Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
73 Cards in this Set
- Front
- Back
|
What is considered the best anti-TB drug?
|
Isoniazid
|
|
|
How is Isoniazid metabolized?
Acetyl Transferase Polymorphism? |
Acetylation in the liver and excreted in the urine.
People can be fast or slow acetylators |
|
|
What is the most common side effect of isoniazid?
|
Neuropathy
|
|
|
What does Isoniazid do to the liver?
What are the symptoms? What potentiates hepatotoxicity? |
Hepatotoxicity
Fatigue, nausea, anorexia, yellow skin Alcohol, Rifampin, Pyrazinamide |
|
|
What does Isoniziad do to the p450 system?
|
Inhibits p450 so it will increase levels of other drugs
|
|
|
What are included in the Rifamycin family?
What kind of drugs are they? |
Rifampin
Rifapentine Rifabutine Family of broad spectrum antibiotics |
|
|
How is the absorption of rifamycin?
How is the distribution of rifamycin? |
They are well absorbed in the GI (Rifampin in the absence of food)
They are well distributed to body tissues and fluids including CSF. |
|
|
What is the mechanism of action of Rifamycins?
|
They inhibit bacterial RNA-polymerase blocking protein syntehsis. They are selective since it doesn't act on mammalian RNA polymerase
|
|
|
Bacterial resistance of rifamycins.
|
Occurs quickly by protein mutations that reduce the affinity of RNA-polymerase to these drugs.
|
|
|
How are rifamycins eliminated?
|
Hepatic Metabolism
|
|
|
What types of infections can Rifamycins treat?
|
TBC, MAC, Leprosy, and short term treatment of nasopharynx infection caused by Neissara menigitdis and MRSA
|
|
|
What do rifamycins do to the P450 system?
|
Strongly induces them
|
|
|
What is pyrazimide?
|
Bactericidal for M. Tuberculosis
|
|
|
How is pyrazimide metabolized?
|
Well absorbed in GI. Metabolized to 5-OH pyrzinoic acid and excreted by kidneys.
|
|
|
What is ethambutol?
|
It is a bacteriostatic drug effective only against M. Tuberculosis.
|
|
|
What is the mechanism of action of Ethambutol?
|
Blocks the incorporation of mycolic acid to the cell wall.
|
|
|
How is ethambutol metabolized?
|
Absorbed well in the GI. Excreted by Kidneys. It inhibits renal excretion of uric acid.
|
|
|
What are side effects of Ethambutol?
|
Dose related optic neuritis: Blurred vision
Disturbance of color discrimination Allergic Reactions: Pruritis Dermatitis GI Disturbances |
|
|
What is the difference between first line and second line drugs of TB?
How are they used? |
2nd line drugs are more toxic and less effective.
In combo with first line drugs to treat pulmonary and disseminated tb. |
|
|
Describe Aminosalicylic acid.
|
Analog of PABA.
Mechanism is similar to sulfonamides. Only effective towards M. Tb A bacteriostatic drug. |
|
|
Metabolism of Aminosalicylic acid?
|
Absorbed from GI, and excreted in urine.
|
|
|
SE of Aminosalicylic acid?
|
Main: GI disturbances
Other: Allergic reactions, goiter, and hepatoxicity. |
|
|
Describe Ethionoamide
|
Prodrug only active against M Tb.
Structurally similar to Isoniazid |
|
|
What is the mechanism of action of Ethionamide?
|
Disruption of mycolic acid synthesis
|
|
|
SE of Ethionamide?
|
Hepatotoxic
GI disturbances |
|
|
What type of drug is cycloserine and how does it work?
|
It is a bacteriostatic drug. It inhibits enzymes involved in cell wall synthesis
|
|
|
What is cycloserine used for?
|
Treat drug resistant TB.
|
|
|
SE of Cycloserine?
|
CNS Effects
Peripheral neuropathy Hepatoxicity Folate Deficiency |
|
|
Capreomycin (Describe)
|
Cyclic Peptide related to aminoglycosides antibiotics
Inhibits protein synth of mycobacterium Combo with first line TB drugs to treat drug resistant TB. Cranial Nerve toxicity. Nephrotoxic. |
|
|
Kanamycin and Amikacin (Describe)
|
Aminoglycoside antibiotics
Combo with first line drugs to treat drug resistant TB |
|
|
Ofloxacin and Ciproflaxcin (Describe)
|
Fluroquinolone antibiotics.
Combo with first line drugs to treat drug resistant TB Prophylaxis |
|
|
What are the two classes of leprosy?
|
Paucibacillary (PB)
Multibacillary (MB) - skin lesions |
|
|
What must you do with drugs therapy if there is a chance of resistance?
|
Use a combination therapy
|
|
|
Describe Dapsone
|
Related to sulfonamides and has similar mechanism of action. Bactericidal or bacteriostatic.
To avoid resistance it is used with Rifamin and Clofazimine |
|
|
SE of Dapsone
|
Se: N/V, anorexia, HA, Rashes
Like sulfonamides it can cause hemolytic anemia |
|
|
Describe Clofazimine
|
bactericidal
Used in combo with Dapsone and Rifampin |
|
|
Metabolism of Clofazimine
|
Absorbed partially in GI. Retained in tissue for a long time. Very long t1/2
|
|
|
SE of clofazimine
|
Red pigmentation of Skin and conjunctiva, may discolor, urine sweat, tears, and saliva
Can cause intestinal pain and obstructions |
|
|
What is a common infection in HIV patients?
|
MAC usually caused by M. avium or M. Intracellulare.
|
|
|
Where does the MAC infection usually reside and where does it spread in HIV patients?
|
Usually limited to Lungs and GI.
In HIV spreads to: Blood, bone marrow, liver, spleen, brain, kidney, and skin |
|
|
SE of Rifabutin
|
Rash, GI upset and Neutropenia
Can produce brown-orange color in urine, sweat, tears and saliva Uveitis have occured in patients taking Rifabutin in combo with clarithromycin. |
|
|
What does Rifabutin do to p450 system?
|
Induces it
|
|
|
What is ribabutin prescribed for?
|
Prophylaxis of MAC
|
|
|
What does clarithromycin do to p450?
|
Inhibits
|
|
|
What does azithromycin do to p450?
|
Does not inhibit
|
|
|
What is the drug therapy for treating disseminated MAC?
|
Ethambutol + one of those macrolides
|
|
|
How does amphotericin B work?
|
Binds to ergosterol and causes membrane leakages. (K+)
Fungicidal or fungistatic |
|
|
SE ofAmphotericin B
|
Nephrotoxic
|
|
|
Route of administration of Amphotericin B
|
Is not absorbed in GI so must be given IV.
If fungal meningitis then it must be intrathecal |
|
|
SE of Amphotericin B when it is being administrated?
What can do you before you administer? |
Fever, chills, rigors, nausea, HA.
Pretreat with aspirin or acetaminophen |
|
|
What drug causes a synergistic effect with AmphotericinB?
|
Flucytosine
|
|
|
What does nystatin treat? and why is this so?
|
GI fungal infections (Candidiasis) since it is not absorbed in GI tract.
|
|
|
What is the mechanism of action of Imidazles and triazoles?
|
Inhibit enzyme needed during egrosterol synthesis.
Fungicidal or static |
|
|
What do aozles do to p450?
|
Inhibits
|
|
|
What must patients avoid taking when on Keoconazole?
|
PPI, antacids etc.
This drug needs acidic environemnts |
|
|
How is ketoconazole metabolized?
|
Metabolized in liver excreted in bile.
|
|
|
SE of Ketoconazole
|
Hepatoxocitiy
This drug inhibits steroid synth so there will be endocrine SE. |
|
|
Parenteral Administeration of Miconzaole can cause?
|
Phlebitis
Nausea Rash Vomiting Thrombocytosis Pruritis Fever |
|
|
What does Itraconazole treat?
|
Blastomycosis
Histoplasmosis Aspergillosis Oral/Esophageal Candidiasis Onychomycosis |
|
|
Mechanism of action of Itraconazole
|
Inhibits synthesis of Ergosterol
|
|
|
SE of itraconaozle
|
N/V Diarrhea, HA, rash, abdominal pain
Negative inotropic effect on heart |
|
|
What does fluconazole treat?
|
Oropharyngeal and Esophageal cadidiasis
Meningitis caused by Crytoccocus Neoformans and Coccidiodes Immitis |
|
|
SE of Fluconazole?
|
All the obvious ones
|
|
|
What is the mechanism of action of Caspofungin
|
inhibits 1,3-b-glucan synthase, which helps synthesize cell walls
Fungicidal against Candida ssp. |
|
|
SE of caspofungin
|
May cause histamine release
|
|
|
SE of topical Azoles
|
Skin: Erythema, Edema, Urticaria, Pruritus
Intravaginal: Burning sensation and lower abdominal cramps |
|
|
What is Griseofulvin prescribed for?
|
If topical azoles don't work.
Treats: Onychomycosis Dermatophytoses (mainly tinea capitis) |
|
|
Metabolism of Griseofulvin
|
GI absorption. Fatty foods increase absorption.
Excreted in Feces. |
|
|
SE of Griseofulvin
|
All the obvious ones
|
|
|
What does Griseofulvin do to the p450 system?
|
May induce it.
|
|
|
How do the Topical Allylamines work?
|
Inhibits Squalene 2-3 epoxidase that is used for ergosterol synth.
|
|
|
Oral terbinafine is used for?
|
Onychomycosis
|
|
|
What does Tolfnaftate work against?
|
Dermatophytic infections and not candida
|
