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180 Cards in this Set
- Front
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azole toxicity
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Endocrine (imidazoles like keto- but not triazoles like itra- flu- vori-)
Liver GI |
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fluconazole toxicity
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Fetopathy
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Itraconazole toxicity
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ITRaconazole
hyperTRIglyceridemia hypokalemia |
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Posiconazole toxicity
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decreased Potassium
decreased Platelet count |
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Voriconazole
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Visual disturbance and color alteration
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enzyme that azoles inhibit
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p450 enzume
C14 alpha sterol demethylase normally conversta lanosterol to ergosterol for the cell wall membrane |
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drug for mucocutaneous candidiasis
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fluconazole
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drug of choice for cryptococcal memingitis
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fluconazole
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rose gardners disease
thorn prick |
sporotrox schenki
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breathing difficulties
arthralgias erythema nodosum was out in the southwest US |
Coccidioides
Valley Fever |
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was in caves in Missouri
weakness sores calcifications in body |
Histoplasma
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weakness
night sweats sores was east of the mississippi or in central america |
blasto
pneumonia or systemic |
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thick white pharyngeal membrane
can progress to paiful swallowing |
Candida
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India ink stain
exposure to birds headache, stiffneck |
Crypto
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yeast inside macrophage
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Histo
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thick walled budding yeast
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blasto
blast a wall blast a bud |
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pseudyhyphae and budding yeasts
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candida
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cysts on cilver
dark oval bodies in cysts (sporozoites) |
pneumocystis
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45 degree branching
clumps of spores |
Aspergillus
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cigar shaped
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sprotrichosis
rose gardners' disease Gardner lights up a cigar |
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most common drugs for fungi
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amphotericin
itraconazole |
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drug for cryptococcus
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fluconazole
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drug for pneumocystis
acute prophylaxis |
TMP SMX
prophylaxis with TMP SMX pentamdine dapsone |
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drug for aspergillos
allergic balls invasive |
allergic - corticosteroids
ball - surgical removal invasive - amphotericin |
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drug for severe fungal infections
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amphotericin
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moa for amphotericin
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binds ergosterol
creates hydrophilic pore in cell wall and things like K+ seep out |
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main toxicity of amphotericin
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Renal
- tubular acidosis - anemaia with decreased EPO |
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antidote for azotemia caused by aphotericin
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sodium loading
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moa for nystatin
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binds ergosterol (like amphotericin)
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moa of caspofungin
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inhibits Beta glucan synthase, preventing formation of chitin in the fungal cell wall
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antifungal that causes flushing, facial swelling and pruritis due to increased histamine release
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caspofungin
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rx for prophyllaxis of invasive aspergillus
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posaconazole
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moa of griseofulvin
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microtubule inhibition
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use for griseofulvin
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dermatophytoses (2nd line)
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rx causing B6 depletion and neuropathy
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isoniazid
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drug causing Na+ channel blockade and neuropathy
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phenytoin
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drug causing dissassebly inhibition of microtubules and neuropathy
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paclitaxel
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drugs causing microtubule assembly inhibition oand neuropathy
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colchicine
griseofulvin vincristine mebendazole, albendazole, thiobendazole |
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side effect of stavudine
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neuropathy
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rx for nail fungi
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terbinafine
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moa of terbinafine
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inhibition of squalene metabolism by inhibiting squalene eopoxidase, which blocks ergosterol synthesis
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moa of flucytosine
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inhibits 5duMPs action on thymidilate synthase in inhibits purines and DNA replication
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use of flucytosine
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cocco
candida |
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moa of cyclovirs, e.g., acyclovir
(difference with gancyclovir) |
inhibits viral DNA polymerase
activated first by VIRAL thymidine kinase and then host kinase in case of ganciclovir the viral kinase is phosphotransferase UL97 |
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ganciclovir side effects
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nutropenia, granulocytopenia
neurotoxicity |
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rx for CMV retinitis
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gangiclovir
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antivirals against herpesviruses that need only host kinase
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cidofovir
trifuluridine |
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antivarials agaisnt herpesviruses that need neither host nor viral kinase
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foscarnet (acts like the -virs)
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moa of fomivirsen
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it's an antisense oligonucleotide that disrupts protein synthesis by blocking CMV mRNA
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cidofovir toxicity and antidote
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nephrotoxic
probenecid |
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moa of enfuvirtide
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fusion blockade
binds gp41 |
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what's the main capsid protein in hiv
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p24 gag
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what's inside the HIV capsid
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RT and Integrase
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what's in between the HIV capside and envelope
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protease
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moa of AZT (Zidovudine)
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RT inhibition
deoxythymidine analog phosphorylated by host kinase into activeform that can inhibit RT |
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which HIV drugs need host kinases
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the NRTIs (one N only)
AZT and the -vudines didanosine abacavir Zalcitabine |
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drug for prophylaxis of HIV transmisstion from mother to fetus
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zidovudine (AZT)
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drug that causes pigmentized nails and insomnia
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AZT - Zidovudine
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the bone the muscle and the head of the PIG
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AZT side effects
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NRTIs both inhibit RT and?
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terminate chain elongation
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HIV med that causes
peripheral neuropathy acidosis pancreatitis |
didanosine
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AZT
d4T 3TC ddI ddC |
Zidovudine
Stavudine Lamivudine Didnosine AzlCitabine |
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What kind of analog is AZT
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deoxythymidine
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what kind of analog is stavudine
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thymidine
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what kind of analog is abacavir
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guanosine
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what kind of analog is zal citabine
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cytosine
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toxicity of abacavir
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Allergy without rechallenge
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why do stavudine and zidovudine decrease each other's action
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both require thymidine kinase for phosphorylation
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common NRTI side effects (especially stavudine, didanosie, zalcitabine)
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with starving:
peripheral neuropathy lactic acidosis with overeating: pancreatisis hepatomegaly with steatosis |
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what are the -navirs
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protease inhibitors
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moa of protease inhibitors
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inhibit assembly of the new virus
cleave Gog-Pol polyprotein blocking protease in progeny virions (it seems like capsid does not form properly) |
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moa of tenofovir
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ints a Nucleotide inhibitor (vs NRTI or NNRTI
RT inhibition and chain elongation termination |
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which HIV drugs can block RT directly, without needing host kinase
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NNs No Need
They work at the END, after hosts would have Efavirenz Nevirapine Delavirdine |
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NNRTI side effects
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p450 substrates (delavirdine and efavirenz also induce and inhibit)
SJ |
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NNRTI that decreases maternal transmission to newborns
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NE(w)virapine
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protease inhibitor side effects
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cushingoid
hyperglycemia hyperlipidemia |
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HIV med that causes cushingoid
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protease inhibitors
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unique side effect of indinavir
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nephrolithiasis adn crystalluria
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unique side effect to amprenavir
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I AM PREtty except for my...
SJ rash |
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which HIV drug to be careful of in hemophiliacs
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protease inhibitor
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protease inhibitors P450 status
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substrate and inhibitor
CYP3A4 |
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what doe HBV have inside its nucleocapsid
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DNA dependent DNA polymerase
(Because a B is like two Ds) partial double stranded viral DNA genome |
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what is the HBV core nucleocpasid made of
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HBcAg
HbeAg |
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what is the envelope made of
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HBsAg
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moa of lamivudine
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HIV and HBV viral RT inhibitor
cytosine analog phosphorylated by host kinase (to 3TC) inhibits RT (HBV or HIV) |
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lamivudine is used for
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HBV and HIV
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first line choice for HBV
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lamivudine
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drug that can cause a stable HBeAg seroconversion
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lamivudine
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rx that can decrease hepatic inflammation and fibrosis in HV
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lamivudine
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us of Ribavirin
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chronic hep C
RSV |
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MOA of ribavirin
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guanosine analog
activated by host kinase phosphorylation inhibits synthesis of -GTP -viral mRNA |
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toxicity of ribavirin
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decreased RBCs
Teratogen |
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drugs for RSV
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ribavirin
palivizumab (agaisnt RSV fusion protein) |
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use and moa of Adefovir
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HBV
phosphorylated by host kinase to inhibit mRNA synthesis |
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meds for HBV
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lamivudine
adefovir |
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use of interferon alpha
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HBV
HCV condylomata acumanatum hairy cell, Kaposi's, follicular, melanoma |
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moa of interferon alpha
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inhibits viral replication by inducing antiviral enzymes in UNinfected cells
increased MHC I on INfected cells and promotion of CTL killing increased activity of NKs |
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use of interferon Beta and Gamma
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Brain disease, MS
Granulomatous CGD |
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what's inside the flue nucleus
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RNA polymerase and RNA segments
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moa of amantadine
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interferes with M2 matrix protein
prevents acidification of the endosome and uncoating |
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moa of zanamavir and oseltamavir
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neuraminidase inhibitors that block neuraminidase
zanamivir directly inhibits it oseltamivir is a prodrug that has to be converted by hydroxylation |
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manin Louisiana
coughing fever abdominal pain pulmonary infiltrates intestinal obstruction increased eosinophils microscopic oval aigs with rough surfaces |
ascaris lumbricoides
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tx for ascaris
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pyrantel
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bug for pinworm
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enterobius
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scolex with no hooks
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Sage and wise not to have hooks
beef tapeworm taenia saginata (the beef is wise) |
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tx for beef tapeworm (taenia saginata)
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nicosamide
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scolex with hooks and sucker
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taenia solium (pork tapeworm)
and Echinococcus (dog tapeworm) |
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vietnamese immigrant
severe headaches and seizure 5 calcified cysts in brain high eosinophils |
pork tapeworm
taenia solium |
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rx for taenia solium
GI Tissues |
GI - niclosamid
tissue - paziquantal |
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larvae in vitreous humor o eyes
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cysticercosis
taenia solium pork tapeworm |
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pig farmer
muscle aches fever periorbital and facial edema diarrhea 2 weeks previous high eosinophila and IgE |
trichinosis
from pigs |
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pigs
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trichinosis
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snails
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schistosomiasis
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black fly
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river blindness, onchocerciasis
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uncooked meat
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trichiniosis
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cysts with larvae in skeletal muscle
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trichinosis
pigs pigs in a blanket |
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3 proglottids
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echinococcus
and doggy makes three |
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large circular mass in the liver with multiple daughter cysts encapsulated by "eggshell" calcifications
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echinococcus
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danger of echinococcus tx
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rupture
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rx for echinococcus
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albendazole
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rx for trichinosis
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mebendazole
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high eosinophils
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think helminths
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helminths that can enter through feet
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strongyloides
necator ancylostoma schistosomes |
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helminth that causes anemia
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hookworm
(ancylostoma or necator) |
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tx for hookworm
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mebendazole
iron and folic acid |
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adult male and femail paired helminths
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schistosomes
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esophageal varices
stool specimens have eggs |
schistosomiasis
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bladder with inflammatory lesions
eggs in urine hydronephrosis of right kidney |
schostosomes
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how do adult schistosomes trick the immune system
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evasive coating trick - take on host antigens
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microfilaria in skin
microfilaria in blood |
onchocerca volvulus
river blindness wuchereria bancrofti filariaasis and elephantiasis |
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elephantiasis
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wuchereria bancrofti
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enourmously swollen scrotum and lower extremeity
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elephantiasis
wuchereria bancrofti |
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tx for elephantiasis
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diethylcarbamazine (agaisnt microfilariae only)
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tx for riverblindness
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ivermectin
surgical removal of nodules |
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skin nodules
hyperpigmented rashes blind |
river blindness
onchocerca volvulus |
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infects venous plexi
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schistosomes
especially in intestine and bladder |
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moa of the bendazoles
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microtubule inhibition
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rx for neurocysticercosis
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albendazole
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rx for cystic hydatid disease
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albendazole
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rx for worms (pin, hook, round, whip)
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mebendazole
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rx for strongyloides
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ivermectin
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moa of praziquantel
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PraziQUANTel - Prazi - Quantitiy of Calcium
lets Ca through the plasma membrane spastic paralysis and removal of worms |
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doc for schostomiasis
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praziquantel
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what is efect of concurrent use of corticosteroids on praziquantel
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increases
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meningismus and seizures after administration of this rx for port tapeworms
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praziquantel
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moa of pyrantel
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depolarizing NMJ blockade
by inhibiting AchE promoting Ach release (sodium channel) this expels roundworms |
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use of pyrantel
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worm infections (but not Whip!!)
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moa of ivermectin
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Ivermectin on the gluc-I
activates invertebrate glutamate-gated Cl channel (GLUCI) hyperpolarization and paralysis |
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difference between Ivermectin and praziquantel
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praziquantel paralyses via Calcium
Ivermectin paralyses via Cl |
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doc for river blindness
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ivermectin
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rx used for riverblindness
fever headache myalgia arthralgia, diarrhea, somnolence hypotension, bronchospasm what med given? what antidote |
Ivermectin for river blindness
give steroids this is the Mazzotti reaction |
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moa of chloroquine
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inhibits meozoin formation
heme accumulation kills schizonts |
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doc for malaria of all species except resistant falciparum
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chloroquine
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cinchonisms
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quinidine
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rx for multidrug resistant falciparum malaria
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quinidine
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moa of primaquine
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kills schizonts in the liver
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blackwater fever
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caused by quinine
massive hemolysis and hemoglobinemia and hemoglobinuria leading to renal failure |
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antibiotics used in malaria
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used for falciparum, along with chloroquine
doxycycline clindamycin Fansidar |
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moa of propylthiouracil
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inhibits synthesis and release of thyroid hormone
peripheral deiodoination inhibitor (this is the part of ptu's action that methimazole does not do) |
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moa of methimazole
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inhibits synthesis and release of thyroid hormones
(but not deiodination) |
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PTU side effects
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AASSH
agranulocytosis alopecia Skin rash SLE-like hepatitis |
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med to give priori to thyroidectomy
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iodide
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tx of thyroid storm
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beta blockers (propranolol)
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deiodination inhibitors
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PTU
propranolol glucocorticoids |
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moa of ketoconazole
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blocks P450SCC
also an azole |
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rx postcoital contraception
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mifepriston
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blackwater fever
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caused by quinine
massive hemolysis and hemoglobinemia and hemoglobinuria leading to renal failure |
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antibiotics used in malaria
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used for falciparum, along with chloroquine
doxycycline clindamycin Fansidar |
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moa of propylthiouracil
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inhibits synthesis and release of thyroid hormone
peripheral deiodoination inhibitor (this is the part of ptu's action that methimazole does not do) |
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moa of methimazole
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inhibits synthesis and release of thyroid hormones
(but not deiodination) |
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PTU side effects
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AASSH
agranulocytosis alopecia Skin rash SLE-like hepatitis |
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med to give priori to thyroidectomy
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iodide
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tx of thyroid storm
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beta blockers (propranolol)
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deiodination inhibitors
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PTU
propranolol glucocorticoids |
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moa of ketoconazole
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blocks P450SCC
also an azole |
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rx postcoital contraception
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mifepriston
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moa of mifepristone
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progesterone receptor blockade
glucocorticoid receptor blockade |
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moa of aledronate
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decrease osteoclast-mediated Ca++ resorption
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rx for hpercalcemia
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etidronate or pamidronate
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rx for Paget's
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aledronate
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