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1
Q

What is the number 1 drug choice for trt of gonorrhea?

A

Ceftriaxone
Just like what we saw in trt for Oc Disease
Cefixime is also used.

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2
Q

What is an adverse effect of Cephalosporin, esp those with methyl thio-tetrazole group

A

Disulfiram like symptoms when take with alcohol

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3
Q

What does Fosfomycin treat?

A

Uncomplicated UTI in pregnant females

Take one oral dose (3g)

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4
Q

Which drug classified under cell wall synthesis inhibitors that is only effective for TB

A

Cycloserine.

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5
Q

Describe Tetracycline resistance

A

Reduce permeability.

Increased efflux by an active transport protein pump (tet-A)

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6
Q

What organisms is Tigecycline effective against?

A 
Tetracycline resistant organisms
MRSA
MRSE
PRSP
VRE
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7
Q

Which group of organisms does Clarithromycin & Azithromycin have enhanced activity against?

A

Mycobacterium Avium intracellulare
Some Protozoa
(Blow that A/C on Mycobacterium)

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8
Q

Which part of bacteria does macrolides bind to?

A

50s subunit

They bind reversibly.

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9
Q

Is Telithromycin a ketolide or macrolide?

A

Ketolide.

The only drug

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10
Q

Name the only protein synthesis inhibitor that is bactericidal

A

Aminoglycosides

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11
Q

What category of drugs does Gentamycin belong to?

Are they more effective against aerobic gram + or - organisms?

A

Aminoglycosides.

Gram - more effective.

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12
Q

What condition is necessary for Gentamycin to work?

A

Oxygen.

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13
Q

MOA of Gentamycin

A
  1. Blockthe formation of translation-initiation-complex
  2. Misread the mRNA code
  3. Disrupt the polysomes resulting in non-functional monosomes
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14
Q

What is the MOA of sulfonamides

A

Prevents the normal bacterial utilization of PABA for the synthesis of folic acid; anti-metabolites

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15
Q

MOA of Quinolones

A

Inhibits gyrase mediated DNA supercoiling.

Inhibit Topoisomerase IV in bacteria

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16
Q

Of the many things that Quinolones treat, name one of them?

A

Trt of UTI with pseudomonas aeruginosa
B4.
Norfloxacin is approved in the US only for UTI

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17
Q

What drug is used as the second line drug against TB?

A

Rifapentine

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18
Q

What is the MOA for Isoniazid?

A

Blocks mycolic acid

Inactivates catalase peroxidase enzyme

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19
Q

What is RIPE?

A

Rifampin
Isoniazid
Pyrazinamide
Ethambutol

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20
Q

Name some AE of Ethambutol?

A

Visual distrubances
Retinal damage
Peripheral nephritis
Headache and confusion

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21
Q

Which drug is the only cell wall synthesis inhibitor for TB?

A

Cycloserine

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22
Q

Which drug is the most effective against M. Leprae and inhibts bacterial folic acid synthesis?

A

Dapone

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23
Q

Name and what do you treat Atypical mycobacterial infections?

A

M. Avium complex

Azithromycin

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24
Q

How does Amphotericin B work?

A

Forms channels and pores by interacting with ergesterol.

Makes the membrane permeable to ions

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25
Q

MOA of flucytosine?

A

It gets deaminated to 5-FU; a potent antimetabolite by cytosine deaminase. 5-FU inhibits thymidylate synthase enzymes.

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26
Q

MOA of griseofulvin?

A

Inhibits mitotic spindle formation

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27
Q

What drugs are used in Hepatitis B?

A 
NRTIs
Lamivudine
Telbivudine
Entecavir
Adefovir
Tenofovir
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28
Q

MOA of foscarnet

A

An inorganic pyrophosphate that interacts directly and inhibits viral RNA polymerase, dnA polymerase and HIV RT

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29
Q

Which drug is used for Trypanosoma Cruzi?

A

Melarsoprol.

A trivalent arsenic used in the later stages of CNS development

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30
Q

MOA of Nifurtimox?

A

Produces intracellular free radicals that kill American Trypanosomiasis

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31
Q

How do you treat Trematodes and Cestodes?

A

Praziquantel

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32
Q

MOA of mebendazole?

A

Inhibits microtubule synthesisis of the parasite.

Parasite is expelled with feces.

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33
Q

List some drugs used against pneumocystosis

A 
TMP-SMZ
Pentamidine
Atovaquone
Dapsone
Eflornithine
NOT Tinidazole
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34
Q

What is Tinidazole used against?

A

Giardia
Amebiasis
Trichomoniasis

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35
Q

What is Metronidazole used against?

A

Giardia
Amebiasis
Trichomoniasis

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36
Q

What conditions is PCN G used for?

A 
Clostridium Perfringens (Gas Gangrene; use with Clindamycin)
Treponema Pallidum
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37
Q

How is PCN eliminated?

A

Kidneys (tubular secretion)

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38
Q

What condition do you use Ampicillin for?

A

Listeria

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39
Q

Which of the two drugs can you only give orally: Ampicillin or Amoxicillin?

A

Amoxicillin

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40
Q

Which beta lactamase inhibitor is ampicillin combined with?

What do they treat?

A

Sulbactam.

Treat intra-abdominal and gynecological infections

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41
Q

If you are in the hospital and need I.V.; should the doctor combine PCN and aminoglycosides?

A

NO

They do work together, but do not combine.

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42
Q

Are you allowed to use Amoxicillin for GI infections?

A

NO

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43
Q

What are the three beta lactamse inhibitors?

A

Clavulanic acid
Sulbactam
Tazobactam

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44
Q

How are cephalosporins excreted?

A

Kidneys - Tubular secretion

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45
Q

In what disease do we see parenteral cephalosporin usage?

A

Gonococcal disease

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46
Q

What drug do we see the prophylactic usage for perioperative infections?

A

Cephalosporins

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47
Q

First generation Cephalsporins was active against what?

A

PEcK
Proteus
E.coli
Klebsiella pneumoniae

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48
Q

Second generation Cephalosporins was active against what?

A 
HENPEcK
Haemophilus influenzae
Enterobacter aerogenes
Neisseria
Proteus
E. coli
Klebsiella pneumoniae
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49
Q

Which cephalosporin drug is used as DOC for prophylaxis surgically?

A

Cefazolin

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50
Q

Which two cephalosporin drugs are used as first line therapy for N. Gonorrhea?

A

Ceftriaxone
Cefixime
Third generation (broad spectrum)

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51
Q

Which two cephalosporin drugs are excreted through the biliary tract?

A

Cefoperazone
Ceftriaxone
No dosage adjustment is necessary in renal insufficiency
Third generation

52
Q

Which generation of cephalosporins are able to cross the BBB?

53
Q

What generation of cephalosporins does Cefepime belong to?

A

4th generation

54
Q

Which group of drugs does disulfiram like symptoms appear in due to aldehyde accumulation?

A

Cephalosporins

55
Q

Which group of drugs is said to be the broadest spectrum of all cell wall synthesis inhibitors?

A

Carbapenems

56
Q

Which group of drug contain a beta lactam ring without a primary ring?

A

Monobactam

57
Q

T/F?

Gram positive gather 100X more erythromycin than gram negative

58
Q

Which macrolide is bacteriostatic and not active against enteric gram - bacilli?

A

Erythromycin

59
Q

Which macrolide is more active against M. avium than erythromycin?

A

Clarithromycin

60
Q

Which macrolide contain long half lives because of extensive tissue sequestration and binding?

A

Azithromycin (68 hours)

There is extensive tissue distribution and high drug concentration within a cell.

61
Q

Which group of drugs contain 2 MOA that are energy dependent and not absorbed via the GI tract?

A

Aminoglycosides.

62
Q

What happens if you combine aminoglycosides and loop diuretics together?

A

Increase in Ototoxicity and Nephrotoxicity

63
Q

What is the name of a semi aminoglycoside used for Gonocci?

A

Spectinomycin.

Only use if pt is allergic to PCN, or gonococci are resistant to other agents.

64
Q

What drug is Gray baby syndrome associated with?

A

Chloramphenicol.

65
Q

What constitutes gray baby syndrome?

A

Vomiting
Flaccidity
Gray color shock
Collapse

66
Q

What is the main usage for Clindamycin?

A

Trt of severe infections due to anaerobes such as Bacteroides.

67
Q

What two species of organisms is clindamycin good at getting rid of?

A

P. Carinii

T. Gondii

68
Q

Name one resistance mechanism of Sulfonamides?

A

An increase in substrate (PABA)

69
Q

For children with Otitis media, what is sulfisoxazole combined with?

A

Erythromycin.

Marketed as Pediazole, Eryzole or Pediagen

70
Q

Which drug is converted into anti-inflammatory?

A

Sulfasalazine
Preferred over corticosteroids for tx of
ulcerative colitis/granulomatous colitis

71
Q

What is the name of topical sulfonamide used for prevention of infection of burns?

A

Silver sulfadiazine.
Reduces microbial colonization
Mafenide as well

72
Q

What is the name of drugs that prevents the colonizatoin of burns?

A

Mafenide

Silver sulfadiazine as well.

73
Q

What does combo of Sulfadoxine and Pyrimethamine trt?

A
  1. second line tx for malaria;
  2. prophylaxis and
    tx of mefloquine resistant plasmodium
    falciparum
74
Q

What is TMP-SMZ used for?

A

Oral Trimethoprim-Sulfamethoxazol
Pneumocystic Jirovecii Pneumonia
shigellosis
systemic salmonella infections, UTI, prostatitis, some ontuberculous mycobacterial infxns

75
Q

Give me a good combo for malaria?

A

Proguanil + atovaquone

76
Q

WHat is the group of drugs that inhibit bacterial topoisomerase?

A

Fluoroquinolones

77
Q

What does sulfonamides cause in neonates?

A

Kernicterus

78
Q

Which generations of FQ mess with QT prolongation?

79
Q

Which drug turns urine to reddish/orange color?

80
Q

Which antimycobacterial drug is used in combo for M. tuberculosis for short regimens?

A

Pyrazinamide

81
Q

MOA of Imidazoles?

A

inhibits ergosterol synthesis by
Inhibiting 14 alpha demethylase
Disrupts the packing of phospholipids

82
Q

Which drug is used as oral troche for oropharyngeal candidiasis?

A

Clotrimazole

Better tasting than Nystatin

83
Q

Which drug is used for cryptococcal meningitis?

A

Fluconazole in combo with Amphotericin B

84
Q

Which drug is used for cutaneous candidiasis and vulvovaginitis?

A

Miconazole

85
Q

What is the problem with Nystatin

A

Foul taste

Very toxic parenterally

86
Q

Which drug is used for invasive candidiasis and aspergillis?

A

Caspofungin

87
Q

Which drug is an anti-herpetic used for CMV retinitis?

A

Ganciclovir

88
Q

Which drug is an anti-herpetic that is an inorganic pyrophosphate?

89
Q

Which drug is used for influenza A and B, Hep C and RSV bronchiolitis and pneumonia;
also prevents capping of viral mRNA?

90
Q

Which drug is used as an antisense mechanism?

A

Fomivirsen

91
Q

At what stage is NRTI initially used for HIV?

A

CD4 is less than 500

92
Q

What drug is an oral for pediatrics greater than 3 months?

A

Emtricitabine

93
Q

Name a couple of nucleotide analogues for HIV and HBV?

A

Tenofovir and Adefovir

94
Q

What do all protease inhibitors end with?

A

“navir”

95
Q

Which drug is a non-peptide protease inhibitor that has the least resistance?

A

Tipranavir

96
Q

Which drug is a fusion inhibitor that binds to GP41?

A

Enfuvirtide

97
Q

Which drug is an Entry inhibitor that binds to CCR5?

98
Q

Which drug is an integration inhibitor?

A

Raltegravir

99
Q

Which drug treats influenza and is used for parkinsonism?

A

Amantadine

100
Q

Which “vir” drug is used intransally & orally

A

Zanamivir

Oseltamivir

101
Q

WHich thingy majig causes african sleeping sickness?

A

Trypanosomiasis

102
Q

Which thingy majig causes SA and chagas disease?

A

Trypanosome Cruzi

103
Q

MOA of Malarsoprol?

A

Inhibits parasitic enzymes

104
Q

What drug is used for unwanted facial hair in women?

105
Q

What is DOC for T. Cruzi (chagas)?

A

Nifirtimox

106
Q

Which drug dreats Giardia/Trichomoniasis?

A

Metronidazole.

107
Q

Which drug is the best choice for taxoplasmosis?

A

Pyrimethamine

Sulfonamide

108
Q

Which drug is the number one anti-malarial?

A

Malarone.

Combo of Atovaquone + Proguanil

109
Q

What is MOA/usage/CI of Mebendazole

A

Inhibits microtubule synthesis
Nematodes
Pregnancy

110
Q

Talk about Praziquantel

A

Treats all species
Only choice for trematodes
CI in cysticercosis

111
Q

How is Cefepime so much diff from 3rd generation drugs like Cefaperazone/Ceftriaxone?

A

More resistnt to beta lactamase produced by enterobacter.

112
Q

What is a major side effect of carbapenem?

A

Excessive levels in pts w/ renal impairment

can lead to seizures

113
Q

Among Meropenem and Imipenem, which is less likely to cause side effect?

A

Meropenem.

114
Q

Are macrolides eliminated from renal or biliary methods?

115
Q

What enzyme do babies lack that result in gray baby syndrome?

A

hepatic glucuronosyl-transferase

drug is not eliminated

116
Q

MOA & Uses for Acyclovir?

A

Inhibits viral DNA polymerase
HSV & CMV
Topical, oral and IV

117
Q

Idoxuridine and Trifluridine is specific for which HSV?

A

HSV 1.
Acyclovir is 10X more potent than this drug.
Topical

118
Q

Which was first drug that was discovered used to treat Herpes?

A

Vidarabine.

Acyclovir is 160X more potent than this drug.

119
Q

Uses of Fomivirsen?

A

-IV for CMV retinitis in AIDs pts

120
Q

MOA of Fomivirsen

A

-Olgionucleotide
-Inhibits CMV through antisense
mechanism ! inhibits protein synthesis

121
Q

T/F?

Zanamivir is taken intranasally?

122
Q

T/F?

Oseltamivir(tamiflu) is taken orally?

123
Q

T/F?

Amantadine is useful in the trt of Parkinsonism (potentiates CNS dopaminergic responses)?

124
Q

Amantine/Rimantine inhibit virus entry into the cell(Messes with the M2 protein).
Zanamivir/Oseltamivir inhibit virus exit out of cell

A

Laura story

125
Q

Name the two Respiratory SYncyial virus drugs?

A

Ribavirin

Palivizumab

126
Q

What can’t you use -navir with?

127
Q

Which drugs Do not compete with nucleoside
triphosphates nor require phosphorylation
to be active

A

Nevirapine, Delavirdine, Efavirenz
These are NNRTI
Very selective for HIV-1

Pharm II (7 decks)

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