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67 Cards in this Set

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Which fungi are dimorphic?
H. Capsulatum
B. dermatitidis
S. Schenckii
Name 2 Polyene antifungals
Amphotericin
Nystatin
What is the hardest fugus to erradicate? (the pseudomonas of fungus)
Aspergillus
Which antifungal is a potent 3A4 inhibitor?
Ketoconazole
Which antifungal is a "supercharged fluconazole"?
voriconazole
What class of antifungal are caspofungin, anidulafungin, and micafungin?
Echinocandins
What infxns can be treated with amphotericin B (although realistically are not always treated with it)
Aspergillosis
Blastomycosis
Candidiasis
Coccidiomycosis
Cryptococcus
Histoplasmosis
Sporotrichosis
Zygomycosis
What infection is characterized by a peripheral "halo sign" or "crescent sign"?
aspergillus
How might it be possible to avoid some of the ADRs associated with Amphotericin B?
pretreat with acetominophen (or ASA), diphenhydramine, meperidine, +/- hydrocortisone
What is the major dose-limiting toxicity associated with Amphotericin B?
nephrotoxicity
sometimes you can't give as much ampho as you want b/c it will knock out the ___________
What is the difference between liposomal amphotericin B and regular amphotericin B?
Liposomal formulation has less toxicity b/c it accumulates in the organs of the reticuloendothelial system instead of the kidney
What is fluconazole used most often to treat?
candida albicans (and other species, but there is resistance of other species)

and cryptococcus
What are the cytochrome interactions associated with fluconazole?
Inhibitor of 2C9

--> increase in warfarin and phenytoin levels
What is cryptococcus associated with?
fungal meningitis (#1 cause)

worry when AIDS pt has CD4 of 50-100

worry about pt on >15mg of prednisone
What drugs will lead to decreased absorption of itraconazole?
PPIs
H2 blockers, etc
needs to be absorbed in acidic environment
What is the cytochrome interaction involving itraconazole?
inhibitor of 3A4
What is voriconazole good for treating?
Aspergillosis
Candidiasis
Zygomycetes
difficult fungal infections
What is the most common side effect associate with voriconazole?
blurred vision, photophobia, altered color perception, "tunnel vision" "lightening bolts"
What formulation is available for caspofungin?
IV
What is caspofungin used to treat?
Candida (non albicans species)

Aspergillus
Which antifungal(s) can be used for deep fungal infections in pregnancy?
amphotericin B

*but must consider trimester and severity of infxn
Which patients are more susceptible to developing peripheral neuropathy or drug-induced lupus after taking INH (isoniazid)?
Slow acetylators
Acetylation (NAT)
How can you decrease the likelyhood a patient will develop peripheral neuropathy on INH?
vitamin B6
What is the cytochrome interaction of rifampin?
inducer of 3A4
Which antimycobacterial agent penetrates prosthetic material?
Rifampin
What are the 2 drugs that cause a "flu-like illness"
#1-rifampin

#2-interferon
Which TB drug is associated with optic neuritis (and possibly irreversible blindness)?
Ethambutol
What other drug is associated with optic neuritis?
Amiodarone
What is the problem with HAART and TB treatment at the same time?
rifampin induces 3A4 --> accelerated metabolism of PIs and some NNRTIs --> dec serum concentration --> HAART failure
HHV-8 is what?
Etiology of Kaposi sarcoma?
What is acyclovir active against?
HSV1 and 2
VZV
What can be a side effect of large IV doses of acyclovir?
crystalline arthropathy and acute renal failure (from precipitation of drug in kidneys)
Which drug is a prodrug of acyclovir?
Valacyclovir
What viruses are covered by valacyclovir?
primary or recurrent genital HSV
Herpes zoster
What viruses are covered by Famciclovir?
HSV 1 and 2
Herpes zoster
When would you tend to use famciclovir?
when you would use valacyclovir
What is Ganciclovir used to treat?
CMV (retinitis, esophagitis)
EBV

HSV
VZV
What is a prodrug of ganciclovir?
valganciclovir
What two drugs are used for prophylaxis and tx of influenza?
oseltamavir
zanamivir
Which influenza tx is inhaled?
zanamivir
What does "pegylation" mean?
hooking it to polyene glycol - can give fewer doses b/c it will have longer half life than original product
Which HIV drugs are associated with pancreatitis and peripheral neuropathy?
DDI (didanosine)
d4T (stavudine)
ddC (zalcitabine) - useless
the "d" drugs
Which anti HIV drug is clasically associated with a hypersensitivity rxn?
ABC (abacavir)
Which NRTIs should not be combined b/c they compete for activation?
d4T and AZT
Which NRTI increases the MCV?
AZT
Which drug if a nucleoTIDE RTI?
Tenofovir (TDF)
Which anti-HIV drug will precipitate in the kidney if pt doesn't drink enough water?
Indinavir
What other drugs (besides indinavir) will precipitate in the kidney if pt does not drink enough water?
Acyclovir
Triamterene
an antiviral and a HTN med
Which PI is not associated with as much lipodystorphy?
Atazanavir
Which PIs have 3A4 interactions?
ALL of them
Which drug is a fusion inhibitor?
Enfuviritide
Examples of good drug regimens for HIV?
2NRTIs +1PI
2NRTIs +1NNRTI
2NRTIs + ritonavir + another PI
Which antiviral may lead to crystalline arthropathy and ARF?
acyclovir
Which antiviral(s) leads to bone marrow suppression (neutropenia)?
ganciclovir
interferon alpha
Zidovudine (AZT)
what is interferon alpha used to treat?
hep B and C
Which NRTIs have HepB activity?
Lamivudine (3TC) and Emtricitabine (FTC)
Tenofovir (TDF) - actually a nucleoTide RTI
Which NRTI is associated w/hyperpigmentation of oral mucosa/nailbeds and myopathy?
Zidovudine
Which NRTI raises the MCV?
Zidovudine (AZT)
What drug besides the NRTIs turns off host mitochondrial enzymes?
Bactrim
What HIV drug has Hep B activity against strains that are resistant to 3TC and FTC?
TDF (Tenofovir) - a nucleoTide RTI
WHat can't TDF be used with?
ABC/3TC or ddI/3TC
In which class of HIV drugs does resistance to one confer resistance to all in the class?
NNRTIs
which NNRTI commonly causes a rash?
Nevirapine (NVP)
Delviradine (but it's useless anyways)
Efavirenz (most potent NNRTI)
Which HIV drug causes vivid dreams (CNS disengagement)?
Efavirenz
WHich anti HIV drug is associated with stones?
Indinavir
What PI is usually started?
lopinavir (tipranavir if resistant)
which anti HIV drug is only available SC?
Enfuviritide (fusion inhibitor)