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USMLE

Pharm 4

QuestionAnswer
Anaerobic infections above diaphragm - ? Anaerobic infections below diaphragm? Above - clindamycin, Below - metronidazole
Toxicity of metronidazole Disulfiram like reaction with alcohol, headache
Bind to cell membranes of bacteria and disrupt their osmotic properties, cationic, basic proteins that act like detergents - treat resistant gram negativ infections Polymyxins
Toxicity for polymyxins Neurotoxicity, Acute renal tubular necrosis
Name anti TB drugs RESPIre, Rifampin, Ethambutol, Streptomycin, Pyrazinamide, Isoniazid
2nd line therapy for TB Cycloserine
All anti TB drugs have same toxicity - name it liver toxicity
Anti TB drug - decreases synthesis of mycolic acids Isoniazid
The only agent used as solo prophylaxis against TB Isoniazid
Toxicity for INH (Isoniazid) Hemolysis if G6PD defficient, Neurotoxicity, Hepatoxocitiy, SLE like syndrome, INH - Injures Neurons and Hepatocytes
_ can prevent neurotoxicity caused by isoniazid Pyridoxine (B6)
Which anti TB drug has different half lifes in fast vs slow acetylators Isoniazid
Anti TB drug - inhibits DNA dependent RNA polymerase Rifampin
Delays resistance to dapsone when used for leprosy Rifampin
Used for meningococcal prophylaxis and chemoprophylaxis in contacts of children with H influenzae type B Rifampin
Rifampin toxicity Minor hepatoxicity and drug interactions (increases P450)
Rifampin 4 R's RNA polymerase inhibitors, Revs up P450, Red/orange body fluids, Rapid resistance if used alone
Beta lactamase cleavage of beta lactam drug is a resistance mechanism against which drugs Penicillins and cephalosporins
Modification via acetylation, adenylation, or phosphorylation is resistance mechanism against which drugs Aminoglycosides
Terminal D ala component of cell wall replaced with D lac, decreases affinity - resistance mechanism against which drug Vancomycin
Modification via acetylation - resistance mechanism against which drug Chloramphenicol
Decreased uptake or increased transport out of cell is resistance mechanism against which drugs Tetracyclines
Altered enzyme (bacterial dihdropteorate synthetase), decreased uptake or increased PABA synthesis is resistance against which drugs Sulfonamides
Drug of choice for prophylaxis of meningococcal infections Alternative? Rifampin, Minocyclin
Prophylaxis of gonorrhea Ceftriaxone
Prophylaxis of syphillis Benzathine penicillin G
Prophylaxis in patients with history of recurrent UTI TMP-SMX
Drug of choice for prophylaxis for pneumocystic carinii pneumonia Alternative TMP-SMX, Aerosolized pentamidine
Binds ergosterol (unique to fungi), forms membrane pores that allow leakage of electrolytes and disrupt homeostasis Amphotericin B
Used for wide spectrum of systemic mycoses (Cryptococcus, Blastomyces, Coccidioides, Aspergillus, Histoplasma, Candida, Mucor). Intrathecally for fungal meningitis, does NOT cross BBB Amphotericin B
Toxicity of Amphotericin B NEPHROTOXICITY, Arrhythmias (amphoterrible), Fever/chills (shake and bake), Hypotension
Binds to ergosterol, disrupting fungal membranes, used as "swish and swallow" for oral candidiasis (thrush) NYSTATIN
Inhibit fungal steroid (ergosterol) synthesis AZOLES
Drug of choice for cryptococcal meningitis in AIDS patients and candidal infections of all types (i.e yeast infections) FLuconazole
Drug of choice for Blastomyces, Coccidioides, Histoplasma, Candida albicans, hypercortisolism Ketoconazole
Toxicity of azoles Hormone synthesis inhibition (gynecomastia), Liver dysfuntion (inhibits cytochrome P450), Fever, chills
Inhibits DNA synthesis by conversion to fluorouracil which competes with uracil, used in systemic fungal infections (Candida, Cryptococcus), causes bone marrow suppression, n/v/d FLUCYTOSINE
Antifungal medication, inhibits cell wall synthesis, clinically used for invasive aspergillosis, can cause GI upset and flushing CASPOFUNGIN
Antifungal, inhibits fungal enzyme squalene epoxidase, used to treat dermatophytoses (especially onychomycosis) TERBINAFINE
Anti fungal, interferes with microtubule function, disrupts mitosis, deposits in keratin containing tissues (nails) - oral treatment of superficial infections, inhibits growth of dermatophytes (tinea, ringworm) GRISEOFULVIN
Toxicity Griseofulvin Teratogenic, Carcinogenic, Confusion, Headache, Increased warfarin metabolism
Antiviral drug used for prophylaxis for influenza A and treatment of Parkinsons Amantadine
Derivative of Amantadine with fewer CNS side effects Rimantidine
Anti viral medication, blocks viral penetration/uncoating, may buffer pH of endosome, also causes release of dopamine from intact nerve terminals Amantadien
Created by: Asclepius
 

 



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