pharm 5 set 4

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  1. 2 types of fungal infections
    • systemic
    • superficial
  2. Amphotericin B / Fungizone
    • broad spectrum anti-fungal for systemic
    • destroys cell wall - attack sterols
    • DOC for systemic infections

    • -nephrotoxicity expected but will resolve
    • -antihistamine and acetaminophen pre-Tx
  3. Flucytosine / Ancobon
    converted to anti-metabolite after uptake by fungi

    hematological effects - bone marrow suppresion
  4. what happens when you use AmphoB with Ancobon?
    it enhances entry into the cell

    used in combo for lower dose/toxity
  5. 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
  6. Nystatin / Mycostatin

    Clotrimazole / Desinex
    for superficial dermatophytic infections

    • these are topical
    • used for thrush among others
  7. Grieofulvin / Fulvicin
    oral for superficial skin infections

    prevents fungal reproduction

    GI issues
  8. onchomycosis
    nail infection
  9. Terbinifine / Lamisil

    Itraconazole / Sporonox
    oral drug for nail infections

    6 month regimen - only 50% effective
  10. Cycloprox / Penlac
    • topical for nail infection
    • used in combo w/ oral

    2 month regimen - 12% effective
  11. 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
  12. Acyclovir / Zovirax
    • supress synthesis of viral DNA
    • resistance in rare

    used for Herpes simplex and Varicella zoster (chix pox)
  13. Gancyclovir / Cytovene
    used for CMV

    • it is a synthetic anti-viral so SE's include:
    • granulocytopenia and thrombocytonmenia
  14. Viral Hepatitis
    inflammation of the liver

    Hep a-g
  15. chronic hepatitis letters?
    B and C

    will lead to cirrhosis, liver failure, carcinoma

    Leading cause of liver transplants
  16. Interferon-aplha
    • Chronic Hep B & C drug
    • Anti-viral, immunomodulator, antimeoplastic
    • blocks viral entry
    • combine with ribavirin

    more effective against B than C

    • SE= depression
  17. Ribavirin / Rebetrol
    • Chronic Hep C drug
    • blocks viral activity - unknown mech

    • combined with Interferon-alpha
    • NOT effective alone
  18. Boceprevin / Victrelis
    chronic Hep C drug

    viral protease inhibitor, which is a viral enzyme

    must be used in combo with interferon/ribaviron
  19. Lamivudin / Epivir
    • nucleoside analog
    • chronic Hep B drug

    • reverse transcriptase inhibitors
    • -inhib viral DNA synth
    • --> bone marrow suppression
  20. 2 types of flu vaccines
    inactivated vaccine - given IM

    • Live, attenuated vaccine - inhaled
    •  -b/w ages 2-49
  21. 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)
  22. who does not get the flu vaccine?
    • <6 months age
    • severe egg allergy
    • past rxns
    • Guillian Barre
    • current fever illness
  23. Flu-varix
    fluvarix= adult

    fluvirin= 4yrs and older

    fluzone= 6months and older
  24. Amantasine / Symmetrel
    Flu A drug only

    • prevent viral entry into cells
    • inhibits early viral replication

    SE= confusion, dizzy, seizures
  25. 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
  26. HIV target cells
    CD4 helper T cells
  27. mech of action (classifications) of antiretrovirals (HIV drugs)
    • stop viral replication
    • prevent viral entry into cell
    • prevent final maturation and release
  28. 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
  29. Malaria
    parasitic disease caused by protozoa
  30. Vivax

    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
  31. Quinine
    • 1st antimalarial drug
    • had many SE
    • not used any more
  32. Chloroquine / Aralen
    • antimalarial
    • mech of action unknown

    DOC for acute attacks

    SE= GI, vision, liver
  33. Primaquine (in liver)

    • DOC for relapse
    • Can cause hemolysis for those lacking G-6-PD
    •  -af. amers, iran, greeks, sardinians
  34. 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
  35. Chloroquine / Aralen use as a prophylactic
    • DOC for suppressive therapy
    • Given in high mosquito populations
  36. Doxycycline
    given in very resistant Malaria areas

    is replacing Aralen
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pharm 5 set 4
pharm 5
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