIZURES. Dose reduction in renal failure.

A

Imipenem side effects?

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32
Q

Broad-spectrum, Beta-lactamase-resistant carbapenem other than Imipenem.

A

Meropenem mechanism of action?

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33
Q

Used for: Doesn’t need cilastatin. Broad spectrum G+ cocci and G- rods.

A

Meropenem uses?

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34
Q

SE: GI distress, skin rash, and less risk of seizures versus imipinem. Dose reduction in renal failure.

A

Meropenem side effects?

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35
Q

Inhibits renal dihydropeptidase I (used with Imipenem.)

A

Cilastatin mechanism of action?

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36
Q

Required for imipenem use.

A

Cilastatin uses?

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37
Q

Bactericidal. Inhibits cell wall peptidoglycan formation by binding D-ala D-ala portion of cell wall precursors (transglycosylation.)

A

Vancomycin mechanism of action?

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38
Q

Used for: Serious G+ infections. MRSA, Enterococcus, and Clostridium difficile (pseudomembranous colitis).

A

Vancomycin uses?

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39
Q

SE: Nephrotoxicity, Ototoxicity, Thrombophlebitis, diffuse flushing- “red man syndrome” (can largely prevent by pretreatment with antihistamines and slow infusion rate).

A

Vancomycin

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40
Q

Bactericidal. Inhibit formation of initiation complex and cause misreading of mRNA (30s subunit.) Requires O2 for uptake therefore ineffective against anaerobes.

A

Amikacin, gentamicin, streptomycin, tobramycin, neomycin

- A “initiates” the Alphabet.

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41
Q

Severe gram-negative rod infections. Synergistic with beta-lactam antibiotics. NOT ANAEROBES.
- Which one for bowel surgery and which one for M. tuberculosis?

A

Amikacin, gentamicin, streptomycin, tobramycin, neomycin uses?
- Neomycin for bowel surgery and Streptomycin for M. tuberculosis.

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42
Q

Nephrotoxicity (especially when used with cephalosporins), ototoxicity (especially when used with loop diuretics), teratogenic, neuromuscular blockade (like botulism.)
- Which one for Contact dermatitis?

A

Amikacin, gentamicin, streptomycin, tobramycin, neomycin

- Neomycin

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43
Q

Bacteriostatic. Inhibits attachment of aminoacyl tRNA to acceptor site (30S). Limited CNS penetration.
- Which one for renal failure because it is fecally eliminated?

A

Tetracycline, doxycycline, demeclocycline, minocycline mechanism of action?
- Doxycyline

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44
Q

Vibrio cholerae, Acne, Chlamydia, Ureaplasma urealyticum, Mycoplasma pneumoniae, Tularemia, H. pylori, Borrelia burgdorferi, Rickettsia*.
- Effective because of it’s ability to accumulate intracellularly.

A

Tetracycline, doxycycline, demeclocycline, minocycline uses?

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45
Q

GI distress, discoloration of teeth and inhibition of bone growth in children, photosensitivity. Contraindicated in children, pregnancy, and ingestion with milk (chelates calcium.) Fanconi’s syndrome (expired tetracyclines).

A

Tetracycline, doxycycline, demeclocycline, minocycline side effects?

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46
Q

Bacteriostatic. Inhibits 50S peptidyltransferase activity.

A

Chloramphenicol mechanism of action?

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47
Q

Meningitis (Haemophilus influenzae, Neisseria meningitidis, Streptococcus pneumoniae).

A

Chloramphenicol uses?

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48
Q

Anemia (dose dependent), aplastic anemia (dose independent), gray baby syndrome (in premature infants because they lack liver UDP-glucuronyl transferase). Inhibits CYP-450s.

A

Chloramphenicol side effects?

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49
Q

Bacteriostatic. Inhibit protein synthesis by blocking translocation (transpeptidation) at 50S subunit.

A

Clindamycin mechanism of action?

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50
Q 
Anaerobic infections (e.g., Bacteroides fragilis, Clostridium perfringens). S. aureus osteomyelitis (enters bone.)
- Treat anaerobes above the diaphragm vs metronidazole (anaerobic infections below the diaphragm).
A

Clindamycin uses?

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51
Q

Pseudomembranous colitis (C. difficile overgrowth), fever, diarrhea.

A

Clindamycin side effects?

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52
Q

Bacteriostatic. Inhibit protein synthesis by blocking translocation via 50S subunit.

A

Erythromycin, azithromycin, clarithromycin mechanism of action?

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53
Q

URIs, pneumonias, STDs, gram-positive cocci (streptococcal infections in patients allergic to penicillin), Mycoplasma, Legionella, Chlamydia, Neisseria.
- Which one for M. avium-intracellulare?

A

Erythromycin, azithromycin, clarithromycin uses?

- Azithromycin

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54
Q

Prolonged QT interval (especially erythromycin), GI discomfort (stimulates motilin receptors), acute cholestatic hepatitis, eosinophilia, skin rashes, deafness. Increases serum concentration of theophyllines, oral anticoagulants by inhibiting CYP-450s (exception: azithromycin.)

A

Erythromycin, azithromycin, clarithromycin side effects?

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55
Q

KETOLIDE. Bacteriostatic. Inhibit protein synthesis by blocking translocation via 50S subunit.

A

Telithromycin mechanism of action?

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56
Q

Macrolide-resistant S. pneumonia.

A

Telithromycin uses?

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57
Q

Bacteriostatic. Inhibits attachment of aminoacyl tRNA to acceptor site (50S) and block extrusion of completed peptide from ribosome.

A

Dalfopristin/quinupristin mechanism of action?

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58
Q

VREF/VRSA

A

Dalfopristin/quinupristin uses?

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59
Q

Bacteriostatic. Inhibits formation of initiation complex via 50S ribosomal subunit.

A

Linezolid mechanism of action?

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60
Q

VREF/VRSA

A

Linezolid uses?

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61
Q

Myelosuppression.

A

Linezolid side effects?

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62
Q

PABA antimetabolites inhibit dihydropteroate synthetase. Bacteriostatic.

A

Sulfamethoxazole, sulfisoxazole, sulfadiazine mechanism of action?

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63
Q

Gram-positive, gram-negative, Nocardia, Chlamydia, Pneumocystis, Toxoplasma (sulfadiazine). Triple sulfas or SMX for simple UTI.

A

Sulfamethoxazole, sulfisoxazole, sulfadiazine uses?

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64
Q

Photosensitivity, hypersensitivity reactions, hemolysis if G6PD deficient, nephrotoxicity (crystaluria), photosensitivity, kernicterus in infants, displace other drugs from albumin (e.g., warfarin).

A

Sulfamethoxazole, sulfisoxazole, sulfadiazine side effects?

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65
Q

Inhibits bacterial dihydrofolate reductase. Bacteriostatic.

A

Trimethoprim, pyrimethamine mechanism of action?

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66
Q

Recurrent UTIs, Shigella, Salmonella, Pneumocystis jiroveci, Toxoplasma (pyrimethamine.)

A

Trimethoprim, pyrimethamine uses?

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67
Q

Megaloblastic anemia, myelosuppression. May alleviate with supplemental folinic acid.

A

Trimethoprim, pyrimethamine side effects?

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68
Q

Inhibit DNA gyrase (topoisomerase II and IV). Bactericidal.

- Must not be taken with antacids.

A

Fluoroquinolones mechanism of action?

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69
Q

Gram-negative rods of urinary, GI tracts, and osteomyelitis (including Pseudomonas.) Neisseria, some gram positive organisms like macrolide-resistant S. pneumonia.

A

Fluoroquinolones uses?

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70
Q

GI upset, superinfections, phototoxicity (skin rashes), headache, dizziness, increase QT interval. Damage cartilage in children. Tendonitis and tendon rupture in adults; leg cramps and myalgias in kids. Contraindicate with antacids/calcium, children, and pregnancy.

A

Fluoroquinolones side effects?

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71
Q

Forms free radical toxic metabolites in the bacterial cell that damage DNA. Bactericidal, antiprotozoal.

A

Metronidazole mechanism of action?

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72
Q

Giardia, Entamoeba, Trichomonas, Gardnerella vaginalis, anaerobes (Bacteroides, Clostridium.) Used with bismuth and amoxicillin (or tetracycline) for “triple therapy” against H. Pylori.

A

Metronidazole

- GET GAP on the Metro with metronidazole!

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73
Q

Disulfiram-like reaction with alcohol; headache, metallic taste.

A

Metronidazole side effects?

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74
Q

Disrupts cell membrane.

A

Polymyxin mechanism of action?

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75
Q

Gram negative organisms.

A

Polymyxin uses?

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76
Q

Neurotoxicity, acute renal tubular necrosis.

A

Polymyxin side effects?

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77
Q

Inhibits synthesis of mycolic acids. Prodrug activated by mycobacterium’s catalase (KatG).

A

Isoniazid mechanism of action?

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78
Q

Mycobacterium tuberculosis. The only agent used as solo prophylaxis against TB .

A

Isoniazid uses?

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79
Q

Neurotoxicity, hepatotoxicity, and sideroblastic anemia. Treat with pyridoxine (vitamin B6.) Induces hemolytic anemia in G6PD deficient patients. Drug induced SLE.

A

Isoniazid side effects?

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80
Q

Inhibits DNA-dependent RNA polymerase (transcription.)

A

Rifampin mechanism of action?

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81
Q

Mycobacterium tuberculosis; delays resistance to dapsone when used for leprosy. Used for meningococcal prophylaxis and chemoprophylaxis in contacts of children with Haemophilus influenzae type B.

A

Rifampin uses?

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82
Q

Minor hepatotoxicity and drug interactions (indces CYP-450); orange body fluids (nonhazardous side effect.)

A

Rifampin side effects?

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83
Q

Effective in acidic pH of phagolysosomes where TB engulfed by macrophages is found.

A

Pyrazinamide mechanism of action?

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84
Q

Mycobacterium tuberculosis.

A

Pyrazinamide uses?

85
Q

Hepatoxicity, hyperuricemia.

A

Pyrazinamide side effects?

86
Q

Inhibits synthesis of arabinogalactan.(decreases carbohydrate polymerization by blocking arabinosyltransferase).

A

Ethambutol mechanism of action?

87
Q

Mycobacterium tuberculosis.

A

Ethambutol uses?

88
Q

Retrobublar neuritis leading to decreased visual acuity and red-green color blindness.

A

Ethambutol side effects?

89
Q

Binds ergosterol; forms membrane pores that allow leakage of electrolytes.

A

Amphotericin B mechanism of action?

90
Q

Used for wide spectrum of systemic mycoses. Cryptococcus, Blastomyces, Coccidioides, Aspergillus, Histoplasma, Candida, Mucor (systemic mycoses). Intrathecally for fungal meningitis; does not cross blood-brain barrier.
- Supplement K and Mg because of altered renal tubule permeability.

A

Amphotericin B uses?

91
Q

Fever/chills (“shake and bake”), hypotension, nephrotoxicity, arrhythmias, anemia, IV phlebitis (“amphoterrible”). Hydration reduces nephrotoxicity. Liposomal amphotericin reduces toxicity.

A

Amphotericin B side effects?

92
Q

Binds to ergosterol, disrupting fungal membranes. Too toxic for systemic use.

A

Nystatin mechanism of action?

93
Q

Swish and swallow for oral candidiasis (thrush); topical for diaper rash or vaginal candidiasis.

A

Nystatin uses?

94
Q

Inhibits fungal ergosterol synthesis via 14-alpha-demethylase. (Inhibits the P-450 enzyme that converts lanosterol to ergosterol)

A

Fluconazole, ketoconazole, clotrimazole, miconazole, itraconazole, voriconazole mechanism of action?

95
Q

Fluconazole for Cryptococcus (crosses BBB) and Candidasis. Ketoconazole for Blastomyces, Coccidioides, Histoplasma, Candida albicans, and hypercortisolism. Clotrimazole and miconazole for topical fungal infections. Itraconazole and voriconazole for aspergillosis and sporotrichosis.

A

Fluconazole, ketoconazole, clotrimazole, miconazole, itraconazole, voriconazole uses?

96
Q

Testosterone synthesis inhibition (gynecomastia), liver dysfunction (inhibits cytochrome P-450), fever, chills.

A

Fluconazole, ketoconazole, clotrimazole, miconazole, itraconazole, voriconazole side effects?

97
Q

Inhibits DNA synthesis by conversion to 5-fluorouracil; inhibits thymidylate synthase.

A

Flucytosine mechanism of action?

98
Q

Used in systemic fungal infections (e.g., Candida, Cryptococcus) in combination with amphotericin B.

A

Flucytosine uses?

99
Q

Nausea, vomiting, diarrhea, myelosuppression suppression.

A

Flucytosine side effects?

100
Q

Inhibits cell wall synthesis by inhibiting synthesis of beta-glucan.

A

Caspofungin, micafungin mechanism of action?

101
Q

Invasive aspergillosis and candidiasis.

A

Caspofungin, micafungin uses?

102
Q

GI upset, flushing (histamine release)

A

Caspofungin, micafungin side effects?

103
Q

Inhibits 2,3-squalene epoxidase.

A

Terbinafine mechanism of action?

104
Q

Dermatophytoses (especially onychomycosis.)

A

Terbinafine uses?

105
Q

Elevated AST/ALT, visual disturbances.

A

Terbinafine side effects?

106
Q

Interferes with microtubule function; disrupts mitosis. Deposits in keratin-containing tissues (e.g., nails).

A

Griseofulvin mechanism of action?

107
Q

Oral treatment of superficial infections; inhibits growth of dermatophytes (tinea, ringworm).

A

Griseofulvin uses?

108
Q

Teratogenic, carcinogenic, confusion, headaches, induces P-450 and thus increases warfarin metabolism. Disulfiram like reaction.

A

Griseofulvin side effects?

109
Q

Blocks viral penetration/uncoating (M2 protein); may buffer pH of endosome. Also causes the release of dopamine from intact nerve terminals. Muscarinic antagonist.

A

Amantadine mechanism of action?

110
Q

Prophylaxis and treatment for influenza A; Parkinson’s disease.

A

Amantadine uses?

111
Q

Ataxia, dizziness, slurred speech. Livedo reticularis and anti-muscarinic like effects.

A

Amantadine side effects?

112
Q

Inhibit influenza neuraminidase, decreasing the release of progeny virus.

A

Zanamivir, oseltamivir mechanism of action?

113
Q

Influenza A and B.

A

Zanamivir, oseltamivir uses?

114
Q

Mech: Inhibits synthesis of guanine nucleotides by competitively inhibiting IMP dehydrogenase. Inhibits RNA polymerase.

A

Ribavirin mechanism of action?

115
Q

Used for RSV, HepC, Lassa fever, Hantavirus (RNA viruses)

A

Ribavirin uses?

116
Q

SE: Hematotoxic (anemia). Severe teratogen. Contraindicate with pregnant women.

A

Ribavirin side effects?

117
Q

Mech: Monophosphorylated by HSV NZV thymidine kinase. Guanosine analog. Triphosphate formed by cellular enzymes. Preferentially inhibits viral DNA polymerase by chain termination.

A

Acyclovir, famciclovir, valacyclovir mechanism of action?

118
Q

Used for HSV and VZV (famciclovir)

A

Acyclovir, famciclovir, valacyclovir uses?

119
Q

Mech: 5’-monophosphate formed by a CMV viral kinase or HSVNZV thymidine kinase.Guanosine analog. Triphosphate formed by cellular kinases. Preferentially inhibits viral DNA polymerase.

A

Ganciclovir mechanism of action?

120
Q

Used for CMV, especially in immunocompromised patients.

A

Ganciclovir uses?

121
Q

SE: Myelosupppression, thrombocytopenia, renal toxicity (maintain hydration.)

A

Ganciclovir side effects?

122
Q

Mech: Inhibits DNA and RNA polymerase by binding to the pyrophosphate binding site of enzyme. Does not require activation by viral kinase.

A

Foscarnet, Cidofovir mechanism of action?

123
Q

Used for CMV retinitis in immunocompromised patients when ganciclovir fails; acyclovir-resistant HSV.

A

Foscarnet, Cidofovir (Long Half-life)

124
Q

SE: Nephrotoxicity (binds calcium and magnesium.) No myelosuppression! Contraindicate with pentamidine or other nephrotoxic drugs.

A

Foscarnet, Cidofovir side effects?

125
Q

Mech: Protease inhibitor (prevent maturation of new viruses)
- Assembly of visions depends on HIV-1 protease (pol gene), which cleaves the polypeptide products of HIV mRNA into their functional parts.

A

Lopinavir, atazanavir, darunavir, fosamprenavir, saquinavir, ritonavir, Indinavir mechanism of action?

126
Q

Mech: HIV with 2 NRTIs. Ritonavir can “boost” other drugs by inhbiitng CYP-4450.

A

Lopinavir, atazanavir, darunavir, fosamprenavir, saquinavir, ritonavir, Indinavir uses?

127
Q

SE: GI intolerance (nausea, diarrhea), gout, hyperglycemia (insulin resistance), lipodystrophy (central adiposity), thrombocytopenia (indinavir). Contraindicate in coronary artery disease. Atazanavir has less association with lipodystrophy and hyperglycemia.

A

Lopinavir, atazanavir, darunavir, fosamprenavir, saquinavir, ritonavir, Indinavir side effects?

128
Q

Mech: Nucleoside reverse transcriptase inhibitor. Competitively inhibit nucleotide binding to reverse transcriptase, causes chain termination (lack of 3’ OH group)

A

Tenofovir, emtricitabine, abacavir, lamivudine, zidovudine, dianosine, stavudine mechanism of action?

129
Q

Used for HIV with another NTRI and a PI/NNRTI/ISTI/FI/CCR5-antagonist, HepB (lamivudine)

A

Tenofovir, emtricitabine, abacavir, lamivudine, zidovudine, dianosine, stavudine uses?

130
Q

SE: Myelosuppression (Zidovudine), hepatotoxicity, nephrotoxicity (Tenofovir), pancreatitis/peripheral neuropathy (Zalcitabine and Didanosine), hypersensitivity (abacavir - do HLA-B5701 testing).

A

Tenofovir, emtricitabine, abacavir, lamivudine, zidovudine, dianosine, stavudine side effects?

131
Q

Mech: Non-nucleoside reverse transcriptase inhibitor. Non-competitive inhibitor of reverse transcriptase at different site than NRTI’s. Does not require phosphorylation to be active.

A

Nevirapine, efavirenz, delavirdine mechanism of action?

132
Q

Used for HIV with 2 NRTIs. Single dose nevirapine for HIV+ mother during delivery.

A

Nevirapine, efavirenz, delavirdine uses?

133
Q

SE: Dysphoric dreams, teratogenic (efavirenz), hepatotoxic and induce CYP450 (nevirapine.) Contraindicate with neuropsychiatric history and pregnancy.

A

Nevirapine, efavirenz, delavirdine side effects?

134
Q

Mech: Fusion inhibitor. Bind viral gp41 subunit; inhibit conformational change required for fusion with CD4 cells. Therefore block entry and subsequent replication.

A

Enfuvirtide mechanism of action?

135
Q

Used for HIV salvage therapy with 2 NRTIs.

A

Enfuvirtide uses?

136
Q

SE: Hypersensitivity reactions, reactions at subcutaneous injection site, increased risk of bacterial pneumonia.

A

Enfuvirtide side effects?

137
Q

Mech: Integrase inhibitor.

A

Raltegravir mechanism of action?

138
Q

Used for HIV with 2 NRTIs.

A

Raltegravir, Maraviroc uses?

139
Q

SE: Hypercholesterolemia.

A

Raltegravir side effects?

140
Q

Mech: CCR-5 antagonist.

A

Maraviroc mechanism of action?

141
Q

Mech: Inhibits DNA polymerase.

A

Cidofovir mechanism of action?

142
Q

Used for: CMV, especially in immunocompromised patients.

A

Cidofovir uses?

143
Q

SE: Nephrotoxicity.

A

Cidofovir side effects?

144
Q

Used for Hep B/C/D, HHV-8 (Kaposi’s sarcoma), CML, multiple myeloma, renal carcinoma, melanoma (alpha interferon). Multiple sclerosis (beta inferferon). Chronic granulomatous disease (gamma interferon.)

A

Interferon alpha/beta/gamma uses?

145
Q

Used for Trypanosoma cruzi

A

Nifurtimox uses?

146
Q

Used for Trypanosoma gambiense and rhodesiense (blood borne)

A

Suramin uses?

147
Q

Used for Trypanosoma gambiense and rhodesiense (CNS penetration)

A

Melarsoprol uses?

148
Q

Mech: Increases calcium influx, leading to vaculization.

A

Praziquantal mechanism of action?

149
Q

Used for Cestodes and flukes - Taenia solium, Diphyllobothrium latum, Schistosoma, Clonorchis sinensis, Paragonimus westermani/

A

Praziquantal uses?

150
Q

Mech: Inhibit glucose uptake, disrupts microtubular structure.

A

Mebendazole/Albendazole mechanism of action?

151
Q

Used for SCABIES. Nematodes - Echinococcus granulosus, Taenia solium (neurocysticercosis), Ancylostoma duodenale, Necator americanus, Strongyloides stercoralis, Trichinella spiralis, Ascaris lumbricoides, Enterobius vermicularis**.

A

Mebendazole/Albendazole uses?

152
Q

Used for Strongyloides stercoralis, onchocera volvulus

A

Ivermectin uses?

153
Q

Used for Leishmaniasis

A

Sodium stibogluconate uses?

154
Q

Used for Babesia microti

A

Quinine plus clindamycin uses?

155
Q

Mech: Nicotinic agonist leading to spastic paralysis.

A

Pyrantel pamoate mechanism of action?

156
Q

Used for Nematodes - Ascaris lumbricoides, Enterobius vermicularis, Ancylostoma duodenale, Necator americanus

A

Pyrantel pamoate uses?

157
Q

Used for Loa loa, Wuchereria bancrofti, toxocara canis

A

Diethylcarbamazine uses?

158
Q

Used for: Dracunculus medinerisis

A

Niridazole uses?

159
Q

Mech: Blocks detoxification of heme into hemozoin. Heme accumulates and is toxic to plasmodia.

A

Chloroquine mechanism of action?

160
Q

Used for: Erythrocyte form of P. vivax, ovale, malariae, falciparum.

A

Chloroquine uses?

161
Q

SE: Hemolytic anemia in G6PD deficiency, cinchonism (alpha and muscarinic antagonist) - blurred/double vision, GI toxicity, tinnitus, cardiac arrythmias, hypotension, Retinopathy.

A

Chloroquine side effects?

162
Q

Mech: Inhibit heme synthesis, causing toxic buildup.

A

Mefloquine mechanism of action?

163
Q

Used for: Chloroquine resistant Plasmodium species.

A

Mefloquine uses?

164
Q

SE: Hemolytic anemia in G6PD deficiency, cinchonism (alpha and muscarinic antagonist) - blurred/double vision, GI toxicity, tinnitus, cardiac arrythmias, hypotension.

A

Mefloquine side effects?

165
Q

Mech: Oxidant, inhibits DNA synthesis.

A

Primaquine mechanism of action?

166
Q

Used for: Liver form of Plasmodium vivax and ovale.

A

Primaquine uses?

167
Q

SE: Hemolytic anemia in G6PD deficiency, cinchonism (alpha and muscarinic antagonist) - blurred/double vision, GI toxicity, tinnitus, cardiac arrythmias, hypotension.

A

Primaquine side effects?

168
Q

Mech: Block Plasmodium endoplasmic ATPase.

A

Artemisinin, amodiaquine mechanism of action?

169
Q

Used for Chloroquine resistant Plasmodium species.

A

Artemisinin, amodiaquine uses?

170
Q

Mech: Damages bacterial DNA.

A

Nitrofurantoin mechanism of action?

171
Q

Used for UTIs (E. coli, broad spectrum). Highly excreted in the urine.

A

Nitrofurantoin uses?

172
Q

Mech: Protease inhibitor.

A

Telaprevir, boceprevir mechanism of action?

173
Q

Used for Hepatitis C.

A

Telaprevir, boceprevir uses?

174
Q

Used for Pneumocystis if patien’t can’t tolerate TMP-SMX or if they are immunosupressed (doesn’t cause myelosuppression).

A

Atovaquone uses?

175
Q

Used for Pneumocystis if patien’t can’t tolerate TMP-SMX

A

Pentamidine uses?

176
Q

SE: Nephrotoxic

A

Pentamidine side effects?

177
Q

Mech: Neurotoxic; binds and activates sodium channels

A

Permethrin mechanism of action?

178
Q

Scabies drug of choice

A

Permethrin uses?

179
Q

Mech: Antibody against RSV F protein.

A

Palivizumab mechanism of action?

180
Q

Used for: Respiratory syncytial virus

A

Palivizumab uses?

181
Q

Organisms not typically covered by cephalosporins

A

LAME: Listeria, Atypicals (Chlamydia, Mycoplasma), MRSA, and Enterococci
- Exception: Ceftaroline covers MRSA

182
Q

Cephalosporin that treats meningitis and gonorrhea

A

Ceftriaxone

183
Q

Cephalosporin that treats Pseudomonas

A

Ceftazidime

184
Q

Resistance to Vancomysin occurs how?

A

Amino acid change of D-ala D-ala to D-ala D-lac.

185
Q

30S Inhibitors and 50S Inhibitors

A

“Buy AT 30, CCEL (sell) at 50”

  • 30S: Aminoglycosides (bactericidal) and Tetracyclines (bacteriostatic)
  • 50S: Chlorampenicol, Clindamycin (bacteriostatic), Erythromycin (macrolides)(bacteriostatic), Linezolid (variable)
186
Q

Aminoglycosides

A

“Mean” (aMINoglycosides) GNATS caNNOT kill anaerobes.

- Gentamicin, Neomycin, Amikacin, Tobramycin, Streptomycin

187
Q

Do not take with milk, antacids, or iron-containing preparations because divalent cations inhibit its absorption in the gut.

A

Tetracyclines

188
Q

ADH Antagonist; acts as a Diuretic in SIADH and rarely used as an antibiotic?

A

Demeclocycline

189
Q

Macrolides

A

Azythromycin, Clarithromycin, Erythromicin

190
Q

Mech: Inhibits protein synthesis by blocking translocations (“macroSLIDES”); bind to the 23S rRNA of the 50S ribosomal unit. Bacteriostatic

A

Macrolides (Azythromycin, Clarithromycin, Erythromicin)

191
Q

Used for Atypical pneumonias (Mycoplasma, Chlamydia, Legionella), STDs (Chlamydia), and gram positive cocci (strep infections in pts allergic to penicillin)

A

Macrolides (Azythromycin, Clarithromycin, Erythromicin)

192
Q

SE: Motility Issues, Arrhythmia caused by prolonged QT, acute Cholestatic hepatitis, Rash, eOsinophilia.
- Increases serum concentration of theophillines, oral anticoagulants.

A

Macrolides (Azythromycin, Clarithromycin, Erythromicin)

- MACRO

193
Q

AE: Kernicterus in fetus/baby

A

Sulfonamides

194
Q

AE: Ototoxicity in fetus/baby

A

Aminoglycosides

195
Q

AE: Cartilage Damage in fetus/baby

A

Fluoroquinolones

196
Q

AE: Embryotoxic in fetus/baby

A

Clarithromycin

197
Q

AE: Discolored teeth, inhibition of bone growth in fetus/baby

A

Tetracyclines

198
Q

AE: Teratogenic

A

Griseofulvin (antifungal) and Ribavirin (antiviral)

199
Q

AE: “Gray baby”

A

Chloramphenicol

200
Q

Antibiotics to avoid in Pregnancy

A

“SAFe Children Take Really Good Care”

  • Sulfonamides, Aminoglycosides, Fluoroquinolones, Clarithromycin, Tetracyclines, Ribavirin (antiviral), Griseofulvin (antifungal), Chloramphenicol
201
Q

Prophylactic for Meningococcal infection

A
  • Ciprofloxacin (DOC), rifampin for kids
202
Q

Prophylactic for Gonorrhea

A

Ceftriaxone

203
Q

Prophylactic for Syphilis

A

Benzathine Penicillin G

204
Q

Prophylactic for History of recurrent UTIs

205
Q

Prophylactic for Endocarditis with surgical or dental procedures

A

Penicillins

206
Q

Prophylactic for Pregnant women carrying group B strep

A

Ampicillin

207
Q

Prophylactic for strep pharyngitis in child with prior rheumatic fever

A

Oral penicillin

208
Q

Prophylactic for prevention of post surgical infection due to S. aureus

209
Q

Prophylactic for prevention of gonococcal or chlamydial conjunctivitis in newborn

A

Erythromycin ointment

Microbiology First Aid USMLE Step 1 (10 decks)

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