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;
103 Cards in this Set
- Front
- Back
|
Amphotericin B
|
Antifungal drugs (polyenes)
*directly bind to ergosterol -> form pores Uses:Systemic Mycoses: Aspergillus, Candida, Cryptococcus, Histoplasma, Mucor Cutaneous Candidiasis Adverse:- Infusion toxicity: fever, chills, muscle spasms, hypotension; Heavy nephrotoxicity -> EPO -> anemia, seizures **use lipid carriers to decrease nephrotoxicity |
|
|
Nyastatin
|
Antifungal drugs (polyenes)
*directly bind to ergosterol -> form pores Uses: candidiasis *too toxic for IV admin |
|
|
Ketoconazole
|
Antifungal (Azoles)
*inhibits 14-a-sterol demethylase -> decr ergosterol synthesis Uses: Superficial Mycoses: dermatophytoses (rarely used for systemic) Adverse: Keto: decreased libido, gynecomastia, decr potency in men, menstrual problems in females (due to P450 -> steroid synthesis) *only oral admin for systemic |
|
|
Fluconazole
|
Antifungal (Azoles)
*inhibits 14-a-sterol demethylase -> decr ergosterol synthesis Uses: (DOC): Candidiasis (Esophageal, oropharyngeal, vulvovaginal) (DOC): Coccidioides (DOC): Cryptococcal meningitis (AIDS related) Superficial dermatophytoses Adverse: ALL Azoles: Minor GI upset, Relatively nontoxic (try to use azoles before using Ampho B) **strong CYP2C9 inhib: phenytoin, zidovudine, warfarin interaction ***Good CSF penetration |
|
|
Itraconazole
|
Antifungal (Azoles)
*inhibits 14-a-sterol demethylase -> decr ergosterol synthesis Uses: Blastomyces, Sporothrix, Histoplasma Aspergillus (not really used) Superficial: dermatophytoses, onychomycosis Adverse: ALL Azoles: Minor GI upset, Relatively nontoxic (try to use azoles before using Ampho B) **strong CYP3A4 -> arrhythmias |
|
|
Voriconazole
|
Antifungal (Azoles)
*inhibits 14-a-sterol demethylase -> decr ergosterol synthesis Uses: Aspergillus, Candida, Fusarium (similar to itracon) Adverse: Visual disturbances **Inhibits CYP2C19, 2C9, 3A4 |
|
|
Posaconazole
|
Antifungal (Azoles)
*inhibits 14-a-sterol demethylase -> decr ergosterol synthesis Uses: Mucor (zygomycetes) **Inhibits CYP3A4 |
|
|
Flucocytosine
|
Antifungal (pyrimadine analog)
*converts to 5-Fluorouracil -> inhibit DNA and protein synthesis Uses: Systemic Mycoses: Cryptocococcus, Candida (Used in combo with Ampho – synergism) Adverse: Bone marrow toxicity |
|
|
Clotrimazole
|
Antifungal (Azoles)
*topical use |
|
|
Miconazole
|
Antifungal (Azoles)
*topical use |
|
|
Caspofungin
|
Antifungal (Echinocandins)
*inhib syn of B(1-3)-D glucans in cell wall Uses: Invasive Aspergillosis, Candidiaisis (HIV pts) Adverse: GI upset, flushing |
|
|
Terbinafine
|
Antifungal (Allyamine)
*inhib squalene epoxidase Uses: Tinea cruris, Tinea corporis (topical admin) Adverse: GI upsets, rash, headache **Topical & Oral Admin - Doesn’t effect P450 -> no drug interactions |
|
|
Griseofulvin
|
Antifungal
*inhibits mitotic spindle Uses:Dermatophytosis (skin, hair, nails) - Largely replaced by itraconadazole, terbinafine Adverse: Induces P450 enzymes – drug interactions (warfarin, etc.) **Oral Admin -> better absorption with Fatty foods |
|
|
Co-trimoxazole
|
Antifungal (Chemotherapy of PCP)
Uses: Pneumocystis jiroveci |
|
|
Prednisone
|
Antifungal (Chemotherapy of PCP)
Uses: Mod-severe Pneumocystis jiroveci pneumonia |
|
|
Clindamycin + Primaquine
|
Antifungal (Chemotherapy of PCP)
Uses: Alternative therapies for Pneumocystis Jirovecii (PCP) |
|
|
Dapsone + trimethoprim
|
Antifungal (Chemotherapy of PCP)
Uses: Alternative therapies for Pneumocystis Jirovecii (PCP) |
|
|
Atovaquone
|
Antifungal (Chemotherapy of PCP)
Uses: Alternative therapies for Pneumocystis Jirovecii (PCP) |
|
|
Pentamidine
|
Antifungal (Chemotherapy of PCP)
Uses: Alternative therapies for Pneumocystis Jirovecii (PCP) |
|
|
Oseltamivir
|
Antivirals - Respiratory Viruses (neuroamainidase inhibitors)
*inhibit sialic acid Uses: Influenza A/B (prevention and Tx) Adverse: GI discomfort, nausea |
|
|
Zanamivir
|
Antivirals - Respiratory Viruses (neuroamainidase inhibitors)
*inhibit sialic acid **inhaled/intranasal Uses: Influenza A/B (prevention and Tx) Adverse: airway irritation, asthma, COPD |
|
|
Amantadine
|
Antiviral - Respiratory Viruses (Ion channel Blockers)
*block viral membrane protein M2 Uses: Influenza A only Adverse:CNS: insomnia, dizzy, ataxia, cerebral atherosclerosis, NOT FOR PREGNANT, decr GI **cross BBB |
|
|
Rimantadine
|
Antiviral - Respiratory Viruses (Ion channel Blockers)
*block viral membrane protein M2 Uses: Influenza A only Adverse: decr GI **not cross BBB |
|
|
Ribavirin
|
Antiviral - Respiratory Viruses (synthetic guanosine analogue)
Uses: Broad spectrum RNA/DNA viruses: RSV, HCV, Lassa fever Adverse: dose-dependent transient anemia, increase bilirubin, NOT FOR PREGNANCY |
|
|
Interferon a
|
Antiviral - Heptatitis (inteferons)
Uses: HCV, HBV, condyloma acuminata, hairy cell leukemia, Kaposi sarcoma Adverse: Flu-like Sxs, Fatigue, Mental depression |
|
|
Interferon B
|
Antiviral - Heptatitis (inteferons)
Uses: Multiple Sclerosis Adverse: Flu-like Sxs, Fatigue, Mental depression |
|
|
Interferon gamma
|
Antiviral - Heptatitis (inteferons)
Uses: NADPH oxidase deficiency Adverse: Flu-like Sxs, Fatigue, Mental depression |
|
|
Lamivudine
|
Antiviral - Heptatitis (nucleoside analogues)
Uses: Hep B Adverse: well tolerated |
|
|
Adefovir
|
Antiviral - Heptatitis (nucleoside analogues)
Uses: Hep B Adverse: renal dysfunction |
|
|
Entecavir
|
Antiviral - Heptatitis (nucleoside analogues)
Uses: Hep B (lamivudine resistant strains) Adverse: renal dysfunction |
|
|
Telbivudine
|
Antiviral - Heptatitis (nucleoside analogues)
*competes w/ thymidine triphosphate Uses: NOT for HIV |
|
|
Acyclovir
|
Antiviral - Herpes (purine/pyrimidine analogs)
*competes w/ dGTP Uses:HSV1+2, VZV, EBV (HSV4) (DOC): HSV encephalitis Genital herpes (prophylaxis) Adverse: Topical admin: local irritation Oral admin: headache, diarrhea, nausea, vomiting |
|
|
Cidofovir
|
Antiviral - Herpes (purine/pyrimidine analogs)
*DNA chain terminator Uses:HSV, adenovirus, CMV retinitis (HIV/AIDS pts.) Adverse: nephrotoxicity |
|
|
Ganciclovir
|
Antiviral - Herpes (purine/pyrimidine analogs)
*DNA chain terminator Uses:(DOC): CMV retinitis (analog of acyclovir) Adverse: BM suppression, neutropenia |
|
|
Vanganciclovir
|
Antiviral - Herpes (purine/pyrimidine analogs)
*Prodrug -> Ganciclovir (increases bioavailability) |
|
|
Famciclovir/Penciclovir
|
Antiviral - Herpes (purine/pyrimidine analogs)
Uses: HSV1+2 , VZV (Famcic is prodrug -> Pencic) |
|
|
Vidarabine
|
Antiviral - Herpes (purine/pyrimidine analogs)
Uses: HSV, CMV, VZV (limited to immunocompromised with herpetic & vaccinal keratitis + HSV keratoconjunctivitis) Adverse: Punctate keratitis, pain, photophobia |
|
|
Trifluridine
|
Antiviral - Herpes (purine/pyrimidine analogs)
Uses: HSV1+2, vaccina virus (DOC): HSV keratoconjunctiv, recurrent epithel keratitis Adverse: Trasient eye & eyelid edema |
|
|
Fomivirsen
|
Antiviral - Herpes (purine/pyrimidine analogs)
Uses: CMV retinitis Adverse: Iritis, Vitritis, incr IOP, changes in vision |
|
|
Foscarnet
|
Antiviral - Herpes (Phosphonoformate)
Uses: HSV+CMV ret (acyclo resist.) CMV + VZV (gancic resist.) Adverse: Nephrotoxicity, hypocalcemia, anemia, CNS effects |
|
|
Zidovudine (ZDV, AZT)
|
Antiretrovirals - NRTIs
*elongation termination Uses: Prophylaxis in exposed HIV pts., prevents prenatal infection Adverse: BM suppression (neutropenia, anemia), headaches |
|
|
Stavudine (d4T)
|
Antiretrovirals - NRTIs
*elongation termination Uses:Prophylaxis + prenatal infec “T analog” Adverse: Periph neuropathy, lipoatrophy, hyperlipidemia |
|
|
Didanosine (ddI)
|
Antiretrovirals - NRTIs
*elongation termination Uses: HIV adults/children (combo) -Purine analog (A+G) Adverse: Pancreatitis, periph neuropathhy Contraindication: d4T (stavudine) |
|
|
Tenofovir (TDF)
|
Antiretrovirals - NRTIs
*elongation termination Uses: HIV pts - Inhibits HIV RT Adverse: Drug interac: increase ddI decrease atazanavir GI effects: nausea, vomiting |
|
|
Lamivudine (3TC)
|
Antiretrovirals - NRTIs
*elongation termination Uses: HIV & HBV Adverse: NO mito DNA inhib or BM suppression |
|
|
Emtricitabine (FTC)
|
Antiretrovirals - NRTIs
*elongation termination Uses: HIV & HBV Adverse: few |
|
|
Abacavir (ABC)
|
Antiretrovirals - NRTIs
*elongation termination Uses: HIV pts – “G analog” Adverse: HS rxn (rash, GI, malaise) |
|
|
Nevirapine (NVP)
|
Antiretroviral - NNRTIs
*non-comp inhibitor of HIV-1 RT Uses: HIV adults/children Adverse: hepatotoxicity, steven-johnson syndrome |
|
|
Efavirenz (EFV)
|
Antiretroviral - NNRTIs
*non-comp inhibitor of HIV-1 RT Uses: Preferred NNRTI (increase CD4 counts, decrease viral load) Adverse: CNS: headache, dizziness, usually resolves; Rash Contraindication: pregnancy |
|
|
Ritonavir (RTV)
|
Antiretroviral - Protease inhibitors
*Reversible inhib of HIV aspartyl protease Uses: PK enhancer/booster of other PIs Adverse: Nausea, vomiting, diarrhea **potent inhib of CYP enzyme |
|
|
Saquinavir (SQV)
|
Antiretroviral - Protease inhibitors
*Reversible inhib of HIV aspartyl protease Uses: Given with dose of RTV Adverse: Headache, fatigue, nausea, GI **fatty meals increase absorption |
|
|
Indinavir (IDV)
|
Antiretroviral - Protease inhibitors
*Reversible inhib of HIV aspartyl protease Uses: Given with RTV Adverse: Usually well tolerated Kidney stones, Fat redistrib **meals -> decrease absorption |
|
|
Nelfinavir (NFV)
|
Antiretroviral - Protease inhibitors
*Reversible inhib of HIV aspartyl protease Uses: HIV (can’t be boosted w/ RTV) Adverse: Diarrhea (give Loperamide), nausea, flatulence |
|
|
Fosamprenavir (fAPV)
|
Antiretroviral - Protease inhibitors
*Reversible inhib of HIV aspartyl protease Uses: Give with RTV (Prodrug -> Amprenavir) Adverse:Headache, fatigue, nausea, vomiting, paresthesisias |
|
|
Lopinavir (LPVr)
|
Antiretroviral - Protease inhibitors
*Reversible inhib of HIV aspartyl protease Uses: Preferred PIs -given with RTV Adverse:GI, hypertriglyceridemia, insulin resistance Contra: St. John Wort |
|
|
Atazanavir (ATV)
|
Antiretroviral - Protease inhibitors
*Reversible inhib of HIV aspartyl protease Uses: Once daily preferred PI with RTV Adverse: Inhib glucuronyl transferase (hyperbilirubinemia + jaundice ), slows heart **Proton pump inhib (do not give w/ H2 blocker or antacids) |
|
|
Tipranavir (TPV)
|
Antiretroviral - Protease inhibitors
*Reversible inhib of HIV aspartyl protease Uses: Used when other PIs are resistant Adverse: Severe & fatal hepatitis, intracranial hemorrhages |
|
|
Darunavir (DRV)
|
Antiretroviral - Protease inhibitors
*Reversible inhib of HIV aspartyl protease Uses: Used when other PIs are resistant Adverse: Rash, same as others |
|
|
Enfuviritide (T-20)
|
Antiretroviral - Fusion inhibitor
*mimics HIV protein gp41 Uses: Treatment experienced pts Adverse: HS rxn (rare), eosinophilia, injection-related injury |
|
|
Maraviroc
|
Antiretroviral - Fusion inhibitor
*blocks CCR5 co-R Uses: Treatment experienced pts Adverse: Well tolerated, risk of hepatotoxicity |
|
|
Raltegravir (RAL)
|
Antiretrovirals - Integrase Inhibitor
*inhibits final step of viral DNA integration Uses: Treatment experienced pts. (use in combo with other drugs) Adverse: Well tolerated, nausea, headache, diarrhea |
|
|
Chloroquine
|
Antimalarials - Blood Schizonticide
Uses: Tx & Prophylaxis of all P. vivax & P. ovale -SAFE IN PREGNANCY Adverse: Well tolerated Pruritis, G6PD hemolysis Contra: Psoriasis Porphyria,vision problems |
|
|
Quinine
|
Antimalarials - Blood Schizonticide
Uses: - Severe P. falciparum malaria - Also oral Tx of falciparum (chloroquine resistant areas) - (DOC) – Severe malaria in pregnancy (Class C) Adverse: Cinchonism, HS rxn, G6PD hemolysis, leucopenia, hypotension, Black water fever (hemolysis and hemoglobinuria) Contra: do not use w/ mefloquine |
|
|
Quinidine
|
Antimalarials - Blood Schizonticide
Uses: - Severe P. falciparum malaria - Also oral Tx of falciparum (chloroquine resistant areas) - (DOC) – Severe malaria in pregnancy (Class C) Adverse: Cinchonism, HS rxn, G6PD hemolysis, leucopenia, hypotension, Black water fever (hemolysis and hemoglobinuria) Contra: do not use w/ mefloquine |
|
|
Mefloquine
|
Antimalarial
Uses: most P.falciparum strains (chloro-resistant strains) (DOC) – Prophylaxis of pregnant in chloro-resistant areas (Class C) Adverse: nausea, vomit, dizzy, leukocytosis, **NOT for epileptics, not used w/ quinine/quinidine/halofantrine Safe in pregnant/Young |
|
|
Primaquine
|
Antimalarial - Liver schizonticide
Uses: Dormant Liver forms of P. vivax, P. ovale; Prophylaxis – all strains Adverse: nausea, ab cramps G6PD hemolysis, rare leucopenia, agranulocytosis, leukocytosis Contra: pregnant **not for G6PD-ve and pregnant |
|
|
Atovaquone
|
Antimalarial - Tissue + RBC schizonticide
Uses: Tx + prophylaxis of P. falciparum Adverse: well tolerated **safe in pregnancy |
|
|
Malarone
|
Antimalarial - Tissue + RBC schizonticide
Atovaquone + proguanil |
|
|
Pyrimethamine
|
Antimalarial - Folate Synthesis Inhibitors
Uses: Pyri + Pro = Erythrocytic form of all malaria species Adverse: Pyri + Sulfadoxine – erythema multiforme, Steven Johnson syn. Contra: do not use pyri + sulfa for severe malaria |
|
|
Proguanil
|
Antimalarial - Folate Synthesis Inhibitors
Uses: Pyri + Pro = Erythrocytic form of all malaria species Pro = some hepatic activity Adverse: Mouth ulcers, alopecia (rare) Contra: do not use pyri + sulfa for severe malaria |
|
|
Sulfadoxine
|
Antimalarial - Folate Synthesis Inhibitors
Uses: Erythrocytic activity (weak) Adverse: Hematologic, GI, CNS, renal, dermatologic Contra: do not use pyri + sulfa for severe malaria |
|
|
Doxycycline
|
Antimalarials - Tetracyclines
Uses: Erythrocytic activity Doxy + quinine: severe P. falciparum Adverse: GI, candidal vaginitis, photosensitivity, discoloration/hypoplasia of teeth, stunting of growth Contra: PREGNANT |
|
|
Artemisinins
|
Antimalarials - from quinghaosu plant
Uses: severe multi-drug resistant falciparum; no effect on hepatic stage Adverse: High doses – neurotoxicity, QT prolongation -CAN use in 2nd & 3rd trimesters in preg. |
|
|
Clindamycin
|
Antimalarials - Other
Uses: Alternative to doxycycline |
|
|
Halofantrine
|
Antimalarials - Other
Uses: Erythrocytic – all parasites Contra: Pregnant, teratogenic |
|
|
Lumefantrine
|
Antimalarials - Other
Uses: Erythrocytic – all parasites Adverse: minor QT prolongation **Coartem = Lume + Artemether |
|
|
Metronidazole
|
Antiamebic (Mixed)
Uses:E. histolytica Also: Giardia lamblia, Trichomonas vaginalis, anaerobic cocci, Gram(-)bacilli Adverse: Metallic taste, oral moniliasis, dark color urine, leucopenia, dizziness, ataxia. |
|
|
Tinidazole
|
Antiamebic (Mixed)
Uses:Amebiasis (and liver abscess) Giardiasis, Trichomoniasis Adverse: Better tolerated than metro |
|
|
Iodoquinol
|
Antiamebic (Luminal)
Uses:E. histolytica (mild-severe infections) Adverse: Periphral neuropathy (rare optic neuritis) Avoid long term use |
|
|
Diloxanide Furoate
|
Antiamebic (Luminal)
Uses: Asymptomatic Amebiasis Adverse: Mild GI distress |
|
|
Paromomycin
|
Antiamebic (Luminal)
Uses: E. histoloytica & tapeworm (luminal forms), also alternative to Cryptosporidiosis in AIDS Adverse: GI distress, diarrhea, systemic absorption can lead to headaches, dizziness, rashes |
|
|
Chloroquine
|
Antiamebic (Systemic)
Uses: liver abscess, intestinal wall infections |
|
|
Emetine
|
Antiamebic (Systemic)
Uses: Severe intestinal or hepatic amebiasis (backup drugs) Adverse: Cardiotoxicity, neuromuscular weakness, dizziness, rash |
|
|
Dehydroemetine
|
Antiamebic (Systemic)
Uses: Severe intestinal or hepatic amebiasis (backup drugs) Adverse: Cardiotoxicity, neuromuscular weakness, dizziness, rash |
|
|
Albendazole
|
Antihelminthics - Benzimidazoles
Uses: Cestodal infections: Taenia solium (cysticercosis) Echinococcus granulosis (hyatid disease) Adverse: Hyatid tx (long term therapy) – hepatotoxicity, agranulocytosis, pancytopenia (inflam response due to dying parasites) Contra: Pregnancy |
|
|
Mebendazole
|
Antihelminthics - Benzimidazoles
Uses: Trichuris trchiura (whipworm) Enterobius vermicularis (pinworm) Necator americanus, Ancylostoma duodenale (hookworms) Ascariasis lumbricoides (roundwor) Adverse:Ab pain, diarrhea, careful in pts with cirrhosis Contra: Pregnancy |
|
|
Thiabendazole
|
Antihelminthics - Benzimidazoles
Uses: Stronglyloides stercoralis (threadworm), Cutaneous larve migrans, early trichinosis Adverse: Erythema multiforme, Steven- Johnson syndrome -Don’t use in kidney, liver dis. pts Contra: Pregnancy |
|
|
Ivermectin
|
Antihelminthics
Uses: Onchocerca volvulus (onchocerciasis) (DOC): Strongyloides, Cutaneous larve migrans Adverse: Mazotti-like rxns: fever, dizziness, somnolence, hypotension -Avoid in pts. with meningitis Contra: Pregnancy **Avoid GABAnergic enhancing drugs |
|
|
Piperazine
|
Antihelminthics
Uses: Ascariasis (alternative treatment) Adverse: Avoid in pts. with seizures |
|
|
Pyrantel Pamoate
|
Antihelminthics
Uses: Roundworms, pinworms, hookworms Adverse: Mild: nausea, vomiting, diarrhea |
|
|
Diethylcarbamazine
|
Antihelminthics
Uses: Lymphatic filariasis, Loiasis, Tropical Eosinophilia Also onchocerciasis (DOC: ivermectin) Adverse: Leukocytosis (common) – may use antihistamines, steroids |
|
|
Doxycycline
|
Antihelminthics
Uses: Wuchereria bancrofti Also onchocerciasis (DOC: ivermectin) |
|
|
Praziquantel
|
Antihelminthics
Uses: (DOC) FOR ALL FORMS OF SCHISTOSOMIASIS, MOST TREMATODES AND CESTODES Adverse: Drug interactions (P450), contraindicated in Tx of ocular cysticercosis Contra: Pregnancy |
|
|
Bithionol
|
Antihelminthics
Uses: Fasciolosis (sheep liver fluke) Pulm paragonimiasis (alternative drug) |
|
|
Niclosamide
|
Antihelminthics
Uses:Cestode infections (2nd line drugs) – lethal to cestode’s scolex, but not ova Adverse: Avoid alcohol within 1 day of dose |
|
|
Melarsoprol
|
Antihelminthics
Uses:Trypanosomiasis – (DOC: mucocutaneous form + late CNS Stage) **aka African Sleeping Sickness |
|
|
Metronidazole
|
Antihelminthics
Uses: Giardia lamblia, Trichomo. vaginalis |
|
|
Nifurtimox
|
Antihelminthics
Uses: T. cruzi (Trypanosomiasis) **aka African Sleeping Sickness |
|
|
Pentamidine
|
Antihelminthics
Uses:Trypanosomiasis (hemolympathic stage), Pneumocystic jiroveci |
|
|
Sulfadiazine + folinic acid
|
Antihelminthics
Uses:Toxoplasma gondi (toxoplasmosis) **Also Pyrimethamine + Clindamycin |
|
|
Sodium Stibogluconate
|
Antihelminthics
Uses: Leishmaniasis (all stages) |
|
|
Suramin
|
Antihelminthics
Uses: Trypanosomiasis ((DOC): hemolympahtic stage) T. brucei gambiense, T. rhodesiense |
|
|
Trimethoprim-Sulfamethoxole
|
Antihelminthics
Uses: DOC: Pneumocystic jiroveci |
