Download 1-28-17 PPT

More Antibiotics
Tutoring for
Pharmacology
By Alaina Darby
Malaria
Which of the following correctly describes the life cycle
of malaria in the human?
a. Schizonts, sporozoites, merozoites, gametocytes
b. Sporozoites, schizonts, merozoites, gametocytes
c. Sporozoites, merozoites, gametocytes, schizonts
d. Merozoites, sporozoites, gametocytes, schizonts
Which of the following drugs is active during the
exoerythrocytic stage?
a. Chloroquine
b. Quinine
c. Primaquine
d. Diaminopyrimidines
Which of the following is present inside the mosquito?
a. Schizonts
b. Merozoites
c. Oocysts
d. Trophozoites
Which of the following is not a consideration when
choosing a malaria therapy?
a. Species of plasmodia
b. Stage of infection
c. Speed of zygote formation
d. Sensitivity of plasmodia
For which of the following life cycle stages would
primaquine not be used?
a. Blood schizontocide
b. Tissue schizontocide
c. Gametocidal
d. Hypnozoitocidal
Which of the following describes resistance to
chloroquine?
a. Increased drug efflux
b. Reduced drug penetration
c. Inability to bind to active site
d. Inactivation of drug
Which of the following is true of the pharmacokinetics
of chloroquine?
a. High plasma concentration after a single dose
b. Quickly metabolized and excreted
c. Undergoes extensive distribution and tissue binding
d. Mostly eliminated as metabolites
Which of the following is not true of the adverse effects
of chloroquine?
a. Visual impairment is related the affinity of
chloroquine for melanin areas in the eye
b. Low blood levels due to distribution to tissues
increases the toxicity of chloroquine
c. Ototoxicity, myopathy, and peripheral neuropathy
may occur with high doses
d. Toxic effects occur in areas that contain a higher
concentration of melanin pigments
Which of the following is not true of the therapeutic
uses of chloroquine?
a. Most versatile agent for malaria treatment
b. Used in the treatment of intestinal amebiasis
c. Often ineffective against P. falciparum
d. Absorption profile limits its versatility
Which of the following is true of quinine?
a. Inhibits nucleic acid biosynthesis
b. Acts as a tissue schizonticide
c. Will kill gametes of falciparum
d. Used in prophylaxis
Which of the following would be a reason to choose
quinine over chloroquine?
a. Reduced prevalence of toxicity
b. More effective against susceptible plamodia
c. Parenterally treats drug-resistant P. falciparum
d. Can be used as prophylaxis
Which of the following is not a similarity that quinine
has with chloroquine in its pharmacokinetic profile?
a. Well absorbed from the GI tract
b. Widely distributed
c. Undergoes hepatic metabolism
d. Excreted rapidly as metabolites
Which of the following is not true of quinine?
a. Well distributed and accumulates in body tissues
b. Metabolized to the dehydroxylated metabolite
c. Plasma levels are increased in malaria patients
d. Excreted primarily as metabolites through the urine
Which of the following is not true of the adverse effects
of quinine?
a. Induction of hyperglycemia
b. Impairment of eighth cranial nerve
c. Decreased blood pressure
d. Uterine smooth muscle contraction
Which of the following is a difference between
quinidine gluconate and quinine?
a. Concentration into tissues
b. Mechanism of action
c. Metabolism in the liver
d. Used to treat falciparum
A patient is experiencing anticholinergic effects and
cardiotoxicity after unusually large doses of his antimalarial medication. Which of the following might be
the best option to decrease the amount of drug in the
body?
a. Acidifying the urine to increase excretion
b. Administering with doxycycline to reduce dose
c. Administering rifampin to accelerate clearance
d. Discontinuing the medication
For which of the following is quinidine gluconate
indicated?
a. P. malariae
b. Hyperglycemia
c. Arrhythmias
d. P. vivax
Which of the following concentrates in the heart?
a. Mefloquine
b. Chloroquine
c. Quinidine gluconate
d. Quinine
Which of the following concentrates in melanin
containing cells?
a. Mefloquine
b. Chloroquine
c. Quinidine gluconate
d. Quinine
Which of the following concentrates in skeletal muscle?
a. Mefloquine
b. Chloroquine
c. Quinidine gluconate
d. Quinine
Which of the following does not accumulate in the
tissues?
a. Mefloquine
b. Chloroquine
c. Quinidine gluconate
d. Quinine
Which of the following concentrates in the red blood
cells?
a. Mefloquine
b. Chloroquine
c. Quinidine gluconate
d. Quinine
Which of the following malarial drugs is often used in
combination with doxycycline or clindamycin?
a. Mefloquine
b. Chloroquine
c. Quinidine gluconate
d. Quinine
Which of the following malarial drugs has the worst
therapeutic index?
a. Mefloquine
b. Chloroquine
c. Quinidine gluconate
d. Quinine
Which of the following is excreted primarily in the bile?
a. Mefloquine
b. Chloroquine
c. Quinidine gluconate
d. Quinine
Which of the following is not an adverse effect that is
seen in mefloquine?
a. Vertigo
b. Visual disturbances
c. GI disturbances
d. Respiratory disturbances
Which of the following antimalarials would not increase
the risk of convulsions when taken with mefloquine?
a. Lumefantrine
b. Chloroquine
c. Quinidine gluconate
d. Quinine
Which of the following is not true of lumefantrine?
a. Only available as a coformulation with Artemether
b. May inhibit heme polymerization
c. Is first-line therapy in African countries
d. Is ineffective against MDR strains
Which of the following would a pharmacist not advise
someone taking lumefantrine?
a. Take with fatty foods
b. May cause arrhythmias
c. May cause headache, dizziness and rash
d. Effects may be altered use of antidepressants
Which of the following is not true of artemisinins?
a. Work by forming radicals
b. Interact with a zinc atom to activate
c. Is dependent on plasmodial heme content
d. Works by alkylating macromolecules
Which of the following is true of artesunate but not of
artemether?
a. Multiple dosing routes
b. Peak plasma level achieved within minutes
c. Converted to dihydroartemisinin
d. Induces its own metabolism through CYP450
Which of the following is not true of aremisinin
combination therapy?
a. Reduces likelihood of resistance
b. May be used for prophylaxis
c. Reduces gametocyte carriage
d. Combination with lumefantrine or mefloquine
For which of the following is primaquine not effective?
a. Asexual erythrocytic form of P. vivax
b. Late hepatic stage of P. ovale
c. Latent tissue stage of P. ovale
d. Gametocytes of P. falciparum
Which of the following is not true of primaquine?
a. Can be administered with food
b. May be administered prophylactically
c. Accumulates in erythrocytes
d. Metabolites excreted in urine
Which of the following is not a therapeutic use of
primaquine?
a. In combination with chloroquine for P. vivax
b. Prophylaxis for P. falciparum malaria
c. Treatment of moderate PCP
d. Radical cure of P. ovale
Which of the following is an adverse effect that is due
to a mutation that may also cause adverse reactions in
patients taking sulfonamides?
a. GI distress
b. Hemolytic anemia
c. Hypersensitivity
d. Renal damage
Which of the following populations would not be more
likely to develop hemolytic anemia while taking
primaquine?
a. Sardinians
b. Greeks
c. Males
d. Lighter-hued Caucasians
Which of the following is not true of pyrimethamine?
a. Inhibits dihydrofolate reductase
b. Should be used with sulfadoxine
c. Schizonticidal for P. vivax
d. Resistance develops at DHFR binding site
Which of the following describes the pharmacokinetics
of pyrimethamine?
a. Concentrates in the liver
b. Given parenterally
c. Distributed into breast milk
d. Excreted in the bile
What would not be a concern when taking
pyrimethamine?
a. Patients with anemia
b. Concurrent use of anti-virals
c. Concurrent use of CYP450 inhibitors
d. Pregnancy or lactation
Which of the following is not a therapeutic use for
pyrimethamine?
a. In combination with sufadoxine for prophylaxis
b. In combination with sulfadoxine for chloroquineresistant falciparum
c. In combination with sulfonamides for toxoplasmosis
In combination with clindamycin for toxoplasmosis