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30 Cards in this Set
- Front
- Back
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Acyclovir general
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-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. |
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Acyclovir uses
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Immunocompromised hosts
-HSV (herpes simplex) -HZV (herpes zoster) Non-immonocompromised hosts -HSV primary and recurrent genital lesions, neonatal, etc. -Varicella-zoster |
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Acyclovir toxicity
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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. |
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Acyclovir MOA
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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.
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Ayclovir competitors are?
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Famciclovir and Valacyclovir
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Famciclovir general
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3x a day treatment as opposed to acyclovir once a day. Category B and adjust in renal failure. Well absorbed.
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Valacylovir general
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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.
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Amantadine general
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Used to prevent and treat influenza A
only oral kidney elimination, reduce dose in renal failure |
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Amantadine toxicity
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increases with age CNS effects
anticholinergic affects like dry mouth and such |
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Amantadine MOA
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to inhibit viral uncoating
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Rimantadine general
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just like amantadine and used for influenza type A
most expesnive |
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Drugs that prevent viral uncoating are?
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Rimantadine and Amantadine
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Neuraminidase inhibitor drugs are?
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Zanamivir and Osteltamivir
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What is the MOA of zanamivir and osteltamivir?
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Blocks viral release from the cell
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zanamivir general
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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 |
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Osteltamivir general
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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. |
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What viral drugs used in aids related patients?
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Foscarnet and Ganciclovir
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Ribaviron general
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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. |
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Superificial skin year use what drug?
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clotrimazole 1%
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Yeast vaginitis use what drug?
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OTC clotrimazole or clotrimazole 1% or tables intravaginally or fluconazole
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penile superficial yeast infection in diabetes called balantis
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oral fluconazole
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amphoterricin B MOA
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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 |
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amphoterricin B general
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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 |
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what drugs are given to counteract amphoterricin B side effects?
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pre-treat acetmoinophen
diphenyhydramine HCL meperidine NSAIDS |
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Flucytosine + amphoterricin B are DOC for?
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CNS cryptococcal infections
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Flucytosine general
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oral only
distributes well and into CSF urine excretion adjust in renal failure not used for monotherapy at all |
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Flucytosine toxicity
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overdose can cause luekopenia and thrombocytopenia
gi upset hepatic enzyme elevation |
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Fluconazole general
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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 |
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Ketoconazole general
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seldom used b/c of to many drug-drug interactions and side effects. Include GI, decreased test levels and gynecomastia
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Voriconazole use and MOA
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Used for invasive asperigillus. many drug drug interaction and it is metabolized via p450. inhibits lanoesterol from going to ergosterol.
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