Zinforo
Zinforo exhibits:
a. Cell wall synthesis
b. Inhibition of protein synthesis by binding at 30s ribosomal subunit
c. Inhibition of protein synthesis by binding at 50s ribosomal subunit
a. Cell wall synthesis
Avibactam is a novel, first-in-class, non-β-lactam β-lactamase inhibitor.
a. True
b. False
a. True
Cresemba is the latest second-generation azole with extended anti-mould activity across Aspergillus species and Mucorales, including Fusarium and Scedosporium.
a. True
b. False
b. False
Ceftolozane-tazobactam is active against ESBL, Enterobacteriaceae, Carbapenem resistant Pseudomonas aeruginosa, CRE including KPC & OXA 48.
a. True
b. False
False.
Ceftolozane-tazobactam is not active against Enterobacteriaceae, CRE including KPC & OXA 48.
What is the brand name of covid vaccine released by Pfizer?
Comirnaty
In CANVAS 1 & 2 integrated analysis, Zinforo monotherapy was associated with a trend towards early clinical response when compared to vancomycin + aztreonam at Day 3. How did both arms perform?
a. Zinforo: 66%; Vanco + Aztreonam: 57%
b. Zinforo: 74%; Vanco + Aztreonam: 66%
c. Zinforo: 81%; Vanco + Aztreonam: 75%
d. Zinforo: 66%; Vanco + Aztreonam: 72%
b. Zinforo: 74%; Vanco + Aztreonam: 66%
Name all the Zavicefta indications.
1. cUTI including pyelonephritis
2. cIAI in combination with metronidazole
3. HAP including VAP
What are the approved indications of Cresemba in Malaysia?
Cresemba is indicated in adults for the treatment of:
• Invasive aspergillosis
• Mucormycosis in patients for whom amphotericin B is inappropriate
In IMPROVIT study, itraconazole was found to have significantly higher discontinuation rate of ____% vs Vfend 46.4%, mainly due to ______ AEs.
Itraconazole 61% vs Vfend 46.4%
GI AEs - vomiting, nausea, diarrhea
Cresemba oral capsule is manufactured in which country?
a. US
b. Italy
c. Switzerland
d. Germany
c. Switzerland
Superiority efficacy of Zinforo over ceftriaxone for the treatment of CAP could be due to several reasons: (select where applicable)
a. Lower MIC levels for Zinforo against key Gram positive pathogens (S. pneumoniae & MSSA)
b. Protein binding of Zinforo in plasma (about 20%) is lower than that of ceftriaxone (95%)
c. Penetration of Zinforo into ELF in healthy volunteers is ~23% of total plasma exposure, achieving concentrations substantially greater than the MICs of relevant bacterial pathogens
d. High affinity for altered PBPs found in methicillin-resistant Staphylococcus aureus (MRSA)
a, b & c only
a. Lower MIC levels for Zinforo against key Gram positive pathogens (S. pneumoniae & MSSA)
b. Protein binding of Zinforo in plasma (about 20%) is lower than that of ceftriaxone (95%)
c. Penetration of Zinforo into ELF in healthy volunteers is ~23% of total plasma exposure, achieving concentrations substantially greater than the MICs of relevant bacterial pathogens
Minimum Inhibitory Concentration (MIC) breakpoints established by the EUCAST for ceftazidime/avibactam:
Enterobacteriaceae: Susceptible ? Resistant ?
P. aeruginosa: Susceptible ? Resistant ?
Enterobacteriaceae:
Susceptible ≤8 mg/L & Resistant >8 mg/L
P. aeruginosa:
Susceptible ≤8 mg/L & Resistant >8 mg/L
What is the recommended dose of Cresemba for IA patient with severe renal impairment?
Loading dose of 200mg TDS for 48 hours (IV or oral), followed by maintenance dose of 200mg OD (IV or oral)
Ampho B has broader indications vs Cresemba. Give us 3 examples of Ampho B indications where Cresemba doesn't covered for.
paediatric patients, candidiasis, empirical treatment, cryptococcal meningitis, visceral leishmaniasis, chronic mycetoma
The Federation of Malaysia was formed on ______? [date & year]
16 September 1963
Benefits and limitations of early endpoints include? (List out 4)
1. switch from IV to Oral therapy
2. discharge of patients based on clinical improvement
3. de-escalate antibiotic treatment to narrower-spectrum agent
4. re-selection of antibiotic treatment
For adults patients presenting with cUTI, what is the recommended intravenous dosing regimen of ZAVICEFTA?
Dose:
Frequency:
Duration:
Infusion time:
2g/0.5g infused over 2 hours every 8 hours for 5-10 days.
SECURE trial is a prospective, randomized, double blind comparative study of Cresemba for the treatment of Invasive Aspergillosis. Please state out 2 key findings of this trial.
1. All-cause mortality from first dose of study drug to day 42 for the ITT population was non-inferior for Cresemba (19%) vs Vfend (20%)
2. Drug-related AEs were significantly fewer with Cresemba vs Vfend especially in skin and subcutaneous tissue, eye and hepatobiliary disorders
Match the correct pair:
1. Loading dose 100mg, maintenance dose 100mg
2. Recommended for salvage therapy in mucormycosis management
3. Standard treatment option with high nephrotoxicity
4. Elevated liver enzyme with high dose use
5. Recommended for salvage therapy for IA
a. Ampho B b. Fluconazole c. Posaconazole
d. Caspofungin e. Micafungin
1. Loading dose 100mg, maintenance dose 100mg - Micafungin
2. Recommended for salvage therapy in mucormycosis management - Posaconazole
3. Standard treatment option with high nephrotoxicity - Ampho B
4. Elevated liver enzyme with high dose use - Fluconazole
5. Recommended for salvage therapy for IA -Caspofungin
Who got the most gold medal in the Olympic Games Tokyo 2020?
United States
Which of the following dosing is correct for age groups below?
a. 7yo, 8mg/kg TDS, 5-60mins infusion
b. 62yo, 600mg TDS, 120mins infusion (High Dose)
c. 65yo, CrCl 25, 400mg BD, 5-60mins infusion
d. 70yo, CrCl 10, 200mg TDS, 120mins infusion (High Dose)
b & d only
b. 62yo, 600mg TDS, 120mins infusion (High Dose)
d. 70yo, CrCl 10, 200mg TDS, 120mins infusion (High Dose)
The combination of ceftazidime and avibactam provides broad spectrum Gram negative coverage, including in vitro activity against:
1.
2.
3.
1. MDR P. aeruginosa
2. CRE, including KPC & OXA 48 producing strains
3. ESBL and AmpC - producing bacteria
VITAL study is a single-arm, open-label trial and case-control analysis, what are the 3 matching criteria set in this study?
1. Severe disease (CNS or disseminated)
2. Hematological malignancy
3. Surgical treatment within 7 days of antifungal treatment initiation
In an economic evaluation study of azoles as primary prophylaxis for the prevention of IFIs in allogenic HSCT patient, what are the 2 key findings from the comparison between Vfend and posaconazole?
1. Vfend has lower IFI breakthrough rate vs posaconazole
2. Vfend has lower mortality rate vs posaconazole
Who is the first Asian hero appeared in Marvel Universe?
Shang-Chi