Antibiotics, Antivirals, & Anti-Infective Agents Flashcards

Question

# What is the common brand name(s) for: clindamycin | (KLIN-da-my-sin)

Answer 1

Cleocin | Class: Lincosamide antibiotic ## Footnote **Indication:** Used for Bacteroides fragilis, Clostridium perfringens, MRSA, skin infections, and prophylaxis of endocarditis. **MOA:** Reversibly binds 50S ribosomal subunit, preventing peptide bond formation and inhibiting protein synthesis. **Side Effects:** Higher incidence of superinfections, severe diarrhea, pseudomembranous colitis. **Contraindications:** Hypersensitivity to drug or lincomycin. **Considerations:** * Use caution in hepatic impairment; dose adjustments may be required. * Inform patients about adherence and notify if severe diarrhea occurs. * Caution in patients with GI disorders or previous superinfections.

Answer 2

Lotrimin | Class: Antifungal, Imidazole Derivative ## Footnote **Indication:** Treats Candida and M. furfur infections, and dermatophyte infections. **MOA:** Alters fungal cell wall permeability, leading to cell death. **Side Effects:** Nausea, vomiting, abdominal pain, elevated LFTs. **Contraindications:** Hypersensitivity to drug or its components. **Considerations:** * Weigh benefits and risks in pregnant women, especially for vaginal candidiasis.

Answer 3

Lotrisone | Class: Antifugal; Corticosteroid ## Footnote **Indication:** Treats tinea corporis, tinea cruris, and tinea pedis. **MOA:** Clotrimazole alters fungal membrane permeability; Betamethasone stabilizes capillary permeability. **Side Effects:** Localized burning, edema, skin rash. **Contraindications:** Hypersensitivity to drug or its components. **Considerations:** * Advise patients to monitor for skin thinning and irritation.

Answer 4

Cubicin | Class: Cyclic Lipopeptide antibiotic ## Footnote **Indication:** Used for MRSA infections; bacteremia; right-sided infective endocarditis **MOA:** Inserts into the bacterial cell membrane, causing depolarization and arresting nucleic acid and protein synthesis **Side Effects:** Headache; dizziness; GI effects; renal insufficiency; rhabdomyolysis **Contraindications:** Hypersensitivity to the drug or its components **Considerations:** * Not for pneumonia due to binding with lung surfactant * Monitor serum creatinine kinase for rhabdomyolysis * Use caution in renal impairment

Answer 5

Prezista | Class: Protease Inhibitors (PIs) ## Footnote **Indication:** Treatment of HIV **MOA:** Binds HIV protease, preventing viral replication and production of immature viral particles **Side Effects:** GI effects; lipodystrophy; insulin resistance; hepatotoxicity **Contraindications:** Co-administration with potent CYP3A inducers **Considerations:** * Not used as monotherapy for HIV; used in combination therapy

Answer 6

Vibramycin | Class: Tetracyclines ## Footnote **Indication:** Treats Lyme disease; Rocky Mountain spotted fever; acne; MRSA; and more **MOA:** Binds to the 30S ribosomal subunit, inhibiting protein synthesis **Side Effects:** Discoloration of teeth; nephrotoxicity; photosensitivity; GI disturbances **Contraindications:** Hypersensitivity to the drug or its components **Considerations:** * Take with water; avoid lying down for 30 minutes * Use sunscreen for photosensitivity * Avoid antacids and supplements near dosing time * Monitor anticoagulant interactions * Complete full course to prevent resistance

Answer 7

Sustiva | Class: Non Nucleoside reverse transcriptase inhibitor (NNRTI) ## Footnote **Indication:** HIV treatment in combination therapy **MOA:** Binds reverse transcriptase, blocking polymerase activity **Side Effects:** Teratogenic; neuropsychiatric reactions **Contraindications:** Hypersensitivity to the drug or its components **Considerations:** * Common CNS effects; hallucinations possible * Acts synergistically with other HIV drugs * Not used as monotherapy due to resistance risk * Many drug interactions; check interaction database * Use caution in pregnancy

Answer 8

Truvada | Class: Emtricitabine: Nucleoside reverse transcriptase inhibitor (NRTI); Tenofovir: Nucleotide reverse transcriptase inhibitor (NRTI) ## Footnote **Indication:** HIV; PrEP; PEP **MOA:** Inhibits viral replication by interfering with viral RNA-dependent DNA polymerase **Side Effects:** Nausea; diarrhea; renal toxicity; headache; reduced bone mineral density **Contraindications:** Hypersensitivity to the drug or its components **Considerations:** * Monitor renal function and bone health * Use caution in pregnancy * Adhere strictly to dosing regimen * Boxed warning for hepatitis B exacerbation and resistance risk

Answer 9

Baraclude | Class: Nucleoside analog ## Footnote **Indication:** Chronic hepatitis B (HBV) infection **MOA:** Inhibits HBV DNA polymerase, reducing viral replication **Side Effects:** Nausea; abdominal pain; headache; fatigue **Contraindications:** Hypersensitivity to the drug or its components **Considerations:** * Dose adjustments for renal impairment * Monitor HBV DNA, liver, and renal function * Adhere to dosing to maintain viral suppression * Use caution in pregnancy * Not for sole HBV treatment in HIV/HBV co-infection

Answer 10

Ery-Tab | Class: Macrolide antibiotic ## Footnote **Indication:** Used for gram-positive and gram-negative infections; prophylaxis against endocarditis **MOA:** Binds to the 50S ribosomal subunit, inhibiting protein synthesis **Side Effects:** Nausea; anorexia; tinnitus; QT prolongation **Contraindications:** Severe allergic reactions to macrolides; use with certain drugs (e.g., terfenadine) **Considerations:** * Potent CYP3A4 inhibitor; monitor co-administered drugs * Monitor in liver disease; dose adjustments may be necessary * Considered safe during pregnancy

Answer 11

Foscavir | Class: Antiviral ## Footnote **Indication:** CMV retinitis in AIDS; acyclovir-resistant herpes simplex **MOA:** Blocks pyrophosphate-binding sites on viral DNA polymerase, preventing DNA attachment **Side Effects:** Renal impairment; electrolyte imbalances; blood dyscrasias; cardiac arrhythmias **Contraindications:** Severe renal dysfunction **Considerations:** * Combine with ganciclovir for resistant infections * Minimize renal impairment with IV fluids * Correct electrolytes before use due to seizure risk * Boxed warning for renal impairment, seizures, and appropriate use

Answer 12

Diflucan Triazole (Azole Derivative) | Class: Antifungal, ## Footnote **Indication:** Prevention of cryptococcal meningitis; candidiasis; UTIs caused by Candida **MOA:** Inhibits ergosterol synthesis, leading to fungal cell death **Side Effects:** GI distress; CNS effects; hepatotoxicity; cardiac abnormalities **Contraindications:** First trimester of pregnancy; coadministration with CYP3A4 substrates causing QT prolongation **Considerations:** * Only oral azole that penetrates CSF well for fungal meningitis

Answer 13

Cytovene | Class: Antiviral ## Footnote **Indication:** CMV prophylaxis and retinitis **MOA:** Inhibits DNA polymerase binding, decreasing DNA synthesis **Side Effects:** Blood dyscrasias; inhibited spermatogenesis **Contraindications:** Hypersensitivity to the drug or its components **Considerations:** * Monitor blood counts regularly * Use caution in renal impairment * Counsel patients on potential fertility effects

Answer 14

Zymaxid | Class: Fluoroquinolones ## Footnote **Indication:** Bacterial conjunctivitis and keratitis **MOA:** Inhibits DNA topoisomerase II (DNA gyrase) and IV, preventing DNA replication **Side Effects:** Chemosis; dysgeusia; headache; conjunctival irritation; decreased visual activity; eye irritation; nausea; pruritus **Contraindications:** Hypersensitivity to the drug or any of its components **Considerations:** * Ophthalmic use for eye infections * Counsel patients to report vision changes immediately

Answer 15

Garamycin | Class: Aminoglycoside antibiotic ## Footnote **Indication:** Severe infections caused by gram-negative bacteria; in combination for serious enterococcal, staphylococcal, or streptococcal infections **MOA:** Binds to the 30S ribosomal subunit, interfering with protein synthesis and causing misreading of the genetic code **Side Effects:** Nephrotoxicity; ototoxicity; dizziness; nystagmus; vertigo; hearing impairment; drug-induced renal failure; glomerular toxicity; respiratory paralysis at high doses **Contraindications:** Hypersensitivity to the drug or any of its components **Considerations:** * Monitor dosing closely due to risk of toxicities * Caution with diuretics use due to increased risk of toxicity * Boxed warnings for potential nephrotoxicity and neurotoxicity

Answer 16

Fulvicin P/G 165 | Class: Antifungal ## Footnote **Indication:** Dermatophyte infections including tinea capitis **MOA:** Disrupts microtubule function and mitosis in dermatophytes; fungistatic **Side Effects:** GI distress; CNS effects; blood dyscrasias; lupus-like syndrome; hepatotoxicity; skin reactions; photosensitivity **Contraindications:** Pregnancy; hepatic failure; porphyria **Considerations:** * Absorption increased with high-fat meal * Induces CYP3A4, reducing plasma concentrations of certain drugs

Answer 17

Stromectol | Class: Anthelmintic ## Footnote **Indication:** Active against nematodes; strongyloidiasis; onchocerciasis **MOA:** Increases chloride permeability of invertebrate muscle cells, leading to paralysis **Side Effects:** Skin reactions; lymphangitis; myalgia; dizziness; eosinophilia; neurotoxicity; CNS depression **Contraindications:** Hypersensitivity to the drug or any of its components **Considerations:** * Use caution in pregnancy and lactation * Caution with other P-glycoprotein inhibitors * Rule out Loa co-infection to avoid encephalopathy

Answer 18

Nizoral Imidazole Derivative | Class: Antifungal, ## Footnote **Indication:** Fungal infections; seborrheic dermatitis; chronic mucocutaneous candidiasis **MOA:** Inhibits lanosterol 14-alpha-demethylase and ergosterol synthesis, leading to fungal cell death **Side Effects:** Adrenal suppression; increased bone fragility; orthostatic hypotension; peripheral edema; CNS effects; skin rashes; thrombocytopenia; cardiac abnormalities; hepatotoxicity **Contraindications:** Acute or chronic liver disease; highly CYP3A4-cleared drugs **Considerations:** * Interacts with many medications; monitor for toxicities * Increased sedation risk with benzodiazepines * Not for meningitis or CNS infections

Answer 19

Levaquin | Class: Fluoroquinolones ## Footnote **Indication:** Gram-negative bacterial infections; UTI; prostatitis; bacterial diarrhea; intra-abdominal infections; anthrax **MOA:** Inhibits DNA topoisomerase II and IV, preventing DNA replication **Side Effects:** GI upset; tendonitis; tendon rupture; peripheral neuropathy; hypo/hyperglycemia; seizures; photosensitivity; QT prolongation **Contraindications:** Hypersensitivity to the drug or any of its components **Considerations:** * Take 2 hours before or after foods with calcium, iron, magnesium, or zinc * Long postantibiotic effect * Not for children, adolescents, nursing mothers, or pregnant women * Boxed warning for serious adverse reactions

Answer 20

Zyvox | Class: Oxazolidinone antibiotic ## Footnote **Indication:** Gram-positive bacterial infections; vancomycin-resistant E. faecium; pneumonia; skin and soft tissue infections **MOA:** Binds to 23S ribosomal RNA of the 50S subunit, preventing formation of the 70S initiation complex **Side Effects:** GI upset; skin reactions; lactic acidosis; serotonin syndrome; myelosuppression **Contraindications:** Concurrent use of MAO inhibitors or within 14 days **Considerations:** * Monitor for myelosuppression in prolonged use * Manufacturer contraindicates use with SSRIs, TCAs, and buspirone

Answer 21

Flagyl | Class: Nitroimidazole, Antiprotozoal ## Footnote **Indication:** Protozoal infections; anaerobic bacterial infections; amebiasis; giardiasis; trichomoniasis **MOA:** Inhibits nucleic acid synthesis by disrupting DNA structure **Side Effects:** GI upset; metallic taste; leukopenia; thrombocytopenia; skin reactions; urine discoloration; hepatotoxicity; CNS side effects **Contraindications:** First trimester of pregnancy; existing blood dyscrasias; chronic alcohol use **Considerations:** * GI side effects common; take with food * Boxed warning for carcinogenic risk in animals

Answer 22

Mycamine Echinocandin | Class: Antifungal, ## Footnote **Indication:** Prophylaxis and treatment of candidiasis and invasive aspergillosis **MOA:** Inhibits fungal cell wall synthesis **Side Effects:** Nausea; vomiting; diarrhea; anemia; tachycardia; neutropenia; thrombocytopenia; hepatotoxicity **Contraindications:** Hypersensitivity to the drug or any of its components **Considerations:** * Monitor for infusion reactions with initial IV doses

Answer 23

Minocin | Class: Tetracycline Derivative ## Footnote **Indication:** Bacterial infections including Lyme disease; acne; MRSA; and others **MOA:** Binds to the 30S ribosomal subunit, preventing protein synthesis **Side Effects:** Discoloration of teeth; nephrotoxicity; hepatotoxicity; photosensitivity; GI disturbances **Contraindications:** Hypersensitivity to the drug or any of its components **Considerations:** * Take with water and wait 30 minutes before lying down * Interacts with divalent cations; space doses by 2–3 hours

Answer 24

Avelox, Vigamox (ophthalmic) | Class: Fluoroquinolones ## Footnote **Indication:** Gram-negative bacterial infections; respiratory infections; skin infections; anthrax **MOA:** Inhibits DNA topoisomerase II and IV, preventing DNA replication **Side Effects:** GI upset; tendonitis; tendon rupture; peripheral neuropathy; QT prolongation **Contraindications:** Hypersensitivity to the drug or any of its components **Considerations:** * Take 2 hours before or after foods with calcium, iron, magnesium, or zinc * Long postantibiotic effect * Boxed warning for serious adverse reactions

Answer 25

Bactroban | Class: Topical antibiotic ## Footnote **Indication:** Topical antibiotic for gram-positive cocci, including methicillin-resistant staphylococci; treats impetigo and nasal colonization of MRSA **Dosage:** Topical use only **MOA:** Reversibly binds to isoleucyl-tRNA synthetase, inhibiting protein synthesis **Side Effects:** Discomfort at application site; rash; burning sensation **Contraindications:** Hypersensitivity to the drug or its components **Considerations:** * Apply to affected area – avoid contamination of the applicator * Monitor for allergic or irritant reactions * Do not use in polyethylene glycol-containing forms on large open wounds

Answer 26

Unipen | Class: Penicillinase-Resistant Antistaphylococcal Penicillins ## Footnote **Indication:** Penicillinase-resistant antistaphylococcal penicillins for bacteremia; endocarditis; osteomyelitis; pneumonia; septic arthritis; skin and soft tissue infections; staphylococcal meningitis (not for MRSA) **MOA:** Binds to penicillin-binding proteins (PBPs), inhibiting bacterial cell wall synthesis **Side Effects:** Infusion site reactions; GI upset; interstitial nephritis; neutropenia; hypokalemia; serum sickness-like reaction; rare: neurotoxicity; cholestasis; elevated LFTs **Contraindications:** Hypersensitivity to the drug or its components **Considerations:** * Nafcillin may contain high doses of sodium; caution in heart failure

Answer 27

Paxlovid | Class: Cytochrome P-450 Inhibitor ## Footnote **Indication:** COVID-19 **MOA:** Inhibits the main protease (M^pro) of SARS-CoV-2, preventing cleavage of viral polyproteins crucial for viral replication; inhibits CYP3A-mediated metabolism, boosting plasma concentration **Side Effects:** Altered or unpleasant taste; diarrhea; nausea; abdominal pain; increased blood pressure; muscle aches; headache **Contraindications:** Contraindicated with medications that are highly dependent on CYP3A for clearance; not recommended in severe renal impairment **Considerations:** * Caution advised in patients with hepatic impairment * Educate patients about the importance of adhering to the prescribed regimen and starting treatment as early as possible

Answer 28

Alinia | Class: Antiprotozoal ## Footnote **Indication:** Diarrhea caused by Cryptosporidium parvum or Giardia lamblia (giardiasis) **MOA:** Nitro thiazolyl-salicylamide derivative; noncompetitive inhibitor of pyruvate-ferredoxin oxidoreductase; inhibits growth of sporozoites and oocysts **Side Effects:** Headache; nausea; abdominal discomfort; diarrhea; urine discoloration **Contraindications:** Hypersensitivity to the drug or any of its components **Considerations:** * Take with food * Exercise caution in patients with significant hepatic or renal impairment * Data in pregnancy and lactation are limited; use caution

Answer 29

Macrobid | Class: Antibiotic ## Footnote **Indication:** Lower UTIs leading to cystitis; acute lower UTIs caused by E. coli, E. faecalis, K. pneumoniae, Staphylococcus saprophyticus; acute cystitis (when resistance to trimethoprim-sulfamethoxazole exceeds 20% in the local community) **MOA:** Inhibition of bacterial enzymes by alteration of bacterial ribosomal proteins; bactericidal **Side Effects:** GI upset (nausea, vomiting, diarrhea); pulmonary fibrosis; hepatitis; hematologic toxicity (elevated LFTs); pancreatitis; blood dyscrasias (rare) **Contraindications:** Anuria; oliguria; severe renal impairment; cholestatic jaundice **Considerations:** * Antimicrobial activity restricted to the urinary bladder * Macrocrystalline form is given with the drug to reduce side effects * Given with food to increase absorption and reduce the risk of GI irritation

Answer 30

Mycostatin | Class: Antifungal ## Footnote **Indication:** Superficial mycoses of the skin and mucous membranes; Candida (mucocutaneous, intestinal, vaginal) **MOA:** Alters fungal cell wall permeability by binding phospholipids, leading to cell death due to a loss of intracellular elements **Side Effects:** Contact dermatitis; Stevens-Johnson syndrome; GI effects (nausea, vomiting, diarrhea) **Contraindications:** Hypersensitivity to the drug or any of its components **Considerations:** * Ensure the patient is taking the medication as prescribed (swish and spit, swish and swallow, topically) * Often needs to be dosed 3–4 times per day to be effective

Answer 31

Floxin | Class: Fluoroquinolones ## Footnote **Indication:** Otitis externa – bacterial (swimmer's ear); otitis media with tympanostomy tubes; chronic suppurative otitis media – with perforated tympanic membrane; respiratory tract infections (community-acquired pneumonia and bronchitis); urinary tract infections; uncomplicated skin infections; intra-abdominal infections; cystitis; cervicitis/urethritis **MOA:** Inhibition of DNA topoisomerase II (DNA gyrase) and IV, preventing DNA replication and separation of chromosomes **Side Effects:** Nausea; vomiting; diarrhea; C. difficile-associated diarrhea; tendonitis and tendon rupture; peripheral neuropathy; hypo/hyperglycemia; seizures; photosensitivity; QT prolongation; CNS stimulation **Contraindications:** Myasthenia gravis **Considerations:** * Should be taken 2 hours before or after foods with calcium, iron, magnesium, or zinc * Long postantibiotic effect * Should not be prescribed to children, adolescents, nursing mothers, or pregnant women * Diabetes is a risk factor for several side effects * Increases warfarin levels * Adjust dose in patients with renal impairment to avoid drug accumulation * Inform patients to report any signs of tendon pain, swelling, or inflammation immediately * Seek medical advice for neurological or cardiac symptoms * Use caution in renal and hepatic impairment

Answer 32

Tamiflu | Class: Neuraminidase inhibitors ## Footnote **Indication:** Prophylaxis and treatment of influenza; reduces complications of influenza (otitis media, pneumonia) **MOA:** Inhibits neuraminidase in influenza A and B, preventing release of virions from infected cells and preventing spread through the respiratory tract **Side Effects:** GI effects (nausea, vomiting, gastrointestinal hemorrhage, hemorrhagic colitis); skin reactions (rashes); neuropsychiatric effects (confusion, hallucinations, delirium); hypersensitivity reactions (angioedema, TEN, Stevens-Johnson syndrome) **Contraindications:** Hypersensitivity to the drug or any of its components **Considerations:** * Outpatient treatment should begin within the first 48 hours of symptom onset; it reduces symptom severity but does not cure the disease * Treatment and prophylaxis outside these parameters are typically for hospitalized, institutionalized, or high-risk patients * Approved for use in patients older than 1 year of age

Answer 33

Pen VK | Class: Narrow-Spectrum Penicillins ## Footnote **Indication:** Gram-positive cocci; pharyngitis (Streptococcus pyogenes) **MOA:** Binds to penicillin-binding proteins (PBPs), inhibiting bacterial cell wall synthesis by inhibiting the transpeptidation step of peptidoglycan synthesis **Side Effects:** Skin reactions (rash, angioedema); Jarisch-Herxheimer reaction; serum sickness-like reaction; neutropenia; electrolyte abnormalities; pseudomembranous colitis **Contraindications:** Hypersensitivity to the drug or any of its components **Considerations:** * Recommended to take penicillin V on an empty stomach for optimal absorption, but can be taken with food if GI upset occurs * Primarily excreted by the kidneys — dose adjustments may be necessary in patients with renal impairment * Caution is advised in patients with a history of beta-lactam allergy * Complete the full course of therapy * Report any signs of an allergic reaction (such as rash, itching, or difficulty breathing) immediately

Answer 34

Zosyn | Class: Penicillin‑class antibacterial; beta‑lactamase inhibitor ## Footnote **Indication:** Complicated intra-abdominal infections; complicated skin and soft tissue infections; hospital-acquired pneumonia (HAP); community-acquired pneumonia (CAP); complicated urinary tract infections (UTIs); febrile neutropenia; postpartum endometritis and pelvic inflammatory disease (PID); septicemia **MOA:** Binds to penicillin-binding proteins (PBPs), inhibiting bacterial cell wall synthesis by inhibiting the transpeptidation step of peptidoglycan synthesis; β-lactamase inhibitor that protects from enzymatic degradation, extending its spectrum of activity **Side Effects:** Infusion site reactions; skin reactions; Jarisch-Herxheimer reaction; serum sickness-like reaction; blood dyscrasias; electrolyte abnormalities; pseudomembranous colitis **Contraindications:** History of severe allergic reactions to beta-lactams **Considerations:** * Dose adjustments necessary in patients with renal impairment * Adjust dosing for pediatric and geriatric patients, and consider pregnancy and lactation risks based on guidelines

Answer 35

Isentress | Class: Integrase Strand Transfer Inhibitors (INSTIs) ## Footnote **Indication:** HIV **MOA:** Inhibits the catalytic activity of integrase, preventing viral DNA insertion into host cell DNA **Side Effects:** GI effects; immune reconstitution syndrome; myopathy; hepatotoxicity; hypersensitivity reactions **Contraindications:** Hypersensitivity to the drug or any of its components **Considerations:** * Caution is advised in patients with moderate to severe hepatic impairment * Caution should be exercised when co-administered with drugs known to induce or inhibit UGT1A1 * Approved for pediatric patients (including adolescents) at weight-appropriate dosing, with dosing adjustments made based on body weight * Adherence to prescribed regimen is necessary

Answer 36

Veklury | Class: Nucleotide analog prodrug ## Footnote **Indication:** COVID-19 **MOA:** Active form incorporates into viral RNA chains via the viral RNA-dependent RNA polymerase (RdRp), leading to premature termination of RNA synthesis and inhibition of viral replication **Side Effects:** Elevations in liver enzymes; nausea; vomiting; diarrhea; renal impairment **Contraindications:** Hypersensitivity to the drug or any of its components **Considerations:** * Administered intravenously, typically as a daily infusion over a 5- to 10-day course * Early treatment is associated with improved outcomes * Approved for pediatric patients (typically aged 12 years and older and weighing at least 40 kg) with COVID-19 under specific guidelines

Answer 37

Copegus Nucleoside | Class: Antiviral, ## Footnote **Indication:** Severe RSV infection; chronic hepatitis; hepatitis A and C; HSV; influenza A and B; mumps virus; adenovirus; Colorado tick fever virus; Crimean-Congo hemorrhagic fever virus; Hantaan virus; respiratory syncytial virus; Rift Valley fever virus; yellow fever virus **MOA:** Inhibits guanine triphosphate and viral nucleic acid synthesis; inhibits synthesis of host cell nucleic acid **Side Effects:** Pulmonary reactions; cardiac effects; hemolytic anemia; neutropenia; hepatotoxicity; renal toxicity; alopecia; skin reactions; stunted growth; CNS effects **Contraindications:** Pregnancy; sexual partners of those who are pregnant; use within 6 months of pregnancy **Considerations:** * Monitor closely for worsening respiratory status, especially with inhaled form

Answer 38

Viread | Class: Nucleoside reverse transcriptase inhibitor (NRTIs) ## Footnote **Indication:** HIV-1 and HIV-2; hepatitis B virus **MOA:** Adenosine-derived nucleoside reverse transcriptase inhibitor (NRTI); inhibits viral replication by interfering with viral RNA-dependent DNA polymerase and inhibits HBV polymerase to inhibit HBV **Side Effects:** Renal impairment; decreased bone mineral density; mitochondrial toxicity; lactic acidosis; immune reconstitution syndrome; GI effects; weight loss; hepatotoxicity; hypercholesterolemia; elevated triglycerides; skin rashes; fatigue **Contraindications:** Hypersensitivity to the drug or any of its components **Considerations:** * Caution in renal or hepatic impairment * Bone density should be monitored in patients with risk factors for osteoporosis * In patients co-infected with HBV, discontinuation of tenofovir can lead to hepatitis B flare; caution advised * Adhere to the prescribed regimen * Boxed warning: do not use aerosolized ribavirin in adults

Answer 39

Lamisil | Class: Allylamine class antifungal ## Footnote **Indication:** Onychomycosis (tinea unguium); tinea pedis; tinea cruris; tinea corporis; cutaneous candidiasis (tinea versicolor) **MOA:** Inhibits the enzyme squalene epoxidase, which is essential in the biosynthesis of a vital component of the fungal cell membrane, leading to a deficiency of ergosterol and an accumulation of squalene within the fungal cell resulting in cell death **Side Effects:** Nausea; diarrhea; abdominal discomfort; dyspepsia; elevated liver enzymes; altered or loss of taste; rash; pruritus; urticaria **Contraindications:** Chronic or active hepatic disease **Considerations:** * Typically used for 6–12 weeks — adherence to therapy and periodic monitoring are essential

Answer 40

Sumycin | Class: Tetracyclines ## Footnote **Indication:** Lyme disease; Rocky Mountain spotted fever; relapsing fever; ehrlichiosis; granuloma inguinale; brucellosis; cholera; peptic ulcer disease; gonorrhea; community-acquired pneumonia; leptospirosis; nontuberculous mycobacterial infections; prophylaxis of protozoal infections; H. pylori; Chlamydia trachomatis; rickettsiae; acne vulgaris; MRSA; spirochetes; mycoplasmas; protozoa **MOA:** Binds to the 30S ribosomal subunit, preventing the addition of new amino acids to the nascent polypeptide chain; bacteriostatic **Side Effects:** Discoloration of teeth; hypoplasia of the enamel in pregnancy **Contraindications:** Pregnancy; children under 8 years old **Considerations:** * Avoid use in pregnant women and children under 8 years old due to risk of teeth discoloration and bone growth retardation * Take on an empty stomach, at least 1 hour before or 2 hours after meals * Avoid taking with milk, antacids, or iron supplements as they can reduce absorption

Answer 41

Tygacil | Class: Glycylcycline antibiotic ## Footnote **Indication:** Treats skin and soft tissue infections; community-acquired pneumonia; complicated intraabdominal infections, including multidrug-resistant strains **MOA:** Minocycline derivative; binds to the 30S ribosomal subunit, inhibiting bacterial protein synthesis **Side Effects:** Skin reactions; photosensitivity; severe nausea/vomiting; cholestasis; pancreatitis; tooth discoloration in patients under 8 years **Contraindications:** Hypersensitivity to the drug or its components **Considerations:** * Increased risk of mortality; use only as a last resort * Caution in children under 8 years, pregnancy, pancreatitis, renal or hepatic impairment

Answer 42

Tobrex | Class: Aminoglycoside antibiotic ## Footnote **Indication:** Effective against Pseudomonas aeruginosa and Enterococcus faecalis **MOA:** Binds to the 30S ribosomal subunit, interfering with protein synthesis initiation and causing genetic code misreading **Side Effects:** Nephrotoxicity; ototoxicity; vestibular and cochlear toxicity; hypersensitivity **Contraindications:** Hypersensitivity to the drug or its components **Considerations:** * Narrow therapeutic index * Dosage adjustments needed for renal impairment * Boxed warning for nephrotoxicity, ototoxicity, neuromuscular blockade, and embryo-fetal toxicity

Answer 43

Bactrim Folate inhibitor | Class: Antibiotic, ## Footnote **Indication:** UTIs; prostatic infections; traveler's diarrhea; pulmonary infections by Pneumocystis jiroveci; Staphylococcus aureus **MOA:** Sulfamethoxazole inhibits dihydrofolic acid formation; trimethoprim inhibits dihydrofolate reductase **Side Effects:** GI distress; severe skin rashes; blood dyscrasias; hepatic necrosis **Contraindications:** Infants under 2 months; megaloblastic anemia due to folate deficiency; severe renal insufficiency **Considerations:** * Caution in elderly, AIDS patients, and those with G6PD deficiency * Monitor for folate deficiency if used chronically

Answer 44

Valtrex | Class: Antiviral ## Footnote **Indication:** Treats HSV; VZV; prophylaxis of CMV **MOA:** Inhibits DNA polymerase, requiring conversion by thymidine kinase for viral replication inhibition **Side Effects:** Generally well-tolerated; headache; GI upset; skin reactions; blood dyscrasia **Contraindications:** Hypersensitivity to the drug or its components **Considerations:** * Improved bioavailability compared to acyclovir * Dose adjustments required in renal impairment * Adequate hydration is important during therapy

Answer 45

Valcyte | Class: Antiviral ## Footnote **Indication:** Treats CMV retinitis and prevents CMV disease **MOA:** Converted into ganciclovir; inhibits CMV replication by causing viral DNA chain termination **Side Effects:** Neutropenia; anemia; thrombocytopenia; diarrhea; renal dysfunction **Contraindications:** Hypersensitivity to the drug or its components **Considerations:** * Regular CBC needed to monitor blood counts * Dose adjustments needed for renal impairment * Generally contraindicated during pregnancy

Answer 46

Vancocin | Class: Glycopeptide antibiotic ## Footnote **Indication:** Treats gram-positive cocci and bacilli infections, including MRSA and penicillin-resistant organisms **MOA:** Binds to D-Ala-D-Ala, inhibiting cell wall synthesis by preventing polymerization and cross-linking **Side Effects:** Nephrotoxicity; ototoxicity; red man syndrome; vestibular and cochlear dysfunction **Contraindications:** Hypersensitivity to the drug or its components **Considerations:** * Caution in renal failure * Serum concentrations monitored * Increased nephrotoxicity with aminoglycosides and amphotericin B

Answer 47

Vfend Triazole (Azole Derivative) | Class: Antifungal, ## Footnote **Indication:** Treats aspergillus and candidiasis infections, including esophageal and invasive candidiasis **MOA:** Inhibits fungal lanosterol 14-alpha-demethylase, interfering with ergosterol synthesis and leading to fungal cell death **Side Effects:** Visual disturbances; infusion reactions; GI distress; CNS effects; hepatotoxicity **Contraindications:** Strong CYP3A4 inhibitors **Considerations:** * High risk of side effects requires close monitoring * Caution in renal or hepatic impairment * Avoid co-administration with potent cytochrome P450 inducers

Answer 48

Relenza | Class: Neuraminidase inhibitors ## Footnote **Indication:** Prophylaxis and treatment of influenza; reducing complications **MOA:** Inhibits neuraminidase in influenza A and B, preventing virion release and spread **Side Effects:** GI effects; skin reactions; neuropsychiatric effects; hypersensitivity reactions **Contraindications:** Hypersensitivity to the drug or its components (contains milk proteins) **Considerations:** * For patients 7 years or older * Caution in patients with respiratory diseases like asthma or COPD

Antibiotics, Antivirals, & Anti-Infective Agents Flashcards

Identify commonly used anti-infective agents, their spectrum of activity, and primary indications relevant to NAPLEX. (72 cards)