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NR-NUR124 | Pharmacology > [5] (P2) ANTIBACTERIAL & ANTI-INFECTIVES > Flashcards

[5] (P2) ANTIBACTERIAL & ANTI-INFECTIVES Flashcards

1
Q

PULMONARY TUBERCULOSIS

ETIOPATHOGENESIS:
* Caused by ____
* Most common site for the development of TB is the ____ (____% of patients)
* Most infectious patients: those with ____ and ____
* Typical TB lesion: ____.

A
  • Caused by Mycobacterium tuberculosis
  • Most common site for the development of TB is the lungs (85% of patients)
  • Most infectious patients: those with cavitary pulmonary disease and laryngeal TB
  • Typical TB lesion: epitheloid granuloma with central caseation necrosis.
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2
Q

PULMONARY TUBERCULOSIS

CLINICAL MANIFESTATIONS:
* In the Philippines, cough of ____ should lead to high index of suspicion for PTB.
* Cough may be accompanied by ____, weight loss, ____, ____, chest pain, fatigue and ____
* Absence of fever (does/does not?) exclude TB
* Physical findings are of ____ utility in PTB

A
  • In the Philippines, cough of two weeks or more should lead to high index of suspicion for PTB.
  • Cough may be accompanied by night sweats, weight loss, anorexia, unexplained fever and chills, chest pain, fatigue and body malaise
  • Absence of fever does not exclude TB
  • Physical findings are of little utility in PTB
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3
Q

ANTITUBERCULAR DRUGS

DRUGS USED FOR TUBERCULOSIS
* ____ – 5 mg/kg max 300 mg
* ____ – 10 mg/kg, max 600 mg
* ____ – 25 mg/kg, max 2 g
* ____ – 15 mg/kg
* ____ – 15 mg/kg, max 1 g

A
  • Isoniazid (H/INH) – 5 mg/kg max 300 mg
  • Rifampicin (R) – 10 mg/kg, max 600 mg
  • Pyrazinamide (Z) – 25 mg/kg, max 2 g
  • Ethambutol (E) – 15 mg/kg
  • Streptomycin (S) – 15 mg/kg, max 1 g
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4
Q

ANTITUBERCULAR DRUGS

ISONIAZID
* Inhibits ____ synthase and ____ synthesis
* Excellent bactericidal activity against both ____ actively dividing MTB
* ____ against slowly dividing organisms

A
  • Inhibits fatty acid synthase and mycolic acid synthesis
  • Excellent bactericidal activity against both intracellular and extracellular actively dividing MTB
  • Bacteriostatic against slowly dividing organisms
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5
Q

ANTITUBERCULAR DRUGS

RIFAMPICIN

  • Binds to and inhibits ____ thereby blocking ____
  • Has both ____, both in dividing and non-dividing MTB
  • Also has ____
  • Most active ____ available and therefore ____ of first-line TB treatment
A
  • Binds to and inhibits mycobacterial DNA-dependent RNA polymerase thereby blocking RNA synthesis
  • Has both intracellular and extracellular bactericidal activity, both in dividing and non-dividing MTB
  • Also has sterilizing activity
  • Most active antimycobacterial agent available and therefore cornerstone of first-line TB treatment
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6
Q

ANTITUBERCULAR DRUGS

PYRAZINAMIDE
* Exact mechanism is ____ ( ____ may be the primary target).
* More active against ____ than against actively replicating organisms
* Active only in ____ environment (pH ____) and are found within ____

A
  • Exact mechanism is unclear (fatty acid synthetase-I may be the primary target.
  • More active against slowly replicating organisms than against actively replicating organisms
  • Active only in acidic environment (pH <6.0) and are found within phagocytes or granulomas
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7
Q

ANTITUBERCULAR DRUGS

ETHAMBUTOL
* Inhibits ____ involved in cell wall synthesis, which probably inhibits the formation of ____ and ____
* ____ agent which provides synergy with other drugs
* ____ potent against MTB

A
  • Inhibits arabinosyltransferases involved in cell wall synthesis, which probably inhibits the formation of arabinogalactan and lipoarabinomannan
  • Bacteriostatic antimycobacterial agent which provides synergy with other drugs
  • Least potent against MTB
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8
Q

ANTITUBERCULAR DRUGS

STREPTOMYCIN
* Inhibits ____ by binding at a site on ____
* ____ against dividing MTB but has only ____ activity

A
  • Inhibits protein synthesis by binding at a site on 30S mycobacterial ribosome
  • Bactericidal against dividing MTB but has only low-level early bactericidal activity
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9
Q

ANTITUBERCULAR DRUGS

Treatment Regimen for PTB - Catergory I
* New PTB (____ or ____)
* New extra-PTB (bacteriologically-confirmed or clincally-diagnosed), except ____

A
  • New PTB (bacteriologically-confimrmed or clinically diagnosed)
  • New extra-PTB (bacteriologically-confirmed or clincally-diagnosed), except CNS/bones or joints
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10
Q

ANTITUBERCULAR DRUGS

Treatment Regimen for PTB - Catergory I
* Initial Phase - ____
* Continuation Phase - ____

A
  • Initial Phase - 2 HRZE
  • Continuation Phase - 4 HR or 4 HRE
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11
Q

ANTITUBERCULAR DRUGS

Treatment Regimen for PTB - Catergory Ia
* New extra-PTB (____)

A
  • New extra-PTB (CNS/bones or joints)
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12
Q

ANTITUBERCULAR DRUGS

Treatment Regimen for PTB - Catergory Ia
* Initial Phase - ____
* Continuation Phase - ____

A

Treatment Regimen for PTB - Catergory Ia
* Initial Phase - 2 HRZE
* Continuation Phase - 10 HR

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13
Q

ANTITUBERCULAR DRUGS

Treatment Regimen for PTB - Catergory II

  • Pulmonary or extra-pulmonary, previously treated ____ (whether bacteriologically-confirmed or clinically-dIagnosed), except ____
  • Relapse
  • Treatment after failure
  • ____ (TALF)
  • ____ (PTOU)
A
  • Pulmonary or extra-pulmonary, previously treated drug-susceptible TB (whether bacteriologically-confirmed or clinically-diagnosed), except CNS/bones or joints
  • Relapse
  • Treatment after failure
  • Treatment after Lost to Follow-Up (TALF)
  • Previous Treatment Outcome Unknown (PTOU)
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14
Q

ANTITUBERCULAR DRUGS

Treatment Regimen for PTB - Catergory II
* Initial Phase - ____
* Continuation Phase - ____

A

Treatment Regimen for PTB - Catergory II
* Initial Phase - 2 HZRES and 1 HRZE
* Continuation Phase - 5 HRE

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15
Q

ANTITUBERCULAR DRUGS

Treatment Regimen for PTB - Catergory IIa
* Extra-PTB (____), previously treated, drug susceptible TB (wheter bacteriologically-confimred or clnically diagnosed)

A
  • Extra-PTB (CNS/bones or joints), previously treated, drug susceptible TB (wheter bacteriologically-confimred or clnically diagnosed)
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16
Q

ANTITUBERCULAR DRUGS

Treatment Regimen for PTB - Catergory IIa
* Initial Phase - ____
* Continuation Phase - ____

A
  • Initial Phase - 2 HRZES and 1 HRZE
  • Continuation Phase - 9 HRE
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17
Q

ANTITUBERCULAR DRUGS

DRUG-RESISTANT TB
* Standard Regimen Drug-Resistant (SRDR) - ____ or ____
* ____ - exclusively drug-resistant TB
* Alternate TB Treatment Regimen - individualized based on ____ and ____

A
  • Standard Regimen Drug-Resistant (SRDR) - rifampacin-resistant or multi-drug resistant TB
  • XDR TB Regimen - exclusively drug-resistant TB
  • Alternate TB Treatment Regimen - individualized based on previous treatment courses and drug sensitivity testing
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18
Q

ANTITUBERCULAR DRUGS

Side Effects and Management - Rifampacin
* Gastrointestinal intolerance - give medication at ____
* ____ urine - reassure the patient
* Flu-like symptoms (e.g., fever, muscle pain) - give ____
* ____ - discontinue and refer

A
  • Gastrointestinal intolerance - give medication at bed time
  • Orange/Red-colored urine - reassure the patient
  • Flu-like symptoms (e.g., fever, muscle pain) - give anti-pyretics
  • Thrombocytopenia, anemia, and shock - discontinue and refer
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19
Q

ANTITUBERCULAR DRUGS

Side Effects and Management - Pyrazinamide
* Arthralgia due to ____ - give ____; if symptoms persist, consider ____

A
  • Arthralgia due to Hyperuricemia - give aspirin or NSAID; if symptoms persist, consider gout

hyperuricemia - high uric levels in blood

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20
Q

ANTITUBERCULAR DRUGS

Side Effects and Management - Isoniazid
* Burning sensation in feet (____) - give ____ (vitamin B6) ____ daily for treatment; ____ daily for prevention
* ____ - discontinue and refer

A
  • Burning sensation in feet (peripheral neuropathy) - give Pyridoxine (vitamin B6) 100-200 mg daily for treatment; 10 mg daily for prevention
  • Psychosis and convulsion - discontinue and refer
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21
Q

ANTITUBERCULAR DRUGS

Side Effects and Management - Streptomycin
* Pain at injection site - apply ____
* Hearing impairment, ____, and dizziness due to damage of ____ - ____ and refer

A
  • Pain at injection site - apply warm compress
  • Hearing impairment, tinnitus, and dizziness due to damage of CN VIII - discontinue and refer
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22
Q

ANTITUBERCULAR DRUGS

Side Effects and Management - Any Kind of Drug
* Mild skin reactions - give ____
* ____ - discontinue anti-TB drugs and refer
* Jaundice due to ____ - discontinue anti-TB and defer; if symptoms subside, ____

A
  • Mild skin reactions - give antihistamines
  • Severe skin rash (hypersensitivity) - discontinue anti-TB drugs and refer
  • Jaundice due to hepatitis - discontinue anti-TB and defer; if symptoms subside, resume treatment and monitor clinically
23
Q

ANTITUBERCULAR DRUGS

Side Effects and Management - Ethambutol
* Impairment of visual acuity and color vision due to ____ - discontinue ethambutol and refer to an ____

A
  • Impairment of visual acuity and color vision due to optic neuritis - discontinue ethambutol and refer to an ophthalmologist
24
Q

ANTITUBERCULAR DRUGS

Side Effects and Management - Streptomycin and Rifampicin
* ____ due to renal disorder - discontinue and refer

A
  • Oliguria or albuminuria due to renal disorder - discontinue and refer
25
Q

ANTIFUNGAL DRUGS

Signs and Symptoms of Fungal Infection (4)

A
  • Skin rash
  • Skin lesions
  • Nail bed infection
  • Oral thrush
26
Q

ANTIFUNGAL DRUGS

Drugs that Affect Fungal Membranes - AMPHOTERICIN B
* Binds to ____, a major component of fungal cell membranes.
* Forms ____ that alter membrane stability and allow leakage of cellular contents
* Indications: ____, initial treatment for ____ (e.g. ____, Histoplasma capsulatum, ____)
* Adverse effects: Chills and fever, ____ (irreversible)

A
  • Binds to ergosterol, a major component of fungal cell membranes.
  • Forms amphotericin pores that alter membrane stability and allow leakage of cellular contents
  • Indications: topical infections, initial treatment for severe fungal infections (e.g. Candida albicans, Histoplasma capsulatum, Cryptococcus neoformans)
  • Adverse effects: Chills and fever, impaired renal function (irreversible)
27
Q

ANTIFUNGAL DRUGS

Drugs that Affect Fungal Membranes - AZOLES
* Includes: (6)
* Inhibit the ____ of ____ to ____ in fungal membranes
* ____-spectrum antifungals.

A
  • Includes: Itraconazole, Ketoconazole, Miconazole, Fluconazole, Clotrimazole, Voriconazole
  • Inhibit the cytrochrome P-450-mediated sterol demethylation of lanostero to ergosterol in fungal membranes
  • Broad-spectrum antifungals.
28
Q

ANTIFUNGAL DRUGS

Drugs that Affect Fungal Membranes - AZOLES (Itraconazole)
* Replaced ____ for the treatment of all mycoses
* Used ____ for ____, and ____ or as a shampoo for ____
* Drug of choice (DOC) for ____
* Inhibition of ____ metabolism (CYP3A4) increases or decreases metabolism of many drugs leading to toxicity
* Side effects: ____, itching, rashes, ____

A
  • Replaced ketoconazole for the treatment of all mycoses
  • Used topically for dermatophyte infections, and mucocutaneous candidiasis or as a shampoo for seborrheic dermatitis
  • Drug of choice (DOC) for disseminated blastomycosis
  • Inhibition of cytochrome P-450 metabolism (CYP3A4) increases or decreases metabolism of many drugs leading to toxicity
  • Side effects: gastric upset, itching, rashes, headache
29
Q

ANTIFUNGAL DRUGS

Drugs that Affect Fungal Membranes - AZOLES (Miconazole and Clotrimazole)
* For ____
* Used in ____ ( ____, ringworm, and ____)

A
  • For topical application
  • Used in dermatophyte infections (tinea pedis, ringworm, and cutaneous and vulvovaginal candidiasis)
30
Q

ANTIFUNGAL DRUGS

Drugs that Affect Fungal Membranes - AZOLES (Nystatin)
* Used topically for ____ infections of the skin, ____ and ____

A
  • Used topically for Candida infections of the skin, mucous membranes and intestinal tract
31
Q

ANTIFUNGAL DRUGS

Drugs that Affect Fungal Membranes - AZOLES (Fluconazole)
* Useful for ____
* Penetrates CSF (DOC for ____ and ____)
* Inhibits ____ and ____
* Adverse effects: nausea, vomiting, ____, and reversible ____

A
  • Useful for oropharyngeal and systemic candidiasis
  • Penetrates CSF (DOC for cryptococcal meningitis and disseminated histoplasmosis)
  • Inhibits CYP3A4 and CYP2C9
  • Adverse effects: nausea, vomiting, diarrhea, and reversible alopecia
32
Q

ANTIFUNGAL DRUGS

Other Antifungal Agents - Flucytosine
* Actively transported into fungal cells and is converted to ____ and subsequently to ____, which inhibits ____ and thus pyrimidine and nucleic acid synthesis
* Resistance develops ____, rarely used as a single drug but is often used in combination with ____.
* Relatively ____
* Adverse effects: ____ (at high doses); ____ administration can limit bone marrow effects.

A
  • Actively transported into fungal cells and is converted to 5-fluorouracil and subsequently to 5-fluorodeoxyuridylic acid, which inhibits thymidylate synthetase and thus pyrimidine and nucleic acid synthesis
  • Resistance develops rapidly, rarely used as a single drug but is often used in combination with other antifungal drugs.
  • Relatively nontoxic
  • Adverse effects: Depression of bone marrow function (at high doses); Uracil administration can limit bone marrow effects.
33
Q

ANTIPARASITIC DRUGS

Agents Active Against Amebiasis
* The major infecting organism is ____, which is ingested in ____ form, divides in the ____, and can invade the ____ to cause ____.

A
  • The major infecting organism is Entamoeba histolytica, which is ingested in cyst form, divides in the colon, and can invade the intestinal wall to cause severe dysentery.
34
Q

ANTIPARASITIC DRUGS

Metronidazole and Tindazole
* Metronidazole and Tindazole are used for ____ as for ____. They are also active agents ____ (formerly G. lamblia) and ____.
* ____ shows activity against many anaerobic bacteria
* Adverse effects: ____ (avoid with alcohol), ____ (avoided during the first trimester of pregnancy)

A
  • Metronidazole and Tindazole are used for intestinal amebiasis as for amebic liver abscesses. They are also active agents Giardia intestinalis (formerly G. lamblia) and T. vaginalis.
  • Metronidazole shows activity against many anaerobic bacteria
  • Adverse effects: Disulfiram-like action (avoid with alcohol), Teratogenic effects (avoided during the first trimester of pregnancy)
35
Q

ANTIPARASITIC DRUGS

Malaria - Pathogenesis
* Most important parasitic disease in humans
* In humans, the ____ is responsible for disease
* Rupture of ____ and release of ____ present clinically as ____ of malaria
* ____ are responsible for disease relapse

A
  • Most important parasitic disease in humans
  • In humans, the erythrocytic cycle is responsible for disease
  • Rupture of schizonts and release of merozoites present clinically as paroxysms of malaria
  • Hypnozoites are responsible for disease relapse
36
Q

ANTIPARASITIC DRUGS

Malaria - Etiology
* Protozoan disease caused by 4 species of ____ (____, ____, ____, and ____) and transmitted by the bite of infected ____ mosquitoes (____ in the Philippines)
* ____ causes nearly all deaths and neurological complications.

A
  • Protozoan disease caused by 4 species of Plasmodium (falciparum, vivax, ovale, and malariae) and transmitted by the bite of infected Anopheles mosquitoes (Anopheles flavirostris in the Philippines)
  • Plasmodium falciparum causes nearly all deaths and neurological complications.
37
Q

ANTIPARASITIC DRUGS

ANTIMALARIAL AGENTS - Chloroquine + Sulfaoxine/Pyrimethamine (CQ + SP)
* Clinical Use: first line treatment in probable and confirmed ____ that is not severe
* Pyrimethamine Side Effects: (3)

A
  • Clinical Use: first line treatment in probable and confirmed falciparum malaria that is not severe
  • Pyrimethamine Side Effects: megaloblastic anemia, pancytopenia, pulmonary infiltration
38
Q

ANTIPARASITIC DRUGS

ANTIMALARIAL AGENTS - Artemeter-Lumefantrine
Clinical Uses:
* ____ line drug for cases which did not respond to adequate ____
* Not recommended for ____ and ____

A
  • Second line drug for cases which did not respond to adequate CQ + SP therapy
  • Not recommended for pregnant women and children < 8 y/o
39
Q

ANTIPARASITIC DRUGS

ANTIMALARIAL AGENTS - Artemeter-Lumefantrine
Side Effects:
* Artemether - (3)
* Lumefantrine - ____

A
  • Artemether - anaphylaxis, utricaria, fever
  • Lumefantrine - none identified
40
Q

ANTIPARASITIC DRUGS

ANTIMALARIAL AGENTS - Quinine + Tetracycline/Doxycyline (Quinine + Clindamycin for Pregnant Women and Children < 8 y/o)
* Clinical Use: ____ line drug for those who did not response to second line regimen; drug of choice for ____
* Quinine Side Effects: ____, ____, high-tone hearing loss, ____, very bitter taste

A
  • Clinical Use: third line drug for those who did not response to second line regimen; drug of choice for severe malaria
  • Quinine Side Effects: cinchonism, tinnitus, high-tone hearing loss, hypoglycemia, very bitter taste
41
Q

ANTIPARASITIC DRUGS

ANTIMALARIAL AGENTS - Primaquine
Clinical Use:

  • Given as a single dose to confirmed ____ cases to prevent transmission
  • Given for ____ days to confirmed ____ to prevent relapse
  • The only drug which can eradicate ____ of the parasite

Side Effect: massive hemolysis in ____

A

Clinical Use:

  • Given as a single dose to confirmed P. falciparum cases to prevent transmission
  • Given for 14 days to confirmed P. vivax to prevent relapse
  • The only drug which can eradicate extrahepatic stages of the parasite

Side Effect: massive hemolysis in G6PD deficiency

42
Q

ANTIPARASITIC DRUGS

ANTIMALARIAL AGENTS - Chloroquine
* Clinical Use: drug of choice for ____
* Side Effects: nausea, ____, ____ , retinopathy (____)

A
  • Clinical Use: drug of choice for P. vivax cases
  • Side Effects: nausea, dysphoria, pruritus, retinopathy (> 100 g)
43
Q

ANTIPARASITIC DRUGS

Drugs used for severe Falciparum malaria (4)

A
  • Artesunate
  • Artemether
  • Quinine Dihydrochloride
  • Quinidine
44
Q

ANTIPARASITIC DRUGS

Drugs for Prophylaxis (2 groups)

A
  • Doxycycline, primaquine, atovaquine/proguanil, chloroquine
  • Mefloquine (only prophylaxis permitted in pregnancy)
45
Q

ANTIPARASITIC DRUGS

ANTIHELMINTHICS
Agents Effective Against Nematode (Roundworm) Infections - Albendazole and Mebendazole
* Bind with high affinity to ____ to inhibit its polymerization and microtubule assembly.
* Also irreversibly ____ by nematodes; the resulting glycogen depletion and decreased ATP production ____ the intestinal parasite, which is then cleared from the GI tract
* ____ is the drug of choice for ____ and cystic hydatid disease.
* Adverse effects: ____ during short term therapy. They are potentially ____.

A
  • Bind with high affinity to parasite free B-tubulin to inhibit its polymerization and microtubule assembly.
  • Also irreversibly inhibit glucose uptake by nematodes; the resulting glycogen depletion and decreased ATP production immobilize the intestinal parasite, which is then cleared from the GI tract
  • Albendazole is the drug of choice for cysticercosis and cystic hydatid disease.
  • Adverse effects: GI distress during short term therapy. They are potentially teratogenic.
46
Q

ANTIPARASITIC DRUGS

ANTIHELMINTHICS
Agents Effective Against Cestode (Tapeworm) and Trematode (Fluke) Infections - Praziquantel
* Causes ____ of the worm due to increased cell membrane permeability of ____
* Most effective drug against all types of ____ ( ____, ____)
* Adverse effects: fever and rashes, contraindicated in ____ (host-defense induced irreversible eye damage)

A
  • Causes paralysis of the worm due to increased cell membrane permeability of calcium
  • Most effective drug against all types of fluke infections (schistosomiasis, paragonimiasis)
  • Adverse effects: fever and rashes, contraindicated in ocular cysticercosis (host-defense induced irreversible eye damage)
47
Q

ANTIPARASITIC DRUGS

ANTIHELMINTHICS
Agents Effective Against Cestode (Tapeworm) and Trematode (Fluke) Infections - Bithionol
* Inhibits ____
* Alternative for ____ and as an alternative to ____ for ____

A
  • Inhibits parasite respiration
  • Alternative for Fasciola hepatica and as an alternative to praziquantel for acute pulmonary paragonimiasis
48
Q

ANTIVIRAL AGENTS

ANTIHERPES VIRUS DRUGS
Acyclovir
* ____, requires ____ to inhibit the activity of viral DNA polymerase
* ____ eradicate latent virus

A
  • Purine analog, requires viral thymidine kinase to inhibit the activity of viral DNA polymerase
  • Does not eradicate latent virus
49
Q

ANTIVIRAL AGENTS

ANTIHERPES VIRUS DRUGS
Penciclovir and Docosanol
* Used as ____ to treat herpes infection.
* Docosanol prevents ____ with cell membranes, thereby inhibiting viral penetration

A
  • Used as topical cream to treat herpes infection.
  • Docosanol prevents fusion with the HSV envelope with cell membranes, thereby inhibiting viral penetration
50
Q

ANTIVIRAL AGENTS

ANTIHERPES VIRUS DRUGS - Ganciclovir
* ____ analog that inhibits ____

A
  • Deoxyguanosine analog that inhibits replication of CMV
51
Q

ANTIVIRAL AGENTS

ANTIHERPES VIRUS DRUGS - Foscarnet
* Inhibits (2)

A
  • Inhibits viral DNA and RNA polymerase and **HIV reverse transcriptase **
52
Q

ANTIVIRAL AGENTS

ANTI-INFLUENZA AGENTS
Amantadine and Rimantadine
* Interact with the ____ of the ____ of the virus to inhibit the uncoating and replication of the viral RNA in infected cells
* Used to treat ____ (influenza A), administered within the ____, and as a prophylaxis during the season
* Adverse effects: mild CNS effects ( ____, ____ ) GI dysfunction. Patients with a ____ needs close monitoring. ____ effects

A
  • Interact with the M2 protein of the proton channel of the virus to inhibit the uncoating and replication of the viral RNA in infected cells
  • Used to treat orthomyxovirus (influenza A), administered within the first 48 hours of symptoms, and as a prophylaxis during the season
  • Adverse effects: mild CNS effects (insomnia, nervousness) GI dysfunction. Patients with a history of seizure needs close monitoring. Teratogenic effects
53
Q

ANTIVIRAL AGENTS

ANTI-INFLUENZA AGENTS
Zanamivir and Oseltamivir
* ____ inhibitors
* Treatment and prophylaxis of ____.
* Effective against ____
* Adverse effects: Abdominal pain and GI dysfunction ( ____ ) bronchospasm ( ____ )

A
  • Neuraminidase inhibitors
  • Treatment and prophylaxis of acute uncomplicated influenza infection.
  • Effective against both influenza A and B
  • Adverse effects: Abdominal pain and GI dysfunction (Oseltamivir) bronchospasm (Zanamivir)
54
Q

ANTIVIRAL AGENTS

ANTIRETROVIRAL DRUGS
* Act by inhibiting HIV-encoded RNA dependent DNA polymerase ( ____ )
* Combination therapy with ____ with drugs from the other classes of antiretroviral agents that reduce or prevent replication and have different modes of action is most effective. It reduce the likelihood of the ____
* Ex. (4)
* Adverse Effects: (2)

A
  • Act by inhibiting HIV-encoded RNA dependent DNA polymerase (reverse transcriptase)
  • Combination therapy with NRTI with drugs from the other classes of antiretroviral agents that reduce or prevent replication and have different modes of action is most effective. It reduce the likelihood of the development of resistance
  • Ex. Zidovudine, Didanosine, Stavudine, Lamivudine
  • Adverse Effects: metabolic acidosis, and hepatic toxicity

NR-NUR124 | Pharmacology (5 decks)

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