pharm - ID2.txt

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pharm - ID2.txt
2012-07-11 22:30:52
pharm ID2

pharm - ID2.txt
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  1. neuraminidase inhibitors drugs
    zanamivir (Relenza), oseltamivir (Tamiflu), peramivir
  2. neuraminidase inhibitors MOA
    viruses have 2 surface proteins. hemagglutinins are responsible for the binding and uptake of the virus, while neuraminidases are responsible for release of new virus (via sialic acid cleavage). NIs block this cleavage, preventing release of new virus.
  3. neuraminidase kinetics
    Tamiflu oral, Relenza inhaled (so not for folks c respiratory disease)
  4. neuraminidase indications
  5. neuraminidase SE
    GI. Tamiflu unusual dreams. Relenza possible bronchospasm
  6. uncoating inhibitors drugs
    amantadine (Symmetrel), rimantadine (Flumadine)
  7. uncoating inhibitors MOA
    flu A: thought to prevent influx of protons through viral M2 channels that causes the pH-dependent process of RNA-protein coat dissociation. parkinsons: amantadine may increase dopamine release and block ACh receptors, enhancing motor control.
  8. uncoating inhibitors kinetics
    amantadine more lipophilic, so more CNS SE than rimantadine (but better for Parkinsons)
  9. nucleoside analogues MOA
    viral enzymes convert nucleoside analogues to active nucleoside triphosphates, which are then incorporated and mess with viral DNA strands.
  10. nucleoside analogues SE
    nephrotoxicity. ganciclovir BBW hematologic toxicity, carcinogen, aspermatogenesis. cidofovir BBW nephrotoxicity, neutropenia, carcinogen.
  11. most effective for reducing duration of cold sores
    oral antivirals (nucleoside analogues)
  12. what is given with probenecid?
    cidofovir (high propensity for nephrotoxicity)
  13. nucleoside analogues drugs
    ALL THE CYCLOVIRS. acyclovir (Zorivax), valacyclovir (Valtrex), codofovir (Vistide)
  14. nucleoside analogues indicated for herpes
    acyclovir, famciclovir, penciclovir
  15. nucleoside analogues indicated for CMV
  16. nucleoside analogues indicated for CMV retinitis
    cidofovir IV
  17. nucleoside analogues indicated for cold sores
    penciclovir topical
  18. azoles drugs
    ALL THE AZOLES. fluconazole (Diflucan), 2G voriconazole (Vfend)
  19. azoles MOA
    block the synthesis of ergosterol, a fundamental constituent of the fungal cell membrane
  20. azoles indications
    superficial topical fungi (candida, dermatophytes), uncomplicated/health pt systemic fungi
  21. azoles interactions
    direct CYP450 inhibitors. inhibit warfarin metabolism (increase INR)
  22. azoles SE
    ketoconazole BBW hepatotoxicity. itraconazole BBW CHF (negative ionotropic effects).
  23. echinocandins drugs
    ALL THE FUNGINS. caspofungin (Cancidas), anindulafingin (Eraxis), micafungin (Mycamine).
  24. echinocandins MOA
    inhibits glucan synthase in fungal cell walls, an enzyme responsible for rigidity (causes weak cell walls that lyse).
  25. echinocandins indications
    severe invasive fungal infections (candida, aspergillus)
  26. echinocandins SE
    watch for anaphylaxis
  27. griseofulvin MOA
    inhibits fungal cell division by binding to proteins like tubulin.
  28. griseofulvin kinetics
    deposited into keratin precurson cells, increasing their resistance to infection.
  29. griseofulvin indications
    dermatophyte infections o skin/hair (trichophyton, microsporum, epidermophyton)
  30. griseofulvin contraindications
    porphyria, pregnancy, hepatic failures. caution if sensitive to penicillin.
  31. griseofulvin interactions
    CYP3A4 inducer.
  32. griseofulvin SE
    photosensitivity, rash
  33. polyenes drugs
    amphotericin B, Nystatin
  34. polyenes MOA
    bind sterols, such as ergosterol found in fungal cell membranes (puts pores in membrane, ions leak, cell dies). also b/c it binds sterols, also binds cholesterols causing its SEs.
  35. polyenes kinetics
    amphotericin B has long half life (15 days) b/c it is accumulated in tissues and released slowly. Nystatin too toxic for parenteral, but works good for topical/oral rinse due to low absorption.
  36. polyenes indications
    amphotericin B: serious invasive/systemic fungal infections. Nystatin: noninvasive candidal infections.
  37. polyenes SE
    nephrotoxicity, INFUSION REACTIONS, electrolyte abnormalities.
  38. pyrimidines drugs
    flucytosin (Ancoban)
  39. pyrimidines MOA
    taken up by cytosine permease, an enzyme present only in fungi. it is then metabolized (> 5-FU > 5-FDUMP) and goes on to inhibit thymidine synthetase (needed for DNA replication)
  40. pyrimidines indications
    severe fungal infections. use in combo with amphotericin B to prevent resistance.
  41. pyrimidines SE
    N/V (give capsules a few at a time over a 15 min period). BBW renal impairment. lots of other kick ass SE including TEN.
  42. quinolines drugs
    ALL THE QUINES. chloroquine (Aralen), hydroxychloroquine (Plaquenil).
  43. quinolines MOA
    largely unknown. chloroquine possibly concentrates in parasitic food vacules, causing toxic heme buildup. primaquine is the only drug that works on both the exoerythrocytic and erythrocytic phases of malarial infection (P vivax, P ovale).
  44. quinolines indications
    malaria (chloroquine first line). also RA, SLE, cutaneous skin disorders. quinine+clindamycin also for babesial infections.
  45. quinolines contraindications
    mefloquine seizures, some psych issues.
  46. quinolines interactions
    quinine+mefloquinine (QT prolongation, seizures). quinine+Aluminum antacids (messes c absorption/excretion).
  47. quinolines SE
    chloroquine visual disturbances (hydroxychloroquine is a less toxic alternative). quinine cinchonism (tinnitus, HA, nausea, dizziness, flushing, visual disturbances)
  48. quinolines kinetics
    slow elimination of mefloquine (second line) allows for single dose treatment (f/u c primaquine for liver bugs)
  49. antihelmintics contraindications
    praziquantal ocular infection, CNS lesions, seizure hx.
  50. antihelmintics SE
    albendazole alopecia, reversible leukopenia, elevated liver enzymes.
  51. three types of worms (helminths)
    nematodes (roundworms), trematodes (flukes), cestodes (tapeworms)
  52. antihelmintics indicated for nematodes
    mebendazole (-worms), diethylcarbamazine (filial), piperazine (ascaris), ivermectin/Stromectal (strongyloides, onchocerciasis - also scabies)
  53. antihelmintics indicated for trematodes
  54. antihelmintics indicated for cestodes
    praziquantal/Biltricide, albendazole/Albenza (neurocysticercosis, Hydatid disease)
  55. antihelmintic albendazole MOA
    disrupts microtubule formation, impairs glucose uptake. also larvicidal, ovicidal.
  56. antihelmintic diethylcarbamazine MOA
    immobilize microfilariae and render them more susceptible to host defenses
  57. antihelmintic praziquantal MOA
    paralyzes (increases Ca++ permiability)
  58. antihelmintic piperazine MOA
    paralyzes (promotes GABA)
  59. antihelmintic ivermectin MOA
    paralyzes (intensifies GABA via Cl- channel activation)
  60. antiprotazoals drugs
    pentamidine (Pentam), melarsoprol, nifurtimox, iodoquinol (Yodoxin)
  61. antiprotazoal MOA
    melarsoprol disrupts protozoal enzymatic activity. nifurtimox inhibits trypanothione reductase.
  62. antiprotazoal pentamidine (Pentam) indications
    pneumocystis, African trypanosomiasis, leishmaniasis
  63. antiprotazoal melarsoprol indications
  64. antiprotazoal nifurtimox indications
    American trypanosomiasis (Chagas disease)
  65. antiprotazoal SE
    pentamidine hypotension/tachycardia, nephrotoxicity*, by IV hypoglycemia (so IM). melarsoprol reactive encephalopathy, polyneuropathy.