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