Mod 1- ID

Question 1

Penicillins- MOA, AE/BB Warnings, Drug Interactions

Answer 1

MOA: Disruption of bacterial cell wall synthesis; AE: GI upset; Most common drug allergy; Can cause a rash mistaken for allergy

Question 2

Penicillins Class, indications and susceptibility and counter drugs

Answer 2

Beta-lactam ABX;
Indications: strep, otitis media, syphillis, Bacterial Rhinosinusitis
susceptible to beta-lactamase; countered by adding tazobactam, sulbactam, and clavulonic acid (augmentin)

Question 3

Cephalosporins: MOA, AE/BB Warnings, Drug interactions

Answer 3

MOA: disruption of cell wall synthesis; AE: GI upset; slight chance of penicillin cross allergy; beta-lactam abx; can increase INR, caution for warfarin interaction

Question 4

Cephalosporins: Examples and indications

Answer 4

Cefazolin, Cefepime, Ceftriaxone; Indications: CAP, meningitis, STIs, pyelonephritis

Question 5

Carbapenems: Examples; Indications; MOA; Administration

Answer 5

Imipenem; Meropenem
MOA:disruptions of cell wall synthesis; beta-lactam ABX but not susceptible to beta-lactamase; Indications: systemic infections; only parenteral administration

Question 6

Vancomycin: Indications; MOA; SE; BB Warning

Answer 6

MRSA; C-diff
Disruption of cell wall
Rapid administration can cause flushing, rash, tachycardia and hypotension
BB: Not to be used when pregnant

Question 7

Aztreonam: MOA; Indications; Administration

Answer 7

Disruption of cell wall synthesis
Indicated for severe infections; inhaled for cystic fibrosis
Available in IV or inhalation

Question 8

Tetracyclines: Examples; MOA; Indications; SE/AE; Education

Answer 8

Tetracycline; Doxycycline
MOA: inhibit protein synthesis, suppressing bacterial growth
Indications: Acne vulgaris; chlamydia; cholera
SE/AE: discoloration of teeth- not to be used in children under 12, or during pregnancy; increased sensitivity to UV light
Education: take on empty stomach

Question 9

Macrolides: Examples; MOA; Indications

Answer 9

Azithromycin
MOA: Inhibit protein synthesis
Indications: Pertussis, diptheria, COPD exacerbation; common alternative if allergic to penicillin
Azithromycin given in loading dose followed by maintenance dose (z-pak)

Question 10

Oxazolidinones: Examaple; MOA; Indications; SE/AE

Answer 10

Linezolid
Inhibit protein synthesis
Indications: MRSA, VRE- commonly given for resistant infections
SE/AE: H/a, risk for serotonin syndrome

Question 11

Aminoglycosides: Examples; MOA; Indications; AE/SE; BB Warnings

Answer 11

Gentamicin; Tobramycin
MOA: disrupt protein synthesis
Indications: Severe gram negative infections- pseuomonas, staphylococcus, serratia
BB Warning: ototoxic, nephrotoxic; do not use after anesthesia or muscle relaxant due to paralysis risk; contraindicated during pregnancy

Question 12

Fluroquinolones: Examples; MOA, Indications; BB Warning

Answer 12

Ciprofloxacin; Levofloxacin
MOA: interferes with DNA
Indications: Plague, anthrax, UTI, HAP
BB Warning: tendon rupture and tendinitis- rarely a first choice- avoided in children

Question 13

Sulfonamide: Examples, MOA, Indications/contraindications

Answer 13

Trimethoprim/ Sulfamethoxazole (TMP-SMX)
MOA: inhibits folate synthesis
Indications: UTI, GI infections; Pneumocystis Pneumonia- fungal pneumonia
Contraindicated in pregnancy

Question 14

Nitrofuratoin (Macrobid): MOA, indication: SE/AE; education

Answer 14

MOA: Damages bacteria DNA
Indication: lower UTI
First line for UTI
Not used for upper UT/pyelonephritis
SE/AE: hepatotoxicity
Education: can change bodily fluids to red-orange

Question 15

Rifampin: MOA; indications; SE/AE

Answer 15

MOA: suppresses RNA synthesis
Indications: Prevention and treatment of TB and meningocccal prophylaxis
Off label: endocarditis and leprosy
AE: Hepatotoxic
Can change body fluid to red-orange

Question 16

Isoniazid (INH): MOA, Indications; SE/AE; BB Warning

Answer 16

MOA: inhibits synthesis of mycolic acid
Prevention and treatment of TB
SE/AE: hepatotoxic; peripheral neuropathy
BB: hepatotoxic

Question 17

TB treatment:

Answer 17

Rifampin and Isoniazid with pyrazinamide and ethambutol

Question 18

Fluconazole (diflucan): MOA, Indication, SE/AE

Answer 18

MOA: interferes with fungal activity
Candidiasis and other fungal infections
SE/AE: cardiac effects and hepatotoxicity
Ketoconazole and miconazole are OTC meds in this class

Question 19

Amphotericin B: MOA, Indications; SE/AE; BB Warning

Answer 19

MOA: causes cell membrane permeability leading to lost cell contents and death
Indications: Severe systemic fungal infections
SE/AE: nephrotoxic and hematologic effects- infusion reaction with fever, chills, nausea, and headache
BB: only for severe fungal infections

Question 20

Antivirals: examples, MOA; indications

Answer 20

Acyclovir; valacyclovir
MOA: suppresses synthesis of viral DNA
Indications: HSV and VZV
Most effective within 72 hours
Does not cure HSV; recurrence is likely
Considered safe during pregnancy

Question 21

Oseltamivir (tamiflu)

Answer 21

MOA: inhibits and influenza enzyme
Influenza
Most effective within 48 hours of symptom onset

Question 22

Interferons

Answer 22

Interferon Alfa-2b; interferon alfa-2a
MOA: interferes with viral replication
Indications: hepatitis B virus and certain cancers
SE?AE: flu like symptoms
BB: can cause or exacerbate other conditions
Parenterally only
Interferon B is used for MS

Question 23

Tenofovir

Answer 23

Nucleoside Reverse Transcriptase Inhibitor
Suppresses replication of viral DNA
Indication: HIV and HBV
SE/AE: lactic acidosis and hepatomegaly

Question 24

Efavirenz

Answer 24

Nonnucleoside Reverse Transcriptase Inhibitor (NNRTIs)
MOA: suppress replication of viral DNA
Indication: HIV
SE/AE: SJS/TEN; hepatotoxicty
Teratogenic

Question 25

Ritanavir

Answer 25

Protease Inhibitor
MOA: prevent HIV maturation
Indication: HIV
SE/AE: hyperglycemia, hyperlipidemia, bone loss

Question 26

Raltegravir

Answer 26

Integrase Strand Transfer Inhibitor
MOA:; interferes with integration of HIV into DNA
Indication: HIV

Question 27

Tenofovir/emtricitabine (Truvada, Descovy)

Answer 27

Combination drug therapy for preexposure
SE/AE: decreased bone mass and kidney injury
Requires routine HIV testing- cannot be used as monotherapy for HIV
BB: Can exacerbate HBV- can lead to resistance if used as monotherapy

Question 28

Mebendazole

Answer 28

MOA: prevents uptake of glucose by worms
Indications: intestinal worms and more
Ivermectin is another drug in this class with different uses

Question 29

Chloroquine

Answer 29

Antimalarial
MOA: multiple actions against malaria
Indications: malarial treatment and prevention
First line for malaria
Hydroxychloroquine is another drug in this class that is used for RA as well as malaria

Question 30

Metronidazole

Answer 30

MOA: Impairs DNA function
Indications: anaerobic bacterial infections, trichomoniasis, amoebic dysentery
Many off label uses- both antiprotazoal and antibacterial
Should avoid alcohol
Carcinogenic in animals

Question 31

Permethrin and Pyethrin

Answer 31

MOA: kills lice and scabies
Scabies: entire body and mucous membranes should be covered for 8-14 hours
Life: wash hair apply product and leave on for 10 minutes, remove nits with comb