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;
153 Cards in this Set
- Front
- Back
|
What is the mechanism of action of Amphotericin B?
|
Interaction with sterols of fungal membrane
|
|
|
what is the anti fungal spectrum of Amphotericin B?
|
Histoplasma, Cryptococcus, Cocci, Candida, Torulopsis glabrata, Blastomyces, Aspergillus
|
|
|
What is the pharmacokinetics of Amphotericin B?
|
IV - for systemic fungal attacks
Not absorbed orally NOT removed by hemodialysis Nephrotoxic (Renal Damage is dose dependent) |
|
|
What diseases is Amphotericin B NOT the DOC for a systemic infection?
|
Aspergillus - Voriconazole
Cryptococcus - Amph B and Flucytosine |
|
|
What is the mechanism of action for Flucytosine?
|
Metabolic antagonism of Fungal DNA
5-fluorouracil interferes with DNA |
|
|
What is Flucytosine most effective against?
|
Cryptococus neoformans
Candida, Aspergillus fumigatus, Sporotrichum schenckii |
|
|
What is the mechanism of Ketroconazole?
|
Sterol or fatty acid metabolism inhibitor of fungi and possibly accumulation of toxic endoperoxides
|
|
|
What are the main problems associated with Ketroconazole
|
Inhibits liver P450 system
Interaction with many drugs Inhibition of Adrenal and Testicular function Gynecomastia |
|
|
What is the mechanism of action of Fluconazole?
|
Blocking synthesis of Ergosterol
|
|
|
What is Fluconazole used to treat?
|
Aspergillus, Blastomyces, Candida, Cryptococcus neoformans**, Cocci, Histo
|
|
|
What are the benefits of using Fluconazole over Ketroconazole?
|
Fluconazole: more reliably absorbed orally
Better CNS penetration Longer half life in patients with impaired renal function No inhibition of testosterone or adrenal function (like ketroconazole) |
|
|
What are the drug interactions of Fluconazole?
|
Much lower affinity for P450 system than ketroconazole but still inhibits metabolism of drugs such as Phenytoin, cyclosporin, warfarin, and oral hypoglycemic drugs
|
|
|
Itraconazole is treats what infections?
|
Oral trazole: Blast, Histo, Onychomycosis (also Terbinafine), esophageal and oropharyngeal candidiasis
|
|
|
What is the pharacokinetics of Itraconazole?
|
Orally absorbed; peak dose after several days
Hepatic metabolism Highly bound to plasma proteins |
|
|
What are the Adverse reactions to Itraconazole?
|
GI effects - N/V/D and and px
Nausea most commonly reported Rash - more common in immunocompromised patients |
|
|
what is Voriconazole used to treat?
|
Aspergillus spp.
Drug has lots of drug interactions |
|
|
When is caspofungin used?
|
Intravenous antifungal
Indicated in treatment of Invasive Aspergillosis May cause GI problems and flushing Blocks cell wall synthesis through Beta (1,3)-D glucans |
|
|
What medication is used to treat ringworm infection of skin, hair, and nails?
|
Grisofulvin: Epidermophyton, microsporum, and trichophyton
MA: Binds to microtubules of certain fungi and destroys mitotic spindles Oral administration Binds to keratin in skin |
|
|
What anti fungal is contraindicated in Acute Intermittent Porphyria and Hepatocellular failure?
|
Griseofulvin
|
|
|
Nystatin
|
Primarily used for CANDIDA infection
MA: similar to Amphotericin B Oral or Topically Tx: Candida, crypto, histo, blasto, trichophyton, epidermophyton, microsporum |
|
|
What medication is indicated for treating onychomycosis?
|
Terbinafine: oral or topical
- Blocks enzyme squalene monooxygenase (sterol synthesis) - No need for dosage adjustments in hepatic or renal impairment |
|
|
What infections does miconazole nitrate treat?
|
Trichophyton, epidermophyton, Microsorum, candida, Cryptococcus, Aspergillus
Tinea Pedis, Vulvovaginal candidiasis |
|
|
What infections does Clotrimazole treat?
|
Dermatophytes, yeasts, and Malassezia furfur
|
|
|
What is the mechanism of action of Acyclovir?
|
Blocks DNA synthesis by competing with dGTP (activated by viral thymidine kinase)
|
|
|
What teratogen category is Acyclovir?
|
Non-teratogenic
|
|
|
What is Gancyclovir/Valganciclovir used for? What is the mechanism of action?
|
Prophylaxis against CMV (retinitis or transplant patients)
Guanosine analog that stops DNA replication (activated by viral kinases) Less active than acyclovir and more toxic |
|
|
What are the toxicities of Ganciclovir?
|
Neutropenia, thrombocytopenia
Nausea, fever, rash Headache confusion, seizures |
|
|
What is the mechanism of action of Foscarnet?
|
RNA and DNA polymerase inhibitors - does not need viral kinase
Used in resistant HSV infections and CMV retinitis |
|
|
What is the mechanism of action of Fomvirsen and what is it used to treat?
|
MA: Antisense viral mRNA compound
Used for CMV retinitis |
|
|
What is the mechanism of action of Oseltamivir (oral), and zanamivir (nasal)?
|
Neuroaminidiase inhibitors - block the release of virus from the cell
Active against Influenza A and B only within 48 hours of infection (oseltamavir for Bird flu) |
|
|
What are the toxicities associated with anti-influenza medications?
|
Zanavir - respiratory problems (COPD, asthma attack)
Oseltamivir - Oral Nausea/vomiting |
|
|
When is Ribavirin used and what are the toxicities?
|
Used for RSV (also Palivizumab) and Hepatitis C (oral)
IV will treat Lassa virus, SARS Toxicities: Teratogenic (category X), Anemia, dyspnea, hypotension |
|
|
What is Palivizumab used for ?
|
Passive immunization for RSV infections
|
|
|
What is the mechanism of action for Interferons and what are they used to treat?
|
MA: glycoproteins that inhibit various stages of viral replication. Induce ribonuclease that degrade viral mRNA
Uses: INF-a: HBV, HCV (with rabavirin), Karposi's INF-B: Multiple sclerosis INF-y: NADPH oxidase deficiency |
|
|
What are the side effects from Interferons?
|
Flu-like symptoms
Myalgias Nausea/vomiting Neutropenia, anemia (worse when in combination with ribavirin, telaprevir, boceprevir) |
|
|
What are Boceprevir and telaprevir used for? What are their toxicities?
|
Protease inhibitors used to treat Hep C (type I genotype - interferon/ribavirin are not very good)
Strong Inhibitor of CYP3A4 Anemia, neutropenia, leukopenia, fatigue, rash |
|
|
What are the treatments for Chronic Hep B?
|
Lamivudine - Reverse transcriptase inhibitor (also used for HIV tx). Drug of Choice for Chronic Hep B
Interferon Alpha 2b |
|
|
What is the mechanism of action of Zidovudine? What are the toxicities?
|
Reverse Transcriptase inhibitor
Prophylaxis, treats AIDS dementia, Psoriasis and T cell leukemia Neutropenia, anemia, Lactic acidosis, hepatotoxicity Tylenol and Ganciclovir increase granulocytopenia Somnolence with Acyclovir |
|
|
What reverse transcriptase inhibitor is combined with Zidovudine to treat HIV?
|
Lamivudine - also used for HBV
|
|
|
What are the Non-nucleoside reverse transcriptase inhibitors
|
Never - Nevirapine
Ever - Efavirenz, Etravirine Deliver - Delaviridine nucleosides |
|
|
What is a common side effect from Didanosine, Zalcitabine, Stavudine?
|
Peripheral Neuropathy and Lactic acidosis (also Zidovudine)
Only Abacavir causes hypersensitivity |
|
|
What reverse transcriptase inhibitors cause Lactic acidosis?
|
Zidovudine, Zalcitabine, Didanosine, Stavudine
|
|
|
What reverse transcriptase inhibitors are known to causes Anemia/granulocytopenia?
|
Zidovudine, Didanosine
|
|
|
Which of the Non-nucleotide RTIs are not used during pregnancy?
|
Efavirenz
|
|
|
What are the toxicities of Nevirapine?
|
Hepatitis, Stevens Johnson
|
|
|
What other HIV medications interact with Non-nucleotide RTIs?
|
Protease inhibitors - both are metabolized by the CYP3Y4 enzymes
|
|
|
What is the major side effects from the protease inhibitors?
|
CYP 3A4 Strong INHIBITORS
Buffalo hump with thin face (different from corticosteroids) Cholesterol/triglicerides increased - Atherosclerosis, CVA, MI, DM, Depression, Abdominal pain |
|
|
What is the Protease inhibitor that is the first drug of choice?
|
Atazanavir - less side effects, but may increase bilirubin
Inhibits UDP-glucuronosyl transferase |
|
|
What are the side effects from Darunavir?
|
Darunavir - headache, nightmares
Protease inhibitors |
|
|
When is Ritonavir used and what kind of drug interactions does it have?
|
Low levels only to increase Protease inhibitor bioavailability
CYP3Y4 inhibitor Contains alcohol - never give with metronidazole (disulfram-like effects) |
|
|
How is the bioavailability increased for Saquinavir?
|
Increase with high fat foods, grapefruit juice, and ritonavir
|
|
|
What are the major side-effects of Indinavir?
|
Cross resistance with ritonavir
Kidney stone; hyperbilirubinemia; Thrombocytopenia? Rifampin will increase |
|
|
What are drug interactions with Amprenavir?
|
Contains propylene glycol - avoid with metronidazole (also ritonavir)
Inhibits CYP3A4 and May cause Steven Johnson's |
|
|
Why is Tiprapnavir unique compared to the other protease inhibitors?
|
Non-pepiditic protease inhibitor
|
|
|
What other infection is more likely to occur when using Fusion Inhibitors?
|
Pneumonia
MA:Blocks the gp41 on the virus |
|
|
What medication is only effective if there is a CCR5 on the surface of the Virus?
|
Maraviroc
|
|
|
What is the major Integrase inhibitor?
|
Raltegravir: Blocks integrase enzyme, prevents viral replication
Used when other drugs stop working Tox: N/V and HA |
|
|
What are the side-effects from Corticosteroids?
|
immune suppression
Osteoporosis Peptic Ulcers Suppress Pituitary hypthalamic axis Menstrual/reproductive |
|
|
What are the T-lymphocyte Suppressants?
|
Calcineurin inhibitors(IL-2 gene): Cyclosporine, Tacrolimus, Pimcrolimus
Sirolimus - blocks cell signaling for proliferation |
|
|
What is the MA of Cyclosporine?
|
Inhibits Calcineurin/T-cell activator
Decreased IL-1/IL-2 Increases TGF-B No bone marrow suppression |
|
|
What are the major drug interactions with cyclosporine?
|
Metabolized by CYP3A4 (drug interaction)
Narrow therapeutic range NO grapefruit juice, Erythromycin, Ketoconazole, verapamil (inhibitors) NO Phenobarbital, phenytoin, rifampin (Inducers - decrease levels) |
|
|
When is cyclosporine used?
|
Prevent/Maintain transplant rejection
Autoimmune disease: Asthma, RA, Bowel inflammation, diabetes |
|
|
What is the major toxicity with Cyclosporine?
|
Renal Toxicity, Hypertension, Gingival hyperplasia
Hyperlipidemia, hyperglycemia, nausea, vomiting, diarrhea, anorexia |
|
|
What medication is the drug used to rescue a liver transplant from a rejection episode?
|
Tacromlimus - similar to Cyclosporine
blocks IL-2 & 4 Used to prevent rejections in Liver, kidney, and heart |
|
|
What are the toxicities of Tacrolimus?
|
Nephrotoxic, Hypertension, Hyperglycemia
Neurotoxic: tremor, headache, insomnia Must take with empty stomach (CYP3A4 reactions as well) |
|
|
What is the mechanism of action for Sirolimus?
|
Inhibits mammalian Target of Rapamycin (mTOR)
Blocks T-cell response to IL-2 and B cell proliferation |
|
|
What is the toxicity of Sirolimus?
|
No renal toxicity unless combined with cyclosporin
Causes Bone marrow suppression Increased Cholesterol/triglycerides |
|
|
What is the mechanism of action of Mycophenolate?
|
Prodrug inhibits monophosphate dehydrogenase - T and B cells need this for PURINE synthesis
Specific for Proliferation of T cells and antibody formation*** Often combined with Tacrolimus (IL-2/4 blockage) |
|
|
What are the major side effects of Mycophenolate?
|
Rash***
Infections - sepsis with CMV Leukopenia NOT used in Pregnancy*** Antacids will block absorption |
|
|
What transplant medication blocks de novo Purine synthesis? What other diseases does it treat?
|
Azathioprine: Treats transplants, glomerulus nephritis in SLE, and Severe RA
|
|
|
what are the major side effects of Azathioprine?
|
Bone marrow suppression: Leukopenia, thrombocytopenia
Teratogenic*** (Metabolized to 6-mercaptopurine) Metabolized by xanthine oxidase** (reduce the dose with allopurinol) |
|
|
What is the mechanism of Cyclophosphamide? What is unique about this immunosuppressant compared to others?
|
MA: cross-links DNA
Destroys T-cells so it is effective in ACTIVE immune response. Also used for Bone marrow transplants (similar to cyclosporine) |
|
|
What transplant medication can cause Hemorrhagic Cytitis, bone marrow suppression, Aspermia, and Alopecia?
|
Cyclophosphamide - prevent hemorrhagic cystitis with hydration and MESNA
|
|
|
What disease can methotrexate treat?
|
Organ transplant
RA, Psoriasis, cancers Causes bone marrow suppression, alopecia, heptotoxicity, fetal toxicity |
|
|
What is the mechanism of action of Thalidomide?
|
Decreases TNF-a, IL-6
Used in multiple myeloma, leprosy, and some cancers Causes sedation and neutropenia |
|
|
What transplant medication binds to CD3 region of T-cells? What are the toxicities with this medication?
|
Muromonab: use with corticosteroids
May cause Cytokine Release Syndrome |
|
|
What medications binds to IL-2 receptor on Activated T-cells?
|
Daclizumab/Basilixumab
No general immunosuppression Used right at transplant for induction Adverse effects similar to humanized and chimeric antibodies |
|
|
What is the mechanism of action of Efalizumab?
|
Binds to CD11a prevent binding to ICAM (increased in Psoriasis***)
Prevents T-cell activation but doesn't destroy cells (vs. cyclophosphamide) |
|
|
What are the uses and side-effects from IL-2?
|
Use: Renal cell carcinoma, Malignant melanoma
Tox: Pulmonary edema, SEVERE** hypotension |
|
|
What is Oprelvekin and what is it used for?
|
Recombinant IL-11
Uses: Prevents thrombocytopenia (from chemo) Tox: Fluid retention, edema |
|
|
When is filgrastim used?
|
CSF- used to treat severe neutropenia by inducing stem cells
Tox: Bone Pain, injection site reaction |
|
|
Interferon Alpha 2b is used to treat what diseases?
|
Hep B, Hep C (with ribavirin)
Hairy cell leukemia, Karposi's sarcoma Condyloma accuminata, Non hodgkin's lymphoma |
|
|
What diseases does INF Alpha 2a treat?
|
Antiviral, antiproliferative, decreases viral transmission
Hairy cells leukemia, Karposi's sarcoma, Hep C |
|
|
What are the major side-effects of Interferons?
|
Depression - Suicide
Flu-like symptoms Bone marrow suppression, alopecia (similar to cyclophosphamide, methotrexate) |
|
|
What anti-malarial medication is used as a first line treatment and for prophylaxis of malaria?
|
Chloroquine - Falciparum may be resistant due to transport pump
|
|
|
What are the major toxicities of Chloroquine?
|
Cardiac arrest if given too quickly (QT elongation)
Ca++ and Mg++ Inhibit absorption Contraindicated with Psoriasis and Porphyria |
|
|
What are the mechanism of action of Quinine?
|
Interferes with plasmodial digestion of hemoglobin
Drug of choice for tx of complicated chloroquine-resistant plasmodia |
|
|
What anti-malarial medication can cause Cinchonism?
|
Quinine and Quinidine:
Tinnitus, HA, Dizziness, flushing, visual disturbances |
|
|
What are the major toxicities of Quinidine?
|
Type IA anti-arrhythmic (QT elongation
Cinchonism Hemolysis in G6PD Insuline release and hypoglycemia |
|
|
What medication is combined with Quinidine in the treatment of Chloroquine-resistant malaria?
|
Doxycycline - used for prophylaxis against multi-drug resistant malaria
|
|
|
What is the drug of choice for Malaria prophylaxis?
|
Mefloquine - Schizonticidal mechanism similar to chloroquine
Oral administration only |
|
|
What are the toxicities of Mefloquine?
|
Depression of myocardium
Seizures and psychosis (do NOT use in pts w/ epilepsy or psychological problems) Potential teratogen |
|
|
What is the mechanism of action for Pyrimethamine, Proguanil, and Sulfadoxine?
|
Inhibition of folate metabolism
Sulfadoxine inhibits the incorporation of PABA into folic acid Pyrimethamine inhibit dihydrofolate reductase |
|
|
What is the treatment of choice for uncomplicated chloroquine-resistant malaria?
|
Atovaquone + proguanil
Interferes with mitochondrial function |
|
|
What medication is used to treat the exoerythrocytic and gametocytes of malaria vivax and oval?
|
Primaquine - used for Terminal prophylaxis
|
|
|
What are the major toxicities of primaquine?
|
GI problems
HA, dizziness Hemolytic anemia in G6PD (similar to quinidine) Teratogenic*** |
|
|
What drugs are part of the MOPP regimen and what do they treat?
|
MEchlorethamine, vincristine (Oncovin), Prednisone, procarbazine
Tx: Hodgkin's disease, lymphocytic leukemia, lymphosarcoma |
|
|
What the toxicities of Mechlorethamine (Mustargen)?
|
Hyperuricemia (from tumor destruction), acute renal failure, nephrolithiasis
Teratogen, Gonadal suppression, GI |
|
|
What diseases does chlorambucil treat?
|
Leukemia (CLL), myeloma, autoimmune diseases
|
|
|
What medication is used to treat bladder cancer?
|
Thiotepa - used for breast, and ovary as a last resort
|
|
|
What is busulfan-myleran used to treat?
|
CML
May cause Pulmonary Fibrosis, Hyperuricemia, myelosuppression |
|
|
What tumors is Carmustine used to treat?
|
Brain, hodgkin's and non-Hodgkin's lymphoma, multiple myeloma, melanoma, GI cancers
Nitrosoureas, bone marrow suppression, kills in all phases |
|
|
What anti-neoplastic drug can cause acoustic nerve damage and renal toxicity?
|
Ciplatin - cross-links DNA
Sensitizes cells to radiation Testicular, ovarian, bladder, head, neck, endometrial, lung |
|
|
What are the Antimetabolite medications used to treat cancer?
|
Methotrexate
Mercaptopurine Fluorouracil |
|
|
What medication is used in combination with methotrexate to reduce some of the side effects?
|
Leucovorin (folinic acid)
|
|
|
What diseases is methotrexate used to treat? What are some of the toxicities?
|
choriocarcinoma (with dactinomycin)
Lymphomas (burkitt's and non-hodgkins) Breast, head and neck, ovary and bladder carcinoma Immunosuppressant for RA and Psoriasis Tox: Renal, alopecia, myelosuppression, hepatotoxicity, pulmonary inflammation, teratogenic |
|
|
What medication will increase the amount of 6-mercaptopurine in the blood?
|
Allopurinol
Metabolized by xanthine oxidase Tox: Bone marrow suppression, Jaundice |
|
|
What medication competes with dCTP, works mainly in the S phase, and is used to treat AML and ALL?
|
Cytarabine
May cause sever leukopenia, thrombocytopenia, anemia |
|
|
What cancer medications act by binding to DNA in S-phase and generate free radicals?
|
Daunorubicin/Doxorubicin (RUBICIN)
Effects are increased by Fe++ (free radicals) May produce cardiotoxicity, myelosuppression, alopecia |
|
|
What cancer medication damages DNA through free radicals in the G2 phase? What does it treat?
|
Bleomycin -
Testicular, ovarian cnacers Little myelosuppression, Pulmonary fibrosis*** |
|
|
What is the mechanism of action for Dactinomycin? What is it used to treat?
|
Binds DNA between C-G and stops RNA synthesis
Uses: Wilm's tumor, rhabdomyosarcoma, choriocarcinoma (methotrexate), sarcomas |
|
|
What is the mechanism of action of Vincristine and Vinblastine?
|
Binds to tubulin - blocks M phase
|
|
|
What are the uses of Vincristine and Vinblastine?
|
Vincristine: leukemia, Hodgkins, non-hodgkin's (neurotoxic)
Vinblastine: Testicular carcinoma, Hodgkin's disease, Kaposi's (Myelosuppression) |
|
|
What is the mechanism of action of Paclitaxel? What is it used for?
|
Binds to tubulin, arrests mitosis
Uses: Breast, ovary, lung, head, neck Tox: Peripheral Neuropathy, myalgia, arthralgia, hypersensitivities, Myelosuppression |
|
|
What does Asparaginase treat? What are the toxicities?
|
Leukemia - cells need asparagine ; used in combination for ALL (also cytarabine)
Tox: Pancreatitis, changes in clotting, hypersensitivity reaction |
|
|
What receptor does Trastuzumab interact with?
|
HER2
May cause cardiotoxicity |
|
|
What protein does Imatinib inhibit? What disease does it treat?
|
Blocks Bcr-Abl Fusion protein
- t(9:22) in CML - GIST |
|
|
What are the anti emetics used during chemotherapy?
|
Ondasetron - 5HT3 Antagonist
Prochlorperazine - D2 antagonist Dronabinol - THC Cyclinzine/Benedryl - H1 antagonist |
|
|
What three cancer medication typically cause neuropathy?
|
Vincristine
Vinblastine Paclitaxel |
|
|
What cancer medications cause pulmonary fibrosis?
|
Bleomycin - testicular cancer and Hodgkin's lymphoma
Busulfan - CML, bone marrow ablation |
|
|
Which cancer medications cause Hyperuricemia?
|
Mechlorethamine (mustargen)
6-Mercaptopurine Busulfan |
|
|
What cancer medications cause hepatic enzymes to increase?
|
Mercaptopurine
Methotrexate BCNU CCNU |
|
|
What is the dosing limitation with Cisplatin?
|
Renal Toxicity - treated with hydration
|
|
|
Which of the Nitrosoureas are used to treat pancreatic cancer?
|
Streptozocin
|
|
|
What kind of infections does Metronidazole treat?
|
E. hystolitica
Giardia Trichomonas Bacteroides Fragilis, C. diff Rosacea - (with clindamycin) topically |
|
|
What are the side-effects from metronidazole?
|
Metallic taste
GI irritation Disulfram-like effects Preg Category B: avoid in first trimester |
|
|
When is Diloxanide used and what medication is it combined with?
|
Tx: luminal trophozoites and cyst of E. hystolitica
Combined with metronidazole to treat amebiasis and asymptomatic carriers |
|
|
What are the uses of Iodoquinol and what are the toxicities?
|
Luminal trophozoites and cysts of E. hystolitica
Tox: skin reactions, thyroid enlargement, HA, diarrhea |
|
|
What two infections does Paromomycin treat?
|
Luminal trophozoites, cysts of E. hystolitica, and T. Vaginalis
|
|
|
When is emetine and dehydroemetin used? What are the toxicities?
|
Used as an alternative to Metronidazole
Tox: Cardiotoxicity, Serious GI effects, teratogen |
|
|
Other than metronidazole what is a medication that is used to treat Giardia?
|
Quinacrine - binds DNA
Pros: Cheap, orally adminst. Cons: Greater toxicities (HA, dizziness, hallucinations, ect.) |
|
|
What medication is a good treatment for giardia in kids?
|
Furazolidone - liquid preparation
|
|
|
What is the drug of choice for Pneumocytosis and is also useful against toxoplasmosis (but not as effective as pyrimethamine)
|
TMP-SMX (Bactrim) - prophylaxis of P. jirovecii in AIDS patients
|
|
|
When is leucovorin used?
|
Methotrexate - reduces symptoms
Pyrimethamine - reduce symptoms TMP - reduce symptoms 5-fluorouracil - INCREASE symptoms/effectiveness |
|
|
What medication can be used to treat P. jirovecii if patients don't tolerate Bactrim?
|
Pentamidine - inhibits DNA replication
Nebulizer form used as prophylaxis Tox: hypotension, arrhythmias, hypoglycemia |
|
|
What are the uses of Atovaquone?
|
Pnuemocystosis in patients that don't tolerate TMP/SMX
Used for malaria also |
|
|
What is the treatment of choice for Toxoplasmosis?
|
Pyrimethamine/Sulfadiazine - administered with folinic acid (leucovorin)
|
|
|
When would you used laxatives with an antihelminth medication?
|
When treating Taenia Solium (pork tapeworm)
May cause cysticercosis |
|
|
What is the drug of choice for roundworm, whipworm, hookworm, pinworm, and trichinosis?
|
Mebendazole - binds to tubulin and interferes with protein function
Teratogenic GI irritation, only 10% absorbed orally |
|
|
Aside from Mebendazole, what medication can treat roundworm, pinworm, and hookworm?
|
Pyrantel Pamoate - Cholinesterase inhibitor; produces depolarizing neuromuscular blockade in the worm
available OTC |
|
|
What is the drug of choice for tapeworms?
|
Niclosamide - inhibits anaerobic, oxidative phosphorylation
Causes Tapeworm to detach from intestine Laxative are used when treating T. solum (doest not treat Cysteicercosis) use albendazole for that |
|
|
What is the drug of choice for shistosomes?
|
Praziquantel - treats many of the cestodes and trematodes
One of the drugs in treating Neurocysticercosis - Albendazole too MA: increased Ca++ permeability then paralysis |
|
|
For female patients, what medications require two forms of birth control?
|
Ribavirin - INF-alpha 2a
Statins Thalidomide Warfarin Isoretinoic acid Misoprosterol |
|
|
What medication have worse effects in the second and third trimesters of pregnancy?
|
ACEI, ARBs - renal dysgenesis
|
|
|
How does Thalidomide cause birth defects?
|
Antimetabolites - Folic acid antagonist
|
|
|
What are the characteristics of Warfarin Syndrome?
|
Saddle nose
Borad, short hands Ophthalmic Bone Use heparin instead (does not cross placenta because of size) |
|
|
What are the teratogenic effects of phenytoin?
|
Growth retardation, mental deficiency
Short broad nose, cleft palate Cardiac abnormalities Abnormal genitalia No fingers/toes/nails |
|
|
What are the effects of taking sex hormones during pregnancy?
|
V - vertebral: hypoplastic vertebrae
A - Anal atresia C - Cardiac: septal defects T - Trachea/esophageal fistula E - Esophagus R - Renal: poor development, inability to urinate L - Limbs: lower arm, thumb |
|
|
What are the teratogenic effects of Isoretinoin?
|
Craniofacial, cardiac, thymus, CNS
Mental retardation Increased spontaneous abortion Single dose of medication |
|
|
What is a category B teratogen?
|
Animal studies with No risk with No human studies,
OR, Animal defects, but none in well-controlled human studies |
|
|
What defines a category C teratogen?
|
No adequate animal or human studies. OR
Defects in animals but no human data Only use if Benefits outweigh the Risks |
|
|
What is a category D teratogen?
|
Evidence of fetal risk has been demonstrated
Use only in life-threatening diseases Anticonvulsants, Benzos (cleft), TCAs, Prozac (cardiac), ACEI, ARBs |
|
|
What defines category X teratogen?
|
Evidence of fetal damage
Risks outweigh any benefits Absolutely contraindicated Statins, Warfarin, Misoprostol, Thalidomide, Ribavirin, Isoretinoin |
