Amphotericin B and 5-flucytosine Usage Quiz

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Questions and Answers

What is the recommended HPLC level of itraconazole associated with toxicity?

  • 10 Mcg/mL
  • 2-3 Mcg/mL (correct)
  • 1 Mog/mL
  • 6 Mcg/mL

Why does itraconazole always require Therapeutic Drug Monitoring (TDM)?

  • Due to its high bioavailability
  • Because of pharmacokinetic (PK) variability (correct)
  • To ensure patient compliance
  • To avoid drug interactions

How long should you wait before checking itraconazole levels after the dose?

  • 1 hour (correct)
  • 30 minutes
  • 4 hours
  • 6 hours

What is recommended to fix a subtherapeutic level of itraconazole?

<p>Increase dosing frequency (D)</p> Signup and view all the answers

How does Amphotericin B work?

<p>Targets the cell membrane (B)</p> Signup and view all the answers

How is voriconazole dosed?

<p>Based on body weight (D)</p> Signup and view all the answers

What is the purpose of 5-flucytosine in combination with Amphotericin B?

<p>To target DNA synthesis (A)</p> Signup and view all the answers

Which formulation of voriconazole is available for administration?

<p>Oral and intravenous (IV) (A)</p> Signup and view all the answers

Why is Amphotericin B formulated with sodium deoxycholate or phospholipids?

<p>To reduce toxicities (A)</p> Signup and view all the answers

What mammalian cells do polyenes like Amphotericin B target?

<p>Kidney cells &amp; erythrocytes (C)</p> Signup and view all the answers

What is the MOA of Griseofulvin?

<p>Binds to keratin in the keratin precursor (B)</p> Signup and view all the answers

What types of rings can azoles contain?

<p>6-membered rings (D)</p> Signup and view all the answers

What is a counseling pearl needed for itraconazole capsules?

<p>Consume acidic foods/beverages (C)</p> Signup and view all the answers

What pharmacokinetic factor leads to the need for Therapeutic Drug Monitoring (TDM) in itraconazole?

<p>Nonlinear PK variability and long half-life (A)</p> Signup and view all the answers

Itraconazole is metabolized by ______________, inhibits ______________, and ____________.

<p>CYP3A4, CYP2D6, P-gP (C)</p> Signup and view all the answers

What does itraconazole metabolize into?

<p>Hydroxy-itraconazole only (B)</p> Signup and view all the answers

What happens when itraconazole interacts with CYP3A4 inducers?

<p>Itraconazole levels decrease (B)</p> Signup and view all the answers

Higher levels of itraconazole are associated with _____________ clinical outcomes.

<p>Improved (B)</p> Signup and view all the answers

What levels of Posaconazole have been associated with toxicity?

<p>0.75 mg/mL (C)</p> Signup and view all the answers

When should therapeutic drug monitoring (TDM) be performed for Posaconazole?

<p>Treatment: always, Prophylaxis: Only if there's concern for toxicity (B)</p> Signup and view all the answers

Where should levels be checked for Posaconazole?

<p>Trough levels (D)</p> Signup and view all the answers

When are peak concentrations for vancomycin typically drawn?

<p>After the end of infusions (A)</p> Signup and view all the answers

What is the purpose of AUC-based monitoring for vancomycin?

<p>To compare vancomycin exposure to MIC of the pathogen (D)</p> Signup and view all the answers

Why is AUC-based monitoring becoming more popular for vancomycin?

<p>To lower total daily doses and reduce nephrotoxicity risk (B)</p> Signup and view all the answers

What is the recommended trough-based vancomycin dosing typically based on?

<p>Actual weight (B)</p> Signup and view all the answers

Which type of infections are excluded from vancomycin AUC monitoring due to their unpredictable kinetics?

<p>End-stage renal disease infections (D)</p> Signup and view all the answers

What level of vancomycin AUC has been associated with increased nephrotoxicity?

<p>400 (C)</p> Signup and view all the answers

For which bacteria is vancomycin typically not considered susceptible?

<p>Pseudomonas (D)</p> Signup and view all the answers

How is the loading dose of vancomycin calculated?

<p>$25-30$ mg/kg based on actual weight (A)</p> Signup and view all the answers

What is a potential adverse effect related to vancomycin infusion?

<p>Redman syndrome (B)</p> Signup and view all the answers

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