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32 Cards in this Set
- Front
- Back
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Amphotericin B
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Binds ergosterol= membrane pores
Systemic mycoses; does not cross blood-brain barrier, need intrathecal admin Tox: caused by binding to cholesterol in host cells Fever, chills, hypotension, nephrotox, arrhythmias, anemia, IV phlebitits |
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Nystatin
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Binds ergosterol= membrane pores
Too toxic for systemic use "Swish and swallow" for oral candiasis Topical for diaper rash or vaginal candiasis |
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-Azoles
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Inhibit Ergosterol synthesis
Inhibits 14α-demethylase= ↑lanosterol Systemic mycoses Tox: hormone synthesis inhibition, gynecomastia, liver dysfunction, inhibits P450's, fever, chills |
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Fluconazole
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Inhibit Ergosterol synthesis
Cryptococcal meningitis in AIDS pts b/c it crosses blood-brain barrier All Candidal infections |
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Ketoconazole
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Inhibit Ergosterol synthesis
Blastomyces, Coccidioides, Histoplasma, Candida, hypercortisolism |
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Flucytosine
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Converts to 5-fluorouracil= Inhibits DNA Synthesis
Systemic mycoses in combo with Amphotericin B Tox: BONE MARROW SUPPRESSION, nausea, vomitting, diarrhea |
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Caspofungin
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Inhibits cell wall synthesis by inhibiting synthesis of β-glucan
Aspergillosis Tox: GI upset, flushing |
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Terbinafine
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Inhibits Squalene Epoxidase= ↑squalene and ↓lanosterol= inhibits ergosterol synthesis
Dermatophytoses (especially onychomycosis) |
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Griseofulvin
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Disrupts microtubule function= disrupts mitosis
Deposits in keratin-containing tissue Superficial infections, Dermatophytes Tox: teratogenic, carcinogenic, confusion, headaches, ↑P450 & warfarin metabolism |
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Amantadine
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Blocks viral penetration/uncoating (M2 protein);
Causes release of dopamine Influenza A, rubellA, Parkinson's Dx Tox: cerebellA problems Resistance: Mutated M2 protein (90% of Influenza A now) A man to dine takes of his coat |
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Rimantidine
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Blocks viral penetration/uncoating (M2 protein)
Less CNS side effects than Amantidine |
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Zanamivir
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Inhibits influenza neuraminidase= ↓release of progeny virus
Influenza A & B |
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Oseltamivir
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Inhibits influenza neuraminidase= ↓release of progeny virus
Influenza A & B |
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Ribavirin
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Inhibits IMP dehydrogenase= ↓guanine nucleotides
RSV, chronic Hep C Tox: severe teratogen, Hemolytic Anemia |
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Acyclovir
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Guanosine analog; monophosphorylated by HSV thymidine kinase; triphosphorylated by cellular kinases
Inhibits VIRAL DNA Polymerase by chain termination Herpes Simplex, Varicella, EBV NO effect on latent forms- use Famciclovir Resistance: lack of thymidine kinase |
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Ganciclovir
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Guanosine analog;
5'-monophosphate by thymidine kinase or viral kinase; triphosphorylated by cellular kinases Inhibits VIRAL DNA Polymerase by chain termination CMV Tox: PANCYTOPENIA, renal toxicity More toxic to host enzymes than Acyclovir Resistance: mutated CMV DNA poly or lack of viral kinase |
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Foscarnet
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pyroFOSphate analog: inhibits viral DNA polymerase at pyrophostate binding site
Does NOT require activation by viral kinase CMV retinitis when Ganciclovir fails Acyclovir-resistant HSV |
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Interferon-α
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Block various stages viral penetration and synthesis
Induce ribonuclease that degrade viral mRNA Chronic Hep B & C Kaposi's Sarcoma (HHV-8) Tox: Neutropenia |
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Interferon-β
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Block various stages viral penetration and synthesis
Induce ribonuclease that degrade viral mRNA Multiple Sclerosis Tox: Neutropenia |
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Interferon-γ
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Block various stages viral penetration and synthesis
Induce ribonuclease that degrade viral mRNA NADPH oxidase deficiency Tox: Neutropenia |
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-Navir
Saquinavir Ritonavir Indinavir Nelfinavir Amprenavir |
HIV Protease Inhibitor: Inhibit maturation of NEW virus
NAVIR (never) tease a proTEASE HAART therapy Tox: GI intolerance, HYPERGLYCEMIA, lipodystrophy, thrombocytopenia (indinavir) |
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Zidovudine (ZDV)
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Nucleoside HIV Reverse Transcriptase Inhibitors
need cellular thymidine kinase to activate HAART Therapy PROPHYLAXIS & during PREGNACY Tox: bone marrow suppression (neutropenia, anemia)- use GM-CSF and EPO peripheral neuropathy, lactic acidosis Megaloblastic Anemia |
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Didanosine (ddI)
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Nucleoside HIV Reverse Transcriptase Inhibitors
HAART Therapy Tox: bone marrow suppression (neutropenia, anemia)- use GM-CSF and EPO peripheral neuropathy, lactic acidosis |
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Zalcitabine (ddC)
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Nucleoside HIV Reverse Transcriptase Inhibitors
HAART Therapy Tox: bone marrow suppression (neutropenia, anemia)- use GM-CSF and EPO peripheral neuropathy, lactic acidosis |
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Stavudine (d4T)
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Nucleoside HIV Reverse Transcriptase Inhibitors
HAART Therapy Tox: bone marrow suppression (neutropenia, anemia)- use GM-CSF and EPO peripheral neuropathy, lactic acidosis |
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Lamivudine (3TC)
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Nucleoside HIV Reverse Transcriptase Inhibitors
HAART Therapy Tox: bone marrow suppression (neutropenia, anemia)- use GM-CSF and EPO peripheral neuropathy, lactic acidosis |
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Abacavir
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Nucleoside HIV Reverse Transcriptase Inhibitors
HAART Therapy Tox: bone marrow suppression (neutropenia, anemia)- use GM-CSF and EPO peripheral neuropathy, lactic acidosis |
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Highly active antiretroviral therapy (HAART)
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HIV Combo Therapy:
Protease inhibitors + Reverse Transcriptase inhibitors Initiate @ high viral load or low CD4 counts (<500 cells/mm3) |
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Nevirapine
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Non-nucleoside HIV Reverse Transcriptase Inhibitors
HAART Therapy Tox: bone marrow suppression (neutropenia, anemia)- use GM-CSF and EPO peripheral neuropathy, rash |
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Efavirenz
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Non-nucleoside HIV Reverse Transcriptase Inhibitors
HAART Therapy Tox: bone marrow suppression (neutropenia, anemia)- use GM-CSF and EPO peripheral neuropathy, rash |
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Delaviridine
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Non-nucleoside HIV Reverse Transcriptase Inhibitors
HAART Therapy Tox: bone marrow suppression (neutropenia, anemia)- use GM-CSF and EPO peripheral neuropathy, rash |
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Enfuvirtide
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HIV Fusion Inhibitor:
Binds viral gp41 subunit= inhibition of conformation change= block entry Use for persistent viral replication in spite of antiretrovrial therapy Tox: Hypersensitivity, bacterial PNEUMONIA |
