Pharm 4 drugs

Card Set Information

Author:
ldewanz
ID:
118307
Filename:
Pharm 4 drugs
Updated:
2011-11-22 12:03:38
Tags:
pharm4
Folders:

Description:
Pharm 4
Show Answers:

Home > Flashcards > Print Preview

The flashcards below were created by user ldewanz on FreezingBlue Flashcards. What would you like to do?


  1. Ethambutol
    • first line
    • active against multiplying MTB
    • blks cell wall arabinogalactan biosynthesis
    • resistance: mutation in embB gene
    • SE: optic neuritis
  2. Isoniazid
    • first line
    • kills actively growing
    • passive penetration of bacillus (activated by MBT)
    • single drug for latent tx
    • binds w/NAD and blks active site on enz
    • resistance by gene mutation/inc transcription
    • SE: periferal neuropathy/inc LFT/fatal hepatitis
  3. Pyrazinamide
    • first line
    • prodrug effective inside macrophage
    • MOA? (mem disadvantage/FA synthesis)
    • actively efflux when activated (inc w/slow met)
  4. Rifampin
    • first line MTB/leprosy too
    • broad spectrum
    • inhibits prokaryotic RNA polymerase (binds to beta subunit/prevents transcription)
    • active against rapid/slow growing
    • resistance: mutation in rpoB gene
    • SE: orange coloing/rashes/nephritis/hepatitis/drug interactions
  5. Streptomycin
    • increasing resistance
    • blk translation
  6. Rifabutin
    • anti-MAC
    • pulm infections in pre-existing conditions
    • tx w/ethambutol/macrolides
  7. Dapsone
    • anti-leprosy
    • few lesions=6 mon tx
  8. Amphotericin B
    • polyene antibiotic
    • bind ergosterol/disrupt membrane
    • forms pores: leak ions/cell death
    • broadest spectrum
    • cidal: based on pH/conc/agent
    • SE: due to small amt cholesterol bind/nephro/anemia/ allergic rxn
    • resist: ergosterol conc dec/affinity dec/non-albican sp
    • NOT GI (unless topical)
    • Drug: digitalis (hypoK)/azoles (inc resist)/nephrotic agents
  9. Nystatin
    • Polyene
    • sim to Amphotericin B
    • Narrower spectrum
    • too toxic for parenterally/use topically
    • SE: bitter taste
  10. Azoles
    • Static drugs
    • oral/parenterally
    • inhib ergosterol synthesis by blk fungal CYP450
    • many drug interactions
  11. Clotrimazole
    • imidazole (2 N) (less specific for fungal CYP)
    • block ergosterol synthesis/fungal P450
    • better taste than Nystatin
    • Use: oropharyngeal candidiasis in AIDS pts
    • SE: oral=GI upset
  12. ketoconazole
    • imidazole (2 N) (less specific for fungal CYP)
    • block ergosterol synthesis/fungal P450
    • most toxic/use topicaly
    • drug: adrenal/gonadal steroid synthesis
    • inc toxicity of other drugs (hepatitis dose-independent)
  13. miconazole
    • imidazole (2 N) (less specific for fungal CYP)
    • block ergosterol synthesis/fungal P450
    • SE: thrombophlebitis
    • cutaneous candidiasis/oropharyngeal candidiasis/ vaginal candidiasis
  14. Fluconazole
    • triazole
    • block ergosterol synthesis/fungal P450
    • oral/IV
    • Use: CNS penetration/cyptococcal meningitis/ prophylaxis in immuno
    • Not: C. krusei/C. glabrata/aspergillus
  15. Itraconazole
    • triazole
    • block ergosterol synthesis/fungal P450
    • broad spectrum/well absorbed
    • Use: Aspergillus/fluconazole-resist candidia
  16. Posaconazole
    • triazole
    • block ergosterol synthesis/fungal P450
    • sim to voriconazole/better for zygomycosis
    • oral
    • SE: rash/LFT
    • Use: prophylaxis for BMT/hematolocial CA neutopenia
  17. Voriconazole
    • triazole
    • block ergosterol synthesis/fungal P450
    • most potent
    • oral/IV
    • SE: dose-dependent visual/rash/inc LFT
    • Use: mold in immuno/aspergillosis/fusarium/ fluconazole-resist candida
  18. Terbinafine
    • allylamine
    • block ergosterol synthesis (squalene epoxidase)
    • dermatophytes
    • topical/oral (good GI absorb)
    • Drug: dec w/rifampin//inc w/cimetidine
  19. Anidulafungin
    • echinocandin
    • inhib glucan syntesis/weaken wall
    • cidal
    • apergillus/azole-rest candida
    • IV
  20. Caspofungin
    • echinocandininhib glucan syntesis/weaken wall
    • cidal
    • apergillus/azole-rest candida
    • IV
  21. Micafungin
    • echinocandin
    • inhib glucan syntesis/weaken wall
    • cidal
    • apergillus/azole-rest candida
    • IV
  22. Flucytosine
    • DNA synthesis antimetabolite
    • pyrimidine analog
    • inhibits DNA/RNA synthesis/static
    • oral against Candida/cryptococcus
    • MOA: convert to 5-FU
    • combo: Ampho B/fluconazole
    • resist: mutation in permease/deaminase
    • Oral/CNS penetration
    • SE: GI/dec bone marrow
  23. Griseofulvin
    • anti-Mitotic spindle
    • disrupts mitosis/static drug
    • oral for dermatophytosis
    • drug: alters CYP isoforms in liver (warfarin/ contraception)
  24. Enfuvirtide
    • Entry inhib
    • binds to N peptide sequence on HIV gp41 (blk fusion)
    • Resist: change in gp41 N peptid
    • salvage therapy
  25. Maraviroc
    • entry inhib
    • binds to CCR5 (prevent gp120 attach)
    • resist: change in HIV gp120 (rapid if monotx)
    • Salvage therapy
  26. AZT (zidovudine)
    • NRT inhib (not Phos)
    • DNA chain termination
  27. Emtricitabine
    • NRT inhib (HIV/RSV/hepatitis)
    • Not Phosphorylated
    • DNA chain termination
    • Resist: RT able to preferentially exclude/remove analog
  28. Lamivudine
    • NRT Inhib (HIV/RSV/Hepatitis)
    • Not phosphorylated
    • DNA chain termination
    • resist posible
  29. Tenofovir
    • NtRT inhib (1 phos)
    • DNA chain termination
    • SE: compete for secretion in kidney/herpes drugs inc serum levels
  30. Efavirenz
    • NNRT inhib
    • binds to allosteric side on RT/dec RT mobility
    • Resist: dec afinity of drug for site
  31. Nevirapine
    • NNRT inhib
    • binds to allosteric side on RT/dec RT mobility
    • Resist: dec afinity of drug for site
  32. Raltegravir
    • Integrase inhib
    • inhib binding viral DNA 3' end to cellular DNA
    • Resist: AA changes in integrase
  33. Ritonavir
    • Protease inhib
    • bind active site on HIV-1 protease/prevent release of individual viral proteins
    • Resist: change in protease (not just at active site)
    • SE: cental adipose/combo w/ritonavir= inc saquinavir/ blks CYP4503A4
  34. Saquinavir
    • Protease inhib
    • bind active site on HIV-1 protease/prevent release of individual viral proteins
    • Resist: change in protease (not just at active site)
    • SE: cental adipose/combo w/ritonavir= inc saquinavir/ many drug intereactions
  35. Palivizumab
    • RSV Entry inhib
    • prophylaxis tx
  36. Ribavirin
    • mixed use/best broad spectrum available
    • depletion of guanosine (can't 5' cap RNAs)
    • indues mutations in RNA/defective viral genomes
    • shift CD4+ to Th1 phenotype
  37. Acyclovir
    • Nucleoside analog (herpes)
    • alpha-herpes first line
    • prodrug activated by viral thymidine kinase
    • Use: HSVin norm and compro/VZV/prophyl in BMT/ HSV encephalitis
    • short 1/2
    • poor oral
    • elevate plasma levels of tenofovir
  38. Cidofovir
    • Nucleoside analog (herpes/CMV)
    • activated by cellular kinases/avoid altered tyrosine kinases
    • competitive inhib of viral DNA polymerase
    • Resist: change in nuleoside kinase/DNA polymerase
  39. Famciclovir
    • Nucleoside analog (herpes)
    • oral prodrug of penciclovir
    • Resist: change in nuleoside kinase/DNA polymerase
  40. Penciclovir
    • Nucleoside analog (herpes)
    • allows short chain extension
    • Resist: change in nuleoside kinase/DNA polymerase
  41. Valacyclovir
    • Nucleoside analog (herpes)
    • prodrug activated by viral thymidine kinase
    • Use: HSVin norm and compro/VZV/prophyl in BMT/ HSV encephalitis
    • sustained higher levels in blood
    • elevate plasma levels of tenofovir
  42. Foscarnet
    • Non-nucleoside analog (herpes/CMV)
    • binds to pyrophosphae-binding site of DNA polymerase
    • NONcompetitive
  43. Docosanol
    • Non-nucleoside analog (herpes)
    • saturated fatty alcohol
    • topical cream (open sores)
  44. Ganciclovir
    • Nucleoside analog (CMV)
    • IV for life-threatening (esp. retinitis)
    • SE: granulocytopenia/thrombocytopenia
    • protein kinase phosphorylates drug
  45. Fomivirsen
    • Antisense RNA (CMV)
    • use: retinitis
  46. Amantadine
    • Inhib of viral penetration (flu)
    • uncoating inhib
    • blk acidification by binding to M2 protein
    • Use: Influenze A strains only/tx in 48hrs/prophylaxis
    • many current strains resistant
    • Parkinson drug
  47. Rimantadine
    • Inhib of viral penetration (flu)
    • uncoating inhib
    • blk acidification by binding to M2 protein
    • Use: Influenze A strains only/tx in 48hrs/prophylaxis
    • many current strains resistant
    • Parkinson drug
  48. Oseltamivir
    • neuraminidase inhib (flu)
    • blk release of cells from surface or host cell
    • Use: Influenza A and B
    • oral
  49. Zanamirvir
    • Neuraminidase inhib (flu)
    • blk release of cells from surface or host cell
    • Use: Influenza A and B
    • aerosol
  50. Boceprevir
    • Protease inhib (hepatitis)
    • parallel tx w/IFN-alpha2a and ribavirin
    • rapid resist to monotx
    • SE: anemia
  51. Carvedilol
    • B-adrenergic antagonist
    • CYP2D6 enz
  52. Codeine
    • prodrug converted by CYP2D6
    • no conversion to morphine/no pain relief
    • rapid met: rapid conversion/toxicity/drug to infants
  53. Irinotecan
    • Topoisomerase Inhib
    • met to SN-38/inactivated by UGT1A1 (can't clear drug)
    • UGT1A1 enz (phase II)
    • Gilbert's syndrome (60% activity)
    • SE: diarrhea/neutropenia
  54. Metoprolol
    • B-adrenergic antagonist
    • CYP2D6 enz
  55. Morphine
    codeine converted to drug by CYP2D6
  56. Venlafaxine
    • SNRI
    • CYP2D6 enz
    • toxicity with std dose (racing HR/long QT)
  57. Warfarin
    • oral anti-coagulant
    • too much=bleeding/too little=not enough anti-coag
    • CYP2C9 enz degradation/VKOR resist

What would you like to do?

Home > Flashcards > Print Preview