-
2 types of fungal infections
-
Amphotericin B / Fungizone
- broad spectrum anti-fungal for systemic
- destroys cell wall - attack sterols
- DOC for systemic infections
- HIGHLY TOXIC
- -nephrotoxicity expected but will resolve
- -antihistamine and acetaminophen pre-Tx
-
Flucytosine / Ancobon
converted to anti-metabolite after uptake by fungi
hematological effects - bone marrow suppresion
-
what happens when you use AmphoB with Ancobon?
it enhances entry into the cell
used in combo for lower dose/toxity
-
Ketoconazole
Azole family
systemic or superficial infection
- inhibs ergosterol
- -essential for fungal membranes
SE= hepattox, inhibs testosterone prod, N/V
Can reduce gastric acid, decreasing absorption of other drugs
-
Nystatin / Mycostatin
Clotrimazole / Desinex
for superficial dermatophytic infections
- these are topical
- used for thrush among others
-
Grieofulvin / Fulvicin
oral for superficial skin infections
prevents fungal reproduction
GI issues
-
onchomycosis
nail infection
-
Terbinifine / Lamisil
Itraconazole / Sporonox
oral drug for nail infections
6 month regimen - only 50% effective
-
Cycloprox / Penlac
- topical for nail infection
- used in combo w/ oral
2 month regimen - 12% effective
-
what do we look for in a Tx for non-HIV viral infections?
try to find mechanisms unique to viral life to avoid harming host cells
-
Acyclovir / Zovirax
- supress synthesis of viral DNA
- resistance in rare
used for Herpes simplex and Varicella zoster (chix pox)
-
Gancyclovir / Cytovene
used for CMV
- it is a synthetic anti-viral so SE's include:
- granulocytopenia and thrombocytonmenia
-
Viral Hepatitis
inflammation of the liver
Hep a-g
-
chronic hepatitis letters?
B and C
will lead to cirrhosis, liver failure, carcinoma
Leading cause of liver transplants
-
Interferon-aplha
- Chronic Hep B & C drug
- Anti-viral, immunomodulator, antimeoplastic
- blocks viral entry
- combine with ribavirin
more effective against B than C
-
Ribavirin / Rebetrol
- Chronic Hep C drug
- blocks viral activity - unknown mech
- combined with Interferon-alpha
- NOT effective alone
-
Boceprevin / Victrelis
chronic Hep C drug
viral protease inhibitor, which is a viral enzyme
must be used in combo with interferon/ribaviron
-
Lamivudin / Epivir
- nucleoside analog
- chronic Hep B drug
- reverse transcriptase inhibitors
- -inhib viral DNA synth
- --> bone marrow suppression
-
2 types of flu vaccines
inactivated vaccine - given IM
- Live, attenuated vaccine - inhaled
- -b/w ages 2-49
-
flu vaccine and egg allergy
only tiny amounts of egg protein involved, so statistically should be fine
If allergy exists, use Inactivated form, not live (inhaled)
-
who does not get the flu vaccine?
- <6 months age
- severe egg allergy
- past rxns
- Guillian Barre
- current fever illness
-
Flu-varix
vs.
-virin
vs.
-zone
fluvarix= adult
fluvirin= 4yrs and older
fluzone= 6months and older
-
Amantasine / Symmetrel
Flu A drug only
- prevent viral entry into cells
- inhibits early viral replication
SE= confusion, dizzy, seizures
-
Oseltavir / Tamaflu
A and B flu drug
stops viral replication
- 2 days after symptoms appear preferable OR sooner
- -effect lessons with flu progression
SE= N/V only
-
HIV target cells
CD4 helper T cells
-
mech of action (classifications) of antiretrovirals (HIV drugs)
- stop viral replication
- prevent viral entry into cell
- prevent final maturation and release
-
How do antiretrovirals:
1. stop viral replication
2. prevent viral entry
3. prevent final maturation and release?
- 1. reverse transcriptase inhibitors
- -integrase inhibitors
- 2. HIV fusion inhibitors
- -CCR5 antagonist
- 3. Protease inhibitors
- -These are MOST effective but have the most SE's
-
Malaria
parasitic disease caused by protozoa
-
Vivax
Falciparum
V= some sporozoiotes remain dormant in the LOVER up to 2 years
- F= more serious, less common
- =does not remain in liver and there are no relapse
-
Quinine
- 1st antimalarial drug
- had many SE
- not used any more
-
Chloroquine / Aralen
- antimalarial
- mech of action unknown
DOC for acute attacks
SE= GI, vision, liver
-
Primaquine (in liver)
antimalarial
- DOC for relapse
- Can cause hemolysis for those lacking G-6-PD
- -af. amers, iran, greeks, sardinians
-
what type of prophylaxis Tx is used for malaria?
suppressive therapy
- can NOT prevent primary infection
- CAN stop infection of erythrocytes
- -parasite remain in the liver
-
Chloroquine / Aralen use as a prophylactic
- DOC for suppressive therapy
- Given in high mosquito populations
-
Doxycycline
given in very resistant Malaria areas
is replacing Aralen
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