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*Unit 6 ER > Pharmacology > Flashcards

Pharmacology Flashcards

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1
Q

In the elderly, anticholinergics can exacerbate _____________, contributing to cognitive decline

A

Alzheimer’s

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2
Q

Pathways that convert a drug to a metabolite of greater, lesser or the same metabolic activity are (Phase I/ Phase II)

A

Phase I

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3
Q

What is Beer’s criteria?

A

A list of drugs and reasons not to prescribe them to old people

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4
Q 
Which if the following is most likely to contribute to a fall in a geriatric pt? 
(A) Acetaminophen.
(B) Hydrochlorothiazide.
(C) Amitriptyline.
(D) Calcium carbonate.
(E) Pravastatin.
A

Amitriptyline

Psychoactive medications such as amitriptyline are associated with a high risk of falls

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5
Q 
Which one of the following medications can you give without adjusting for patient age? 
(A) Metoprolol.
(B) Digoxin.
(C) Diazepam.
(D) Furosemide
A

Metoprolol
is metabolized in
the liver through phase II reactions

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6
Q 
Which has the adverse side effect of anorexia, nausea, vomiting and abdominal pain? 
(A) Aspirin
(B) Furosemide
(C) Digoxin
(D) Lisinopril
(E) Acetaminophen
A

Digoxin

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7
Q

What are the 3 ways to stimulate a gastric parietal cell to produce acid?

A
  1. gastrin
  2. histamine
  3. Acetylcholine
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8
Q 
Where do 
1. gastrin
2. histamine
3. Acetylcholine 
come from?
A

gastin: g-cells
histamine: mast cells
Acetylcholine: vagal stim

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9
Q

What is the effect of atropine on the stomach?

A

reduce acid secretion, reduce spasm

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10
Q

What is propantheline used for?

A

reduce stomach acid secretion, reduce spasm

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11
Q

What are the antihistamines for acid reflux?

A
  1. cimetidine
  2. ranitidine
  3. famotidine
  4. nizatidie
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12
Q

How are H2 blockers eliminated?

A

CYP 450 in liver

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13
Q

What time of day should PPI’s be taken?

A

before breakfast, parietal cells must be “turned-on” before PPI’s can inhibit

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14
Q

What PPI can be given IV?

A

Pantoprazole

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15
Q

What are the H+/K+ ATPase inhibitors?

A
  1. Omeprazole
  2. Landsoprazole
  3. Raberprazole
  4. Esomeprazole
  5. Pantoprazole
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16
Q

What are bismuth salts and sucralfate used for?

A

coat stomach ulcer craters, ulcer treatment esp. H. pylori

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17
Q

What drug should be give for NSAID induced gastric ulcers?

A

misoprostol

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18
Q

What is ‘quadruple therapy’?

A
  1. PPI 2x daily
  2. tetracycline
  3. bismuth
  4. metronidazole
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19
Q

what is advantage of liquid prep antacids?

A

speed, they are faster

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20
Q

What are the 2 promotility agents for GERD?

A
  1. Metochlopramide

2. Cisapride

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21
Q

What is the mechanism for Metochlopramide and Cisapride?

A

Dopamine agonist -> increase motor tone of LES and stomach

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22
Q

The trade name of British anti-Lewisite is ___________

A

Dimercaprol

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23
Q

The trade name for 2,3-dimercaptosuccinic acid is __________

A

Succimer

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24
Q

What do British anti-lewisite, BAL and 2,3-dimercaptosuccinic acid treat?

A

Arsenic, lead and mercury poisoning

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25
Q

‘Mad as a hatter’ could be poisoning with _________

A

Mercury

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26
Q

Poisoning with _______ causes ‘rice water’ diarrhea

A

Arsenic

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27
Q

Long QT interval and rice water diarrhea is __________ poisoning

A

Arsenic

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28
Q

Basophilic stippling of RBCs occurs with _________ poisoning

A

Lead

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29
Q

What do you give someone with lead encephalopathy?

A

BAL, British anti-lewisite

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30
Q

When pipercillin and tazobactam are combined, it is called _______

A

Zosyn

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31
Q

What commonly causes otitis media and sinusitis? How do you treat it?

A
  1. strep pneumonia
  2. haemophilus influenza
  3. Moraxilla
    treat w/ amoxicillin
    ceftriaxone is also effective against h influenza systemic dz
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32
Q

Pneumonia with Strep pneumococcus and Haemophilus influenza can be treated with ________

A

Amoxicillin

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33
Q

Amoxicillin + Clavulanate is called ________

A

Augmentin

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34
Q

Which stomach acid reducing drugs are known for drug-drug interactions due to CYP450 interference?

A

Histamine receptor blockers:

  1. Cimetidine
  2. Ranitidine
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35
Q

Toxin mediated diarrhea causes increased _______ in enterocytes

A

cAMP

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36
Q

How can anticholinergics like atropine reduce diarrhea?

How do opioids like loperamide reduce diarrhea?

A

anticholinergics -> relax sm. muscle -> decrease gastric motility
Opioids -> constrict muscle -> decrease gastric motility

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37
Q

Diphenoxylate, Codine sulfate, Lopermide

uses?

A

mu receptor interaction

decrease gastric motility

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38
Q

What is metamucil?

A

a COLLOID that absorbs water, reduces diarrhea but does not prevent dehydration

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39
Q

What is bismuth subsalicylate = kaopectate?

A

a PECTIN that absorbs water, reduces diarrhea but does not prevent dehydration
AKA pepto bismol

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40
Q

What are 3 anti-inflammatory drugs for acute IBD?

A
  1. Sulfasalazine
  2. Olsalazine
  3. Mesalamine
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41
Q

What are 3 Immunosuppressants that can be used for chronic IBD?

A
  1. Azithioprine
  2. Cyclosporine
  3. Infliximab
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42
Q

How do Dolasetron, Granesitron and Ondansetron work?

A

Antagonists (block) 5HT3 receptors, anti-emetic effect

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43
Q

How does promethazine work?

A

Antihistamine, H1 receptor antagonist, anticholinergic and anti-emetic

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44
Q

What is prochlorperazine?

A

An anti-emetic that reduces CRTZ stimulation

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45
Q

What is the CRTZ?

A

the chemoreceptor trigger zone: an area of the medulla that checks blood and mediates vomiting

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46
Q

What drug is used to increase the fecal elimination of thallium?

A

prussian blue

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47
Q

The antidote for Iron toxicity is _________

A

Deferoxamine

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48
Q

Which chelating agent is solvated in peanut oil?

A

BAL, British anti-lewisite

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49
Q

What is Deferoxamine? What is it’s side effect if treated for >24hrs?

A

Deferoxamine is the antidote for Iron poisoning, If treated for more than 24 hour, can cause Acute Lung Injury

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50
Q

Sodium nitroprusside is used as a _________

A

vasodilator, releases NO

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51
Q

If blood lead levels are greater than 50 µg/dl,
calcium disodium edetate (Ca Na2 EDTA) is administered. If the blood levels exceed 70 µg/dl,
dimercaprol (British-Anti-Lewisite [BAL]) is added. Why?

A

Dimercaprol (i.e., BAL) has a larger VD and hence will penetrate to sites inaccessible to Ca
Na2 EDTA

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52
Q

Which has a thick cell wall and which has an outer membrane, gram +/-?
As cephalosporins increase in generation, which do they cover better?

A

Thick cell wall: gram +
Outer membrane protiens: gram - w/ LPS
Cephalosporins have more gram - coverage with each generation

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53
Q

Which generation cephalosporin?

Cefazolin

A

Gen 1

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54
Q

Which generation cephalosporin?

cephalexin

A

Gen 1

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55
Q

Which generation cephalosporin?

Cefuroxime

A

Gen 2

fur fox in the grand tetons

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56
Q

Which generation cephalosporin?

Cefoxitin

A

Gen 2

fur fox tetons

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57
Q

Which generation cephalosporin?

Cefotetan

A

Gen 2

fur fox tetons

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58
Q

Which generation cephalosporin?

Cefepime

A

Gen 4

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59
Q

Which generation cephalosporin?

Ceftazadime

A

Gen 3

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60
Q

Which generation cephalosporin?

Cepodoxime

A

Gen 3

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61
Q

Which generation cephalosporin?

Ceftriaxone

A

Gen 3

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62
Q

Which generation cephalosporin?

Ceftaroline

A

Gen 5

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63
Q

How does castor oil relive constipation?

A

irritates GI, causes peristalsis

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64
Q

How does MRSA evade beta-lactam Abx?

A

Alteration of PBP, specifically PBP2a

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65
Q

Which cephalosporin has activity against MRSA?

A

ceftaroline, Gen 5

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66
Q

How is Ceftriaxone excreted?

What are Ceftriaxone side effects?

A

Ceftriaxone is excreted 30% renal, 70% hepatobiliary
Other cephalosporins excreted renaly
Ceftriaxone Side effects: biliary sludge, gallstones
bilirubin encephalopathy in new borns

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67
Q

which has better oral bio availability? (ampicillin/ amoxicillin)

A

amoxicillin

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68
Q

What is the #1 cause of pneumonia in CF patients?

Also common in burn victims + nosocomial infections

A

pseudomonas

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69
Q

Which penicillins are used for pseudomonas?

Which cephalosporin can be used for pseudomonas?

A

penicillins: Piperacillin, Ticarcillin
cephalosporin: cefepime, gen 4

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70
Q

What two Abx are combined to make zosyn?

A

pipercillin and tazobactam

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71
Q

What two drugs are combined to make augmentin?

A

amoxacillin and clavulanate

72
Q

64 y. o. with a total knee replacement that is now infected with MSSA. What Abx should you use?

a. penicilin G IV
b. Ampicillin IV
c. oxacillin IV
d. dicloxacillin PO

A

oxacillin IV, is penecillinase reistant and antistaphylococcal.
has better bioavailability than dicloxacillin

73
Q

What 2 Abx are best know for disulfram like rxn w/ alcohol?

A

Metronidazole and cefalosporins

specifically with cefamandole 2nd gen, cefotetan 2nd gen, and cefoperazone 3rd gen

74
Q

What are the PEcK bugs?

Which generation of cephalosporins has activity against the PEcK bugs?

A

Proteus, E coli, Klebsiella

Gen 1: Cefazolin, Cephalexin, Cephadroxil

75
Q

What cephalosporin is used for surgical prophylaxis?

A

Cefazolin, 1st generation

76
Q 
What class of drug is Aztreonam? 
What is the coverage of Aztreonam?
A 
Monobactam
aerobic gram (-) only, good for serious systemic infections  
(B pertussis
F tularemia
Listeria 
B henslae
pseudomonas
Brucells)
77
Q

What are the Carbapenams?

A
  1. Doripenem
  2. Ertapenem
  3. Meropenem
  4. Imipenem
78
Q

What must be given with imipenem to prevent degradation with renal enzyme dehydropeptidase 1?

A

Cilastin

79
Q

What is the empiric treatment of endocarditis?

A

Vancomycin

covers staph and strep families

80
Q

Vancomycin is poorly absorbed. It is only used orally for treatment of _________

A

C difficile

81
Q

Red man syndrome with vancomycin is due to release of __________

A

histamine

vanco can also cause ototox and nephrotox

82
Q

What microbes does Daptomycin cover?

A

Gram (+), staph, Strep, Enterococcus works on VRE

83
Q

How do tetracyclines work?

A

bind 30s subunit, Inhibit Ribosomal translation by stopping tRNA docking

84
Q

What 2 bacteriostatic drug classes bind the 30s ribosomal subunit?

A
  1. tetracyclines

2. aminoglycosides

85
Q

What drug works on infections acquired in the great outdoors including rickettsia, ehrlichia, borellia, francisella, coxiella, brucella

A

Doxycycline

or minocycline, but worse side effects

86
Q

where does vancomycin work?

cell wall/ DNA gyrase/ DNA dir RNA pol/ 50S/ 30S/ DHF red/ DHPT synth

A

cell wall, inhibits transglycosylation

87
Q

Where do sulfanamide Abx work?

cell wall/ DNA gyrase/ DNA dir RNA pol/ 50S/ 30S/ DHF red/ DHPT synth

A

Dihydropteroate synthase

88
Q

where do aminoglycosides work?

cell wall/ DNA gyrase/ DNA dir RNA pol/ 50S/ 30S/ DHF red/ DHPT synth

A

30s

A and T

89
Q

where do tetracyclines work? (cell wall/ DNA gyrase/ DNA dir RNA pol/ 50S/ 30S/ DHF red/ DHPT synth)

A

30s

A and T

90
Q

where does clindamycin work?

(cell wall/ DNA gyrase/ DNA dir RNA pol/ 50S/ 30S/ DHF red/ DHPT synth)

A

50s

macrolides and singles

91
Q

where does macrolides work?

(cell wall/ DNA gyrase/ DNA dir RNA pol/ 50S/ 30S/ DHF red/ DHPT synth)

A

50s, block ribosomal AA translocation

macrolides and singles work at 50s

92
Q

where does rifampin work? (cell wall/ DNA gyrase/ DNA dir RNA pol/ 50S/ 30S/ DHF red/ DHPT synth)

A

dna directed rna polymerase

esp TB

93
Q

where do fluoroquinolones work?

(cell wall/ DNA gyrase/ DNA dir RNA pol/ 50S/ 30S/ DHF red/ DHPT synth)

A

DNA gyrase

94
Q

Where does trimethoprim work?

(cell wall/ DNA gyrase/ DNA dir RNA pol/ 50S/ 30S/ DHF red/ DHPT synth)

A

DHF reductase

95
Q

Where do cephalosporins work? (cell wall/ DNA gyrase/ DNA dir RNA pol/ 50S/ 30S/ DHF red/ DHPT synth)

A

cell wall

96
Q

What are the uses of chloremphenicol?

A

meningitis outbreaks in third world, pregnant women with rickestial Dz where tetracyclines are contraindicated

97
Q

What are the uses of linezolid?

A

binds 50S, serious gram + infections, MRSA, VRE

98
Q

What are the side effects of linezolid?

A

thrombocytopenia, anemia, neutropenia, optic neuropathy

99
Q

What is first line treatment for acute prostatis in men?

A

Bactram, TMP-SMX

100
Q

What are the ‘big guns’ for MRSA?

A

Vancomycin, daptomycin, linezolid
second line:
bactram, ceftaroline

101
Q

what is the treatment for toxoplasmosis?

A

Pyrimethamine/ Sulfadiazine

102
Q

What are 2 major side effects of inhibiting folate synthesis?

A

1 megalolastic anemia

2. neural tube defects in first trimester

103
Q

Which can treat MRSA and anaerobes like clostridium perfringins? (clarithromycin/ clindamycin)

A

clindamycin

104
Q

Which is a macrolide? (clarithromycin/ clindamycin)

A

clarithromycin and azithromycin are macrolides

105
Q

First line treatment for an uncomplicated UTI is ________

For complicated UTI with diabetes, _______

A

uncomplicated: Bactram, TMP-SMX
complicated: fluoroquinolones: Ciprofloxacin and Levofloxacin

106
Q

What is the cardiac side effect of fluoroquinolines, Moxifloxacin, Levofloxacin, Ciprofloxacin

A

QT prolongation

both macrolides and fluoroquinolones

107
Q

Which Abx are known for causing tendon and cartilage damage?

A

fluoroquinolines: Moxifloxacin, Levofloxacin, Ciprofloxacin

108
Q

metals like Ca2+, Fe2+ and Mg2+ decrease absorption of what Abx?

A

fluoroquinolones and tetracyclines

109
Q

Which component of RIPE therapy inhibits mycolic acid synthesis?

A

Isoniazid

110
Q

Isoniazid is abreviated INH. What are the side effects of isoniazid?

A

Injury to Nerves and Hepatocytes (INH)

111
Q

Which componenet of RIPE therapy inhibits DNA synthesis?

A

Rifampin, inhibits DNA dependant RNA polymerase

112
Q

What vitamin MUST isoniazide be administered with to prevent peripheral neuropathy?

A

B6

113
Q

Isoniazid inhibits CYP 450, what anti-epiliptic is implicated?

A

phenytoin can be raised to toxic levels

114
Q

Which part of RIPE therapy is a CYP inhibitor? Inducer?

A

Isoniazid is inhibitor

Rifampin is inducer

115
Q

Which part of RIPE therapy inhibits arabinosyl transferase involved in cell wall synthesis?

A

Ethambutol

116
Q

What is the side effect of ethambutol?

A

red/green color blindness

117
Q

What is the DOC for MSSA?

A

Oxacillin, Nafcillin

118
Q

Which generation of Cephalosporins is best for meningitis? what is the empiric treatment for post-surgical meningitis?

A

gen 3 crosses BBB best,

Ceftazidime best for post surg meningitis

119
Q

Which cephalosporin can cause akinetic seizures?

A

cefepime, gen 4

120
Q

When would you combine Daptomycin w/ ceftaroline, gen 5?

A

For complicated bacteremia. MRSA. VRE

121
Q

Dalbavancin and Oritivancin work similar to vancomycin, but what is special about thier pharmokinetics?

A

Dalbavancin and Oritivancin, long half life 200 hours

122
Q 
Which of the following is an appropriate empiric regimen for a hospital-acquired intraabdominal
infection?
A. Gentamicin plus vancomycin
B. Clindamycin plus vancomycin
C. Meropenem
D. Ciprofloxacin
A

Meropenam

123
Q 
Which one of the following agents is an ORAL option to treat Pseudomonas infection?
A. Levofloxacin
B. Doxycycline
C. Moxifloxacin
D. Cefotetan
A

Levofloxacin

124
Q 
Which one of the following agents is the most acceptable for the treatment of MSSA
bacteremia?
A. Daptomycin
B. Vancomycin
C. Cefazolin
D. Piperacillin-tazobactam
A

cefazolin

125
Q

Which of the following antibiotics can cause nephrotoxicity?
A. Trimethoprim-sulfamethoxazole (Bactrim)
B. Amikacin (aminoglycoside)
C. Vancomycin
D. Piperacillin-tazobactam
E. All of the above

A

E. All of the above

126
Q 
Which of the following antibiotics inhibits the last step in cell wall synthesis
(transpeptidation)?
A. Tigecycline
B. Cephalexin
C. Daptomycin
D. Levofloxacin
A

B. Cephalexin
tigecycline: 30S
Daptomycin: depolarizes
Levofloxacin: DNA gyrase and topoisomerase

127
Q 
Which of the following is NOT an appropriate choice for treatment of MRSA pneumonia?
A. Daptomycin
B. Linezolid
C. Vancomycin
D. Meropenem
E. A & D
A

A & D
Daptmycin, Linezolid and Vancomycin all cover MRSA
Daptomycin is inactivated by pulmonary surfactant

128
Q

What are the fluoroquinolines?

A
  1. Ciprofloxacin, gen 1
  2. Levofloxacin, Gen 2
  3. Moxicloxacin, Gen 2
129
Q

A 56-year-old male is receiving ciprofloxacin and linezolid for a 6 week course of
prosthetic knee infection. After 4 weeks, the patient calls his doctor’s office and
complains of gum bleeding after brushing his teeth. What is the most likely explanation?
A. Hemolytic anemia from ciprofloxacin
B. Thrombocytopenia from ciprofloxacin
C. Hemolytic anemia from linezolid
D. Thrombocytopenia from linezolid

A

Thrombocytopenia from linezolid

130
Q 
A 56-year-old female with CAP presents with cough and increased sputum production. CXR is consistent with pneumonia. Which of the following is an appropriate empiric antibiotic
regimen?
A. Aztreonam
B. Ciprofloxacin
C. Levofloxacin
D. Ceftriaxone
A

Levofloxacin, cipro does not cover pneumococcus, levo does

131
Q

This PGE1 analog can increase mucous production and bicabonate secretion in the stomach

A

Misoprostol

also induces labor-> abortion

132
Q

What is the DOC for syphilis?

A

Benzapine-penicillin G

133
Q

What is the DOC for Clostridium difficile?

A

Metronidazole, oral vancomycin is a back-up

134
Q

What is the coverage of Vancomycin?

A

MRSA, entercocci, back up drug for Clostridium difficile

135
Q 
A patient diagnosed with an intraabdominal Pseudomonas aeruginosa infection would be most effectively treated with which of the following?
A.Amoxicillin
B.Cefuroxime
C.Meropenem
D.Methicillin
E.Vancomycin
A

Meropenam

136
Q 
A patient who had an anaphylactic allergic reaction to ceftriaxone is least likely to experience an allergic reaction if administered which of the following?
A.Aztreonam
B.Cefuroxime
C.Imipenem
D.Loracarbef
A

Aztreonam

137
Q

Which bacteria are no covered by cephalosporins?

A 
LAME
Listeria monocytogenes
Atypicals
MRSA (covered by Ceftaroline) 
Enterococci
138
Q

What is the DOC for yersinia and tularemia?

A

Streptomycin

139
Q

Which Abx can cause phototoxicity, a rash when exposed to sunlight?

A

FoToS

Fluoroquinolones, Tetracyclines, Sulfonamides,

140
Q

What is the DOC for chlamydia infection

A

Tetracycline,r 7 days or azithromycin, single dose

141
Q

What do you use for lyme Dz in an adult? a child?

A

adult: tetracycline, doxycycline
child: amoxacillin

142
Q

What tetracycline can be used for both MRSA and VRE?

A

tigecycline

143
Q

What is the DOC for nocardia?

A

Bactram

144
Q

A patient with a deficiency of glucose-6-phosphate dehydrogenase is at a significantly higher risk for developing hemolytic anemia if he receives which of the following antibiotics?

A.Ampicillin
B.Cefaclor
C.Ciprofloxacin
D.Tetracycline
E.Trimethoprim/sulfamethoxazole
A

Trimethoprim/sulfamethoxazole

145
Q

A pregnant woman gives birth to an infant who has abnormally high levels of unconjugated bilirubin. Which of the following antibiotics was most likely administered to the mother?

A.Ampicillin
B.Ciprofloxacin
C.Metronidazole
D.Trimethoprim/sulfamethoxazole
E.Vancomycin
A

Trimethoprim/sulfamethoxazole

146
Q

A 65-year-old man is diagnosed with acute bacterial prostatitis and is prescribed ciprofloxacin for 6 weeks. This agent exerts its therapeutic effect through which of the following mechanisms?

A.Competitive inhibition of para-aminobenzoic acid
B.Inhibition of bacterial cell wall synthesis
C.Inhibition of DNA gyrase
D.Inhibition of viral replication, decreased viral shedding, and reduced time for healing of lesions
E.Reversible binding to the 50S subunit of bacterial ribosomes

A

Inhibition of DNA gyrase

147
Q

Vestibular dysfunction and nephrotoxicity are most commonly seen with which of the following?

A.Ethambutol
B.Isoniazid
C.Pyrazinamide
D.Rifampin
E.Streptomycin
A

Streptomycin

148
Q

After consuming alcohol, a patient who is currently taking an antibiotic experiences severe nausea, vomiting, sweating, and tachycardia. Based on this information, the patient is most likely receiving which of the following?

A.Acyclovir
B.Cefaclor
C.Metronidazole
D.Tetracycline
E.Trimethoprim/sulfamethoxazole
A

Metronidazole

149
Q

What is the treamtnet for Mycobacterium Avium complex, MAC?

A

MAC, Macrolides, Azithromycin, clarithromycin

150
Q

What is the dose limiting toxicity of zidovudine, AZT?

A

bone marrow suppression

151
Q

Why cant you use both Lamivudine and Emtricitabine in combination to treat HIV?

A

Both are cytosine analogs, compete against each other

152
Q

Why do we use Ritonavir with other protease inhibitors? what are the other protease inhibitors?

A 
Ritonavir is a p450 inhibitor, raises drug conc of others:
Fosamprenavir
Atazanavir
Darunavir
Lopinavir
153
Q

Which of the following is indicated for the treatment of cytomegalovirus retinitis and is associated with the development of interstitial nephritis, severe hypocalcemia, hyperphosphatemia, and hypokalemia?

A.Acyclovir
B.Cidofovir
C.Foscarnet
D.Nevirapine
E.Zidovudine
A

Foscarnet

154
Q

The dose-limiting side effect of ganciclovir is which of the following?

A.Agranulocytosis
B.Azotemia
C.Cataracts
D.Neutropenia
E.Pulmonary fibrosis
A

Neutropenia

155
Q

Which of the following is contraindicated for use with furosemide?

A.Amantadine
B.Efavirenz
C.Foscarnet
D.Indinavir

A

Foscarnet

156
Q

A patient who is being treated for an influenza A infection complains of increased nervousness and insomnia. The patient is most likely being treated with which of the following agents?

A.Amantadine
B.Ganciclovir
C.Oseltamivir
D.Ribavirin

A

Amantadine

157
Q

The mechanism of action of which of the following involves the blocking of viral penetration and UNCOATING?

A.Acyclovir
B.Amantadine
C.Efavirenz
D.Indinavir

A

Amantadine

158
Q

Which of the following agents is classified as a protease inhibitor?

A.Didanosine
B.Nevirapine
C.Ritonavir
D.Zalcitabine

A

Ritonavir, saquinavir, and indinavir are classified as protease inhibitors

159
Q

Which of the following agents is most likely to increase the INR of a patient receiving warfarin?

A.Didanosine
B.Nevirapine
C.Ritonavir
D.Stavudine

A

Ritonavir

160
Q

What are the components of HIV post-exposure prophylaxis? PrEP?

A

PrEP: tenofovir+emtricitabine

Post exposure: tenofovir+emtricitabine+raltegravir

161
Q

What are the HIV integrase inhibitors?

A

-tegravir

Raltegravir, Elvitegravir, Dolutegravir

162
Q

What are the fusion inhibitors for HIV?

A
  1. Enfuviritide, binds gp41

2. Maraviroc, binds CCR5 on macrophages

163
Q

What can be administered with amphotericin B to reduce infusion reactions like fever chills and rigor?

A

antihistamine

164
Q

What is the DOC for aspergillus?

A

Vorconazole

165
Q

Which antifungals penetrates the CSF?

A

Fluconazole, Flucytosine

166
Q

Which anti-fungal can lead to gynecomastia, menstrual irregularities, and decreased libido? Why?

A

Ketoconazole -> inhibits p450’s -> decreased sex steroid synthesis

167
Q

Which anti-fungal has this Mech of action: converted by fungal cytosine deaminase to 5-FU, a toxic chemotherapeutic

A

Flucytosine

168
Q

Which anti-fungals are given IV and inhibit the cell wall?

A

Echinocandins:

Caspofungin, Anidulafungin, Micafungin

169
Q

Amphotericin B is the drug of choice as a single agent for treatment of which of the following?

A. Clostridium difficile
B. Cryptococcus
C.Herpes simplex
D. Histoplasma

A

Cryptococcus

170
Q

The most common side effect of amphotericin B is most appropriately treated with which of the following?

A.Diltiazem
B.Folic acid
C.Gabapentin
D.Meperidine

A

Meperidine, an opioid

171
Q

Which of the following is most likely to result in an oral Candida infection?

A.Aerosolized albuterol
B.Aerosolized beclomethasone
C.Aerosolized ipratropium
D.Oral fluconazole

A

Aerosolized beclomethasone

172
Q

What is the significance of Linezolid inhibiting MAO?

A

can result in serotonin syndrome if given with serotonergic agents

173
Q

Which 2 antibiotic classes can result in long QT or torsades?

A

Fluoroquinolones esp moxifloxacin

AND macrolides

174
Q

What drug is used as prophylaxis for nisseria meningitidis?

A

Rifampin

175
Q

What supplement must be given with Isoniazid?

A

B6, prevent neuropathy

176
Q

What type of pneumonia are AIDS patients especially at risk for? What is the prophylaxis?

A

Pneumocystis jirovecci

Rx: Bactram

177
Q

What type of rash can be cause by TMP-SMX?

A

SJS or TEN

*Unit 6 ER (3 decks)

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