Pharm Block 2 Antiinfectives

Front 1

1.    Antivirals

Back 1

c

Front 2

acyclovir is phosphorlyated to: via what

Back 2

acyclovir-triphosphate via viral thymidine kinase

Front 3

viral host cellular enzymes do what to acyclovir

Back 3

di and tri-phosphorylate

Front 4

a.    Specific MOA of active acyclovir

Back 4

active form inhibits viral DNA polymerase, acts as a DNA chain terminator

Front 5

b.    Mechanisms of development of resistance to acyclovir (mention the specific enzyme involved)

Back 5

lack of viral thymidine kinase (activator), changes in viral DNA polymerase (target enzyme)

Front 6

virus that acylovir dosent cover

Back 6

CMV

Front 7

c.    ADR of acyclovir

Back 7

cns tox (confusion, hallucination, tremor) renal failure (from crystal deposit)

Front 8

Ganciiclovir MAO and adr

Back 8

Mao: same as acyclovir but no chain terminate, adr: hepatotoxicity: leukopenia, thrombocytopenia, mucosistits, crystalluria, seizures in overdose (as w/ acyclovir)

Front 9

d.    Indications and ADR of Ganciclovir

Back 9

HSV, VZV, CMV (first line)

Front 10

e.    MOA of foscarnet

Back 10

directly inhibits DNA and RNA polymerases (also HIV reverse transcriptase), needs no activation in cell

Front 11

e.   Specific uses of foscaranet

Back 11

acyclovir-resistant strains of HSV, ganciclovir-resistan CMV, VZV, HSV and HIV

Front 12

ADR of foscaranet

Back 12

nephrotoxicity (acute tubular necrosis)

Front 13

e.    MOA fomivirisen

Back 13

binds to mRNA and inhibits pt synthesis and viral replication

Front 14

uses of  Fomivirisen

Back 14

CMV retinits (given as an intrvitreal injection)

Front 15

ADR of formivirisen

Back 15

iritis, increase intraocular pressure

Front 16

Specific MOA of oseltamavir and zanamvir (name of the enzyme involved)

Back 16

neuramidase inhibitors (on the outer cell membrane of viral particles); prevents the enzyme from releasing and spreading the infection

Front 17

indication of oseltamavir and zanamvir

Back 17

influenza A and B

Front 18

Specific MOA of Amatadine & Rimantadine

Back 18

inhibits earlt step in replication by blocking attachment, penetration and virus uncoating

Front 19

ADR Amatadine & Rimantadine

Back 19

seizures and arrhythmias at high dose, CNS toxicity (more amantadine)

Front 20

drug interactions of Amatadine & Rimantadine

Back 20

inc'd tox w/ antihistamines, anticholin. Thiazides

Front 21

oseltamavir and zanamvir ADR

Back 21

PO; mild GI upset

Front 22

h.    Indications for use of interferons and what is the type of interferon used

Back 22

Hep C. pegylated interferon alfa-2a and 2-b

Front 23

i.      Drugs for RSV (which one is used as a nebulizer)

Back 23

ribavarin

Front 24

Lamivudine ADR

Back 24

co-infection w/ HIV can cause pancreatitis

Front 25

Adefovir dipivoxil ADR

Back 25

nephrotoxic

Front 26

which drug used for Hep B has no side effects?

Back 26

entecavir

Front 27

Ribavarin indication , MAO, and ADR

Back 27

Hep c, inhibits RNA dependent polymerase, hemolytic anemia

Front 28

j.      Drugs used in the Rx of Hepatitis B (3)

Back 28

lamivudine, adefovir dipivoxil, entecavir

Front 29

2.    Drugs used in HIV/AIDS:

Front 30

specific MOA of NRTIs

Back 30

"inhibit reverse transcriptase after phosphorylation by cellular **active against only retrovirues. Competitivly inhibt HIV-1 reverse transcriptase and can be inc'd into the growin DNA chain to cause termination. **always used in combo w/ other drugs.

Front 31

8 NRTI's

Back 31

zid, did, zal, stav, lam, em, aba, tin

Front 32

ZID ADR

Back 32

)zid = bone marrow supression

Front 33

peripheral neuritis and lactic acidosis (2 NRTIs)

Back 33

zid, stav

Front 35

DDI (didanosine) ADR

Back 35

hyperuricemia? Pancreatits (inc'd serum amylase)

Front 36

c.    Drug used in prevention of vertical transmission of HIV infection

Back 36

AZT full dose in trimester 2 and 3 + 6 wks to neonate

Front 37

NNRTI drugs

Back 37

Nevirapine, delavirdine, efavirenz

Front 38

nevirapine ADR

Back 38

rash, hepatitis

Front 39

delavirdine ADR

Back 39

rash

Front 40

Efavirenz ADR

Back 40

dizziness, headache

Front 41

specific MOA of NNRTI

Back 41

don’t compete with nucleoside triphosphates, don’t need to by phosphorylated, metabolized by cyp450

Front 42

e.    Names of Protease inhibitors

Back 42

saq, indi, nel, rit, amp, ata, lopi

Front 43

f.     Specific MOA of protease inhibitors

Back 43

block proteases from processing gag and pol polyproteins into mature HIV components

Front 44

what happens when protease is blocked?

Back 44

noninfectious HIV is produced

Front 45

g.    Ritanovir + Lopinavir - kinetic boost

Back 45

ritona is potent, lopi has low oral bioavaliability, so when given together, lopi's effects are increased.

Front 46

which protease inhibitor is the most potent inhibitor if CYP enzymes?

Back 46

ritonavir

Front 47

which PI is the least potent cyp inhibitor

Back 47

saquinavir

Front 48

h.    Important ADR of protease inhibitors (effect on lipid/cholesterol metabolism)

Back 48

lipodystrophy, hperglycemia. (ritonavir too)

Front 49

i.      MOA of enfuviritide

Back 49

Fusion inhibitor: binds to GP41, causes local skin rxs, active against drug resistant HIV

Front 50

drugs effective in the Rx of Hepatitis B:

Back 50

                                              i.     Interferon-α

Front 51

Lmividine

Back 51

effective in chronic HBV infection

Front 52

treatment for cryptococcal meningitis (2)

Back 52

amp B + flucytosine. Amp B forms pores in cell mem. Which incs flu's uptake

Front 53

indications for sulfamethoxazole + trimeth (cotrimoxazole)

Back 53

UTI, e.coli, proteus, pneumonia = p. jeroveci

Front 54

chloroquine ADR

Back 54

ocular tox - retinopathy

Front 55

treatment for chloroquine resistent malaria

Back 55

sulfadoxine + pyrimethamine

Front 56

treatment for toxoplasmosis

Back 56

sulfadiazine + pyrimehtamine

Front 57

comb to prevent TB resistance

Back 57

INH + rif + pyz+ etham

Front 58

combo to prevent leprosy resis.

Back 58

rifampicin + dapsone + clofazamine

Front 59

use and MAO for chloroquine + primaquine

Back 59

P. vivax, ovale malaria. Kills exoerthrocytes/hypnozoites - prevents relapse

Front 60

treat amebiasis

Back 60

metronidazole + diloxanide; kills both tissue and luminal forms

Front 61

prevent HIV resistance

Back 61

zid + lam + saq

Front 62

INHs MOA

Back 62

inhibits mycolic acid synthesis

Front 63

INH resistance

Back 63

high level resistance-deletion of katG gene (codes for catalase needed for INH activation)

Front 64

INH toxicity

Back 64

peripheral neuropathy - comon in slow acetylators - prevent with pyridoxine

Front 65

Rifampicin MOA

Back 65

inhibit DNA dependent RNA polymerase

Front 66

ehtambutol MOA

Back 66

inhibit arabinogalactan - cell wall component

Front 67

ethambutol ADR

Back 67

ocular tox - colour blindness, dec'd viscual acuity

Front 68

pyrazanimide ADR

Back 68

hyperuricemia (gout)

Front 69

pyrazinamide MOA

Back 69

inhibits FAS 1 - enzyme that synth F.A. from acetyl coA

Front 70

streptomycin MOA

Back 70

inhibits pt synthesis

Front 71

4 drugs that cause hemolysis in G6PD def pts (hemoglobinuria)

Back 71

sulfonamides, primaquine, dapsone, INH

Front 72

symptoms of disufarim rx

Back 72

nasuea, vomit, tach, cv collapse, headache

Front 73

disulfiram like rx w/ alcohol

Back 73

metronidazole, griseofulvin

Front 74

infusion related ADR that causes renal stones

Back 74

indinavir

Front 75

infusion related ADR of fever, rashes, hypotension

Back 75

amp B

Front 76

infusion related ADR of flu like syndrome

Back 76

interferon alpha

Front 77

streptogramins

Back 77

arthralgia myalgia syndrome

Front 78

floroquinones ADR

Back 78

tendon rupture

Front 79

methicillin ADR

Back 79

interstial nephritis

Front 80

sulfonamides' nephrotox ADR

Back 80

crystalluria

Front 81

2 drus that cause steven johnsons

Back 81

sulfonamides, nevirapine