Respiratory Drugs

Question 1

Isoniazid

Answer 1

Inhibits synthesis of mycolic acid needed for cell wall

Resistance if used alone to treat (can use alone for prophylactic)

Question 2

Isoniazid side effects

Answer 2

peripheral neuropathy if not administered with pyridoxine, hepatotoxicity

Question 3

rifampin

Answer 3

inhibits RNA polymerase,

induces metabolism of drugs by cytochrome P450

Question 4

amphotericin B

Answer 4

hydrophobic face binds to ergosterol in fungal cell wall, forms pore leading to osmotic lysis
side effects: fever, chills, nephrotoxicity

Question 5

caspofungin / echinocandins

Answer 5

inhibit cell wall synthesis

Question 6

triazole mechanism of action

Answer 6

inhibits fungal cyp450 needed for ergosterol synthesis

Question 7

ketoconazole

Answer 7

inhibits human cyp450 which decreases steroid hormone, can lead to gynecomastia

Question 8

itraconazole

Answer 8

inhibition of cyp3A4 can lead to increased levels of macrolides, risk of prolonged QT, and warfarin,
drug of choice for histoplasmosis or blastomycosis

Question 9

voriconazole

Answer 9

drug of choice for invasive aspergillus

inhibits cyp450, transient visual disturbances, and photosensitivity

Question 10

fluconazole

Answer 10

wide therapeutic window, fewer drug interactions

Question 11

oseltamivir, zanamivir

Answer 11

treatment and prophylaxis of flu virus,
inhibits viral neuraminidase needed for release,
resistance through neuraminidase mutations

Question 12

oseltamivir side effects

Answer 12

high oral bioavailablity,

rare psychiatric effects

Question 13

zanamivir

Answer 13

low oral bioavailability,

airway brochospasm or fatal lung deterioration in patients with airway disease

Question 14

B-lactams

Answer 14

penicillin, amoxicillin, ampicillin
transpeptidase inhibitors (cell wall)
side effect: hypersensitivity rxns

Question 15

vancomycin

Answer 15

inhibits transgylcosylase and chain elongation by binding to cell wall precursors attached to lipid carriers,
effective only for gram (+)

Question 16

vancomycin use and side effects

Answer 16

MRSA, penicillin resistant pneumococcal infections

flushing, “red man syndrome”

Question 17

aminoglycosides

Answer 17

gentamicin, tobramycin - bactericidal
binds 30S subunit inhibiting translation,
aerobic gram (-) bacteria, but not Legionella because will not penetrate macrophages

Question 18

aminoglycoside side effects

Answer 18

narrow therapeutic window

nephrotoxicity, tinnitus, hearing loss, vertigo

Question 19

tetracyclines

Answer 19

doxycycline - bacteristatic

binds 30S subunit inhibiting translation, blocks binding of aminoacyl tRNA

Question 20

tetracycline use and side effects

Answer 20

Rickettsia (RMSF, lyme disease), spirochetes

dental staining in kids, photosensitivity

Question 21

macrolides

Answer 21

erythromycin, azithromycin, clarithromycin

binds to 50S subunit inhibiting translation, blocks translocation of peptidyl tRNA

Question 22

macrolide use and side effects

Answer 22

aerobic gram (+), mycoplasma, mycobacteria
prolonged QT interval

Question 23

drug of choice for pertussis or diphtheria

Answer 23

erythromycin

Question 24

drug of choice for Legionnaire’s

Answer 24

azithromycin

Question 25

fluoroquinolones

Answer 25

ciprofloxacin, levofloxacin - bactericidal

inhibit DNA gyrase (topo IV)

Question 26

fluoroquinolone side effects

Answer 26

cartilage damage, tendon rupture, photosensitivity, prolonged QT interval

Question 27

trimethoprim-sulfamethoxazole

Answer 27

bactrim
inhibits folate synthesis
useful in treatment and prophylaxis of Pneumocystis jjrovecii or nocardia asteroides infection

Question 28

empiric therapy for community acquired pneumonia

Answer 28

macrolides or doxycycline

Question 29

treatment of strep pneumoniae related pneumonia

Answer 29

pneumonia: ceftriaxone

Question 30

characterisitics of atypical pneumonia

Answer 30

nonproductive cough, low fever, does not appear very sick

Question 31

community acquired pneumonia

Answer 31

S. pneumoniae
M. catarrhalis
H. influenzae
M. pneumoniae

Question 32

hospital acquired pneumonia

Answer 32

S. aureus
E. coli
K. pneumoniae
P. aeruginosa