Pharmacology: Anti-Fungal And Antiviral

Front 1

What are the most common strains of the Herpes Virus?

Back 1

1.Herpes Simplex Virus
2. Varicella-Zoster Virus
3. Cytomegalovirus (CMV)

Front 2

What are the treament options for the Herpes Virus?

Back 2

All nucleioside analogues except foscarnet

Front 3

What is the one exception to the nucleoside analogues?

Back 3

Foscarnet

Front 4

What do the Nuceloside Analogues End -In?

Back 4

All end in "LOVIR"

Front 5

How are the LOVIRs classified?

Back 5

They are prodrugs

Front 6

What is the MOA of the FLOVIRs?

Back 6

1. Phosphorylated
2. INHIBITION OF VIRAL DNA POLYMERASE PREVENTS THE SYNTHESIS OF VIRAL DNA

Front 7

What are the routes of the FLOVIRs?

Back 7

PO, IV, Topical

Front 8

What are the adverse effects of the Nucleoside Analogues?

Back 8

1. GI
2. Headache
3. Rash
4. Drop in WBC, Drop in Platelet

Front 9

What is the unique adverse effect caused by IV acyclovir?

Back 9

Increased Serum Creatinine due to Crystalluria

Front 10

How should you administer Acyclovir by IV?

Back 10

Over 1 hour and keeping patients hydrated

Front 11

Which nucleoside analogues are used to treat CMV?

Back 11

1. Ganciclovir
2. Valganciclovir
3. Cidofovir

Front 12

What are the adverse effects of Gancilovir?

Back 12

1. Bone marrow suppresion
2. GI

Front 13

What are the adverse effects of Cidovir?

Back 13

VERY TOXIC!
1. Bone marrow suppression
2. Nephrotoxicity

Front 14

How should Cidovir be administered?

Back 14

Only in Combination with PROBENECID!!!
-helps increase renal clearance

Front 15

What is the MOA of Foscarnet?

Back 15

Works on the enzyme DNA polyermase preventing attachment of nucleotide precursors to DNA

Front 16

What is the main use of Foscarmet?
What is an alternate use?

Back 16

Main: CMV!
Alternate: acyclovir resistant HSV, VZV

Front 17

How is foscarnet administered?

Back 17

IV ONLY

Front 18

What are the adverse effects of Foscarnet?

Back 18

TOXIC PRODRUG!
-Nephrotoxicity
-Anemia, seizures, arrhythmias
-Electrolyte abnormalities

Front 19

What are the two types of RNA virus?

Back 19

Type A and B

Front 20

What type of drugs are available for Influenza?

Back 20

Vaccines and for Treatment

Front 21

Which 2 drugs for influenza have viruses become resistant to?

Back 21

1. Amantadine
2. Rimantadine

Front 22

What is the main class of drugs used for influenza?

Back 22

Neuraminidase Inhibitors

Front 23

Describe the result of inhibiting neuraminidase in influenza A and B

Back 23

Prevente the release of new virions

Front 24

For neuraminidase to be used as a treament option, when must it be delivered?

Back 24

Within 48 hours of onset of symptoms

Front 25

How long is the treatment of neuraminidase inhibitors?

Back 25

5 days

Front 26

What two reasons is neuraminidase inhibitors given?

Back 26

Treatment and prevention

Front 27

What is the overall effect of administering nueraminidase inhibs?

Back 27

Symptoms lessen in 24 hours

Front 28

Which neuraminidase inhibitor can be administered as an inhaler?

Back 28

Zanamivir

Front 29

What are the adverse effects of neuraminidase inhibitors?

Back 29

GI: nausea
respiratory tract infections (inhaler)

Front 30

What are the 2 types of fungus?

Back 30

Yeast(easier to treat) and Mold

Front 31

What are some examples of systemic fungal infections?

Back 31

UTIs
-pneumonia
-meningitis
-fungemia/sepsis
Often occur in pts with compromised immune systems

Front 32

What are the most common superficial fungal infections?

Back 32

Nail
-skin
-mucous membranes

Front 33

What are the Dermatophytes?

Back 33

The Tineas
-unguium or onchomycosis (nails)
-pedis (athlete's foot)
-capitis (ringworm of scalp)
-corporis (ringworm of the body)
-cruis (jock itch)

Front 34

What fungus is responsible for yeast infections?

Back 34

Candida

Front 35

List the drug classes used to treat Systemic Fungal infection

Back 35

Systemic:
-Amphotericin B
-Azoles
-Flucytosine
-Echindocandins

Front 36

What drugs are used to treat superficial fungal infections?

Back 36

Superficial:
-Azoles
-Griseofulvin
-Nystatin
-Allylamines (teribinafine)

Front 37

What is the MOA of Amphitericin B?

Back 37

Binds to the ergosterol in the fungal CELL MEMBRANE

Front 38

How should amphotericin B be administered?

Back 38

IV only in DEXTROSE SOLUTION!! OVER 2-4 hours!!

Front 39

How long does Amphotericin take to be excreted in urine?

Back 39

Very LONG! 24hours-15 days!!

Front 40

What are the side effects of Amphotericin B?

Back 40

"Amphoterrible" Bad side effects!
-Fever, chills, vomiting, headache
-Nephrotoxicity (keep pt well hydrated)
-Electrolyte disturbances

Front 41

Which days of treatment with Amphotericin show the most side effect?

Back 41

Days 3-5

Front 42

What should you do prior to administering Amphotericin B?

Back 42

Pre medicate the patient to deal with the side effects

Front 43

What is the MOA of Flucytosine?

Back 43

Inhibits fungal DNA synthesis

Front 44

What type of drug is Flucytosine converted into?

Back 44

Fluorouracil (oncology drug)

Front 45

How is Fluctyosine administered?

Back 45

Always PO and in combination

Front 46

What are some common side effects fo Flucytosine?

Back 46

Bone marrow suppression, Hepatotoxicity

Front 47

What MOA is used by the Echinocandins?

Back 47

Inhibit fungal cell wall sythesis by inhibiting Beta Glucan synthase!

Front 48

What suffix is common in the Echinocandins?

Back 48

Fungin's

Front 49

What are some adverse effects of the Fungin's?

Back 49

"Echinocandins"
-Thrombophlebitis
-Abnormal liver enzymes***

Front 50

What is the common suffix for the Azoles?

Back 50

Azole! :)

Front 51

State the MOA of the Azoles.

Back 51

Inhibit synthesis of ergosterol (fungal cell mem component)

Front 52

Which Azole is excreted in the urine?

Back 52

Fluconazole

Front 53

Which Azole is the most absorbed when administered orally?

Back 53

Fluconazole

Front 54

Which antifungal causes visual disturbances?

Back 54

Voriconazole (Azole)
-causes halos or blurry vision

Front 55

What are the adverse effects of Azoles?

Back 55

Topical agents cause local irritation
-Hepatotoxicity
-Visual disturbances (voriconazole)

Front 56

Do Azoles have any drug interactions?

Back 56

YES! Potent inhibitors of CYP450

Front 57

Which drugs are active against dermatophytes?

Back 57

1. Griseofulvin
2. Terbinafine

Front 58

Which antifungal inhibits the mitosis of dermatophytes?

Back 58

Griseofulvin

Front 59

How long is the treatment using Griseofulvin?

Back 59

6-12 MONTHS

Front 60

How should Griseofulvin be administered? What causes a increase in its absorption?

Back 60

PO only
-High fat meals cause increase in absorption

Front 61

What are some adverse effects of Griseofulvin?

Back 61

GI, hepatitis, photosensitivity
Tetrogenic and carcinogenic in the lab (not for pregnant women!)

Front 62

What is the length of therapy for Terbinafine (Lamisil)

Back 62

Nails: 6 weeks
Toenails: 12 weeks

Front 63

Which antifungal suffers the First Pass?

Back 63

Terbinafine

Front 64

Which 2 antifungals inhibit ergosterol synthesis?

Back 64

Terbinafine and Azoles

Front 65

What are the adverse effects of Terbinafine?

Back 65

GI, rash, dizziness, JOINT AND MUSCLE PAIN, HEPATOTOXICITY, neutropenia

Front 66

WHIch drug is limited to the surfaces where it can be in direct contact with the mold?

Back 66

Nystatin

Front 67

How do you administer Nystatin PO?

Back 67

Swish and Swallow!!

Front 68

Which drug is used to treat Candida?

Back 68

Nystatin