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12 Cards in this Set
- Front
- Back
- 3rd side (hint)
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Isoniazid
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Used for latent and active TB, only active against MTB and M. Kansasii. Spontaneous mutation can occur.
MOA0inhibits synthesis of mycolic acid Readily absorbed from GI, diffuses into all body fluids, including CSF. majority excreted in urine, metabolized by liver Toxicity-Rash, fever, hypersensitivity, bone marrow suppression, vasculitis, SLE, CNS, peripheral neuropathy, hepatotoxicity. Inhibits metabolism of phenytoin and disulfram |
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Rifampin
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Broad spectrum, also MTB and AFB
MOA-inhibits DNA dependent RNA polymerase absorbed and eliminated in bile, has enterohepatic recirculation Used of MTB, post influenzae and prophylaxically, for menigococcal and s. aureus. Toxicity-hepatotoxicity, light chain proteinuria, flu like symptoms. hypersensitivity, thrombocytopenia, red discoloration interactions-increases metabolism of protease inhibitors, non nucleotide reverse transcriptase inhibitors. decreases levels of methadone, coumadin, steroids, oral contraceptives, oral hypoglycemic agents, digoxin, anticonvulsants, dapsone, ketoconazole, and cyclosporin. |
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Rifabutin
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more active than rifampin against MAC, MOA same
toxicity like rifampin, uveitis when given with azoles or clarithromycin drug interactions same as rifampin except for ritonavir |
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Rifapentene
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slightly more active than rifampin against MTB, MOA same as rifampin
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Pyranzinamide
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Bactericidal against intracellular MTB only. MOA-unkown
used for treatment of MTB, shorter courses toxicity-hepatotoxicity, hyperuricemia, nausea, vomiting, rash, arthralgia |
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ethambutol
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Active against MTB, M. Kansasii and MAC. blocks arabinosyl transferases in cell wall formation
75% excreted in urine. Used for MTB, MAC and M. Kansasii toxicity-optic neuritis at high doses |
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CCRS receptor antagonist
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Maraviroc
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MOA-blocks HIV entry by binding to CCR5 recepots on CD4 cells, if virus can bind to another receptor then maraviroc won't work
Toxicity-abdominal pain, cough/upper resp. infection, allergic reaction iwth rach and fever, hepatotoxicity, orthostatic hypotension interactions-can't used with CYP3A4 inhibitor (protease inhibitor drugs) |
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Fusion inhbitors
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Enfuvirtide
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inhibits fusion of HIV viral membrand with the host cell membrande. MOA-binds to GP 41 on CD 4+ and prevents fusion
Toxicity-injection site skin reaction, bacterial pneumonia it is expensive and must be injected |
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Nucleoside Reverse Transcriptase inhibitor (NRTI's)
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zidovudine
lamivudine tenofovir emtricitabine |
MOA-competes with viral nucleic acid for reverste transcriptase enzime, competitive inhibitor, also incorporates into viral DNA and terminates synthesis
Toxicity-mitochondrial toxcicity-lactic acidosis leading to organ failure and death, hepatic steatosis Sidovudine-thymine analog, can't be used with stavudine. Toxicity-0bone marrow toxicity leading to anemia and decreased WBC Lamivudine-cytidine analog Tenofovir-adenine anolog, can't be used with didanosine, both A anaolog. Toxicity-renal toxicity, bone loss Emtricitabine-cytidine analog. toxicicty-skin discoloration. Advantages-lost pill burden, few drug interactions. Must adjust if renal failure |
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Non-nucleoside reverse transcriptase inhibitiors (NNRTI's)
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Efavirenz
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MOA-reversible non-competitive inhibitor of HIC reverse transcriptase enzyme, binds to reverse transcriptase and blocks DNA synthesis from RNA
must take on an empty stomach, P450 CYP3A4 inducer toxicity-CNS-dizzy, confused, decreased concentrations-teratogenic-skiin rash-steven johnson syndrome (necrosis)-hepatotoxicity interactions-can't be used with TB drugs or psych drugs advantages-less fat maldistribution than PI, potent and long half life Disadvantages-multi-drug resistance, skin rash |
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Integrase inhibitors
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Raltegravir
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MOA-inhibits HIV-1 integrase, no insertion of HIV DNA into host cell genome->can't form provirus
interaction-decreases potency of rifampin toxicity-nausea, vomiting, fever, increased CPK enzyme, resistance |
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Protease Inhbiitors
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Atazanavir
Darunavir |
MOA-blocks protease cleavage of viral gog and pol proteins, can't form mature infectious virus
Toxicity-increased bleeding, hepatotoxicity, fat maldistribution, coronary artery disease, hyperlipidemia, diabetes, osteonecrosis Atazanavir-interactions-can't used with PPI, rifampin, or psych drugs. Toxicity-increased bilirubin, jaundice, skin rash, heart EKG changes Darunavir-interactions-can't use with rifampin or psych drugs. toxicities-rash |
