Pharm: Antimycobacterials and antifungals

Question 1

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

Answer 1

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

Question 2

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

Answer 2

Rifampicin

Question 3

T/F hyperuricemia occurs with the use of pyrazinamide.

Answer 3

True. But the polyarthralgia involved is NON-GOUTY.

Question 4

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

Answer 4

Ethambutol

Question 5

What enzyme does ethambutol inhibit?

Answer 5

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

Question 6

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

Answer 6

Isoniazid

Question 7

Who are at risk for pyridoxine deficiency with INH treatment?

Answer 7

Diabetics
Malnourished
AIDS px

Question 8

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

Answer 8

Clarithromycin/Azithromycin +/- rifabutin

Question 9

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

Answer 9

Pyridoxine 25-50 mg/day

Question 10

Which anti-TB drug undergoes enterohepatic recycling?

Answer 10

Rifampin

Question 11

Which of the anti-TB drugs are bacteriostatic

Answer 11

Ethambutol

Pyrazinamide

Question 12

Which anti-TB drug causes porphyria and photo sensitivity?

Answer 12

Pyrazinamide

Question 13

Fluconazole is the drug of choice for:

Answer 13

Esophageal and oropharyngeal candidiasis

Infections with Coccidioides

Treatment and secondary prophylaxis against cryptococcal meningitis

Question 14

Itraconazole is the drug of choice for:

Answer 14

Blastomycosis
Sporothrichosis
Subcutaneous chromoblastomycosis

Question 15

Only azole with activity against Rhizopus

Answer 15

Posaconazole

Question 16

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

Answer 16

Micafungin

Question 17

Which antifungal has disulfiram reactions with ethanol?

Answer 17

Griseofulvin

Question 18

Terbinafine inhibits which enzyme?

Answer 18

Squalene epoxidase

Question 19

Which antifungal is a will cause an increase in warfarin?

Answer 19

Ketoconazole

Question 20

What is the MOA of nystatin?

Answer 20

Disrupts fungal membranes by binding to ergosterol.

Question 21

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

Answer 21

Voriconazole

Question 22

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

Answer 22

Griseofulvin

Question 23

Which anti fungal causes disulfiram-like reactions with alcohol?

Answer 23

Griseofulvin

Question 24

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

Answer 24

Mucocutaneous candidiasis

Dermatophytes

Question 25

Which of the azoles are active against Aspergillus?

Answer 25

Itraconazole | Voriconazole

Question 26

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

Answer 26

Clofazimine

Question 27

Amphoteric is distributed to all tissues except?

Answer 27

Brain

Question 28

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

Answer 28

Premeditated with antihistamine antipyretic meperidine glucocorticoids

Question 29

Amphotericin B causes what dose limiting kidney dysfunction? Remedy?

Answer 29

RTA with Mg and K wasting and decreased EPO. Concomitant saline infusion

Question 30

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

Answer 30

Fluconazole. Voriconazole is also reliable absorbed orally.

Question 31

Azole use prevents the synthesis of?

Answer 31

Ergosterol

Question 32

What is the broadest spectrum triangle present?

Answer 32

Posaconazole

Question 33

What is the current DOC for Sporothrix infection?

Answer 33

Itraconzole

Question 34

What synthesis is inhibited with the use of caspofungin?

Answer 34

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

Question 35

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

Answer 35

katG gene. inhA gene for low level resistance