Pharm final exam questions for Antibiotics 3&4 + Antivirals

What are the 2 most significant adverse effects of aminoglycosides?

1) Ototoxicity [auditory/vestibular] 2) Nephrotoxicity [renal failure] *May be irreversible; monitoring drug levels= critical throughout therapy *Warning Signs of Ototoxicity= dizziness, tinnitus, hearing loss *Warning Signs of Nephrotoxicity= urinary casts, proteinuria, elevated BUN and serum creatinine levels *Other adverse effects= -skeletal muscle paralysis -skin rash -superinfection

What are the 2 interferon-gamma release assays approved by the FDA and available in the US?

1) QuantiFERON 2) T-SPOT (+)= infected with TB bacteria; additional tests needed to determine if latent or active (-)= TB not likely

Which of the following is associated with a hypersensitivity reaction (drug, fever, rash, GI symptoms, malaise, or respiratory distress)? a) Abacavir b) Emtricitabine c) Tenofovir d) Lamivudine e) Zidovudine

a) Abacavir

Which of the following protozoal illnesses presents with dysentery, hepatitis, liver abscess? a) Amebiasis b) Giardiasis c) Trichomoniasis d) Toxoplasmosis e) Leishmaniasis f) Pneumocystosis

a) Amebiasis *Dysentery= severe diarrhea + nausea + inflammatory bowel

The combination of which 2 medications creates Unasyn (IM or IV)? a) Ampicillin + Sulbactam b) Amoxicillin + Clavulanic Acid c) Ticarcillin + Clavulanic Acid d) Piperacillin + Tazobactam

a) Ampicillin + Sulbactam

Which of the following protease inhibitors may prolong the PR interval? a) Atazanavir b) Nelfinavir c) Ritonavir d) Darunavir

a) Atazanavir

Which of the following echinocandins is first line option for patients with invasive candidiasis, dose should be adjusted in moderate hepatic dysfunction, and should not be administered together with cyclosporine? a) Caspofungin b) Micafungin c) Anidulafungin d) B&C

a) Caspofungin

Which of the following miscellaneous antibiotics is a lipoglycopeptide antibiotic that is used for the treatment of acute bacterial skin and skin structure infections, and has a caution of Red Man syndrome? a) Dalbavancin b) Oritavancin c) Linezolid d) Tedizolid e) C&D f) Fosfomycin

a) Dalbavancin

Which of the following miscellaneous antibiotics is an alternative to vanco and linezolid for treating infections cause by MRSA and VRE? a) Daptomycin b) Quinupristin/Dalfopristin c) Chloramphenicol d) Colestimethate e) Tigecycline f) Telavancin

a) Daptomycin

Which of the following miscellaneous antifungal agents blocks nucelic acid synthesis? a) Flucytosine b) Griseofulvin c) Terbinafine d) Ciclopirox

a) Flucytosine

Which treatment of Hepatitis B is a family of naturally occurring inducible glycoproteins that interfere with the ability of viruses to infect cells? a) Interferons b) Peginterferon alfa-2a c) Lamivudine d) Adefovir e) Entecavir f)Tenofovir Disoproxil Fumarate

a) Interferons

Which of the following antiprotozoals is indicated for intestinal amebiasis? a) Iodoquinol b) Pentamidine c) Paromomycin d) Chloroquine e) Pyrimethamine f) Tinidazole g) Atovaquone

a) Iodoquinol

Which of the following TB drugs is a prodrug that inhibits lipid and nucleic acid synthesis leading to disruption of the cell wall? a) Isoniazid b) Rifampin c) Pyrazinamide d) Ethambutol

a) Isoniazid

Which of the following TB drugs requires monitoring of LFTs during treatment and has a black box warning for potentially fatal hepatotoxicity? a) Isoniazid b) Rifampin c) Pyrazinamide d) Ethambutol

a) Isoniazid

Which of the following miscellaneous antibiotics is used for both prophylaxis/suppression and treatment of UTI? a) Nitrofurantoin b) Methenamine mandelate c) Methenamine hippurate d) Telithromycin e) Clindamycin f) Vancomycin

a) Nitrofurantoin B&C= prophylaxis/suppression ONLY

Which of the following neuraminidase inhibitors is a prodrug, excreted unchanged in the urine, and therefore the dose should be adjusted in renal impairment? a) Osletaminivir b) Zanamivir c) Peramivir

a) Osletamivir

Which of the following Herpetic agents is an acyclic guanosine derivative that inhibits HSV DNA polymerase, and is indicated for HSV-1, HSV-2, VZV? a) Peniclovir b) Famciclovir c) Ganciclovir IV/PO/Intraocular d) Ganciclovir ophthalmic gel e) Valgancyclovir f) Valacyclovir g) Trifluridine

a) Peniclovir

Which of the following antihelminthics is indicated for nematode infestations (pinworm)? a) Pyrantel b) Praziquantel c) Albendazole

a) Pyrantel

Which RSV drug is administered via inhalation (oral/nasal), inhibits replication of RNA and DNA viruses, and is pregnancy category X? a) Ribavarin b) Palivizumab

a) Ribavarin

Which of the following second-line TB drugs is an aminoglycoside antibiotic that inhibits protein synthesis? a) Streptomycin b) Para-aminosalicyclic acid c) Capreomycin d) Cycloserine e) Ethionamide f) Fluroquinolones g) Macrolides h) Bedaquiline

a) Streptomycin

Which of the following Sulfa drugs is indicated for treatment of malaria and toxoplasmosis? a) Sulfadizaine b) Silver Sulfadiazine (Silvadene) c) Bactrim d) Pediazole e) Sulamyd f) Mafenide g) Phenazopyridine

a) Sulfadizaine

Which of the following topical antifungals is the drug of choice for treating dermatophyte onychomycoses (fungal infection of nails)? a) Terbinafine b) Naftifine c) Butenafine d) A,B,C e) Griseolfulvin f) Cyclopirox g) Tavaborole

a) Terbinafine

Which of the following has a special indication for post-exposure prophylaxis in HIV exposed health-care workers, and can also be used to reduce transmission rate from HIV positive mother to fetus? a) Zidovudine b) Ritonavir c) Cobicistat d) Truvada

a) Zidovudine

Which of the following best describes the MOA of quinolones? a) bactericidal b) bacteriostatic c) prevents breakdown of folic acid d) inhibits protein synthesis

a) bactericidal *FYI no effect on the human DNA

All of the following are true regarding Ribavirin [Hepatitis C treatment] EXCEPT? a) for treatment of chronic HCV this should be used alone b) guanosine analog c) dosage is weight based d) primary toxicity is hemolytic anemia e) pregnancy category X

a) for treatment of chronic HCV this should be used alone *MUST BE USED AS PART OF A MULTI-DRUG REGIMEN

Which 2 diseases are caused by non-tuberculosis mycobacterium?

1) LEPROSY= caused by Mycobacterium leprae; treated with Dapsone, Rifampin, Clofazimine 2) Mycobacterium Avium Complex (MAC)= M. avium, M. intracellulare, and M. chimaera; use Macrolides and Clofazimine as Tx

Which of the following second-line TB drugs inhibits protein synthesis and can cause nephrotoxicity and ototoxicity? a) Streptomycin b) Para-aminosalicyclic acid c) Capreomycin d) Cycloserine e) Ethionamide f) Fluroquinolones g) Macrolides h) Bedaquiline

c) Capreomycin

Which of the following miscellaneous antibiotics is restricted to life-threatening infections when no alternative exist? a) Daptomycin b) Quinupristin/Dalfopristin c) Chloramphenicol d) Colestimethate e) Tigecycline f) Telavancin

c) Chloramphenicol

Preferred first line drugs for TB include all of the following EXCEPT? a) Isoniazid b) Rifampin c) Cycloserine d) Ethambutol e) Pyrazinamide

c) Cycloserine *Standard short-course therapy= Isoniazid, Rifampin, Ethambutol & Pyrazinamide for 2 months (intensive phase)... followed byIsoniazid & Rifampin for 4 months (continuation phase)

Which of the following is NOT an example of a Nucleoside Reverse Transcriptase Inhibitor [NRTI]? a) Abacavir b) Emtricitabine c) Efavirenz d) Lamivudine e) Zidovudine

c) Efavirenz

Which of the following Herpetic agents is an analog of acyclovir with greater activity against CMV, is indicated for CMV retinitis and CMV prophylaxis, and accumulates in patients with renal failure? a) Peniclovir b) Famciclovir c) Ganciclovir IV/PO/Intraocular d) Ganciclovir ophthalmic gel e) Valgancyclovir f) Valacyclovir g) Trifluridine

c) Ganciclovir IV/PO/Intraocular

All of the following are true regarding antifungal agents EXCEPT? a) include Imidazoles and Triazoles b) Imidazoles and Triazoles are similar in MOA/spectrum of activity but differ in therapeutic uses c) Imidazoles are administered systemically, Traizoles are applied topically d) MOA is predominantly fungistatic

c) Imidazoles are administered systemically, Traizoles are applied topically *OPPOSITE: Imidazoles= topical, Triazoles= systemically

Which treatment of Hepatitis B is a nuceloside reverse transcriptase inhibitor active against HIV and HBV? a) Interferons b) Peginterferon alfa-2a c) Lamivudine d) Adefovir e) Entecavir f)Tenofovir Disoproxil Fumarate

c) Lamivudine

Which of the following antiprotozoals is indicated for intestinal protozoal infections, orphan drug status for leishmaniasis, and as adjunct therapy in hepatic coma? a) Iodoquinol b) Pentamidine c) Paromomycin d) Chloroquine e) Pyrimethamine f) Tinidazole g) Atovaquone

c) Paromomycin

Which of the following neuraminidase inhibitors is used for treatment of seasonal influenza A&B virus in adults 18 years+, and adverse effects include diarrhea, constipation, insomnia, and HTN? a) Osletaminivir b) Zanamivir c) Peramivir

c) Peramivir

Which of the following TB drugs must be enzymatically hydrolyzed, is active against tuberculosis bacilli in acidic lesions, and its most clinical benefit occurs early in treatment? a) Isoniazid b) Rifampin c) Pyrazinamide d) Ethambutol

c) Pyrazinamide

All of the following are TB drug precautions EXCEPT? a) patients should not consume ETOH on therapy b) Isoniazid & Rifampin increase the metabolism of oral contraceptives c) Rifampin may cause optic neuritic and blindness, especially in renal impaired d) Pyrazinamide & Ethambutol may cause decrease in uric acid excretion

c) Rifampin may cause optic neuritic and blindness, especially in renal impaired *ETHAMBUTOL CAUSES THAT

Which of the following has a long t1/2, and may be used once weekly in patients with latent TB and in select HIV-negative patient with minimal pulmonary TB? a) Rifampin b) Rifabutin c) Rifapentine

c) Rifapentine

All of the following are examples of neuraminidase inhibitors [anti-influenza agents] EXCEPT? a) Oslteaminivir b) Zanamivir c) Rimantadine d) Peramivir

c) Rimantadine *Neuraminidase inhibitors= effective against both type A & type B influenza viruses!

All of the following agents are included in topical coverage for tinea EXCEPT? a) Ciclopirox b) Ketoconazole c) Terconazole d) Terbinafine

c) Terconazole

The combination of which 2 medications creates Timentin (IV)? a) Ampicillin + Sulbactam b) Amoxicillin + Clavulanic Acid c) Ticarcillin + Clavulanic Acid d) Piperacillin + Tazobactam

c) Ticarcillin + Clavulanic Acid

Which of the following protozoal illnesses presents as an STD? a) Amebiasis b) Giardiasis c) Trichomoniasis d) Toxoplasmosis e) Leishmaniasis f) Pneumocystosis

c) Trichomoniasis

All of the following are examples of drugs that are contraindicated for use with protease inhibitors EXCEPT? a) Amiodarone b) St. John's wort c) Warfarin d) Ergotamine e) Rifampin

c) Warfarin *Anticoagulants= require dose modifications/caution

Adverse effects of tetracyclines include all of the following EXCEPT? a) diarrhea/GI upset b) discoloration of permanent teeth and tooth enamel in kids [contraindicated under 8] c) pregnancy category X d) enterocolitis e) maculopapular rash, superinfections, photosensitivity during therapy

c) pregnancy category X *CATEGORY D: may retard fetal skeletal development if taken during pregnancy

All of the following are true regarding Vancomycin EXCEPT? a) it is a tricyclic glycopeptide b) used for life threatening GM-positive infections resistant to PCN c) resistance is seen in staph aureus d) oral route is limited to C diff only due to poor absorption e) major side effect includes Red Man syndrome [due to rapid IV infusion rate]

c) resistance is seen in staph aureus *Emergence of resistance increasingly observed in E. faecium [alterations in binding affinity to peptidoglycan precursors]..prudent use of vancomycin is warranted= VRE RESISTANCE *Red Man Syndrome= sudden drop in BP accompanied by flushing and/or macropapular or erythematous rash on face, neck chest & upper extremities. [Monitor BP during infusion]

All of the following are true regarding TB chemoprophylaxis EXCEPT? a) TB drugs used to prevent disease following exposure b) close contacts and/or family members c) therapy beings immediately before taking the PPD skin test d) patients with HIV/AIDS or patient on immunosuppressant drugs

c) therapy beings immediately before taking the PPD skin test *AFTER (+) PPD

All of the following are true regarding Mycobacterium TB infections EXCEPT? a) common infection sites include lung [primary site], brain, bone, liver, kidney b) droplets are expelled by coughing/sneezing and enter body via inhalation c) tubercle bacilli do not become dormant in the body organs/lymphatic systems d) disseminated TB begins with a first degree lung lesions and spreads throughout the entire body

c) tubercle bacilli do not become dormant in the body organs/lymphatic systems *DO

All of the following are true regarding the MOA of Cephalosporins EXCEPT? a) bactericidal b) inhibits cell wall synthesis c) coverage depends on generation d) 3rd generation have beta-lactam ring

d) 3rd generation have beta-lactam ring *1st GEN

Which of the following topical antifungals inhibit squalene epoxidase, block biosynthesis of ergosterol in cell membrane, leading to cell death? a) Terbinafine b) Naftifine c) Butenafine d) A,B,C e) Griseolfulvin f) Cyclopirox g) Tavaborole

d) A,B,C

Which treatment of Hepatitis B is a nucelotide analog that prevents HV replication and may cause lactic acidosis and hepatomegaly with steatosis? a) Interferons b) Peginterferon alfa-2a c) Lamivudine d) Adefovir e) Entecavir f)Tenofovir Disoproxil Fumarate

d) Adefovir *Do not use concomitantly with tonofovir disoproxil fumarate= potential for ↑levels of either agent due to competition for active tubular secretion [both drugs excreted by GF & TS]

Which of the following is NOT an example of a Non-Nucleoside Reverse Transcriptase Inhibitor [NNRTI]? a) Delavirdine b) Efavirenz c) Rilpivirine d) Atazanavir

d) Atazanavir

Which of the following echinocandins is first line option for treatment of invasive candidiasis [candidemia] and does not have associated drug interactions? a) Caspofungin b) Micafungin c) Anidulafungin d) B&C

d) B&C

All of the following are true regarding Clofazimine [Leprosy drug] EXCEPT? a) MOA involves binding to DNA b) Bacteriocidal to M. leprae c) Recommended by WHO as part of shorter regimen (9-12 mos) for MDR-TB d) Causes orange skin discoloration e) May cause eosinophilic enteritis

d) Causes orange skin discoloration *PINK TO BROWN-ISH BLACK

Which of the following antiprotozoals is indicated for extraintestinal amebiasis and malaria? a) Iodoquinol b) Pentamidine c) Paromomycin d) Chloroquine e) Pyrimethamine f) Tinidazole g) Atovaquone

d) Chloroquine

Which of the following miscellaneous antibiotics is a pro-drug that is used as salvage therapy for patients with MDR infections? a) Daptomycin b) Quinupristin/Dalfopristin c) Chloramphenicol d) Colestimethate e) Tigecycline f) Telavancin

d) Colestimethate

Which of the following second-line TB drugs disrupts D-alanine incorporation into cell wall and accumulates in renal insufficiency/can cause seizures? a) Streptomycin b) Para-aminosalicyclic acid c) Capreomycin d) Cycloserine e) Ethionamide f) Fluroquinolones g) Macrolides h) Bedaquiline

d) Cycloserine

Which of the following protease inhibitors is approved for initial therapy in treatment-naive HIV infected patients as well as for treatment-experienced patients with HIV resistant to other PIs? a) Atazanavir b) Nelfinavir c) Ritonavir d) Darunavir

d) Darunavir

Which of the following TB drugs is bacteriostatic and specific for mycobacteria, and may be discontinued if isolate is susceptible to the other 3 medications of the TB regimen? a) Isoniazid b) Rifampin c) Pyrazinamide d) Ethambutol

d) Ethambutol

Which of the following Herpetic agents is indicated for herpes keratitis? a) Peniclovir b) Famciclovir c) Ganciclovir IV/PO/Intraocular d) Ganciclovir ophthalmic gel e) Valgancyclovir f) Valacyclovir g) Trifluridine

d) Ganciclovir ophthalmic gel

Which of the following is FALSE regarding influenza virus? a) types A&B cause seasonal epidemics each year b) type C causes mild respiratory illness [not epidemic] c) type D primarily affect cattle [not known to cause illness in people] d) Influenza B viruses are further broken down into subtypes

d) Influenza B viruses are further broken down into subtypes *INFLUENZA A -H1N1 [Swine] -H3N2 = these together with Influenza B viruses make up each year's vaccine

Which of the following is NOT an example of a protease inhibitor? a) Atazanavir b) Nelfinavir c) Ritonavir d) Maraviroc

d) Maraviroc *FYI resistance develops quickly with PIs!

Which of the following Sulfa drugs is available only in suspension, and is combined with Erythromycin for treatment of OM in young children? a) Sulfadizaine b) Silver Sulfadiazine (Silvadene) c) Bactrim d) Pediazole e) Sulamyd f) Mafenide g) Phenazopyridine

d) Pediazole

The combination of which 2 medications creates Zosyn (IV)? a) Ampicillin + Sulbactam b) Amoxicillin + Clavulanic Acid c) Ticarcillin + Clavulanic Acid d) Piperacillin + Tazobactam

d) Piperacillin + Tazobactam

All of the following are true regarding the stages of AIDS EXCEPT? a) Stage I= acute stage of 3-6 months with mild flu like symptoms b) Stage II= asymptomatic stage that can last up to several years where the patient looks/feels well aside from swollen lymph glands c) Stage III= symptomatic stage that has both early and late phases that features skin rashes, oral ulcers, persistent diarrhea and other symptoms d) Stage IV= late stage where a definitive diagnosis is made by the patient having CD4 count of 200 or less AND history of an "AIDS defining illness"

d) Stage IV= late stage where a definitive diagnosis is made by the patient having CD4 count of 200 or less AND history of an "AIDS defining illness" *it's the CD4 count OR the history

All of the following are types of Sulfa drugs EXCEPT? a) Sulfisoxazoles b) Sufacetamide c) Sulfamethoxazoles d) Sulfamecanolide e) Sulfadiazines

d) Sulfamecanolide

Which of the following protozoal illnesses presents as encephalitis in immune suppressed patients, brain/retina birth defects in pregnancy? a) Amebiasis b) Giardiasis c) Trichomoniasis d) Toxoplasmosis e) Leishmaniasis f) Pneumocystosis

d) Toxoplasmosis

All of the following are true regarding Lefamulin, EXCEPT? a) it is part of a new class of antibiotics known as "Pleuromutilins" b) approved for treatment of community-acquired bacteria pneumonia c) MOA is inhibiting bacterial protein synthesis d) active against Enterobacteriaceae and Pseudomonas aeruginosa e) adverse effects include QT prolongation and it should not be used in pregnancy or breastfeeding f) drug interactions are due to its metabolism by CYP3A4

d) active against Enterobacteriaceae and Pseudomonas aeruginosa *It is NOT active against Enterobacteriaceae or Pseudomonas aeruginosa. It IS active against Streptococcus pneumoniae, Haemophilus influenzae, Mycoplasma pneumoniae, Chlamydia pneumoniae, Legionella pneumophila, and methicillin-susceptible strains of Staphylococcus aureus (MSSA)

All of the following are true regarding echinocandins EXCEPT? a) inhibit cell wall synthesis leading to lysis and cell death b) includes Capsofungin, Micafungin, Anidulafungin c) potent activity against Aspergillus and most Candida including those resistant to azoles d) administer as a fast IV infusion e) most common adverse effects include fever, rash, nausea, phlebitis at infusion site

d) administer as a fast IV infusion *SLOW= to avoid histamine-like reaction (flushing) that occurs with rapid infusion!

Which of the following is INCORRECTLY paired for treatment of Hepatitis C? a) Voxilaprevir= NS3/NS4A protease inhibitor= rash, pruritus, nausea, fatigue, anemia b) Dasabuvir= NS5B polymerase inhibitor= well tolerated with few adverse effects c) Ledipasvir= NS5A replication complex inhibitor= absorption reduced when gastric pH is elevated d) all of the above are correctly paired

d) all of the above are correctly paired NS3/NS4A Protease Inhibitors ["-previr"] NS5B Polymerase Inhibitors ["-buvir"] NS5A Replication Complex Inhibitors ["-asvir"]

All of the following chemicals inhibit penicillinase EXCEPT? a) Clavulanic acid b) Tazobactam c) Sulbactam d) all of the above inhibit

d) all of the above inhibit

All of the following are true regarding NTM [Non-tuberculous Mycobacterium] EXCEPT? a) has been isolated from animals, plants, soil, ice, hot tubs, etc. b) Mycobacterium Abscessus is a common water contaminant c) Mycobacterium Abscessus also contaminates medications and medical devices d) causes acute lung disease, post-traumatic wound infection, disseminated cutaneous disease e) extremely difficult to eradicate

d) causes acute lung disease, post-traumatic wound infection, disseminated cutaneous disease *CHRONIC LUNG DISEASE

All of the following are true regarding Cidofovir EXCEPT? a) indicated for CMV retinitis in patients with AIDS b) nucleotide analog of cytosine c) very nephrotoxic= infusion must be given over 1 hour d) contraindicated with patients with liver impairment e) administered together with oral probenecid and normal saline to decrease risk of nephrotoxicty

d) contraindicated with patients with liver impairment *patients with preexisting RENAL IMPAIRMENT & in those taking nephrotoxic drugs

All of the following are true regarding macrolides EXCEPT? a) Erythromycin, Azithromycin, Clarithromycin b) broad spectrum c) often used as a substitute for PCN allergy d) drug of choice for typical pneumonia e) MOA is either bactericidal or bacteriostatic depending on dose/target organisms

d) drug of choice for typical pneumonia *ATYPICAL pneumonias... -Legionnaire's disease -Mycomplasma pneumonia -Chlamydia pneumonia

Side/adverse effects of Foscarnet include all of the following EXCEPT? a) fever b) diarrhea c) hypophosphatemia & hyperphosphatemia d) hyercalcemia & hypermagenesmia e) hypokaelmia & seizures

d) hyercalcemia & hypermagenesmia *HYPOcalcemia & HYPOmagnesemia [due to chelation with divalent cations]

All of the following are true regarding Amphotericin B EXCEPT? a) it is the polyene prototype b) IV infusion is its route c) requires administration of a test dose d) indicated for less intense fungal infections e) exceeding a total daily dose of 1.5 mg/kg should never occur [risk of cardiorespiratory arrest]

d) indicated for less intense fungal infections *PROGRESSIVE, POTENTIALLY, LIFE-THREATENING SYSTEMIC FUNGAL INFECTIONS

All of the following are true regarding the new drug Fidaxomicin EXCEPT? a) PO b) macrocyclic antibiotic with structure similar to the macrolides c) disrupts bacterial transcription d) indicated for treatment of TB e) caution in patients with hypersensitivity to macrolides

d) indicated for treatment of TB *C-diff associated diarrhea in adults

All of the following are true regarding Foscarnet EXCEPT? a) unlike most antiviral agents, Foscarnet is not a purine or pyrimidine analog b) MOA= selectively inhibits viral DNA and RNA polymerases c) indicated for CMV retinitis in Acyclovir- resistant HSV 1&2 d) must be administered infrequently e) monitor creatinine clearance and electrolytes

d) must be administered infrequently *FREQUENTLY to avoid relapse when plasma levels fall

Risk factors for systemic fungal infection include all of the following EXCEPT? a) AIDS b) chemotherapy c) burn patients d) organ donors e) long term systemic steroid therapy f) cancer

d) organ donors *ORGAN TRANSPLANTS

All of the following are true regarding systemic fungal infections EXCEPT? a) they are uncommon in healthy immune system b) affect internal organs like the brain or lungs c) often acquired through inhalation d) potentially fatal to immunocompetent e) treated with oral/parenteral drugs f) higher side effect profile

d) potentially fatal to immunocompetent *IMMUNOCOMPROMISED

Which of the following topical antifungals is a pyridine antimitotic that disrupts DNA, RNA and protein synthesis, and can be used as Tx for onychomycosis as nail lacquer formulation? a) Terbinafine b) Naftifine c) Butenafine d) A,B,C e) Griseolfulvin f) Cyclopirox g) Tavaborole

f) Cyclopirox

Which of the following second-line TB drugs inhibits DNA synthesis and plays an important role in treating MDR-TB? a) Streptomycin b) Para-aminosalicyclic acid c) Capreomycin d) Cycloserine e) Ethionamide f) Fluroquinolones g) Macrolides h) Bedaquiline

f) Fluroquinolones

Which of the following miscellaneous antibiotics is a synthetic derivative of phosphonic acid that is considered first line treatment for acute cystitis? a) Dalbavancin b) Oritavancin c) Linezolid d) Tedizolid e) C&D f) Fosfomycin

f) Fosfomycin

Which of the following Sulfa drugs is used topically for infection/burns and is in a miscellaneous class of the sulfa drugs similar to the sulfadiazines family? a) Sulfadizaine b) Silver Sulfadiazine (Silvadene) c) Bactrim d) Pediazole e) Sulamyd f) Mafenide g) Phenazopyridine

f) Mafenide [Sulfamylon Topical]

All of the following agents are included in topical coverage for candida EXCEPT? a) Nystatin b) Clotrimazole c) Terconazole d) Tioconazole e) Fluconazole f) Oxiconazole g) Naftifine

f) Oxiconazole

Which of the following protozoal illnesses is a common complication in HIV/AIDS, formerly known as PCP? a) Amebiasis b) Giardiasis c) Trichomoniasis d) Toxoplasmosis e) Leishmaniasis f) Pneumocystosis

f) Pneumocystosis

Which of the following miscellaneous antibiotics is a lipoglycopeptide antibiotic that should be reserved for use when alternative medical for hospital acquired or ventilator associated bacterial pneumonia are not suitable? a) Daptomycin b) Quinupristin/Dalfopristin c) Chloramphenicol d) Colestimethate e) Tigecycline f) Telavancin

f) Telavancin

Which treatment of Hepatitis B is a nucleotide reverse transcriptase inhibitor active against HIV and HBV and may cause renal impairment/acute renal failure? a) Interferons b) Peginterferon alfa-2a c) Lamivudine d) Adefovir e) Entecavir f) Tenofovir Disoproxil Fumarate

f) Tenofovir Disoproxil Fumarate

Which of the following antiprotozoals is indicated for amibiasis, giardiasis, trichimoniasis, and BV [non-pregnant]? a) Iodoquinol b) Pentamidine c) Paromomycin d) Chloroquine e) Pyrimethamine f) Tinidazole g) Atovaquone

f) Tinidazole

Which of the following Herpetic agents is a valyl ester of acyclovir and is indicated for HSV-1, HSV-2, and herpes zoster? a) Peniclovir b) Famciclovir c) Ganciclovir IV/PO/Intraocular d) Ganciclovir ophthalmic gel e) Valgancyclovir f) Valacyclovir g) Trifluridine

f) Valacyclovir

Effectiveness of antitubercular therapy depends on which of the following? a) site of infection b) adequate dosing c) sufficient duration of treatment d) drug compliance e) selection of an effective drug combination f) all of the above

f) all of the above

The MOA of antivirals is best described by which of the following? a) interfere with viral nucleic acid synthesis and/or regulation b) interfere with virus' ability to bind to cells c) stimulate the body's immune system to work harder d) inhibit viral attachment e) prevent genetic copying of virus and viral protein synthesis f) all of the above

f) all of the above

The most common therapeutic indications for aminoglycosides include which of the following? a) Pseudomonas b) Proteus c) E coli d) Klebsiella e) Serratia f) all of the above

f) all of the above *NEOMYCIN= pre-op bowel cleanse (PO) *Plazomicin (Zemdri) = approved in 2018 for adults with complicated UTIs (cUTI); active against multi-drug resistant strains of Enterobacteriaceae, including strains resistant to other aminoglycosides

HAART protocol for HIV includes which of the following classes of drugs? a) Reverse Transcriptase Inhibitors [Nuceloside, Nucleotide, Non-nucleoside] b) Protease Inhibitors c) Fusion [Entry] Inhibitors d) Integrase Inhibitors e) Pharmacokinetic Enhancers f) all of the above are included

f) all of the above are included -Nucleoside reverse transcriptase inhibitors (NRTIs) - phosphorylated to active metabolites that compete for incorporation into viral DNA. They inhibit the HIV reverse transcriptase enzyme competitively and terminate synthesis of DNA chains. -Non-nucleoside reverse transcriptase inhibitors (NNRTIs) - bind directly to the reverse transcriptase enzyme. -Protease inhibitors (PIs) - inhibit the viral protease enzyme that is crucial to maturation of immature HIV virions after they bud from host cells. -Nucleotide reverse transcriptase inhibitors (nRTIs) - competitively inhibit the HIV reverse transcriptase enzyme, as do NRTIs, but do not require initial phosphorylation. -Entry inhibitors (EIs), sometimes called fusion inhibitors,- interfere with the binding of HIV to CD4+ receptors and chemokine co-receptors; this binding is required for HIV to enter cells. For example, CCR-5 inhibitors block the CCR-5 receptor. Integrase inhibitors - prevent HIV DNA from being integrated into human DNA.

Side/adverse effects of Quinolones includes all of the following EXCEPT? a) tendinitis/tendon rupture b) oral thrush c) rash/urticaria d) nausea/vomiting e) dizziness/fatigue/blurred vision f) all of the above are side effects

f) all of the above are side effects *Contraindicated in kids under 18 → risk of tendon rupture *Risk of tendon rupture now applies to all ages [greatest risk is in patients over 60, and increased if taking corticosteroids concomitantly] **Quinolones are contraindicated in MYASTHENIA GRAVIS [due to risk of exacerbation of muscle weakness]

All of the following are sites for superficial fungal infections EXCEPT? a) hair b) scalp c) skin d) nails e) mucosa (oral/vaginal) f) all of the above are sites

f) all of the above are sites *Superficial Fungal Infections [aka dermatophytic infections]; often treatable with topical antifungals--> topicals less toxic/fewer side effects

All of the following are examples of Triazoles EXCEPT? a) Fluconazole b) Itraconazole c) Posaconazole d) Voriconazole e) Butoconazole f) Isavuconazole

e) Butoconazole *Example of Imidazole [along with a long list of many others.... see slide 95]

All of the following are true regarding pseudomembranous colitis EXCEPT? a) clinical signs include severe (possibly bloody) diarrhea, high fever, abdominal cramping/pain, prostration b) drug of choice is Metronidazole (Flagyl) c) alternative drug is Vancomycin d) caused by Clostridium difficile e) C diff does not affect the normal flora of the colon

e) C diff does not affect the normal flora of the colon *Produces toxins that can lead to fulminant diarrhea, colectomy or even DEATH

Which of the following miscellaneous antibiotics is effective against GM positive organisms including resistant isolates, but is associated with irreversible peripheral neuropathies and optic neuritis is used for more than 28 days? a) Dalbavancin b) Oritavancin c) Linezolid d) Tedizolid e) C&D f) Fosfomycin

e) C&D [the OXAZOLIDINONES]

All of the following are true regarding 2nd generation cephalosporins EXCEPT? a) more potent than 1st generation b) better resistance to beta-lactamase producing bacteria c) better gram negative coverage than 1st gen, with good gram positive coverage d) includes Cefaclor, Cefoxitin, Cefuroxime sodium, Cefotetan e) Cefoxitin has good aerobic coverage

e) Cefoxitin has good aerobic coverage *good ANAEROBIC coverage -IV and IM only -Surgical prophylaxis -Abdominal/colorectal surgeries

Which treatment of Hepatitis B is a guanosine nucleoside analong that is effective against lamivudine-resistant strains of HBV and should avoid concomitant use with other nephrotoxic drugs? a) Interferons b) Peginterferon alfa-2a c) Lamivudine d) Adefovir e) Entecavir f) Tenofovir Disoproxil Fumarate

e) Entecavir

Which of the following second-line TB drugs disrupts mycolic acid synthesis and can cause hypothyroidism, gynecomastia, alopecia, impotence? a) Streptomycin b) Para-aminosalicyclic acid c) Capreomycin d) Cycloserine e) Ethionamide f) Fluroquinolones g) Macrolides h) Bedaquiline

e) Ethionamide

Which of the following topical antifungals inhibits fungal mitosis by disrupting mitotic spindle and can also be used to treat onychomycoses? a) Terbinafine b) Naftifine c) Butenafine d) A,B,C e) Griseolfulvin f) Cyclopirox g) Tavaborole

e) Griseolfulvin

Which of the following protozoal illnesses is a cutaneous disease, visceral disease, and is not commonly seen in the US? a) Amebiasis b) Giardiasis c) Trichomoniasis d) Toxoplasmosis e) Leishmaniasis f) Pneumocystosis

e) Leishmaniasis

Other aminoglycosides include all of the following EXCEPT? a) Tobradex b) Cortisporin Otic c) Tobi Podhaler d) Neosporin e) Mupirocin

e) Mupirocin

All of the following are true regarding Avycaz EXCEPT? a) it is a 3rd gen cephalosporin + b-lactamase inhibitor [ceftazidime + avibactam] b) given in complicated intra-abdominal infections caused by gram (-) organisms c) given in complicated UTIs, including pyelonephritis d) given for hospital-acquired bacterial pneumonia and ventilator associated bacterial pneumonia e) PO route

e) PO route *IV

Which of the following antiprotozoals is indicated for toxoplasmosis and malaria prophylaxis? a) Iodoquinol b) Pentamidine c) Paromomycin d) Chloroquine e) Pyrimethamine f) Tinidazole g) Atovaquone

e) Pyrimethamine

Which of the following Sulfa drugs is a Sulfacetamide and is used to treat bacterial eye infections or as prophylaxis in eye injuries? a) Sulfadizaine b) Silver Sulfadiazine (Silvadene) c) Bactrim d) Pediazole e) Sulamyd f) Mafenide g) Phenazopyridine

e) Sulamyd [Sulfacetamide Opthalmic] *NOT for viral "pink eye"!

Which of the following miscellaneous antibiotics is a glycine antibiotic that is broad spectrum with a large volume of distribution, making it a poor option for bloodstream infections? a) Daptomycin b) Quinupristin/Dalfopristin c) Chloramphenicol d) Colestimethate e) Tigecycline f) Telavancin

e) Tigecycline

Which of the following Herpetic agents is a valyl ester of ganiciclovir, is carcinogenic as well as teratogenic, and has a boxed warning for use in pregnancy? a) Peniclovir b) Famciclovir c) Ganciclovir IV/PO/Intraocular d) Ganciclovir ophthalmic gel e) Valgancyclovir f) Valacyclovir g) Trifluridine

e) Valgancyclovir *Male patients should be advised to use barrier contraception during treatment and for at least 90 days after last dose

All of the following are true regarding Ketoconazole EXCEPT? a) it is an Imidazole that is administered PO b) antacids impair its absorption c) it should never be used together with Amphotericin B d) indications include histoplasma, candida, dermatophytes, etc. e) adverse effects include N/V, hepatic dysfunction, and galactorrhea

e) adverse effects include N/V, hepatic dysfunction, and galactorrhea *GYNECOMASTIA [not galactorrhea] because of inhibition of testosterone and cortisol synthesis

All of the following are true regarding carbapenems EXCEPT? a) resistant to most beta lactamase enzymes b) IV or IM routes only c) indicated for moderate to severe infections d) both gram + and gram - coverage e) aerobic coverage f) contraindicated in PCN-allergy

e) aerobic coverage *ANAerobic coverage + p. aeruginosa

Absorption of tetracyclines decreases when they are taken with which of the following? a) dairy products b) antacids c) calcium supplements d) iron supplements e) all of the above

e) all of the above

Which of the following is true regarding side/adverse effects of cephalosporins? a) similar to PCNs b) should be used in caution with PCN allergic patients c) contraindicated if PCN reaction is urticaria or anaphylaxis d) hold in clinic 20 minutes after PCN or cephalosporin injection e) all of the above

e) all of the above

Which of the following miscellaneous antibiotics is generally reserved for serious life-threatening infections? a) Daptomycin b) Quinupristin/Dalfopristin c) Chloramphenicol d) Colestimethate e) Tigecycline f) Telavancin e) all of the above

e) all of the above

Tetracyclines are the drug of choice for which of the following? a) Rocky Mountain Spotted Fever [Rickettsia] b) Cholera c) Lyme disease d) Chlamydia e) all of the above

e) all of the above *Demeclocycline additional indications= SIADH , pleural and pericardial effusions *Azithromycin or Doxycycline= first line now for Chlamydia

All of the following are indications of Sulfonamides EXCEPT? a) UTI b) Shigellosis c) PCP in AIDS d) prophylaxis/treatment of traveler's diarrhea e) all of the above are indications

e) all of the above are indications

All of the following are true regarding Ceftazidime sodium EXCEPT? a) IV and IM only b) excellent gram negative coverage c) used for difficult to treat organisms like Pseudomonas d) excellent overall spectrum of coverage e) all of the above are true

e) all of the above are true

Quinolone indications include all of the following EXCEPT? a) lower respiratory tract infections b) bone and joint infections c) urinary tract infections d) skin infections e) gonorrhea/chlamydia

e) gonorrhea/chlamydia *CDC no longer recommends for GC, but the slides do list sexually transmitted diseases in general

All of the following are true regarding Clindamycin EXCEPT? a) PO/IM/IV are all possible routes b) reserved for serious to life-threatening infections that cannot be treated with other Abx c) carries high risk of pseudomembranous colitis d) used for bacterial vaginosis and for acne e) safety risk with the non-systemic formulations [i.e. vaginal, topical]

e) safety risk with the non-systemic formulations [i.e. vaginal, topical] *NO SAFETY RISK for those

All of the following are true regarding tuberculosis EXCEPT? a) it is a highly contagious infection b) caused by Mycobacterium tuberculosis c) immune response isolates pathogens in tubercles that are calcified or fibrous tissue d) infection can be latent [without signs/symptoms of active TB disease] e) second leading ID cause of death worldwide

e) second leading ID cause of death worldwide *LEADING -increasing frequency of diseases caused by non-tuberculosis mycobacteria (NTM seen): M. avium-intracellulare, M. chelonae, M. abscessus M. kansasil, M. fortuitum

All of the following are true regarding Mebendazole (Vermox) EXCEPT? a) prototype for antihelminthics b) indicates in cestode and nematode infestation c) drug of choice for pinworn d) inhibits uptake of glucose and other nutrients e) adverse effects include diarrhea, abdominal pain, and tissue necrosis f) all of the above are true

f) all of the above are true

Which of the following is FALSE regarding penicllins? a) molecular structure of natural PCNs does not include beta-lactam ring b) beta-lactam ring allows a PCN to be effective against a variety of bacteria c) some bacteria secrete penicillinase d) penicillinase splits the beta lactam ring making PCN ineffective

a) molecular structure of natural PCNs does not include beta-lactam ring *DOES

Which of the following is FALSE regarding Metronizadole (Flagyl)? a) pregnancy category C b) MOA is by disrupting nucleic acid sysnthesis c) major drug interaction with Bulsulfan [acute toxicity] d) side effects include metallic taste, diarrhea, N/V e) cannot be taken with ETOH [Difulfiram-like reaction]

a) pregnancy category C *CATOEGORY B: contraindicated in 1st trimester *FYI patients should also avoid drinking for 48 hours after finishing course of Flagyl to avoid N&V, skin flushing, tachycardia, SOB

All of the following are true regarding 3rd generation cephalosporins EXCEPT? a) shorter duration of action b) even broader spectrum of activity than 2nd gen c) most effective group against gram negative, less active against gram positive d) resistant to beta lactamase producing bacteria e) Ceftriaxone, Ceftazidime sodium, Cefdinir

a) shorter duration of action *LONGER

All of the following are true regarding RSV EXCEPT? a) stands for respiratory symptomatic virus b) most common cause of lower respiratory tract illness in infants c) severe RSV-related illness requiring hospitalization occurs more frequently in infants younger than 3 months d) RSV is the most common cause of serious lower respiratory tract infections and rehospitalization in premature infants

a) stands for respiratory symptomatic virus *RSV= respiratory SYNCYTIAL virus

All of the following are true regarding fungi EXCEPT? a) they are single celled only b) more complex structure than bacteria c) many are normal host flora d) cause superficial and/or systemic infections

a) they are single celled only *single celled OR MULTICELLULAR ORGANISMS

The combination of which 2 medications creates Augmentin (PO)? a) Ampicillin + Sulbactam b) Amoxicillin + Clavulanic Acid c) Ticarcillin + Clavulanic Acid d) Piperacillin + Tazobactam

b) Amoxicillin + Clavulanic Acid

Which of the following is NOT an example of an integrase inhibitor [INSTIs]? a)Dolutegravir b) Atazanavir c) Raltegravir d) Elvitegravir e) Bictegravir

b) Atazanavir

All of the following are true regarding Dapsone [Leprosy drug] EXCEPT? a) Inhibits dihydropteroate synthase in folic acid pathway b) Bactericidal for M. leprae c) Also used in tx of pneumonia caused by Pneumoccystis jirovecii in immunosuppressed pts d) Well absorbed orally and is distributed throughout the body, with high conc. in the skin e) Adverse effects include hemolysis, methemoglobinemia, peripheral neuropathy

b) Bactericidal for M. leprae *BACTERIOSTATIC

Which of the following is a safe option for HIV patients coinfected with TB, but causes dizziness and vivid dreams and is contraindicated in 1st trimester of pregnancy? a) Delavirdine b) Efavirenz c) Rilpivirine d) Nevirapine

b) Efavirenz

Which of the following Herpetic agents is a prodrug, indicated for HSV-1 HSV-2 and herpes zoster, and features headache and nausea as adverse effects? a) Peniclovir b) Famciclovir c) Ganciclovir IV/PO/Intraocular d) Ganciclovir ophthalmic gel e) Valgancyclovir f) Valacyclovir g) Trifluridine

b) Famciclovir

Which of the following protozoal illnesses presents with diarrhea? a) Amebiasis b) Giardiasis c) Trichomoniasis d) Toxoplasmosis e) Leishmaniasis f) Pneumocystosis

b) Giardiasis

Which of the following miscellaneous antifungal agents disrupts microtubule function? a) Flucytosine b) Griseofulvin c) Terbinafine d) Ciclopirox

b) Griseofulvin

Which of the following echinocandins is indicated for prophylaxis in patients undergoing Hematopoietic stem cell transplantation? a) Caspofungin b) Micafungin c) Anidulafungin d) B&C

b) Micafungin

Which of the following miscellaneous antibiotics is a lipoglycopeptide antibiotic that is used for the treatment of acute bacterial skin and skin structure infections, and has a caution of infusion-related reactions? a) Dalbavancin b) Oritavancin c) Linezolid d) Tedizolid e) C&D f) Fosfomycin

b) Oritavancin

Which RSV drug is a monoclonal antibody that neutralizes and inhibits fusion of the virus and is administered IM? a) Ribavarin b) Palivizumab

b) Palivizumab

Which of the following second-line TB drugs inhibits folic acid synthesis and is still an important component of regiments for MDR-TB? a) Streptomycin b) Para-aminosalicyclic acid c) Capreomycin d) Cycloserine e) Ethionamide f) Fluroquinolones g) Macrolides h) Bedaquiline

b) Para-aminosalicyclic acid

Which treatment of Hepatitis B is a subcutaneous injection that is used for treatment of chronic HBV in adults, with multiple principle dose limiting toxicities [bone marrow suppression, severe fatigue/weight loss, etc]? a) Interferons b) Peginterferon alfa-2a c) Lamivudine d) Adefovir e) Entecavir f)Tenofovir Disoproxil Fumarate

b) Peginterferon alfa-2a

Which of the following antiprotozoals primary use is in PCP [P jirovecii] and may be used for other protozoal infections? a) Iodoquinol b) Pentamidine c) Paromomycin d) Chloroquine e) Pyrimethamine f) Tinidazole g) Atovaquone

b) Pentamidine

Which of the following antihelminthics is indicated for trematode infestation as well as cestode infestation? a) Pyrantel b) Praziquantel c) Albendazole

b) Praziquantel

Which of the following miscellaneous antibiotics is reserved for treatment of severe infections caused by VRE in the absence of other therapeutic options? a) Daptomycin b) Quinupristin/Dalfopristin c) Chloramphenicol d) Colestimethate e) Tigecycline f) Telavancin

b) Quinupristin/Dalfopristin

Which of the following is preferred for TB patients coinfected with HIV who are receiving protease inhibitors or several of the NNRTIs? a) Rifampin b) Rifabutin c) Rifapentine

b) Rifabutin

Which of the following TB drugs blocks mycobacteria RNA transcription and should NOT be given as a single agent during active TB as resistant strains rapidly emerge during monotherapy? a) Isoniazid b) Rifampin c) Pyrazinamide d) Ethambutol

b) Rifampin

Which of the following TB drugs causes reddish-orange staining in urine, stool, saliva, sputum, sweat, tears, and contact lenses? a) Isoniazid b) Rifampin c) Pyrazinamide d) Ethambutol

b) Rifampin

Which of the following Sulfa drugs is indicated for treatment of burns? a) Sulfadizaine b) Silver Sulfadiazine (Silvadene) c) Bactrim d) Pediazole e) Sulamyd f) Mafenide g) Phenazopyridine

b) Silver Sulfadiazine (Silvadene)

Which of the following neuraminidase inhibitors should be used with caution in asthma/COPD patients due to side effect of bronchospasm? a) Osletaminivir b) Zanamivir c) Peramivir

b) Zanamivir

Which of the following best describes the MOA of penicillins? a) bacteriostatic b) bactericidal c) inhibit protein wall synthesis d) c) prevents breakdown of folic acid

b) bactericidal *Inhibit cell wall synthesis *Broad spectrum

Which of the following best describes the MOA of Sulfonamides? a) bactericidal b) bacteriostatic c) prevents breakdown of folic acid d) inhibits cell wall synthesis

b) bacteriostatic *Prevents synthesis of folic acid

All of the following are true regarding Telithromycin EXCEPT? a) part of a new class known as "Ketolides" [semi-synthetic derivative of erythromycin] b) binds to the 30S ribosomal subunit c) indicated for community acquired pneumonia d) administered PO e) contraindicated in myasthenia gravis due to a possibility of causing life-threatening exacerbation and link to development of acute liver failure

b) binds to the 30S ribosomal subunit *50S

HAART adverse/side effects include all of the following EXCEPT? a) nausea/vomiting b) constipation c) seizures d) skin rashes e) acute renal failure

b) constipation *DIARRHEA

Which of the following antihelminthics is indicated for neurocysticerosis, a CNS disease causing headaches, seizures, ataxia, dementia, and hydrocephalus? a) Pyrantel b) Praziquantel c) Albendazole

c) Albendazole

Choose the correct option: _________ & ______ are aminopenicillins; _______ & ________ are extended-spectrum penicillins? a) Amoxicillin & Ticarcillin; Ampicillin & Piperacillin b) Amoxicillin & Piperacillin; Ampicillin & Ticarcilin c) Ampicillin & Amoxicillin; Piperacillin & Ticarcillin d) Ampicillin & Piperacillin; Amocixillin & Ticarcillin

c) Amoxicillin & Ampicillin; Piperacillin & Ticarcillin

Which of the following is NOT one of the penicillinase-resistant penicillins? a) Dicloxacillin b) Nafcillin c) Ampicillin d) Oxacillin

c) Ampicillin

All of the following are examples of Carbapenems EXCEPT? a) Ertapenem b) Meropenem c) Aztreonam d) Imipenem/cilastatin e) Doripenem

c) Aztreonam =MONOBACTAM *These are all "other beta lactams"= not penicillins, but similar in structure *Indicated for moderate to severe infections

Which of the following Sulfa drugs is a Sulfamethoxazole that is combined with trimethoprim for treatment of UTI, PCP, OM, COPD chronic bronchitis? a) Sulfadizaine b) Silver Sulfadiazine (Silvadene) c) Bactrim d) Pediazole e) Sulamyd f) Mafenide g) Phenazopyridine

c) Bactrim

Which of the following antiprotozoals is indicated for mild to moderate P. jirovecii, P jirovecii prophylaxis, and toxoplasmosis prophylaxis? a) Iodoquinol b) Pentamidine c) Paromomycin d) Chloroquine e) Pyrimethamine f) Tinidazole g) Atovaquone

g) Atovaquone

Which of the following second-line TB drugs inhibits protein synthesis and might be preferred for patients at greater risk of drug interactions? a) Streptomycin b) Para-aminosalicyclic acid c) Capreomycin d) Cycloserine e) Ethionamide f) Fluroquinolones g) Macrolides h) Bedaquiline

g) Macrolides

Which of the following Sulfa drugs is not an antibiotic, but is a topical bladder analgesic/anesthetic prescribed in conjunction with an Abx for UTI? a) Sulfadizaine b) Silver Sulfadiazine (Silvadene) c) Bactrim d) Pediazole e) Sulamyd f) Mafenide g) Phenazopyridine

g) Phenazopyridine *Turns urine bright orange *May stain contact lenses *Only prescribe enough for 2 days

Which of the following topical antifungals inhibits fungal protein synthesis and is used as a topical solution for onychomycosis? a) Terbinafine b) Naftifine c) Butenafine d) A,B,C e) Griseolfulvin f) Cyclopirox g) Tavaborole

g) Tavaborole

Which of the following Herpetic agents is indicated for herpes keratitis and herpes keratoconjuncitivis, and its adverse effects include transient eye irritation and palpebral edema? a) Peniclovir b) Famciclovir c) Ganciclovir IV/PO/Intraocular d) Ganciclovir ophthalmic gel e) Valgancyclovir f) Valacyclovir g) Trifluridine

g) Trifluridine =1% Ophthalmic solution

3rd generation cephalosporins are the drugs of choice for which of the following organisms? a) Pseudomonas b) Klebsiella c) Neisseria d) Salmonella e) Proteus f) Haemophilus influenza g) all of the above

g) all of the above

Which of the following should be monitored when administering HAART to HIV patients? a) plasma HIV RNA [viral load] b) CD4 counts c) CBC d) LFTs e) renal function f) blood glucose levels g) all of the above

g) all of the above

Non-malarial protozoal infections include all of the following EXCEPT? a) Amebiasis b) Giardiasis c) Pneumocystosis d) Toxoplasmosis e) Trichomoniasis f) Leishmaniasis g) all of the above are non-malarial

g) all of the above are non-malarial

Which of the following second-line TB drugs iinhibits ATP synthase and has a boxed warning for QT prolongation [monitor EKG]? a) Streptomycin b) Para-aminosalicyclic acid c) Capreomycin d) Cycloserine e) Ethionamide f) Fluroquinolones g) Macrolides h) Bedaquiline

h) Bedaquiline

All of the following are indications for macrolides EXCEPT? a) substitute for many infections when there is PCN allergy b) pneumonia c) bronchitis d) URI from H flu e) sinusitis f) OM g) STDs h) all of the above are indications

h) all of the above are indications

All of the following are indications for Metronidazole (Flagyl) EXCEPT? a) Trichomoniasis b) Intestinal amebiasis c) Amebic liver abscess d) Giardiasis e) PID f) Anaerobic bacterial infections g) Bacterial Vaginosis h) C diff i) all of the above are indications

i) all of the above are indications

T/F: Sulfonamides are broad spectrum

FALSE *No longer considered broad spectrum due to the development of much resistance over the years

T/F: In AIDS, B cell deficiency leads to viral, fungal, and protozoan infections while T cell deficiency leads to increased susceptibility to bacterial infections

FALSE *OPPOSITE: B cell= bacterial, T cell= the other infections

T/F: Adamantane derivatives are limited to Influenza B infections only

FALSE *limited to Influenza A [Amantadine, Rimantadine] *Due to widespread resistance, they are not recommended for use in the US for Tx or prophy of influenza A

T/F: Amphotericin B is absolutely contraindicated when a patient is taking either Streptozocin or Cidofovir due to risk of ototoxicity

FALSE *those ARE absolute contraindications but due to NEPHROTOXICITY *Monitor: BUN, Cr, CBC, Lytes, LFTs

T/F: Pharmacokinetic enhancers such as Ritonavir and Cobicistat are known as "boosters" and are used in combination treatments for HIV

TRUE

T/F: the MOA of polyenes is fungicidal

TRUE

T/F: the integrase inhibitors are generally well tolerated, with the most common adverse effect being nausea and diarrhea

TRUE

T/F: immunization against influenza is the preferred approach over the use of antiviral agents

TRUE *Antiviral agents are used when patients are allergic to the vaccine or when outbreaks occur

T/F: antifungal therapy is used for both superficial as well as systemic infections

TRUE *Both are difficult to eradicate [pharm therapy can take weeks to months; mostly immunocompromised patients with systemic infections]

T/F: Fusion inhibitors include Enfuvirtide and Maraviroc and are used in combination with drugs from other classes to affect the virus at various points

TRUE *FYI: adverse effects of Enfuviritide= pain at injection site, erythema, induration, nodule; Maraviroc is associated with severe hepatotoxicity [monitor liver function during therapy]

T/F: Foscarnet is not for use in any other indications aside from CMV retinitis and/or acyclovir-resistant HSV in immunocompromised patients

TRUE [Black Box Warning] -Renal Impairment= risk of major toxicity in renal impaired patient -Seizures= risk of seizures with mineral/electrolyte imbalance

T/F: adverse effects of Acyclovir depend on the route of administration

TRUE oral= nausea, diarrhea, headache, vomiting oral/IV= tremors, delirium IV= nephrotoxicity topical= burning

All of the following are true regarding adverse effects/interactions/monitoring of Fluconazole EXCEPT? a) side effects include N&V, increased LFT, diarrhea, abdominal pain b) contraindicated with concomitant use with drugs that are known to shorten QT interval c) need to monitor creatinine and LFTs d) headache and rash are other common adverse effects

b) contraindicated with concomitant use with drugs that are known to shorten QT interval *PROLONG QT

All of the following are true regarding Aztreonam EXCEPT? a) narrow spectrum of coverage b) covers aerobic gram + rods c) no gram + coverage d) highly resistant to beta-lactamase enzymes e) IM or IV routes only f) caution in PCN allergy [not absolute contraindication]

b) covers aerobic gram + rods *covers AEROBIC GRAM - RODS [ex: p. aeruginosa]

All of the following are true regarding Herpes Virus infections EXCEPT? a) they are associated with a broad spectrum of diseases [cold sores, viral encephalitis, genital infections] b) drugs are effective in both the acute and latent phases c) HSV-1= non-genital [mouth, face, skin], HSV-2=genital [rectum, skin, hands] d) Cytomegalovirus [CMV] is a serious illness in immunosuppressed patients that may lead to blindness e) Epstein-Barr virus [EBV] can lead to Burkitt's lymphoma

b) drugs are effective in both the acute and latent phases *EFFECTIVE DRUGS EXERT THEIR EFFECTS IN ACUTE PHASE ONLY

All of the following are true regarding 1st generation cephalosporins EXCEPT? a) beta lactam ring b) effective against betalactamase producing bacteria c) good gram positive coverage, poor gram negative coverage d) indications include surgical prophylaxis, URI, OM e) Cefadroxil, Cephalexin, Cefazolin

b) effective against betalactamase producing bacteria *INEFFECTIVE

All of the following are true regarding MRSA, EXCEPT for? a) stands for "Methicillin-Resistant Staph Aureus" b) effective in penicillinase-producing bacteria c) serious problem in hospitals d) also problematic in community acquired infections

b) effective in penicillinase-producing bacteria *INEFFECTIVE

All of the following are side/adverse effects of Amphotericin B EXCEPT? a) fever, headache, chills b) hypertension c) renal toxicity and neurotoxicity d) muscle pain and malaise e) hypokaelemia and hypomagenesmia

b) hypertension *HYPOTENSION

Which of the following is FALSE regarding trichomoniasis? a) symptoms are more prominent in females b) male carriers are often symptomatic c) profuse green frothy malodorous vaginal discharge d) strawberry cervix with pH >5.0 e) all partners must be treated

b) male carriers are often symptomatic *ASYMPTOMATIC

All of the following are true regarding Fluconazole EXCEPT? a) it is the triazole prototype b) most active of the triazoles c) spectrum is limited to years and some fungi d) no role in treatment of aspergillosis or zygomycosis e) primary use for prophylaxis of fungal infection in recipients of bone marrow transplant

b) most active of the triazoles *LEAST

All of the following are true regarding Mycobacteria EXCEPT? a) they are rod-shaped aerobic bacilli b) multiple quickly c) cell walls contain mycolic acids d) produce highly lipophilic cell walls that stain poorly with Gram stain, and once stained they are not easily decolorized ["acid fast bacilli"] e) infections result in formation of slow growing lesions causing destruction in the body

b) multiple quickly *SLOWLY

All of the following are true regarding Ceftriaxone EXCEPT? a) IV and IM only b) short half-life c) once a day dosing d) easily crosses into CSF= good for treating CNS infections e) now has indication for OM in kids

b) short half-life *LONG

Which of the following is NOT one of the 4 classes of penicillins? a) natural penicillins b) synthetic penicillins c) penicillinase-resistance penicillins [antistaphylococcal] d) aminopenicillins e) extended-spectrum penicillins

b) synthetic penicillins

All of the following are examples of fungal infections from tinea EXCEPT? a) tinea pedis (foot) b) tinea magnum (hand) c) tinea cruris (groin) d) tinea capitis (scalp) e) tinea barbae (beard)

b) tinea magnum *tinea MANUUM

All of the following are true regarding antihelminithics EXCEPT? a) used to treat parasitic worm infections b) unlike protozoa, helminths are small with simple cellular structures c) drug treatment is very specific [need to match the drug to the worm] d) pathogenic helminths include cestodes (tapeworms), nematodes (roundworms), trematodes (flukes) e) search for ova/larvae in feces, urine, blood, sputum, tissue

b) unlike protozoa, helminths are small with simple cellular structures *LARGE WITH COMPLEX CELLULAR STRUCTURES

All of the following are true regarding enterobiasis EXCEPT? a) these are pinworm b) worms lay eggs before dark c) can test at home with tape test or paddle test d) can test using a flashlight

b) worms lay eggs before dark *AFTER

All of the following are true regarding Acyclovir EXCEPT? a) it is the treatment of choice in HSV encephalitis b) most common use is in therapy for genital herpes infections c) administered prophylactically to seropositive patients after bone marrow transplant and before heart transplant d) it accumulates in patients with renal failure e) valacyclovir has greater oral bioavailability than acyclovir f) significant drug interaction when used together with Probenecid

c) administered prophylactically to seropositive patients after bone marrow transplant and before heart transplant *BEFORE bone marrow transplant and AFTER heart transplant [to protect individuals from herpetic infections]

All of the following are true regarding tetracyclines EXCEPT? a) includes Doxycycline, Minocycline, Tigecycline, Eravacycline [2019], and topical forms for acne b) both natural and semi-synthetic c) broad spectrum d) MOA= bacteriostatic by inhibiting protein synthesis, and interfering with many essential functions of susceptible bacteria

c) broad spectrum *Used to be broad spectrum but widespread use in 50s and 60s led to many resistant strains so now it has very limited therapeutic indications!

All of the following are true regarding penicillin EXCEPT? a) primary use is in gram + infections b) used for streptococcus, enterococcus, staphylococcus c) common side effects include nausea, vomiting, constipation, abdominal pain d) allergic reactions occur in patients [urticaria, maculopapular rash, angioedema]

c) common side effects include nausea, vomiting, constipation, abdominal pain *DIARRHEA

Sulfonamides adverse effects include all of the following EXCEPT? a) photosensitivity b) TEN c) constipation d) hemolytic anemia e) toxic nephrosis f) headache

c) constipation *Diarrhea

Which of the following is the most significant side effect of the TB drugs? a) nausea/vomiting b) fever c) hepatotoxicity d) jaundice e) depression f) anorexia

c) hepatotoxicity

All of the following are true regarding PCP EXCEPT? a) symptoms include fever, dyspnea, dry cough b) CXR features diffuse bilateral perihilar infiltrates, but some will have normal x-ray c) hypoxemia often presents only if the chest x-ray shows infiltrate d) TMP/SMX is the treatment for 14-21 days e) it is recommended to join the therapy with corticosteroids [Prednisone]

c) hypoxemia often presents only if the chest x-ray shows infiltrate *EVEN when the chest x-ray shows NO infiltrate= important clue to diagnosis

All of the following are true regarding Cephalosporins EXCEPT? a) broad spectrum b) semi-synthetic c) inferior coverage to PCN d) classified into 4 generations based on spectrum of activity

c) inferior coverage to PCN *Most are SUPERIOR to PCN

All of the following are true regarding treatment for tuberculosis EXCEPT? a) generally it includes four first line drugs b) second line drugs are generally less effective and more toxic [used in patients who cannot tolerate first line or are infected with resistant TB] c) latent TB can be treated with 12 months of Isoniazid monotherapy d) active TB must be treated with several drugs for at least 6 months (to 12 months), and up to 2 years for multi-drug resistant TB

c) latent TB can be treated with 12 months of Isoniazid monotherapy *9 MONTH

All of the following is true regarding the MOA of Aminoglycosides EXCEPT? a) bacteriocidal b) inhibits bacterial protein synthesis c) most effective for anerobic gram - bacteria d) limited gram + coverage e) indicated for serious to life threatening infections f) often used in combination with other antibiotics for synergistic effect

c) most effective for anerobic gram - bacteria *AEROBIC

All of the following are true regarding Steven-Johnson syndrome EXCEPT? a) severe to life threatening b) hypersensitivity affecting skin and mucus membranes c) most often occurs in response to an illness

c) most often occurs in response to an illness *More often occurs in response to a drug (may occur in response to an illness)

All of the following are true regarding viruses/viral infections EXCEPT? a) viruses are obligate intracellular parasites b) viruses lack a cell wall/membrane c) most viral infections require pharmacotherapy d) clinical symptoms appear late in the course of infection further complicating treatment e) immunocompromised patients have frequent viral infections [i.e. cancer, transplant, AIDS]

c) most viral infections require pharmacotherapy *most DO NOT [a well functioning immune system will eliminate or effectively destroy viral replication]

All of the following are true regarding natural penicillins EXCEPT? a) lots of resistance b) allergic reactions are likely c) narrow-spectrum of activity d) includes Penicillin G & V

c) narrow-spectrum of activity *BROAD

All of the following is true regarding 4th generation Cephalosporins EXCEPT? a) newer agents that are IV and IM form only b) Cefepime is the only one currently approved in the US c) narrower spectrum of activity vs. 3rd gen d) better gram + than 3rd gen. and excellent coverage of pseudomonas e) effective against bugs that have developed resistance to earlier cephalosporins

c) narrower spectrum of activity vs. 3rd gen *BROADER ~New Kid on the Block.... Ceftaroline fosamil (IV)= 5th gen. -CAP -Skin/skin suture infections

Side/adverse effects of macrolides include all of the following EXCEPT? a) nausea/vomiting and diarrhea b) metallic taste [Biaxin] c) obesity d) jaundice & hepatotoxicity

c) obesity *Anorexia (& flatulence) *Macrolides= highly protein bound [serious interaction with other protein-bound drugs]

All of the following are true regarding drugs used for Herpes Virus infections EXCEPT? a) lessens the severity of acute herpes simplex infections b) longer period between outbreaks c) orals are given for 14-18 days d) several topical forms are available

c) orals are given for 14-18 days *7 TO 10 DAYS

All of the following are true regarding Aminoglycosides EXCEPT? a) natural and synthetic b) first agent effective for TB c) poor IV absorption d) very potent with serious toxicities e) amino group + sugar group f) Gentamicin, Neomycin sulfate, Streptomycin, Tobramycin, Amikacin

c) poor IV absorption *poor ORAL absorption= PO forms rarely used except for pre-op bowel cleanse [NEOMYCIN]

All of the following are true regarding Fluroquinolones (Quinolones) EXCEPT? a) very broad spectrum of coverage b) both gram - and gram + coverage c) poor oral absorption d) convenient BID or QD dosing e) Ciprofloxacin, Levofloxacin, Ciprofloxacin Opthalmic, Ciprofloxacin Otic

c) poor oral absorption *EXCELLENT oral absorption [first oral form to cover gram neg; oral absorption decreases with antacids]

All of the following are true regarding Vabomere EXCEPT? a) it is a combination of meropenem + vaborbactam [carbapenem + b-lactamase inhibitor] b) indicated for treatment of patients 18 years and older with complicated UTIs c) can be used to cover pyelonephritis caused by E coli, Klebsiella pneumoniae d) there are no restrictions for use of Vabomere

d) there are no restrictions for use of Vabomere *To reduce the development of drug-resistant bacteria and maintain the effectiveness of VABOMERE and other antibacterial drugs, VABOMERE should be used only to treat or prevent infections that are proven or strongly suspected to be caused by susceptible bacteria.

All of the following are true regarding candidal fungal infections EXCEPT? a) candida albicans may result in overgrowth and systemic infections b) oral thrush can occur in healthy neonates as well as immunocompromised patients c) cutaneous infections include diaper dermatitis in healthy babies d) vaginal [aka yeast infection] can occur in pregnancy, diabetes insipidus, oral contraceptives, Abx therapy

d) vaginal [aka yeast infection] can occur in pregnancy, diabetes insipidus, oral contraceptives, Abx therapy *DIABETES MELLITUS

All of the following are true regarding MAC [mycobacterium avium complex] EXCEPT? a) it is a combination of M. avium and M. intracellulare b) risk is inversely related to CD4 count c) early disease features night sweats, weight loss, fatigue, GI issues d) late disease features invasive pulmonary infections, skin infections, soft tissue infections e) treatment requires one antibiotic

e) treatment requires one antibiotic *treatment requires COMBINATION of multiple "big gun" antibiotics [Rifampin, Rifabutin, Cipro, Amikacin, Ethambutol, Streptomycin, Clarithromycin, Azithromycin]