Antimicrobials Homework Questions

Antimicrobials Homework Questions Please make sure to know the drug classes, examples of agents in the class, MOA, SE, monitoring parameters, uses. 1. List reasons for the increasing incidence of systemic fungal infections.   Increasing incidence of chronic immune disorders: HIV, immunosuppression therapy, chemotherapy, chemotherapy Difficult to treat 2. Liposomal amphotericin formulations were developed to reduce the risk of _______________ toxicity.  Reduce renal and infusions toxicity 3. What is meant be the terminology "low therapeutic index"?  4. A small test dose (1mg) of amphotericin is given to test for testing anaphylaxis before administering the full dose. 5. Fever and chills associated with amphotericin can be minimized by the administration of premedicate with with APAP or hydrocortisone 6. Blood disorders seen with amphotericin administration include:     Anemia Leukopenia Eosinophilia Thrombocytopenia 7. Flucytosine is converted to 5 FU in vivo. 8. Flucytosine is used in treating meningitis caused by Cryptococcus Neoforman & candida albicans as add on therapy with another antifungal. This drug should not be used alone because resistance develops quickly. 9. The azoles have good coverage for Candida species, except which strain? NOT Candida krusei 10. Ketoconazole has been largely replaced with other agents due to many SEs. These include: Signifying toxicity – inhibits goandal and adrenal steroid synthesis including cortisol reduction - Gynecomastia Decrease libirda Impotence Menstrual irregularities 11. Fluconazole may be administered IV and PO 12. A single dose of fluconazole may be administered po for the treatment of vaginal candidiasis 13. Itraconazole is considered DOC for blastomycosis, sporotrichosis and histoplasmosis 14. Why has terbinafine replaced griseofulvin in treating onychomycosis? Better polerated and shorter therapy (3 months) 15. How long (duration) is standard terbinafine therapy for treating onychomycosis? 3 months This shorter duration is due to terbinafine's long t1/2 of 200-400 hours 16. Naftifine and butenafine are used topically in the treatment of cutaneous infections and tinea pedis 17. How is nystatin administered in the treatment of oral candidiasis? Split and swallow 18. Tolnaftate is used primarily to treat tinea infections of the tinea infections of the foot, hands scalp?? 19. The imidazoles are anole derivatives used topically (admin) to treat dermatophytic infeciotns and ulnar/candianl cadidai infeciotns Examples of these agents are: 20. Ciclopirox is used topically to treat:    Seoprrheic dermaitis T pedis, T composers, Onychomycosis  Tinea infections     21. Standard TB therapy includes these first line drugs: Isoniazid Ethambutol Rifampin Pyrazinamide Which two drugs may be discontinued after 2 months if the patient is responding?  Ethambutaol and Pyrazinamide for 2 months How long must the other two drugs be continued?  Continue Isoniazid and rifampin for addition 4 months 22. Explain the reasons for using DOT in TB treatment. “drug of therapy”     Better completion and outcome rates Decreases reissitnace and relapse, and mortality rates Imrpove cure rates Regularly monitored 23. Isoniazid must be administered with pyridoxine (Vitma to prevent Parasetheisas of heads and feet secondary to a pryidoxine defeiciny What other agents discussed should be administered with pyridoxine for the same reason? Should also give pyrisdiomine with ethionamide 24. Why is it important to warn patients not to drink alcohol while taking many of the anti-TB medications?  Isoniazid has zero ETOH tolerance due to potential hepatotoxicity 25. Rifampin may be used in prophylactic protocols for H. infleunnza and meningococcal meningitis. 26. What significant SE of rifampin should you warn patients about? Body fluids will be colored organge Interaction with CYP450 enzymes —> increased clearence 27. What advantages do rifabutin and rifapentine have over rifampin?  Longer half life, only have do dose weekly 28. Which two anti-TB agents may cause retention of uric acid?    Pyrazinamide Ethambutol ——> GOUT ATTACK 29. What distinguishes first line anti-TB therapy agents from second line TB therapy agents? What agents are used as second line agents?  MORE ADRs 30. What is the bacterial cause of "Hansen's Disease"?  Mycobacterium leprae 31. The triple drug combination for leprosy is dapsone, rifampin and clozapine and is continued for 624 months. 33. Why are parasitic infections more difficult to treat pharmacologically   Eukaryotic cells are simailr to our won Any serious ADRs 34. The four species of Plasmodium include:   Plasmodium falciparum P vivax   Pmalariase P ovale The most common and most pathogenic of the species is: P falciparum 35. Dapsone is used in the treatment of leprosy, but can also be used as second-line therapy for P. jiroveci in HIV patients. 36. During which stages of the plasmodium lifecycle are the antimalarials effective? 37. Which patients may be particularly susceptible to anemia with primaquine administration? 38. Primaquine may also be used as second line therapy for P. jiroveci in HIV patients. 39. ADRs associated with quinine use include: Cinchonism, hemolytic anemic and arrhythmias, drug interactions these ADRs have significantly decreased the use of quinine. 40. Agents used to treat toxoplasmosis include:   Pyrimethamine Clindamycin 41. Giardia lamblia is found as a drinking water contaminant. Giardiasis is treated with metronidazole 43. Pinworm disease is caused by Enterobiasis It is treated with pyrantel pamoate albendazole, mabendazole (OTC), RX: albendazole mabendazole Who should also be treated when a child in the house is infected?   Everyone in the household Wash all bedding and everything gin h not water