Pharm: Antimycobacterials and antifungals Flashcards
Differentiate the effect of Rifampicin and Isoniazid on the blood levels of warfarin, phenytoin and carbamazepine.
INH will increase the levels whole Rifampicin will decrease the levels.
Which anti-TB medication can be used as a 2nd line drug against MRSA.?
Rifampicin
T/F hyperuricemia occurs with the use of pyrazinamide.
True. But the polyarthralgia involved is NON-GOUTY.
Which among the anti-TB drugs causes red green color blindness?
Ethambutol
What enzyme does ethambutol inhibit?
Arabinosyl transferase. For the synthesis of arabinogalactan a vital part of mycobacterial cell walls.
Which of the antiTB drugs can cause drug-induced lupus?
Isoniazid
Who are at risk for pyridoxine deficiency with INH treatment?
Diabetics
Malnourished
AIDS px
Recommended regimen for prophylaxis in patients with CD4 counts <50 (against MAC)
Clarithromycin/Azithromycin +/- rifabutin
What do you give px treated with INH to prevent pyridoxine deficiency?
Pyridoxine 25-50 mg/day
Which anti-TB drug undergoes enterohepatic recycling?
Rifampin
Which of the anti-TB drugs are bacteriostatic
Ethambutol
Pyrazinamide
Which anti-TB drug causes porphyria and photo sensitivity?
Pyrazinamide
Fluconazole is the drug of choice for:
Esophageal and oropharyngeal candidiasis
Infections with Coccidioides
Treatment and secondary prophylaxis against cryptococcal meningitis
Itraconazole is the drug of choice for:
Blastomycosis
Sporothrichosis
Subcutaneous chromoblastomycosis
Only azole with activity against Rhizopus
Posaconazole
Which antifungal increase the release of histamine and increases the levels of cyclosporine?
Micafungin
Which antifungal has disulfiram reactions with ethanol?
Griseofulvin
Terbinafine inhibits which enzyme?
Squalene epoxidase
Which antifungal is a will cause an increase in warfarin?
Ketoconazole
What is the MOA of nystatin?
Disrupts fungal membranes by binding to ergosterol.
Which anti fungal cases immediate but transient visual disturbances in >30% of patients?
Voriconazole
This anti fungal causes photosensitivity and must be avoided in patients with porphyria.
Griseofulvin
Which anti fungal causes disulfiram-like reactions with alcohol?
Griseofulvin
Ketoconazole is the most toxic of the azoles and is rarely used for systemic mycoses. What are indications for its use?
Mucocutaneous candidiasis
Dermatophytes
Which of the azoles are active against Aspergillus?
Itraconazole
Voriconazole
What anti mycobacterial agent may cause skin discoloration ranging from red brown to nearly black?
Clofazimine
Amphoteric is distributed to all tissues except?
Brain
How will a shock like fall in BP, fever, chills, muscle spasm, vomiting with administration of amphotericin B be prevented?
Premeditated with antihistamine antipyretic meperidine glucocorticoids
Amphotericin B causes what dose limiting kidney dysfunction?
Remedy?
RTA with Mg and K wasting and decreased EPO.
Concomitant saline infusion
Which azole is has both GOOD ORAL absorption and GOOD CNS penetration and is ELIMINATED UNCHANGED in the kidneys.
Fluconazole.
Voriconazole is also reliable absorbed orally.
Azole use prevents the synthesis of?
Ergosterol
What is the broadest spectrum triangle present?
Posaconazole
What is the current DOC for Sporothrix infection?
Itraconzole
What synthesis is inhibited with the use of caspofungin?
Beta 1-2 fly can a component of the fungal cell wall
What gene has to be deleted to result in HIGH level resistance to INH?
katG gene.
inhA gene for low level resistance
