Pharm: Antimycobacterials and antifungals Flashcards

1
Q

Differentiate the effect of Rifampicin and Isoniazid on the blood levels of warfarin, phenytoin and carbamazepine.

A

INH will increase the levels whole Rifampicin will decrease the levels.

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2
Q

Which anti-TB medication can be used as a 2nd line drug against MRSA.?

A

Rifampicin

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3
Q

T/F hyperuricemia occurs with the use of pyrazinamide.

A

True. But the polyarthralgia involved is NON-GOUTY.

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4
Q

Which among the anti-TB drugs causes red green color blindness?

A

Ethambutol

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5
Q

What enzyme does ethambutol inhibit?

A

Arabinosyl transferase. For the synthesis of arabinogalactan a vital part of mycobacterial cell walls.

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6
Q

Which of the antiTB drugs can cause drug-induced lupus?

A

Isoniazid

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7
Q

Who are at risk for pyridoxine deficiency with INH treatment?

A

Diabetics
Malnourished
AIDS px

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8
Q

Recommended regimen for prophylaxis in patients with CD4 counts <50 (against MAC)

A

Clarithromycin/Azithromycin +/- rifabutin

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9
Q

What do you give px treated with INH to prevent pyridoxine deficiency?

A

Pyridoxine 25-50 mg/day

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10
Q

Which anti-TB drug undergoes enterohepatic recycling?

A

Rifampin

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11
Q

Which of the anti-TB drugs are bacteriostatic

A

Ethambutol

Pyrazinamide

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12
Q

Which anti-TB drug causes porphyria and photo sensitivity?

A

Pyrazinamide

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13
Q

Fluconazole is the drug of choice for:

A

Esophageal and oropharyngeal candidiasis

Infections with Coccidioides

Treatment and secondary prophylaxis against cryptococcal meningitis

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14
Q

Itraconazole is the drug of choice for:

A

Blastomycosis
Sporothrichosis
Subcutaneous chromoblastomycosis

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15
Q

Only azole with activity against Rhizopus

A

Posaconazole

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16
Q

Which antifungal increase the release of histamine and increases the levels of cyclosporine?

A

Micafungin

17
Q

Which antifungal has disulfiram reactions with ethanol?

A

Griseofulvin

18
Q

Terbinafine inhibits which enzyme?

A

Squalene epoxidase

19
Q

Which antifungal is a will cause an increase in warfarin?

A

Ketoconazole

20
Q

What is the MOA of nystatin?

A

Disrupts fungal membranes by binding to ergosterol.

21
Q

Which anti fungal cases immediate but transient visual disturbances in >30% of patients?

A

Voriconazole

22
Q

This anti fungal causes photosensitivity and must be avoided in patients with porphyria.

A

Griseofulvin

23
Q

Which anti fungal causes disulfiram-like reactions with alcohol?

A

Griseofulvin

24
Q

Ketoconazole is the most toxic of the azoles and is rarely used for systemic mycoses. What are indications for its use?

A

Mucocutaneous candidiasis

Dermatophytes

25
Q

Which of the azoles are active against Aspergillus?

A

Itraconazole

Voriconazole

26
Q

What anti mycobacterial agent may cause skin discoloration ranging from red brown to nearly black?

A

Clofazimine

27
Q

Amphoteric is distributed to all tissues except?

A

Brain

28
Q

How will a shock like fall in BP, fever, chills, muscle spasm, vomiting with administration of amphotericin B be prevented?

A

Premeditated with antihistamine antipyretic meperidine glucocorticoids

29
Q

Amphotericin B causes what dose limiting kidney dysfunction?

Remedy?

A

RTA with Mg and K wasting and decreased EPO.

Concomitant saline infusion

30
Q

Which azole is has both GOOD ORAL absorption and GOOD CNS penetration and is ELIMINATED UNCHANGED in the kidneys.

A

Fluconazole.

Voriconazole is also reliable absorbed orally.

31
Q

Azole use prevents the synthesis of?

A

Ergosterol

32
Q

What is the broadest spectrum triangle present?

A

Posaconazole

33
Q

What is the current DOC for Sporothrix infection?

A

Itraconzole

34
Q

What synthesis is inhibited with the use of caspofungin?

A

Beta 1-2 fly can a component of the fungal cell wall

35
Q

What gene has to be deleted to result in HIGH level resistance to INH?

A

katG gene.

inhA gene for low level resistance