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14 Cards in this Set
- Front
- Back
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Mycobacteria |
Tuberculosis - M. tuberculosis Leprosy - M. leprae Atypical mycobacteria infections - M. avium |
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Tx for TB |
Isoniazid, rifampin, pyrazinamide combination해서 사용한다 (셋다 간독성의 문제점이 있다) |
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Isoniazid |
-inhibition of mycolic acid synthesis; -peripheral neuritis (말초성 신경염)+ pyridoxine 결핍의 부작용..../hypersensitivity -따라서 pyridoxine을 보충해줘야 합니다. -inactivated by acetylation. |
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Rifampin |
inhibition of RNAP; hypersensitivity의 부작용.
-Red color in urine, tears. -liver toxicity -induction of hepatic microsomal enz --> leads to DDI
트리플 R. |
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Antifungals (Systemic Use) - Amphotericin B |
-pore 형성한다. macromolecule 입니다. -Hydrophilic & Hydrophobic 한 부분을 갖고 있습니다. -부작용 = renal impairment. |
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Antifungals (Systemic Use) - Azole |
MOA: inhibition of fungal cytochrome P450 → reduction of ergosterol synthesis;
ADR = due to human CYP450 interaction. a. Ketoconazole: 처음으로 만들어진 azole계통. 너무 강하므로 oral x / topical O. 간독성. b. Itraconazole: most potent antifungal activity; active on aspergillus. IV formulation is possible. Strong drug interaction (CYP3A4) c. Fluconazole: 뇌 감염이 있을 때 (good CSF penetration) d. Voriconazole, Posaconazole: 항암요법으로 면역력이 떨어져 있는 환자에게 예방/치료의 목적으로 모두 사용. Voriconazole의 특징은 CYP2C19에 의해 대사. Posaconazole은 CYP3A4에 의한 대사 기억할 것!!
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Antifungals (Systemic Use) - Flucytosine |
FC taken up into fungal cells by cytosine permease. Intracellular metabolism to 5FU.
inhibit DNA, RNA synthesis (사람 세포에서는 active metabolite로 전환되지 않음) |
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Antifungals (Mucocutaneous Infection) - Terbinafine |
–inhibit squalene epoxidase → ergosterol synthesis is inhibited, squalene accumulated (fungicidal); no effect on CYP450 system. |
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Antifungals (Topical) - Nystatin/Ciclopirox
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전신에는 사용하지 않고 topical로만 사용한다. 토O피컬 - 동그라니(Nysta)까 ciclopirox.
cf) nystatin binds to ergosterol. |
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Respiratory virus infection (eg. Influenza) |
a. Influenza A virus M2 Blocker = Amantadine, RiMantadine. Rimantadine의 효과가 더 크다. rhymes with M! b. Neuraminidase Inhibitor = Zanamivir, Oseltamivir (viral clumping 유도; sialic acid 분해 억제); 잘라(Zana)낸다 c. Ribavirin: guanosine anagloue. inhibit wide target of DNA & RNA virus. (구라 Gu-RibA)
Respiratory 니깐 Riba
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Hepatic viral infection |
a. interferon b. acyclic nucleoside analogue -Adefovir: adenosine analogue -Lamivudine: cytosine analogue. Used for HBV as well as HIV. (큰일남. Cy-Lami)
(hepa는 Adefovir로 치료하면 Lam(낫)는다)) |
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For Herpes (HSV, VZV) & CMV infection |
a. Acyclic nucleoside analogue. Acyclovir (acyclic guanosine): 3단계의 phosphorylation을 필요로 한다 (by virus TK); Ganciclovir - acyclovir의 유도체 (CMV 효과 100배, ADR - myelosuppression; (간보다가 망함) Cidofovir - requires two phosphorylation
b. Foscarnet: no need for phosphorylation; ADR = nephrotoxicity (포스가 있는대신 독성이 있다)
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Antiretroviral.
HAART (highly active antiretroviral therapy) = three/four drugs taken in combo |
a. NRTI: must be phosphorylated by intracellular kinase into their active triphosphated forms -Zidovudine = AZT: thymidine analogue/ ADR = myelosuppression (Zola 놀다 망함) -Didanosine: deoxyadenosine 형태/zidovudine 내성균 -Abacavir: guanosine analogue. 아빠 구해줘요. (지단. Zi-Di-Aba) + Tenofovir (oral adenosine analogue) b. NNRTI = allosteric 한 작용; CYP에 대사 (cf. NRTI는 CYP에 의해 대사 x); HIV1 specific Efavirenz (에파비렌즈), Nevirapine (네피라핀) 아플(Efa) 때(Nevirapine)
c. PI (protease inhibitor) Squinavir, Ritonavir (boosting 효과가 있다. ritnonavir --> 다른 약품의 효과 높힘. Strong CYP3A inhibition), Indinavir
프로(protease)의 조건- Indefinitely (Indinavir) 다시 (Ri) 스퀏 (Squinavir)
d. fusion and entry inhibitor e. Integrase Inhibitor (d, e 넘어감)
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Combination Therapy |
Trizivir = abacavir + zidovudine + lamivudine 세가기 뭔지 알지 (A L Z)? |
