• Shuffle
    Toggle On
    Toggle Off
  • Alphabetize
    Toggle On
    Toggle Off
  • Front First
    Toggle On
    Toggle Off
  • Both Sides
    Toggle On
    Toggle Off
  • Read
    Toggle On
    Toggle Off
Reading...
Front

How to study your flashcards.

Right/Left arrow keys: Navigate between flashcards.right arrow keyleft arrow key

Up/Down arrow keys: Flip the card between the front and back.down keyup key

H key: Show hint (3rd side).h key

A key: Read text to speech.a key

image

Play button

image

Play button

image

Progress

1/71

Click to flip

71 Cards in this Set

  • Front
  • Back
  • 3rd side (hint)
Penicillin
Antibiotic, Bactericidal

Mech: Bind penicillin-binding proteins (PBPs); block transpeptidase cross-linking of bacterial cell wall; activate autolytic enzymes

Ind: Mostly gram+ and syphilis. S. pneumoniae, S. pyogenes, Actinomyces.
Bactericidal for gram+ cocci, gram+ rods, gram- cocci, and spirochetes.
Tox: Hypersensitivity, hemolytic anemia.

Res: Penicillinase or β-lactamase
Methicillin, nafcillin, dicloxacillin
Antibiotic, penicillinase-resistant penicillins

Mech: Bind penicillin-binding proteins (PBPs); block transpeptidase cross-linking of bacterial cell wall; activate autolytic enzymes

Ind: S. aureus (except MRSA - resistant due to altered PBP target site)
Tox: Hypersensitivity
Methicillin - interstitial nephritis

Overcomes penicillinase due to bulkier R group
Ampicillin, amoxicillin
Antibiotic, aminopenicillins

Mech: Bind penicillin-binding proteins (PBPs); block transpeptidase cross-linking of bacterial cell wall; activate autolytic enzymes

Ind: extended spectrum: some gram+ bacterial & gram- rods. H. influenzae, E. coli, Listeria, Proteus, Salmonella, enterococci.
Tox: Hypersensitivity rxns; ampicillin rash; pseudomembranous colitis

Mnemonic (indications): HELPS kill enterococci.
Haemophilus
E. coli
Listeria
Proteus
Salmonella
Ticarcillin, carbenicillin, piperacillin
Antibiotics, antipseudomonals

Mech: Bind penicillin-binding proteins (PBPs); block transpeptidase cross-linking of bacterial cell wall; activate autolytic enzymes

Ind: Pseudomonas spp. & gram- rods.
Tox: Hypersensitivity

Res: susceptible to penicillinase (use with clavulanic acid)

Mnemonic (drugs): TCP - Takes Care of Pseudomonas
Clavulanic acid, sulbactam, tazobactam
Antibiotic adjuncts; β-lactamase inhibitors

Ind: use with penicillin Abx to protect it from β-lactamase destruction
Mnemonic (drugs): CAST
Cefazolin, cephalexin
Antibiotics, 1st generation cephalosporins. Bactericidal

Mech: β-lactam drugs; inhibit cell wall synthesis, less susceptible to penicillinases.

Ind: gram+ cocci, Proteus, E. coli, Klebsiella pneumoniae
Tox: Hypersensitivity, Vit K deficiency.
Poss cross-hypersensitivity with penicillins
Inc. nephrotoxicity of aminoglycosides
Poss disulfram-like rxn with ethanol

Mnemonic (indications): PEcK
Cefoxitin, cefaclor, cefuroxime
Antibiotic, 2nd generation cephalosporins. Bactericidal.

Mech: β-lactam drugs; inhibit cell wall synthesis, less susceptible to penicillinases.

Ind: gram+ cocci; H. influenzae; Enterobacter; Neisseria spp.; Proteus; E. coli; Klebsiella pneumoniae; Serratia marcescens
Tox: Hypersensitivity, Vit K deficiency.
Poss cross-hypersensitivity with penicillins
Inc. nephrotoxicity of aminoglycosides
Poss disulfram-like rxn with ethanol

Mnemonic (indications): HEN PEcK
Ceftriaxone, cefotaxime, ceftazidime
Antibiotics, 3rd generation cephalosporins. Bactericidal

Mech: β-lactam drugs; inhibit cell wall synthesis, less susceptible to penicillinases.

Ind: serious gram- infxns resistant to other β-lactams
Ceftriaxone - meningitis & gonorrhea
Ceftazidime - Pseudomonas
Tox: Hypersensitivity, Vit K deficiency.
Poss cross-hypersensitivity with penicillins
Inc. nephrotoxicity of aminoglycosides
Poss disulfram-like rxn with ethanol
Cefepime
Antibiotic, 4th generation cephalosporin. Bactericidal

Mech: β-lactam drug; inhibit scell wall synthesis, less susceptible to penicillinases.

Ind: for inc. activity against Pseudomonas & gram+ organisms
Tox: Hypersensitivity, Vit K deficiency.
Poss cross-hypersensitivity with penicillins
Inc. nephrotoxicity of aminoglycosides
Poss disulfram-like rxn with ethanol
Aztreonam
Antibiotic. Monobactam with β-lactamase resistance.

Mech: Binds PBPs, inhibits cell wall synthesis. Synergy with aminoglycosides.

Ind: gram- rods only!! No activity against gram+s or anaerobes.
For penicillin-allergic pts or pts with renal insufficiency (aminoglycosides are C/I)
Tox: No cross-allergenicity or cross-sensitivity with penicillins or cephalosporins
Occasional GI upset; generally nontoxic
Imipenem/cilastin, meropenem
Antibiotic (with adjunct)

Mech: Imipenem - broad-spectrum, β-lactamase-resistant carbapenem.
Cilastin - inhibits renal dihydropeptidase I
Together, dec. inactivation of drug in renal tubules. ALWAYS use together!
Meropenem - stable to dihydropeptidase I by itself

Ind: gram+ cocci, gram- rods, anaerobes. Wide spectrum, but only used as 2nd line or for life-threatening infxns
Tox: significant; limits use
CNS toxicity [seizures] at high plasma levels (less so for meropenem)
GI distress, skin rash

Mnemonic (drugs): Imipenem's kill is LASTIN' with ciLASTATIN.
Vancomycin
Antibiotic, Bactericidal

Mech: binds D-ala-D-ala portion of cell wall precursor, inhibits cell wall mucopeptide formation.

Ind: gram+ only! For serious, multidrug-resistant organisms - S. aureus, enterococcim, C. difficile
Tox: Generally well-tolerated
Nephrotoxicity, Ototoxicity, Thrombophlebitis, diffuse flushing ("red man syndrome")
Toxicities dec. by pretreatment with antihistamines & slow infusion

Res: amino acid change from D-ala-D-ala to D-ala-D-lac

Mnemonic (toxicities): does NOT have many problems.
Gentamicin, Neomycin, Amikacin, Tobramycin, Streptomycin
Antibiotic, aminoglycosides. Bactericidal.

Mech: inhibit formation of ribosome initiation complex, cause misreading of mRNA.

Ind: Severe gram- rod infxns. Synergy with β-lactams.
Neomycin for bowel surgery
No fx on anaerobes (needs oxygen for uptake)
Tox: Nephrotoxicity (esp with cephalosporins)
Ototoxicity (esp with loop diuretics)
Teratogen

Res: Transferase enzymes inactivate drugs by acetylation, phosphorylation, or adenylation

Mnemonic (drugs, indication, toxicities): "Mean" GNATS canNOT kill anerobes.
Tetracycline, doxycycline, demeclocycline, minocycline
Antibiotics, tetracyclines. Bacteriostatic.

Mech: Bind 30S ribosomal unit and prevent aminoacyl-tRNA attachment.
Limited CNS penetration

Ind: Borrelia, H. pylori, M. pneumoniae.
Rickettsia, Chlamydia - can accumulate intracellularly
Demeclocycline is an ADH antagonist; acts as a diuretic.
Doxycycline is fecally eliminated - can use in pts with renal failure
Tox: Tooth discoloration & inhibition of bone growth in children.
Photosensitivity, GI distress
Doxycycline can't be taken with milk, antacids, or Fe-containing preparations; divalent cations inhibit its absorption.

Res: dec. uptake into cells or inc. efflux out of cells (plasmid-encoded transport pumps)
Erythromycin, azithromycin, clarithromycin
Antibiotic, macrolides. Bacteriostatic.

Mech: bind 23S rRNA of the 50S ribosomal subunit; block translocation, inhibit protein synthesis.

Ind: Atypical pneumonias (Mycoplasma, Chlamydia, Legionella)
URIs, STDs, gram+ cocci (strep infxns if pt allergic to penicillin), Neisseria
Tox: prolonged QT interval (esp erythromycin)
GI discomfort (causes noncompliance)
Acute cholestatic hepatitis
Eosinophilia, skin rashes
Inc. serum concentration of theophyllines & oral anticoagulants

Res: methylation of 23S rRNA binding site.
Chloramphenicol
Antibiotic. Bacteriostatic.

Mech: inhibits 50S peptidyltransferase activity, blocks growth of polypeptide

Ind: Meningitis (H. influenzae, Neisseria meningitidis, Strep pneumoniae)
Toxicities limit use.
Tox: anemia (dose dependent), aplastic anemia (dose independent)
Gray baby syndrome (in premature infants due to no UDP-glucuronyl transferase)

Res: Plasmid-encoded acetyltransferase inactivates drug
Clindamycin
Antibiotic. Bacteriostatic

Mech: blocks peptide bond formation at 50S ribosomal subunit.

Ind: Anaerobic infxns above the diaphragm (Bacteroides fragilis, Clostridium perfringens, etc.). Aspiration pneumonia, lung abscesses
Tox: Pseudomembranous colitis (C. diff overgrowth)
Fever, diarrhea
Sulfamethoxazole (SMX), sulfisoxazole, sulfadiazine
Antibiotic. Bacteriostatic.

Mech: PABA antimetabolite; inhibit dihydropteroate synthetase

Ind: Gram+, gram-, Nocardia, Chlamydia.
Triple sulfas or SMX for simple UTI
Tox: Hypersensitivity, sulfa allergy, photosensitivity, kernicterus in infants
If G6PD deficient, hemolysis
Nephrotoxicity due to tubulointerstitial nephritis
Displaces other drugs from albumin (e.g., warfarin)

Res: altered bacterial dihydropteroate synthetase resists binding
Dec. uptake into cells
Inc. PABA synthesis
Trimethoprim (TMP)
Antibiotic. Bacteriostatic

Mech: Inhibits bacterial dihydrofolate reductase. Synergy with sulfonamides - sequential block of folate synthesis.

Ind: recurrent UTIs, Shigella, Salmonella, Pneumocystis jiroveci pneumonia
Tox: Megaloblastic anemia, leukopenia, granulocytopenia.
Can be eased with leucovorin rescue - supplemental folinic acid.

Mnemonic (toxicity): TMP Treats Marrow Poorly
Ciprofloxacin, norfloxacin, ofloxacin, sparfloxacin, moxifloxacin, gatifloxacin, enoxacin
Antibiotics, fluoroquinolones. Bactericidal.

Mech: inhibit DNA gyrase (topoisomerase II). Don't take with antacids.

Ind: gram- rods of UTIs or GI tracts. Pseudomonas, Neisseria, some gram+s.
Tox: superinfxns, GI upset, skin rash, headache, dizziness.
C/I in pregnant women & kids - risk of cartilage damage. Tendonitis & tendon rupture in adults; leg cramps & myalgias in kids.

Res: Chromosome-encoded mutation in DNA gyrase.

Mnemonic (toxicity): FluoroquinoLONES hurt attachments to your BONES.
Metronidazole
Antiprotozoan, antibiotic (bactericidal)

Mech: forms free radical toxic metabolites in bacterial cell, causes DNA damage.

Ind: Giardia, Entamoeba, Trichomonas, Gardnerella vaginalis, Anaerobes (Bacteroides, Clostridium).
For H. Pylori when with bismuth & amoxicillin (or tetracycline) - "triple therapy"
Anaerobic infxn below the diaphragm
Tox: Disulfram-like rxn with alcohol
Headache, metallic taste

Mnemonic (indications): GET GAP on the Metro
Polymixin B, colistimethate (polymixin E)
Antibiotic, polymixins.

Mech: bind cell membranes, disrupt osmotic properties.
Cationic, basic proteins - act like detergents.

Ind: for resistant gram- infxns
Tox: Neurotox, acute renal tubular necrosis

Mnemonic (mechanism): 'MYXins MIX up membranes
Drugs for M. tuberculosis
Treatment - Rifampin, Isoniazid, Pyrazinamide, Ethambutol

Prophylaxis - Isoniazid
Mnemonic: RIPE
Drugs for M. avium-intracellulare
Treatment - Azithromycin, rifampin, ethambutol, streptomycin

Prophylaxis - Azithromycin
blank
Drugs for M. leprae
Treatment - Dapsone, Rifampin, Clofazimine

Prophylaxis - none
Mnemonic: Dr. C. treats leprosy
Pyrazinamide
Anti-mycobacterial

Mech: works in acidic pH of phagosomes (where TB is after phagocytosis)

Ind: TB
Tox: hepatotox

Mnemonic (TB drugs): RIPE
or - INH-SPIRE
Streptomycin
Pyrazinamide
Isoniazid (INH)
Rifampin
Ethambutol
Ethambutol
Antimycobacterial

Mech: blocks arabinosyltransferase, dec. carbohydrate polymerization of mycobacterium cell wall

Ind: TB
Tox: optic neuropathy (red-green color blindness)

Mnemonic (TB drugs): RIPE
or - INH-SPIRE
Streptomycin
Pyrazinamide
Isoniazid (INH)
Rifampin
Ethambutol
Isoniazid (INH)
Antimycobacterial

Mech: dec. synthesis of mycolic acids.
Converted to active metabolite by bacterial catalase-peroxidase
Different half-lives - fast v. slow acetylators

Ind: Mycobacterium tuberculosis.
Only Rx used as solo prophylaxis
Tox: Neurotox, hepatotox, lupus.
Vit B6 can prevent neurotox & lupus.

Mnemonic (toxicity): INH Injures Neurons & Hepatocytes
Rifampin
Antimycobacterial

Mech: Inhibit DNA-dependent RNA Pol

Ind: Mycobacterium tuberculosis. Leprosy - delays resistance to dapsone.
Prophylaxis for meningococcus
Chemoprophylaxis in contacts of kids with Haemophilus influenzae type B
Tox: Minor hepatotox
Drug interactions - inc. P450
Orange/red body fluids (no adverse effects)

Mnemonic: Rifampin's 4 Rs:
RNA Pol inhibitor
Revs up cP450
Red/orange body fluids
Rapid resistance if used alone
Amphotericin B
Antifungal

Mech: binds ergosterol on fungal cell membrane; forms pores -> electrolyte leakage

Ind: serious, systemic mycoses (not to be used lightly!)
Ex: Cryptococcus, Blastomyces, Coccidioides, Aspergillus, Histoplasma, Candida, Mucor
Intrathecally for fungal meningitis
Tox: nephrotoxicity, IV phlebitis
Less important: fever/chills, hypotension, arrhythmias, anemia

Reduce nephrotox with hydration
Less toxicity with liposomal amphotericin
Nystatin
Antifungal

Mech: binds ergosterol on fungal cell membrane, forms holes -> electrolyte leakage

Ind: topical only! (v. toxic)
Thrush ("swish & swallow"), diaper rash, or vaginal candidiasis
Tox: not sure, but it must be bad.
Fluconazole
Antifungal

Mech: inhibit ergosterol synthesis by inhibiting P450

Ind: systemic mycoses.
Cryptococcal meningitis (AIDS) b/c can cross BBB
Candidal infections
Tox: hepatotox (inhibits P450!)
Inc. effect of drug metabolized by P450
Inhibits hormone synthesis -> gynecomastia
Ketoconazole
Antifungal

Mech: inhibit ergosterol synthesis by inhibiting P450

Ind: systemic mycoses.
Blastomyces, Coccidioides, Histoplasma, Candida
Hypercortisolism (inhibits hormone synthesis)
Tox: hepatotox (inhibits P450!)
Inc. effect of drug metabolized by P450
Inhibits hormone synthesis -> gynecomastia
Clotrimazole
Antifungal

Mech: inhibit ergosterol synthesis by inhibiting P450

Ind: topical fungal infections
Tox: not a big problem when topical!
Miconazole
Antifungal

Mech: inhibit ergosterol synthesis by inhibiting P450

Ind: topical fungal infections
Tox: not a big problem when topical
Itraconazole
Antifungal

Mech: inhibit ergosterol synthesis by inhibiting P450

Ind: systemic mycoses.
Sporothrix!
Tox: hepatotox (inhibits P450!)
Inc. effect of drug metabolized by P450
Inhibits hormone synthesis -> gynecomastia
Voriconazole
Antifungal

Mech: inhibit ergosterol synthesis by inhibiting P450

Ind: systemic mycoses.
Tox: hepatotox (inhibits P450!)
Inc. effect of drug metabolized by P450
Inhibits hormone synthesis -> gynecomastia
Flucytosine
Antifungal

Mech: converted to 5-fluorouracil (think: cancer drugs), inhibits DNA/RNA synthesis

Ind: systemic infections (Candida, Cryptococcus, etc)
In combo with amphotericin B
Tox: myelosuppression!
Nausea, vomiting, diarrhea
Caspofungin

Hint: C-ASP-ofungin
Antifungal

Mech: inhibit synthesis of betal glucan -> inhibit cell wall synthesis

Ind: invasive aspergillosis
Tox: minimal. GI upset, flushing.
Terbinafine
Antifungal

Mech: inhibits squalene epoxidase -> blocks ergosterol

Ind: dermatophytoses, esp. onychomycosis
Can also use systemically (oral)
Tox: ?
Griseofulvin
Antifungal

Mech: blocks microtubule function, inhibits mitosis

Ind: oral for superficial infections
Inhibits dermatophytes
Tox: increases P450! Check LFTs, drug interactions (e.g., warfarin)
Teratogenic, carcinogenic

Special: dewposits in keratin-containing tissues; makes nails resistant to fungal infxn, but not until nail grows out entirely (~6 mos!)
Amantadine
Antiviral

Mech: blocks viral penetration & uncoating (via M2 protein)
Causes dopamine release

Ind: used to be used for influenza A; useless now
Parkinson's
Tox: anti-cholinergic effects
Ataxia, dizziness, slurred speech

Res: mutated M2 protein
Rimantidine
Antiviral

Mech: blocks viral penetration & uncoating (via M2 protein)
Causes dopamine release

Ind: used to be used for influenza A; now resistance makes it pointless
Tox: less than amantadine! Does not cross BBB
BUT - can't use it for Parkinson's
Zanamivir
Antiviral

Mech: inhibit influenza neuraminidase -> blocks release of new virions

Ind: influenza A & B, H1N1, H5N1
Resistance growing; only used when necessary.
Oseltamivir
Antiviral

Mech: inhibit influenza neuraminidase -> blocks release of new virions

Ind: influenza A & B, H1N1, H5N1 (avian flue)
Resistance growing; only used when necessary.
Ribavirin
Antiviral

Mech: competitively inhibits IMP dehydrogenase -> inhibits guanine synthesis

Ind: RSV, chronic hepatitis C
Tox: hemolytic anemia
Severe teratogen

ONLY for use in adults!!
(& since when do they get RSV?)
Acyclovir
Antiviral - herpes

Mech: guanosine analog, activated by HSV/VZV thymidine kinase.
Inhibits DNA Pol (preferentially viral) -> chain termination

Ind: HSV, VZV, EBV
Treat within 24-48 hrs if possible!
HSV-induced mucocutaneous/genital lesions or encephalitis
Prophylaxis for immunocompromised
Only against active forms; no effect on latent virus
Tox: not bad.

Res: lack of viral thymidine kinase
Valacyclovir
Antiviral - herpes

Mech: guanosine analog, activated by HSV/VZV thymidine kinase.
Inhibits DNA Pol (preferentially viral) -> chain termination

Ind: HSV, VZV, EBV
Treat within 24-48 hrs if possible!
HSV-induced mucocutaneous/genital lesions or encephalitis
Prophylaxis for immunocompromised
Only against active forms; no effect on latent virus
Tox: not bad.

Res: lack of viral thymidine kinase
Famciclovir
Antiviral - herpes

Mech: guanosine analog, activated by HSV/VZV thymidine kinase.
Inhibits DNA Pol (preferentially viral) -> chain termination

Ind: HSV, VZV, EBV
Treat within 24-48 hrs if possible!
Good for herpes zoster!
HSV-induced mucocutaneous/genital lesions or encephalitis
Prophylaxis for immunocompromised
Only against active forms; no effect on latent virus
Tox: not bad.

Res: lack of viral thymidine kinase
Ganciclovir
Antiviral - herpes

Mech: guanosine analog. Activated by CMV viral kinase or HSV/VZV thymidine kinase
Inhibits viral DNA Pol

Ind: CMV, especially if immunocompromised
2nd line for other herpes viruses
Tox: serious!
Leukopenia, neutropenia, thrombocytopenia
Renal tox

Res: mutated DNA Pol, lack of viral kinase
Foscarnet
Antiviral - herpes.
"3rd line"

Mech: pyrophosphate analog. Inhibits viral DNA Pol
Needs no activation

Ind: CMV retinitis in immunocompromised pts when ganciclovir fails
acyclovir-resistant HSV
Tox: nephrotox
Dec. seizure threshold (via renal wasting of Mg & chelation of Ca)

Res: mutated DNA Pol
Saquinavir

Hint: -navir
Protease inhibitor

Mech: inhibits protease -> inhibits cleavage of HIV polypeptide -> inhibits assembly of virions

Ind: HIV/AIDS, HAART therapy
Tox: hyperglycemia, lipodystrophy (fat redistribution), diabetes mellitus
Inhibits P450 (might enhance other HAART drugs!)
GI intolerance
Ritonavir
Protease inhibitor

Mech: inhibits protease -> inhibits cleavage of HIV polypeptide -> inhibits assembly of virions

Ind: HIV/AIDS, HAART therapy
Tox: lipodystrophy (fat redistribution)
Inhibits P450 (might enhance other HAART drugs!)
Pancreatitis, GI intolerance
Indinavir
Protease inhibitor

Mech: inhibits protease -> inhibits cleavage of HIV polypeptide -> inhibits assembly of virions

Ind: HIV/AIDS, HAART therapy
Tox: hyperglycemia, lipodystrophy (fat redistribution), diabetes mellitus
Inhibits P450 (might enhance other HAART drugs!)
Thrombocytopenia, nephrolithiasis (renal stones)
GI intolerance
Nelfinavir
Protease inhibitor

Mech: inhibits protease -> inhibits cleavage of HIV polypeptide -> inhibits assembly of virions

Ind: HIV/AIDS, HAART therapy
Tox: lipodystrophy (fat redistribution)
Inhibits P450 (might enhance other HAART drugs!)
GI intolerance
Amprenavir
Protease inhibitor

Mech: inhibits protease -> inhibits cleavage of HIV polypeptide -> inhibits assembly of virions

Ind: HIV/AIDS, HAART therapy
Tox: hyperglycemia, lipodystrophy (fat redistribution), diabetes mellitus
Inhibits P450 (might enhance other HAART drugs!)
GI intolerance
Lopinavir
Protease inhibitor

Mech: inhibits protease -> inhibits cleavage of HIV polypeptide -> inhibits assembly of virions

Ind: HIV/AIDS, HAART therapy
Tox: lipodystrophy (fat redistribution)
Inhibits P450 (might enhance other HAART drugs!)
GI intolerance
Atazanavir
Protease inhibitor

Mech: inhibits protease -> inhibits cleavage of HIV polypeptide -> inhibits assembly of virions

Ind: HIV/AIDS, HAART therapy
Tox: lipodystrophy (fat redistribution)
Inhibits P450 (might enhance other HAART drugs!)
GI intolerance
Zidovudine (ZDV)
Nucleoside Reverse Transcriptase Inhibitor (NRTI)

Mech: competitively inhibit nucleotide binding to reverse transcriptase -> end DNA chain
Requires phosphorylation by TK

Ind: HIV/AIDS, HAART
Prophylaxis (e.g., needle stick injury, pregnancy)
Tox: myelosuppression (don't add ganciclovir!) - can be reversed with G-CSF & EPO
Megaloblastic anemia, lactic acidosis, GI intolerance
Didanosine (ddI)
Nucleoside Reverse Transcriptase Inhibitor (NRTI)

Mech: competitively inhibit nucleotide binding to reverse transcriptase -> end DNA chain
Requires phosphorylation by TK

Ind: HIV/AIDS, HAART
Tox: pancreatitis, hepatic steatosis, lactic acidosis
Peripheral neuropathy
Zalcitabine (ddC)
Nucleoside Reverse Transcriptase Inhibitor (NRTI)

Mech: competitively inhibit nucleotide binding to reverse transcriptase -> end DNA chain
Requires phosphorylation by TK

Ind: HIV/AIDS, HAART
Tox: pancreatitis, lactic acidosis
Peripheral neuropathy
Stavudine (d4T)
Nucleoside Reverse Transcriptase Inhibitor (NRTI)

Mech: competitively inhibit nucleotide binding to reverse transcriptase -> end DNA chain
Requires phosphorylation by TK

Ind: HIV/AIDS, HAART
Tox: pancreatitis, lactic acidosis, hepatic steatosis
Peripheral neuropathy
Lamivudine
Nucleoside Reverse Transcriptase Inhibitor (NRTI)

Mech: competitively inhibit nucleotide binding to reverse transcriptase -> end DNA chain
Requires phosphorylation by TK

Ind: HIV/AIDS, HAART
Prophylaxis for occupational exposure (e.g., needle stick injury)
Tox: lactic acidosis
Occasional peripheral neuropathy
Abacavir
Nucleoside Reverse Transcriptase Inhibitor (NRTI)

Mech: competitively inhibit nucleotide binding to reverse transcriptase -> end DNA chain
Requires phosphorylation by TK

Ind: HIV/AIDS, HAART
Tox: hypersensitivity reactions
Nevirapine
Non-Nucleoside Reverse Transcriptase Inhibitor (NNRTI)

Mech: NON-competitively binds reverse transcriptase -> end DNA chain
Does not need phosphorylation

Ind: HIV/AIDS, HAART
Tox: rash
Efavirenz
Non-Nucleoside Reverse Transcriptase Inhibitor (NNRTI)

Mech: NON-competitively binds reverse transcriptase -> end DNA chain
Does not need phosphorylation

Ind: HIV/AIDS, HAART
Tox: rash, confusion
False positive drug test to cannabinoids
Declaviridine
Non-Nucleoside Reverse Transcriptase Inhibitor (NNRTI)

Mech: NON-competitively binds reverse transcriptase -> end DNA chain
Does not need phosphorylation

Ind: HIV/AIDS, HAART
Tox: rash
Enfuvirtide
Fusion inhibitor

Mech: binds viral gp41, inhibits conformation change needed to fuse with CD4 cells
Blocks entry & replication

Ind: HIV/AIDS, HAART
2nd line - for pts with persistent viral replication
Tox: hypersensitivity, reactions at injection site
Inc. risk of bacterial pneumonia
IFN-α
Interferon

Mech: synthesized by virally-infected cells
Block RNA/DNA viral replication

Ind: chronic HBV or HBC
Kaposi's sarcoma (HHV-8)
Tox: neutropenia
IFN-β
Interferon

Mech: synthesized by virally-infected cells
Block RNA/DNA viral replication

Ind: multiple sclerosis
Tox: neutropenia
IFN-γ
Interferon

Mech: synthesized by virally-infected cells
Block RNA/DNA viral replication

Ind: NADPH oxidase deficiency

Not sure what that has to do with viruses...
Tox: neutropenia