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Medications for Exam 6

Total questions: 55

Worksheet time: 1hrs 5mins

Name
Class
Date
1.

Organize these options into the right categories

Categorize the following

acyclovir

Valacyclovir

Valtrex

Famciclovir

Famvir

penciclovir

docosanol

Abreva

Cidofiver

Foscarnet

ganciclovir

letermovir

valganciclovir

dexamethasone

remdesivir

nirmatrelvir/ritonavir

baricitinib

molnupiravir

tociluzumab

Renal Dose Adjustment
No Renal dose adjustment
2.

Organize these options into the right categories

Categorize the following

oseltamivir

peramavir

zanamivir

baloxavir

nirmatrelvir/ritonavir

baricitinib

dexamethasone

remdesivir

molnupiravir

tocilizumab

cidofivir

foscarnet

Renal Dose Adjustment
No Renal Dose Adjustment
3.

First line therapy for treatment and prevention of seasonal influenza

a)

oseltamivir

b)

zanamivir

c)

peramavir

d)

baloxavir

e)

amantadine

4.

Treatment and prevention of seasonal influenza

a)

oseltamivir

b)

zanamivir

c)

peramavir

d)

baloxavir

e)

amantadine

5.

Treatment of influenza in patients who are unable to take medications by mouth

a)

oseltamivir

b)

zanamivir

c)

peramavir

d)

baloxavir

e)

amantadine

6.

Match the brand/generic

a)

oseltamivir

1.

Tamiflu

b)

zanamivir

2.

Relenza

c)

baloxavir marboxil

3.

Xofluza

d)

Remdesivir

4.

Veklury

e)

Nirmatrelvir / Ritonavir

5.

Paxlovid

7.

match the characteristics

a)

Oral bioavailability (10-30%) decreases with increasing doses

1.

acyclovir

b)

L-valyl ester of acyclovir; enhanced bioavailability (70%)

2.

valacyclovir

c)

Oral prodrug of penciclovir

3.

famciclovir

d)

Longer intracellular half-life but lower affinity for HSV DNA polymerase than acyclovir

4.

penciclovir

e)

Used only for episodic treatment of secondary herpes labialis

5.

docosanol

8.

match the characteristics

a)

Intravenous vehicle hydroxypropyl betadex may accumulate in renal failure

1.

letermovir

b)

long intracellular half-life allows for weekly dosing

2.

cidofivir

c)

only effective against replicating virus

3.

foscarnet

d)

Not beneficial in outpatients or hospitalized patients who do not require supplemental oxygen

4.

dexamethasone

e)

Contains sulfobutyl ether beta-cyclodextrin sodium (SBECD) which accumulates in renal dysfunction; clinical significance unclear

5.

remdesivir

9.

match the characteristics

a)

Drug-drug interactions are a major concern and concomitant medications should be evaluated for interactions before prescribing

1.

nirmatrelvir / ritonavir

b)

Should not be used in pregnant patients due to concerns for mutagenesis

2.

molnupiravir

c)

Preferred over XX for those with acute VTE, severe renal dysfunction, or unable to receive pharmacologic VTE prophylaxis

3.

tocilizumab

d)

pharmacologic VTE prophylaxis should be given concomitantly

4.

baricitinib

e)

Most used antiviral medication for prevention and treatment of influenza

5.

oseltamivir

10.

match the characteristics

a)

contraindicated in patients on mechanical ventilation

1.

zanamivir

b)

Do not use in immunocompromised hosts, in patients hospitalized with influenza infection, pregnancy, or patients ≤ 5 years

2.

baloxavir marboxil

c)

Should not be prescribed after hospital discharge

3.

dexamethasone

d)

If a patient requires hospitalization after starting treatment, the full 5-day treatment course of ritonavir-boosted nirmatrelvir should be completed unless there are drug-drug interactions that preclude its use.

4.

nirmatrelvir / ritonavir

e)

Only available as a topic dosage form

5.

penciclovir

11.

MOA

a)

Competitive inhibition of reverse transcriptase leads to premature chain termination

1.

NRTI

b)

Directly bind to HIV reverse transcriptase at a different site than XX, resulting in blockade of enzyme activity; not substrates of the enzyme

2.

NNRTI

c)

responsible for maturation of new virus particles by cleaving  the Gag-Pol polyproteins.

3.

Protease Inhibitors

d)

prevent integration of HIV ds-DNA to host cell DNA thus, interrupting the HIV replication cycle

4.

Integrase Inhibitors

12.

match the drug

a)

nephrotoxicity

1.

tenofovir

b)

lipoatrophy and insulin resistance, macrocytic anemia, neutropenia

2.

zidovudine

c)

nucleoside unrelated compounds therefore do not need intracellular phosphorylation

3.

NNRTIs

d)

vary in their ability to inhibit mtDNA polymerase leading to mitochondrial toxicity: hepatic steatosis, lactic acidosis, myopathy, pancreatitis

4.

NRTIs

e)

traditionally most potent class of antiretroviral agents

5.

Protease Inhibitors

13.

fat redistribution / dyslipidemia

a)

Darunavir

b)

Fosamprenavir

c)

Lopinavir with ritonavir

d)

atazanavir

e)

Tipranavir

14.

increase indirect bilirubin, urinary calculi

a)

Darunavir

b)

Fosamprenavir

c)

indinavir

d)

atazanavir

e)

Tipranavir

15.

sulfonamide allergy

a)

Darunavir

b)

Fosamprenavir

c)

indinavir

d)

atazanavir

e)

Tipranavir

16.

minimal drug interactions; GI effects, headache, CPK elevations

a)

raltegravir

b)

elvitegravir

c)

dolutegravir

d)

bictegravir

e)

fostemsavir

17.

CPY3A4 substrate; must be given with cobicistat

a)

raltegravir

b)

elvitegravir

c)

dolutegravir

d)

bictegravir

e)

fostemsavir

18.

metabolized mainly by UGT; partially by CYP3A4; substrate of P-gp; can increase serum creatinine; insomnia

a)

raltegravir

b)

elvitegravir

c)

dolutegravir

d)

bictegravir

e)

fostemsavir

19.

Used in combination with other ARVs to treat HIV-1 in heavily treated adults with multidrug resistant virus

a)

raltegravir

b)

elvitegravir

c)

dolutegravir

d)

bictegravir

e)

fostemsavir

20.

Contraindicated in strong P450 3A4 inducers carbamazepine, phenytoin, rifampin, St. John’s wort, mitotane, statin therapy. 

a)

raltegravir

b)

elvitegravir

c)

dolutegravir

d)

bictegravir

e)

fostemsavir

21.

match the drug

a)

bictegravir + Tenofovir alafenamide + emtricitabine

1.

Biktarvy

b)

dolutegravir + lamivudine

2.

Dovato

c)

dolutegravir + Rilpivirine

3.

Juluca

d)

dolutegravir + abacavir + lamivudine

4.

Triumeq

e)

darunavir + cobicistat + tenofovir alafenamide + emtricitabine

5.

Symtuza

22.

match the drug

a)

capsid inhibitor interfering with multiple early/late-stage processes of viral life cycle

1.

lenacapavir

b)

CCR5 inhibitor for CCR5+ HIV-1 virus tropism

2.

maraviroc

c)

fusion inhibitor (protein available as injectable only)

3.

enfuvirtide

d)

gp120 attachment inhibitor

4.

fostemsavir

e)

monoclonal antibody preventing HIV fusion and entry into CD4 cell

5.

ibalizumab-uiyk

23.

match the disease

a)

TMP-SMZ 15-20mg/kg/d in 3-4 divided doses for 21 days

1.

PCP - PJP treatment

b)

TMP-SMZ 1 DS or SS qd

2.

toxoplasmic encephalitis prophylaxis

c)

4 drug therapy INH+RIF+PZA+ETH

3.

active TB

d)

2 drug therapy INH + pyridoxine

4.

latent TB

e)

fluconazole 100-200mg po QD

5.

candidiasis treatment

24.

match the disease

a)

pyrimethamine 50-100mg QD + sulfadiazine 1-2GM PO QID for 6-12 weeks

1.

Toxoplasmic encephalitis treatment

b)

amphotericin B 0.5-1mg/kg IV + flucytosine 100mg/kg/d divided QID

2.

cryptococcal meningitis treatment

c)

fluconazole 100-200mg PO QD for life

3.

cryptococcal meningitis prophylaxis

d)

amphotericin B 0.5-1mg/kg IV + flucytosine 100mg/kg/d divided QID + itraconazole 200mg BID

4.

Histoplasmosis treatment

e)

lamivudine, emtricitabine, tenofovir (TAF or TDF)

5.

HIV + HBV

25.

match the disease

a)

HCV if patient on TDF and COB or has CrCl > 60

1.

Harvoni

b)

HCV but not with DRV, EFV, LOP/r, RPV

2.

Viekira Pak

c)

HCV with HIV

3.

Mavyret or Epclusa

d)

dapsone 50mg po QD + pyrimethamine 50mg po Qweek

4.

Toxoplasmic encephalitis prophylaxis

e)

dapsone 50mg QD + pyrimethamine 50mg QW + leucovorin 25mg QW

5.

PJP or PCP prophylaxis

26.

match the treatment

a)

once weekly for 3 months for latent TB infection

1.

Isoniazid and rifapentine

b)

daily for 3 months for latent TB infection

2.

isoniazid and rifampin

c)

daily for 4 months for latent TB infection

3.

rifampin

d)

daily for 8 weeks - 7 days/week for 56 doses or 5 days/week for 40 doses for active TB disease

4.

INH + Rifampin+Pyrazinamide + Ethambutol

e)

7 days/week for 56 doses for active TB disease

5.

Rifapentin+Moxifloxacin+INH+Pyranzinamid

27.

match the drug

a)

highly specific for TB; should be given on empty stomach

1.

INH Isoniazid

b)

shows bactericidal activity against M. tuberculosis and M. bovis and M. kansasii

Oral doses are best on an empty stomach

2.

Rifamycins

c)

is a less potent enzyme inducer than XX, it may be used for patients who are receiving HIV protease inhibitors

3.

Rifabutin

d)

a long-acting rifamycin that has been tested as part of a 4-month regimen that includes moxifloxacin – has been shown to be efficacious

4.

Rifapentine

e)

may be bacteriostatic or bactericidal depending on the concentration and the susceptibility of the organism

5.

Pyrazimamide (PZA)

28.

Match the drug

a)

Hepatotoxicity is the major limiting adverse effect and is dose-related when given daily.

1.

pyrazinamide

b)

should not be given with antacids; retrubulbar neuritis is the major adverse effect

2.

ethambutol (EMB)

c)

that operates by a new mechanism which targets the ATP synthase pump and depletes cellular energy stores and does not demonstrate cross-resistance with existing TB drugs

3.

Bedaquiline

d)

synthetic inhibitor of ribosomal translation

4.

linezolid

e)

GI distress and skin discoloration are the most important adverse reaction

5.

clofazimine

29.

match the drug

a)

requires EKG for QT monitoring

1.

bedaquiline

b)

known for turning bodily-fluids reddish orange

2.

Rifampin

c)

turns skin a blue-ish hue

3.

clofazimine

d)

food increases absorption

4.

pretomanid

e)

chemically related to metronidazole and work through inhibiting mycolic acid synthesis

5.

delamanid

30.

match the treatment

a)

Cefotaxime 2 GM IV every 4 hours or ceftriaxone 2GM every 12 hours

1.

treatment of N. meningitidis

b)

ceftriaxone IM

2.

pregnancy prophylaxis of N. Meningitidis

c)

600mg rifampin Q12 hrs for 4 doses

3.

adult prophylaxis N. meningitidis

d)

10mg/kg rifampin every 12 hours for 4 doses or 5mg/kg rifampin every 12 hours for 4 doses

4.

children prophylaxis N. Meningitidis

e)

ceftriaxone 2gm IV Q12 hours + Vancomycin

5.

Pneumococcus highly resistant treatment

31.

Match the treatment

a)

3rd generation cephalosporins (ceftriaxime or cefotaxime)

1.

H. influenzae txt pt & close contacts

b)

Rifampin 600mg po QD for 4 days; 20mg/kg po x4 d; 10mg/kg po QD

2.

prophylaxis for H. influenzae

c)

Neonates: ampicillin 100 mg/kg IV Q8hr ± aminoglycoside or Adults: ampicillin 200mg/kg IV Q4 hr ± aminoglycoside for 3 weeks or longer

3.

treatment for L. monocytogenes

d)

acyclovir 10mg/kg Q8h in pt with normal renal function

4.

Herpes Virus

32.

Match the treatment

a)

4th generation cephalosporin

vancomycin

1.

Trauma or neurosurgery

b)

vancomycin

2.

endocarditis

c)

3rd gen cephalosporin

3.

congenital cardiac malformations

d)

ampicillin

4.

lungs

33.

match the treatment

a)

Nafcillin 2mg IV Q4h + Vancomycin 30-40mg/kg/d

1.

shunt infection S. Aureus

b)

Vancomycin 30-40mg/kg/d

2.

shunt infection s. epidermis

c)

3rd generation cephalosporin + metronidazole

3.

otitis media or mastoiditis

d)

3rd generation cephalosporin ± metronidazole

4.

paranasal sinusitis

e)

PCN ± metronidazole

5.

dental infection

34.

match the drug

a)

reduces the AUC of pretomanid by 35%

1.

efavirenz

b)

reduces the AUC of pretomanid by 66%

2.

Rifampin

c)

may cause goiter with or without hypothyroidism, gynecomastia, alopecia, impotence, menorrhagia, and photodermatitis

3.

ethionamide

d)

INH, PZA, ethionamide, cycloserine, linezolid

4.

penetrate well into the CSF

e)

RIF, ethambutol, amikacin

5.

variable CNS penetration

35.

match the drug

a)

cabotegravir + rilpivirine

1.

Cabenuva

b)

approved for MSM

2.

Truvada

c)

approved for MSM + TG

3.

Descovy

d)

approved for MSM + TG + cis-gendered females

4.

cabotegravir-LA

36.

Match the drug

a)

high barrier for resistance

1.

Protease inhibitors

b)

relatively low barrier for resistance

2.

NNRTI

c)

a "booster" for PIs and integrase inhibitors

3.

Ritonavir

d)

selective CYP3A4 inhibitor

4.

Cobicistat

37.

match the drug

a)

the prototype, a thymidine analog

1.

zidovudine

b)

less renal and bone toxicity

2.

Tenofovir alafenamide

c)

approved for treatment of HBV infection

3.

tenofovir disoproxil

d)

hyperpigmentation of palms and soles in African American patients

4.

emtricitabine

e)

potentially fatal hypersensitivity reaction

5.

abacavir

38.

match the characteristics

a)

Do not use in patients less than 18 years due to bone and cartilage toxicity

1.

molnupiravir

b)

avoid in subjects with high bleeding risk or severe renal impairment

2.

baricitinib

c)

avoid in patients with COPD/asthma

3.

zanamivir

d)

is not used for chemoprophylaxis

4.

peramivir

e)

Chemoprophylaxis and treatment doses are the same

5.

baloxavir marboxil

39.

match the characteristics

a)

Probenecid 2 g three hours before and 1 g two and eight hours after each infusion is recommended to reduce nephrotoxicity

1.

Cidofovir

b)

Only available as a parenteral dosage form

2.

Foscarnet

c)

not as effective of an inhibitor of CMV polymerase as acyclovir triphosphate but its longer intracellular half-life and higher concentrations make ___ a more effective inhibitor in vivo

3.

ganciclovir

d)

valine ester of ganciclovir and has higher availability

4.

valganciclovir

e)

Avoids myelosuppressive effects of ganciclovir

5.

letermovir

40.

Match the brand/generic

a)

tocilizumab

1.

Actemra

b)

Valacyclovir

2.

Valtrex

c)

famciclovir

3.

Famvir

d)

Docosanol

4.

Abreva

41.

match the AE's to the generic

a)

Nausea, vomiting (administration with food may improve tolerability)

1.

oseltamivir (Tamiflu)

b)

Bronchospasm

2.

Zanamivir (Relenza)

c)

Hyperglycemia

Infection

Neuropsychiatric symptoms (e.g., delirium, psychosis)

3.

Dexamethasone (Decadron)

d)

infection, GI perforation

4.

Tocilizumab (Actemra)

e)

Infection, VTE, GI perforation

5.

baricitinib

42.

Rohan has been diagnosed with sickle cell disease. During a consultation, his doctor discusses various supplements that can support his nutrition. Which of the following is NOT given as a supplement to nutrition in a person with sickle cell?

a)

folic acid 1mg/day

b)

Vitamin B12 & B6

c)

multivitamin with iron

d)

Vitamin D

e)

Vitamin C

43.

Maya is a physician treating a patient with sickle cell disease. She wants to increase fetal hemoglobin in order to decrease RBC sickling in her patient. Which of the following medications could Maya consider using?

a)

hydroxyurea

b)

butyrate

c)

decitabine

d)

Azacitidine

e)

Lenalidomide

44.

Sophia is a pediatrician treating infants and children with a condition that requires stimulating the production of HbF. She needs a medication that is FDA approved for this age group, prevents painful crises, delays progression of organ dysfunction, and decreases mortality, hospitalizations, and transfusions. Which medication should Sophia prescribe?

a)

hydroxyurea

b)

butyrate

c)

decitabine

d)

Endari

e)

Lenalidomide

45.

Jackson is a 7-year-old patient diagnosed with a blood disorder. His doctor wants to prescribe a treatment that increases free glutamine, providing anti-oxidant effects. This treatment is FDA approved for patients 5 years and older to reduce severe complications associated with the disorder. Which medication is the doctor most likely to prescribe?

a)

hydroxyurea

b)

butyrate

c)

decitabine

d)

Endari

e)

Lenalidomide

46.

David, age 7, is taking a medication and starts experiencing constipation, nausea, headache, abdominal pain, cough, pain in extremities, back and chest. Which medication is most likely responsible for these adverse effects?

a)

hydroxyurea

b)

Vaxelotor (Oxbryta)

c)

decitabine

d)

Endari

e)

Lenalidomide

47.

Crystal, a patient with sickle cell disease, is discussing treatment options with his doctor. The doctor mentions a medication that may inhibit RBC sickling, improve RBC deformability and reduce whole blood viscosity. Which medication is the doctor referring to?

a)

hydroxyurea

b)

Vaxelotor (Oxbryta)

c)

decitabine

d)

Endari

e)

Lenalidomide

48.

Maya is being treated for sickle cell disease with hydroxyurea. Her doctor is considering adding another medication that can be co-administered with hydroxyurea. Which of the following medications can be safely given alongside hydroxyurea?

a)

Adakveo

b)

Vaxelotor (Oxbryta)

c)

decitabine

d)

Endari

e)

Lenalidomide

49.

David is a patient with sickle cell disease. His doctor wants to prescribe a medication that blocks interactions between endothelial cells, platelets, RBCs, and leukocytes to help prevent pain crises. Which medication should the doctor choose?

a)

Adakveo

b)

Vaxelotor (Oxbryta)

c)

decitabine

d)

Endari

e)

Lenalidomide

50.

Samuel is a 17-year-old patient with sickle cell disease who frequently experiences vaso-occlusive crises. His doctor wants to prescribe a medication approved for patients 16+ to reduce the frequency of these crises. Which medication is most appropriate?

a)

Adakveo

b)

Vaxelotor (Oxbryta)

c)

Exagamglogene autotemcel (Casgevy)

d)

Endari

e)

Lenalidomide

51.

Charlotte is a 14-year-old patient with sickle-cell disease who has been experiencing recurrent vaso-occlusive crises. Her physician is considering FDA-approved treatments for patients 12+ to help prevent these crises, but notes that some options may be cost prohibitive. Which of the following medications could be considered for Charlotte?

a)

Adakveo

b)

Vaxelotor (Oxbryta)

c)

Exagamglogene autotemcel (Casgevy)

d)

Endari

e)

lovotibeglogene Autotemcel (Lyfgenia)

52.

Ava has a condition that requires frequent blood transfusions, putting her at risk for iron overload. Her doctor wants to prescribe an oral medication to help prevent this complication. Which of the following are the best options?

a)

deferasirox (Exjade)

b)

deferiprone (Ferriprox)

c)

Venofer

d)

Epoetin alpha

e)

Desmopressin (DDAVP)

53.

match the AE's to the generic

a)

Crystalline nephropathy (IV dosage form)

Phlebitis/injection site reactions

1.

acyclovir

b)

Nephrotoxicity, anemia, neutropenia, alopecia

2.

cidofivir

c)

nephrotoxicity, symptomatic electrolyte disturbances

3.

foscarnet

d)

myelosuppression (dose-dependent, reversible), confusion, convulsions

4.

ganciclovir & valganciclovir

54.

match the treatment

a)

vancomycin

1.

empiric therapy if has shunt infection

b)

ceftriaxone + vancomycin + dexamethasone + ampicillin

2.

empiric therapy > 50 years old

c)

ceftriaxone + vancomycin + dexamethasone + acyclovir

3.

empiric therapy if immunosuppressed

d)

consider amphotericin B + 5-FC

4.

empiric therapy if HIV+ & CD4 cells <50

e)

cefepime + vancomycin

5.

if recent neurosurgery

55.

Which of the following are correct for Prophylactic Penicillin for Sickle Cell Disease

a)

to age 3 Pen VK 125mg PO BID

b)

ages 3-5 Pen VK 250mg PO BID

c)

ages 5-12 Pen VK 500mg PO BID

d)

Erythromycin 20mg/kg day if allergic

e)

SMZ-TMP SS PO BID if allergic

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