Week 9 Topical - Anti-infectives

Question 1

Which of the topical antibacterials is available only with a prescription?

Answer 1

Mupirocin (bactroban, centany)

Question 2

What is the mechanism of action of mupirocin?

Answer 2

inhibits bacterial protein synthesis

Question 3

Mupirocin has bacteri-_______ effects on gram ________ organisms

Answer 3

-cidal, positive and negative

Question 4

true or false

mupirocin provides coverage for MRSA

Answer 4

True

Question 5

What are the two indications for mupirocin listed in the book?

Answer 5

• Impetigo (“school scores”
• treatment for Nasal MRSA carriers

Question 6

Bacitracin is a topical __________

Answer 6

antibacterial

Question 7

What is the mechanism of action of bacitracin?

Answer 7

cell wall synthesis inhibitor

Question 8

True or false

Bacitracin is mostly bactericidal

Answer 8

false - it has minimal bactericidal effects

Question 9

Bacitracin primarily has gram ________ coverage

Answer 9

positive

Question 10

What are the active ingredients in the OTC double-antibiotic ointment (Polysporin)?

Answer 10

Bacitracin, polymixin B

Question 11

Polymixin B has bactericidal activity vs gram _______ organisms

Answer 11

negative

Question 12

What is the mechanism of action of neomycin?

Answer 12

aminoglycoside - protein synthesis inhibitor

Question 13

Double and triple antibiotic ointments combine products to provide _______ spectrum coverage

Answer 13

broad

Question 14

What is a possible ADR when using topical antibacterials?

Answer 14

skin reactions

Question 15

_________ systemic absorption occurs with topical antibiotics

Answer 15

minimal

unless they are applied to large areas of non-intact skin

Question 16

Dermatophytes are a type of fungus, and include ________

Answer 16

-TINEA’s
* corporis (ringworm)
* cruris (jock itch)
* pedis (athletes foot)
* capitis

Question 17

What is the mechanism of action of nystatin?

Answer 17

changes fungal cell membrane permeability

Question 18

True or false

In addition to being used for oral, mucosal, and cutaneous candida, nystatin is also effective against dermatophytes

Answer 18

False

Question 19

The azole class of antifungals includes clotrimazole (lotrimin) and ketaconazole. What are their MOA’s?

Answer 19

Alter cell membrane by inhibiting ergosterol synthesis

Question 20

True or false

Clotrimazole (lotrimin) is first line therapy for candida species

Answer 20

True

topical antifungal

Question 21

The “azole” topical antifungals are effective against _______

Answer 21

yeast and dermatophytes

Question 22

Ketoconazole is contraindicated in pregnancy because of possible __________

Answer 22

teratogenic effects

even though it is topical, risk vs benefit

Question 23

What is the MOA of terbinafine (lamisil)

Answer 23

inhibits ergosterol synthesis

topical antifungal

Question 24

Terbinafine is used to treat _______

Answer 24

topical dermatophyte infections

Question 25

What is the mechanism of action of butenafine (lotrimin ultra)

Answer 25

inhibits ergosterol synthesis

Question 26

Acyclovir (zovirax) is a topical __________

Answer 26

antiviral

Question 27

What are the indications for topical acyclovir (zovirax)?

Answer 27

Herpes Simplex Virus
* HSV1 - non genital
* HSV2 - genital

Question 28

When prescribing acyclovir (zovirax), it is important to warn patients about what adverse reaction?

Answer 28

Skin reaction
* burning
* stinging

Question 29

What are the active ingredients in the OTC triple-antibiotic ointment (Neosporin)?

Answer 29

Bacitracin
Neomycin
Polymixin B

Question 30

What is the mechanism of action of polymixin B?

Answer 30

disrupts cell membranes/alters permeability