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30 Cards in this Set

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Acyclovir general
-oral not as good 15-30% of dose
-IV higher levels
-distribution excellent with modest levels in CSF
-renal excretion, adjust dose in renal failure
-drug-drug not major problem but if in combination with another renal drug the other drug will hang around more.
Acyclovir uses
Immunocompromised hosts
-HSV (herpes simplex)
-HZV (herpes zoster)

Non-immonocompromised hosts
-HSV primary and recurrent genital lesions, neonatal, etc.
-Varicella-zoster
Acyclovir toxicity
Wide window so its safe
IV phlebitis
neurotoxicity if don't adjust in renal failure patients

IV doses given for more severe patients.
Not given to children under age of 2 and its a category C agent.
Expensive
Resistnace can occur especially in HIV + patients.
Acyclovir MOA
Thymidine kinase (TK) AKA viral kinase. This enzyme is made by the virus and it helps to make acylclovir become a variant DNA bulding block which competes with viral DNA synthesis and gets incorporated into replicating viral DNA causes DNA disruption.
Ayclovir competitors are?
Famciclovir and Valacyclovir
Famciclovir general
3x a day treatment as opposed to acyclovir once a day. Category B and adjust in renal failure. Well absorbed.
Valacylovir general
2x a day treatment as opposed to acyclovir once a day treatment. Adjust in renal failure. Thrombotic thrombocytopenia purpura (TIP) in high dose in patients. Might be used in pregnancy.
Amantadine general
Used to prevent and treat influenza A
only oral
kidney elimination, reduce dose in renal failure
Amantadine toxicity
increases with age CNS effects
anticholinergic affects like dry mouth and such
Amantadine MOA
to inhibit viral uncoating
Rimantadine general
just like amantadine and used for influenza type A
most expesnive
Drugs that prevent viral uncoating are?
Rimantadine and Amantadine
Neuraminidase inhibitor drugs are?
Zanamivir and Osteltamivir
What is the MOA of zanamivir and osteltamivir?
Blocks viral release from the cell
zanamivir general
inhaler made
bronchospam in some patients with its use
no drug-drug
expensive and improvment within 24 hours of onset. take off a day they say.
therapy for influenza type A and B
Osteltamivir general
use to prevent and treat influenza type A or B
well tolerated
useful in high risk patients
if start within 24 hours of onset will get a 24-36 hour decrease in symptom time. like zanamivir.
What viral drugs used in aids related patients?
Foscarnet and Ganciclovir
Ribaviron general
used for RSV bronchitis and pneumonia in children. Aerosol forms. Rarely used cause not needed and cost $1k a day.
Oral form with interferon used in select cases of HCV $16K a year.
Superificial skin year use what drug?
clotrimazole 1%
Yeast vaginitis use what drug?
OTC clotrimazole or clotrimazole 1% or tables intravaginally or fluconazole
penile superficial yeast infection in diabetes called balantis
oral fluconazole
amphoterricin B MOA
considered the big gun
ampho b bindsd to ergosterol which is found in the membranes of fungi allowing leakage of the pores causing fungal death
amphoterricin B general
IV must use
elimination via biliary
goes to tissues, organs and CSF
NEPHROTOXICITY IS BIG CONCERN with good IV hydration risk is decreased
Hypokalemia: renal tubular defect in 25%
Fever and chills which can be reduced with use of other drugs.
Vomiting, nausea, anorexia
what drugs are given to counteract amphoterricin B side effects?
pre-treat acetmoinophen
diphenyhydramine HCL
meperidine
NSAIDS
Flucytosine + amphoterricin B are DOC for?
CNS cryptococcal infections
Flucytosine general
oral only
distributes well and into CSF
urine excretion adjust in renal failure
not used for monotherapy at all
Flucytosine toxicity
overdose can cause luekopenia and thrombocytopenia
gi upset
hepatic enzyme elevation
Fluconazole general
alternative to ampho B
adjust dose in renal failure
IV/oral
single dose treatment for yeast vaginitis
AIDS patients rx and supress candidad and cryptococcus

Side effects:
GI upset and rashes
Ketoconazole general
seldom used b/c of to many drug-drug interactions and side effects. Include GI, decreased test levels and gynecomastia
Voriconazole use and MOA
Used for invasive asperigillus. many drug drug interaction and it is metabolized via p450. inhibits lanoesterol from going to ergosterol.