Pharmacology Week 1: Antifungal Medications

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Questions and Answers

What determines bacterial resistance to penicillin?

Overproduction of bacteria

Presence of viruses in the bacterial environment

Inaccessibility of penicillin to bacterial targets (correct)

Failure to produce penicillin-binding proteins

Which type of penicillin is stable in stomach acid and suitable for oral therapy?

Penicillin V (correct)

Penicillin Z

Penicillin G

Penicillin A

What is the mechanism of action (MOA) of penicillin?

Weakens the cell wall (correct)

Blocks DNA replication

Disrupts metabolic pathways

Inhibits protein synthesis

What is a key reason some penicillins are ineffective against gram-negative bacteria?

Gram-negative bacteria have an extra cell envelope layer Signup and view all the answers

Cephalosporins are classified as what type of drugs?

Bactericidal Signup and view all the answers

What serious side effect should be monitored when using vancomycin?

Renal impairment Signup and view all the answers

Which of the following is an appropriate therapeutic use of prophylactic antibiotics?

Surgery Signup and view all the answers

What should be avoided in conjunction with cephalosporins due to potential drug interactions?

Alcohol Signup and view all the answers

What is the main route of administration for Amphotericin B due to its absorption properties?

Intravenous Signup and view all the answers

Which of the following drugs is known to inhibit CYP3A4 leading to increased levels of other medications?

Itraconazole Signup and view all the answers

What is the primary therapeutic use of Caspofungin?

Aspergillus & Candida infections Signup and view all the answers

For what type of infections is Griseofulvin indicated?

Dermatophytic infections Signup and view all the answers

What common precaution should be taken for those using oral Terbinafine?

Target ringworm and onychomycosis Signup and view all the answers

What is a major concern when prescribing azoles to older adults?

Reduced absorption due to achlorhydria Signup and view all the answers

What is the recommended treatment for Tinea Pedis?

Topical fungal therapy and hygiene measures Signup and view all the answers

What is the mechanism of action for Acyclovir?

Suppresses the synthesis of viral DNA Signup and view all the answers

Which drugs are commonly used in combination with aminoglycosides to enhance bacterial kill?

Penicillins Signup and view all the answers

What is the primary mechanism of action (MOA) for aminoglycosides?

Disruption of bacterial protein synthesis Signup and view all the answers

What is one cause of resistance to aminoglycosides?

Production of enzymes that inactivate aminoglycosides Signup and view all the answers

Which of the following is NOT a noted adverse effect of aminoglycosides?

Hepatotoxicity Signup and view all the answers

Which of the following drugs could potentially interact negatively with aminoglycosides due to ototoxicity?

Loop diuretics Signup and view all the answers

What is a notable side effect of Oxybutynin?

Dry mouth Signup and view all the answers

Which drug's M3 selectivity is key for its therapeutic use?

Darifenacin Signup and view all the answers

What is a non-pharmacologic treatment option for managing symptoms?

Bladder training Signup and view all the answers

What should be monitored to evaluate the therapeutic effect of anticholinergics?

Urinary patterns Signup and view all the answers

What serious risk is associated with Solifenacin?

QT prolongation Signup and view all the answers

What is an important consideration when prescribing anticholinergics?

Current medication regimen Signup and view all the answers

Which strategy is effective in minimizing adverse effects of anticholinergics?

Implementing dose adjustments Signup and view all the answers

What is an essential baseline assessment before initiating treatment with anticholinergics?

Medication history evaluation Signup and view all the answers

What is one contraindication for the use of oral contraceptives?

A history of migraine headaches Signup and view all the answers

What therapeutic effect is NOT associated with testosterone?

Reduction in bone density Signup and view all the answers

Which is a common adverse effect of 5-α-reductase inhibitors?

Erectile dysfunction Signup and view all the answers

What symptom is menopausal hormone therapy NOT typically used to address?

Facial hair growth Signup and view all the answers

What is the primary mechanism of action (MOA) for phosphodiesterase-5 inhibitors?

Increased cyclic GMP levels Signup and view all the answers

What is NOT a preferred drug for treating syphilis?

Ceftriaxone Signup and view all the answers

Which statement about the treatment of Chlamydia during pregnancy is accurate?

Amoxicillin is a safe alternative Signup and view all the answers

Which adverse effect can result from using anticholinergic drugs?

Constipation Signup and view all the answers

What is the main therapeutic use of Alprostadil?

Treat erectile dysfunction Signup and view all the answers

What condition is mirabegron (Myrbetriq) primarily used to treat?

Overactive bladder Signup and view all the answers

Which statement about Gonorrhea is accurate?

Evaluation of sex partners is recommended Signup and view all the answers

What is a known risk factor for thrombotic stroke when using hormonal contraceptives?

Obesity Signup and view all the answers

Which type of therapy is NOT typically employed for the treatment of the Genitourinary Syndrome of Menopause?

Antidepressants Signup and view all the answers

Which of the following is a contraindication for receiving the flu vaccine?

Pregnancy (must receive the inactivated vaccine) Signup and view all the answers

What is the mechanism of action (MOA) of NRTIs in HIV treatment?

Inhibiting HIV replication by suppressing synthesis of viral DNA Signup and view all the answers

Which of the following adverse effects is associated with Protease Inhibitors?

Hyperglycemia and development of diabetes Signup and view all the answers

Which drug is the first choice for treating intestinal worms?

Mebendazole Signup and view all the answers

How does Albendazole work in treating parenchymal neurocysticercosis?

By inhibiting polymerization of tubulin Signup and view all the answers

What is a common adverse effect of Integrase Strand Transfer Inhibitors (INSTIs)?

Dizziness and insomnia Signup and view all the answers

Which of the following is NOT a typical treatment choice for Enterobiasis?

Ribavirin Signup and view all the answers

What is the first step in determining drug susceptibility for antibiotics?

Identify the microbe causing the infection Signup and view all the answers

Study Notes

Week 1:

Amphotericin B:
- Poorly absorbed orally, administered intravenously.
- Elimination is unknown; can take up to a year to eliminate completely.
- Renal excretion minimal; dose/frequency adjustments may be needed in renal impairment.
- Minimize nephrotoxicity by infusing one liter of normal saline daily.
Itraconazole:
- Inhibits CYP3A4, increasing levels of other drugs.
- Drug interactions include interactions with drugs like ciaspide, pimozide, dofetilide, and quinidine.
Caspofungin:
- Used to treat Aspergillus and Candida infections.
- Potential side effects include: fever, injection-site phlebitis, headache, rash, nausea, and vomiting.
Griseofulvin:
- Treatment for skin, hair, and nail infections (dermatophytic).
Oral Terbinafine:
- Treats ringworm and onychomycosis (nail fungus).
Azoles in Older Adults:
- Older adults are at higher risk for reduced acid production in the stomach, affecting absorption of some antifungal agents.
- Concurrent use with other medications, like warfarin, phenytoin, and oral hypoglycemics, may require careful monitoring.
Tinea Pedis Treatment:
- Topical antifungal therapy is common.
- Maintaining dry feet, changing socks/shoes regularly, are important steps for managing this condition.
Systemic Mycoses Treatment:
- Amphotericin B and azoles are preferred treatments.
Acyclovir:
- Mechanism of action (MOA) is inhibiting viral DNA synthesis.
- Used for Herpes simplex infections and Varicella Zoster infections (chicken pox).
- Route of administration can be considered for treatment.
Osteltamivir (Tamiflu):
- Antiviral treatment for influenza.

Week 2:

Antibiotics:
- Drug susceptibility testing is crucial for appropriate antibiotic selection.
- Infants are highly susceptible to antibiotic-related toxicity due to underdeveloped liver and kidney functions.
- Antibiotic stewardship emphasizes appropriate antibiotic use to prevent resistance.
- Inappropriate use can lead to drug-resistant infections.
Penicillin:
- Resistance mechanisms include inactivation by bacterial enzymes and production of penicillin-binding proteins (PBPs) with low affinity.
- Penicillin V is stable in stomach acid and can be taken with meals , while Penicillin G cannot.
- Penicillin G is a bactericidal option effective against gram-positive and some gram-negative bacteria.
Cephalosporins: -Mechanism of action (MOA) involves disrupting bacterial cell wall synthesis and activating autolysins.
- Drug interactions include those that promote bleeding (e.g., NSAIDs).
- Structure is beta-lactams.

Week 3:

Carbapenems:
- Mechanism of action (MOA) targets bacterial cell wall resulting in cell lysis.
- Dose adjustments are usually needed for the elderly and those with impaired renal function.
- Primarily eliminated by renal routes.
Vancomycin:
- MOA is inhibition of bacterial cell wall synthesis, leading to bacterial lysis and death.
- Can be used to treat C.difficile infections.
- Careful monitoring of kidney function is critical due to potential nephrotoxicity associated with the drug.
Aminoglycosides:
- Enhance the effectiveness of some other drugs, such as penicillins. -Can be used in combination with other treatments to achieve a better outcome when treating infections.
- Have potential ototoxicity (hearing loss) and nephrotoxicity (kidney damage).

Week 4:

Anticholinergic Drugs: (Chapter 14)
- Used for overactive bladder (OAB), but with potential side effects.
- Key focus includes understanding the MOA of drugs, considering adverse effects, and monitoring parameters for patient safety when prescribing.
Bethanechol (Chapter 13):
- Cholinergic agonist, used for treating urinary retention.
- Focus is on MOA, adverse effects, and therapeutic use.

Other Chapters (Chapters 50-53, and National STD Curriculum)

Estrogen, Progestins (Chapter 50), Contraceptives (Chapter 51), Phosphodiesterase-5 Inhibitors (Chapter 53): The study notes cover various aspects of hormone therapy, contraception, and erectile dysfunction treatment.
National STD Curriculum: This section details the evaluation, treatment, and follow-up for sexually transmitted infections such as gonorrhea, syphilis, chlamydia, and herpes.

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Description

This quiz covers key information on antifungal medications including Amphotericin B, Itraconazole, Caspofungin, Griseofulvin, and Oral Terbinafine. You'll learn about their administration routes, side effects, and important drug interactions. Test your understanding of the pharmacological principles of these essential treatments.