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All Drugs Exam 4 Flashcards

1
Q

Penicillin G

A

Drug Class/Route: Natural Penicillin IV and IM
Indication/Spectrum: Highest antibacterial activity w/ Gram +’ve and some Gram -‘ve
MOA Bactericidal Targets PBPs but need a growing cell well with Autolysins Prevents the cross linking of transpeptidation,
Contraindications: Potential Allergy and can’t given in combo with protein synth inhibitor
Adverse Effects: Competes with other acids in the kidneys
Resistance: B-Lacatamases/Penicillinases
Notes: Eliminated by the kidneys with poor CNS penetration DOC Gram +

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2
Q

Penicillin V

A

Drug Class/Route: Natural Penicillin ORAL
Indication/Spectrum: Highest antibacterial activity w/ Gram +’ve and some Gram -‘ve
MOA Bactericidal Targets PBPs but need a growing cell well with Autolysins Prevents the cross linking of transpeptidation,
Contraindications: Potential Allergy and can’t given in combo with protein synth inhibitor
Adverse Effects: Competes with other acids in the kidneys
Resistance: B-Lacatamases/Penicillinases
Notes: Eliminated by the kidneys with poor CNS penetration DOC Gram +

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3
Q

Nafcillin

A

Drug Class/Route: Penicillinase Resistance IV/IM
Indication/Spectrum: lower activity of Gram +’ve with some Gram -‘ve DOC for penicillinase producing S. aures(MSSA)
MOA Bactericidal Targets PBPs but need a growing cell well with Autolysins Prevents the cross linking of transpeptidation,
Contraindications: Potential Allergy and can’t given in combo with protein synth inhibitor
Adverse Effects:
Resistance: Resistance to Penicillinase
Notes: Hepatic Metabolism and Renal Excretion

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4
Q

Oxacillin

A

Drug Class/Route: Penicillinase Resistance Oral
Indication/Spectrum: lower activity of Gram +’ve with some Gram -‘ve DOC for penicillinase producing S. aures(MSSA)
MOA Bactericidal Targets PBPs but need a growing cell well with Autolysins Prevents the cross linking of transpeptidation,
Contraindications: Potential Allergy and can’t given in combo with protein synth inhibitor
Adverse Effects:
Resistance: Resistance to Penicillinase
Notes: Hepatic Metabolism and Renal Excretion

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5
Q

Methicillin

A

Drug Class/Route: Penicillinase Resistance
Indication/Spectrum: TESTING ONLY
MOA Bactericidal Targets PBPs but need a growing cell well with Autolysins Prevents the cross linking of transpeptidation,
Contraindications:
Adverse Effects:
Resistance:
Notes:

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6
Q

Ampicillin

A

Drug Class/Route: Extended Spectrum ORAL
Indication/Spectrum: Lower G+ coverage but Extended Gram -‘ve coverage
MOA Bactericidal Targets PBPs but need a growing cell well with Autolysins Prevents the cross linking of transpeptidation,
Contraindications: Potential Allergy and can’t given in combo with protein synth inhibitor
Adverse Effects: RASH Not necessarily Hypersensitivity
Resistance: B-Lacatamases/Penicillinases Need to use B-Lactamase Inhibitor in Combo
Notes: Extended Gram Coverage, Urinary Excretion

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7
Q

Amoxicillin

A

Drug Class/Route: Extended Spectrum ORAL
Indication/Spectrum: Lower G+ coverage but Extended Gram -‘ve coverage
MOA Bactericidal Targets PBPs but need a growing cell well with Autolysins Prevents the cross linking of transpeptidation,
Contraindications: Potential Allergy and can’t given in combo with protein synth inhibitor
Adverse Effects: RASH Not necessarily Hypersensitivity
Resistance: B-Lacatamases/Penicillinases Need to use B-Lactamase Inhibitor in Combo
Notes: Extended Gram Coverage, Urinary Excretion

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8
Q

Pipercillian

A

Drug Class/Route: Antipseudomonal IV
Indication/Spectrum: * P. Aeruginsoa*
MOA Bactericidal Targets PBPs but need a growing cell well with Autolysins Prevents the cross linking of transpeptidation,
Contraindications: Potential Allergy and can’t given in combo with protein synth inhibitor
Adverse Effects:
Resistance: B-Lacatamases/Penicillinases Need to use B-Lactamase Inhibitor in Combo
Notes: DOC Pseudomonal Use in combo with Aminoglycosides

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9
Q

Ticarcillin

A

Drug Class/Route: Antipseudomonal IV
Indication/Spectrum: DOC P. Aeruginsoa
MOA Bactericidal Targets PBPs but need a growing cell well with Autolysins Prevents the cross linking of transpeptidation,
Contraindications: Potential Allergy and can’t given in combo with protein synth inhibitor
Adverse Effects:
Resistance: B-Lacatamases/Penicillinases Need to use B-Lactamase Inhibitor in Combo
Notes: DOC Pseudomonal Use in combo with Aminoglycosides

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10
Q

B-lactamase inhibitors

A

Clavulanic acid, sulbactam, and tazobactam to Ampicillin, Amoxicillin, ticarcillian and Piperacillin to extend the spectrum of penicillinase susceptible… Not active for MRSA

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11
Q

Cefazolin

A

Drug Class/Route: First Generation Cephalosporin IM OR IV
Indication/Spectrum: Good activity for G+ bacteria with some G -‘ve DOC for SX prophylaxis
MOA Bactericidal Targets PBPs but need a growing cell well with Autolysins Prevents the cross linking of transpeptidation. Has 7-mythl group for increased Penicillinase resistance
Contraindications: Dose dependent renal toxicity when paired with Aminoglycoside
Adverse Effects: Superinfection, Disulfram RXN Allergy(10% cross RXN) Renal Tubular Necrosis
Resistance: Increased B-lactamase Resistance
Notes: Renal Excretion DOC SX Prophylaxis

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12
Q

Cephalexin

A

Drug Class/Route: First Generation Cephalosporin ORAL
Indication/Spectrum: Good activity for G+ bacteria with some G -‘ve
MOA Bactericidal Targets PBPs but need a growing cell well with Autolysins Prevents the cross linking of transpeptidation. Has 7-mythl group for increased Penicillinase resistance
Contraindications: Dose dependent renal toxicity when paired with Aminoglycoside
Adverse Effects: Superinfection, Disulfram RXN Allergy(10% cross RXN) Renal Tubular Necrosis
Resistance: Increased B-lactamase Resistance
Notes: Renal Excretion

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13
Q

Cefaclor

A

Drug Class/Route: 2nd Generation Cephalosporin ORAL
Indication/Spectrum: Good activity for G+ bacteria with some G -‘ve
MOA Bactericidal Targets PBPs but need a growing cell well with Autolysins Prevents the cross linking of transpeptidation. Has 7-mythl group for increased Penicillinase resistance
Contraindications: Dose dependent renal toxicity when paired with Aminoglycoside
Adverse Effects: Superinfection, Disulfram RXN Allergy(10% cross RXN) Renal Tubular Necrosis
Resistance: Increased B-lactamase Resistance
Notes: Renal Excretion

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14
Q

Cefurxomine

A

Drug Class/Route: 2nd Generation Cephalosporin IV or IM
Indication/Spectrum: Good activity for G+ bacteria with some G -‘ve
MOA Bactericidal Targets PBPs but need a growing cell well with Autolysins Prevents the cross linking of transpeptidation. Has 7-mythl group for increased Penicillinase resistance
Contraindications: Dose dependent renal toxicity when paired with Aminoglycoside
Adverse Effects: Superinfection, Disulfram RXN Allergy(10% cross RXN) Renal Tubular Necrosis
Resistance: Increased B-lactamase Resistance
Notes: Renal Excretion

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15
Q

Ceftriaxone

A

Drug Class/Route: 3rd Generation Cephalosporin IV or IM
Indication/Spectrum: Good activity for G+ bacteria with some G -‘ve
MOA Bactericidal Targets PBPs but need a growing cell well with Autolysins Prevents the cross linking of transpeptidation. Has 7-mythl group for increased Penicillinase resistance
Contraindications: No Neonates, Billrubin
Adverse Effects: Superinfection, Disulfram RXN Allergy(10% cross RXN) Renal Tubular Necrosis
Resistance: Increased B-lactamase Resistance
Notes: Renal Excretion DOC N. Gonnorrhea

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16
Q

Cefixime

A

Drug Class/Route: 3rd Generation Cephalosporin ORAL
Indication/Spectrum: Good activity for G+ bacteria with some G -‘ve
MOA Bactericidal Targets PBPs but need a growing cell well with Autolysins Prevents the cross linking of transpeptidation. Has 7-mythl group for increased Penicillinase resistance
Contraindications: Dose dependent renal toxicity when paired with Aminoglycoside
Adverse Effects: Superinfection, Disulfram RXN Allergy(10% cross RXN) Renal Tubular Necrosis
Resistance: Increased B-lactamase Resistance
Notes: Renal Excretion

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17
Q

Cefepime

A

Drug Class/Route: 4thGeneration Cephalosporin IV
Indication/Spectrum: Good activity for G+ bacteria with some G -‘ve
MOA Bactericidal Targets PBPs but need a growing cell well with Autolysins Prevents the cross linking of transpeptidation. Has 7-mythl group for increased Penicillinase resistance
Contraindications: Dose dependent renal toxicity when paired with Aminoglycoside
Adverse Effects: Superinfection, Disulfram RXN Allergy(10% cross RXN) Renal Tubular Necrosis
Resistance: Increased B-lactamase Resistance
Notes: Empirical Therapy, Broad Coverage Enterobacteriacee, MSSA, Pseudomonsas EMERGENT SITUATION Renal Excretion

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18
Q

Ceftraloine

A

Drug Class/Route: 5th Generation Cephalosporin IV
Indication/Spectrum: Good activity for G+ bacteria with some G -‘ve
MOA Bactericidal Targets PBPs but need a growing cell well with Autolysins Prevents the cross linking of transpeptidation. Has 7-mythl group for increased Penicillinase resistance
Contraindications: Dose dependent renal toxicity when paired with Aminoglycoside
Adverse Effects: Superinfection, Disulfram RXN Allergy(10% cross RXN) Renal Tubular Necrosis
Resistance: Increased B-lactamase Resistance
Notes: MRSA/VRSA ONLY NO ANTIPSEUDOMONAL Renal Excretion

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19
Q

Vancomycin

A

Drug Class/Route: Other IV
Indication/Spectrum: DOC MRSA Only Gram + ORAL for C-Diff
MOA Binds to D-ala-D-ala
Contraindications:
Adverse Effects: ototoxic and nephrotoxic… Redmans Syndrome(Flushing of Histamine
Resistance: Mutation of terminal D-ala will make it unusable, no binding.
Notes:

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20
Q

Erythromycin

A

Drug Class/Route: Macrolides Oral and IV
Indication/Spectrum: Similar to Pen G with G+ most susceptible
MOA Bacteriostatic Reversibly binds to the 50S subunit
Contraindications:
Adverse Effects: GI Symptoms and Most CYP interactions(Inhibitor), Prolonged QT(lowest of Macrolides)
Resistance: Majority are G- resistant. Efflux pumps and Methylation of the binding site to inactive, no ribosomal activity
Notes: Potent CYP INHIBITOR could lead to increased concentration of other drugs… Hepatotoxic and Hyperbuliema

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21
Q

Clarithromyocin

A

Drug Class/Route: Macrolides Oral
Indication/Spectrum: Similar to Pen G with G+ most susceptible
MOA Bacteriostatic Reversibly binds to the 50S subunit
Contraindications:
Adverse Effects: LEAST GI Symptoms and CYP interactions(Inhibitor), Prolonged QT
Resistance: Majority are G- resistant. Efflux pumps and Methylation of the binding site to inactive, no ribosomal activity
Notes: CYP INHIBITOR could lead to increased concentration of other drugs… Hepatotoxic and Hyperbuliema

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22
Q

Azitromyocin

A

Drug Class/Route: Macrolides Oral and IV
Indication/Spectrum: Similar to Pen G with G+ most susceptible
MOA Bacteriostatic Reversibly binds to the 50S subunit
Contraindications:
Adverse Effects: Moderate GI Symptoms and CYP interactions(Inhibitor), WORST Prolonged QT
Resistance: Majority are G- resistant. Efflux pumps and Methylation of the binding site to inactive, no ribosomal activity
Notes: LEAST CYP INHIBITOR of macrolides… Hepatotoxic and Hyperbuliema

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23
Q

Streptomycin

A

Drug Class/Route: Aminoglycosides IV or IM
Indication/Spectrum: uberculosis(second line) G-‘ve rods combined with Blactam, Tularemia, bubonic plague, TB and Endocarditis
MOA irreversibly binds to 30s and bacterialcidal
Contraindications: Not used for G+ or anaerobic
Adverse Effects: Oto and Nephrotoxic
Resistance: deficiency of ribosomal receptor, lack of permeability, medication(methylation) and drug efflux
Notes: Polarity is responsible for pharmokinectics, needs to have active transport(O2), Aerobic** **used in combo with antipseudominal(Piparcillin or Ticarcillin) as DOC*. PAE Once a day

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24
Q

Gentamicin

A

Drug Class/Route: Aminoglycosides IV/IM and Topical
Indication/Spectrum: Topical for wounds and burns caused by gram negative
MOA irreversibly binds to 30s and bacterialcidal
Contraindications: Not used for G+ or anaerobic
Adverse Effects: Oto and Nephrotoxic
Resistance: deficiency of ribosomal receptor, lack of permeability, medication(methylation) and drug efflux
Notes: Polarity is responsible for pharmokinectics, needs to have active transport(O2), Aerobic** **DOC entercocus spp Gentamicin and pen G. *DOC strep spp Gentamicin and pen G. PAE Once a day. PAE Once a day

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25
Neomycin
***Drug Class/Route:*** Aminoglycosides oral and Topical Indication/Spectrum: Topical for wounds and burns caused by gram negative ***MOA*** ***irreversibly binds to 30s*** and ***bacterialcidal*** ***Contraindications:*** Not used for G+ or anaerobic ***Adverse Effects:*** Oto and Nephrotoxic ***Resistance:*** deficiency of ribosomal receptor, lack of permeability, medication(methylation) and drug efflux ***Notes:*** Polarity is responsible for pharmokinectics, needs to have active transport(O2), ***Aerobic*** PAE Once a day
26
Tetracycline
***Drug Class/Route:*** Tetracyclines Oral and Topical Indication/Spectrum: Broad Spectrum(G + G-, aerobes, aerobes, spirochetes, richettsiae, mycoplasma ***MOA*** Binds ***reversibly*** to the 30S ribosome, prevents the access of tRNA ***Bacteriostatic*** ***Contraindications:*** No Prego and no kids under 8 cross placenta and breast milk ***Adverse Effects:*** Nml flora change, Photosensitivity, onycholysis, inhibit bone growth and dental discoloration, liver damage ***Resistance:*** B. Fragilis, Proteus, Pseudomonas Effulx pump ***Notes:*** DOC(Cholera, Mycoplasma Pneumonia, chlamydia, rickettsia, Borrelia burgdorferi, Plague and Vibrio. Chelated w/ Ca2+, Fe2+ and Al3+, can be deposited in bone and teeth wide distribution, metabolized through the liver
27
Doxycycline
***Drug Class/Route:*** Tetracyclines Oral and Topical Indication/Spectrum: Broad Spectrum(G + G-, aerobes, aerobes, spirochetes, richettsiae, mycoplasma ***MOA*** Binds ***reversibly*** to the 30S ribosome, prevents the access of tRNA ***Bacteriostatic*** ***Contraindications:*** No Prego and no kids under 8 cross placenta and breast milk ***Adverse Effects:*** Nml flora change, Photosensitivity, onycholysis, inhibit bone growth and dental discoloration, liver damage ***Resistance:*** B. Fragilis, Proteus, Pseudomonas Effulx pump ***Notes:*** DOC(Cholera, Mycoplasma Pneumonia, chlamydia, rickettsia, Borrelia burgdorferi, Plague and Vibrio. Chelated w/ Ca2+, Fe2+ and Al3+, can be deposited in bone and teeth wide distribution, metabolized through the liver
28
Minocycline
***Drug Class/Route:*** Tetracyclines Oral and Topical Indication/Spectrum: Broad Spectrum(G + G-, aerobes, aerobes, spirochetes, richettsiae, mycoplasma ***MOA*** Binds ***reversibly*** to the 30S ribosome, prevents the access of tRNA ***Bacteriostatic*** ***Contraindications:*** No Prego and no kids under 8 cross placenta and breast milk ***Adverse Effects:*** Nml flora change, Photosensitivity, onycholysis, inhibit bone growth and dental discoloration, liver damage ***Resistance:*** B. Fragilis, Proteus, Pseudomonas Effulx pump ***Notes:*** DOC(Cholera, Mycoplasma Pneumonia, chlamydia, rickettsia, Borrelia burgdorferi, Plague and Vibrio. Chelated w/ Ca2+, Fe2+ and Al3+, can be deposited in bone and teeth wide distribution, metabolized through the liver
29
Ciprofloxacin
***Drug Class/Route:*** Fluroquinolones ***ORAL*** Indication/Spectrum: aerobic G- rods and G+ coverage… Systemic infection, UTI, antrazx, P. Aeruginosa, Prostititis, STD(not syphilus) TB ***MOA*** Inhibits DNA Gyrase no relaxation of supercoils needed for transcription ***Bacteriocidal*** ***Contraindications:*** Preg or nursing women in children ***Adverse Effects:*** GI disturbances, Increased QT intervals, Cartilage erosion, tendon rupture, photosensitivity ***Resistance:*** Plasmid mediated resistance ***Notes:***Moxifloxacin and gemifloxacin I can do anaerobes ***DOC Antrax ***
30
Levofloxacin
***Drug Class/Route:*** Fluroquinolones ***ORAL*** Indication/Spectrum: aerobic G- rods and G+ coverage… Systemic infection, UTI, antrazx, P. Aeruginosa, Prostititis, STD(not syphilus) TB ***MOA*** Inhibits DNA Gyrase no relaxation of supercoils needed for transcription ***Bacteriocidal*** ***Contraindications:*** Preg or nursing women in children ***Adverse Effects:*** GI disturbances, Increased QT intervals, Cartilage erosion, tendon rupture, photosensitivity ***Resistance:*** Plasmid mediated resistance ***Notes:***Moxifloxacin and gemifloxacin I can do anaerobes ***DOC Antrax***
31
Metronidazole
***Drug Class/Route:*** Oral, IV, Topical Indication/Spectrum: Anaerobes G- and B+ bacilli(anaerobes) ***MOA*** ***Prodrug*** non-enzymatically reducing by reacting with reduced ferredoxin(only in ANAEROBES, metabolites taken up by bacterial DNA and form unstable molecules ***Bacterialcidal*** ***Contraindications:*** ***Adverse Effects:*** ***Resistance:*** Disulfiram like reaction and gisegusia(Metallic taste) ***Notes:*** C-Diff ***alternate*** to oral Vance, endocarditis H-pylori… Liver metabolism and eliminated in urine
32
Sulfamethoxazole + Trimethoprim and Cotrimoxazole
***Drug Class/Route:*** Oral and Parenteral Indication/Spectrum: ***MOA*** PABA cell membrane competes with PABA in folic acid Less sensitive in human enzyme. Synergistic relationship ***Bacteriostatic, in Urinary bacteriocidal*** ***Contraindications:*** ***Adverse Effects:*** Aplastic anemia, SJS, Kerniterus, photosenctitiy ***Resistance:*** Efflux pathways ***Notes:***DOC for UTI
33
Mupircin
***Drug Class/Route:*** Topical Indication/Spectrum: Impetigo, MRSA(Intranasally) G+ and Some G- ***MOA*** Reversibly binds to bacterial isoleucy TRNA Synthesizes, inhibiting protein and RNA synths ***Contraindications:*** ***Adverse Effects:*** ***Resistance:*** ***Notes:***
34
Polymixin B
***Drug Class/Route:*** Gram - Indication/Spectrum: G- phospholipids (Lipid A endotoxin) ***MOA*** ***Bacteriacidal*** binds to G- phospholipids A ***Contraindications:*** ***Adverse Effects:*** ***Resistance:*** ***Notes:***
35
Acyclovir
***Drug Class/Route:*** AntiViral Herpes, Oral, topical and IV Indication/Spectrum: ***DOC for VZV*** ***MOA*** Guanosine analogue, needs phophorlyation and activation by viral Thymidine Kindase. Inhibits DNA synthesis but competing w/ dGTP. Concentrates in viral infected cells ***Contraindications:*** CMV ***Adverse Effects:*** Well tolerated, due to conc in viral cells, ***nephrotoxic*** w high IV dose, need hydration… ***safe in Prego*** ***Resistance:*** Mutation to viral TKinase ***Notes:***
36
Valacyclovir
***Drug Class/Route:*** Anti-viral(Herpes) Oral higher bioavailability Indication/Spectrum: ***DOC for HSV and VZV*** ***MOA*** Pro drug converted to acylclovir still need phophrylation ***Contraindications:*** ***Adverse Effects:*** Well tolerated, due to conc in viral cells, ***nephrotoxic*** w high IV dose, need hydration… ***safe in Prego*** ***Resistance:*** Mutation to viral TKinase ***Notes:*** Immunocompr pt
37
Docosanol
***Drug Class/Route:*** Anti-viral(herpes) Oral OTC Indication/Spectrum: HSV ***MOA*** Inhibits viral fusion to hot plasma membrane(virus can not get into the cell) ***Contraindications:*** ***Adverse Effects:*** MINOR irritates skin, and HA ***Resistance:*** ***Notes:***
38
Osltamivir
***Drug Class/Route:*** Anti-Viral(Flu) Oral Indication/Spectrum: Influenza A and B ***MOA*** need to start w/in 48 hours s/p onset ***Contraindications:*** ***Adverse Effects:*** NV needs to be taken w/ food ***Resistance:*** ***Notes:*** ***only for greater than 1 y/o***
39
Zanamivir
***Drug Class/Route:*** Anti-Viral(Flu) nasal or oral inhaler Indication/Spectrum: Influenza A and B ***MOA*** need to start w/in 48 hours s/p onset ***Contraindications:*** ***Adverse Effects:*** Worsen fin in COPD, bronchospasm in asthmatics and not recommended for those w/ airway dz ***Resistance:*** ***Notes:*** ***only for greater than 7 y/o***
40
Sofobuvir/Ledipasvir
***Drug Class/Route:*** Hep-C ***CURE*** Indication/Spectrum: HEP-C ***MOA*** Sofobuvir(Uridine Analogue, inhibits viral NS5B blocking replication of HCV) Ledipasvir(inhibits HCV NS5A protein may block hyperphosphyrlayion MOA unknown) ***Contraindications:*** ***Adverse Effects:*** Fatigue, HA and irritability ***Resistance:*** ***Notes:*** Well tolerated COSTLY
41
Ganciclovir
***Drug Class/Route:*** Ocular implant, oral and IV… CMV or Herpes Indication/Spectrum: ***DOC CMV or CMV/Herpes co infection***CMV rentintis ***IV w/ life threaten*** ***MOA*** Guanosine analogue, needs phophorlyation and activation by viral kinase in cell w/ infected herpes or CMV activated drug inhibits DNA polymers ***Contraindications:*** No prego, ***Category C*** ***Adverse Effects:*** ***Myelosupression: neutropenia, Thrombocytopenia, leukopenia,*** CNS (HA, Confusion, and SZ) NV, Phlebitis and hepatotoxic ***Resistance:*** ***Notes:*** Less selective than acyclovir and ***more Toxic***
42
Valganciclovir
***Drug Class/Route:*** Oral only… CMV or Herpes Indication/Spectrum: ***DOC CMV or CMV/Herpes co infection***CMV rentintis ***IV w/ life threaten*** ***MOA*** Guanosine analogue, needs phophorlyation and activation by viral kinase in cell w/ infected herpes or CMV activated drug inhibits DNA polymers ***Contraindications:*** No prego, ***Category C*** ***Adverse Effects:*** ***Myelosupression: neutropenia, Thrombocytopenia, leukopenia,*** CNS (HA, Confusion, and SZ) NV, Phlebitis and hepatotoxic ***Resistance:*** ***Notes:*** Less selective than acyclovir and ***more Toxic***
43
Isoniazid
***Drug Class/Route:*** Active TB Antimicrobial Indication/Spectrum: Active TB along w/ R, P, or E… ***Latent is monotherpy*** ***MOA*** Inhibits biosynthesis of mycotic acid ***Needs KatG*** to be active, prodrug ***Contraindications:*** ***Adverse Effects:*** hepatitis(needs liver fin test), peripheral neuritis, hemolysis in pt w/ ***6-GPD*** deficiency, lupus like syndrome, CNS(SZ, insomnia, restlessness, and psych) ***Resistance:*** ***Notes:*** Lupus like syndrome(HIP drug hydralazine, INH and procanimamide)
44
Rifampin
***Drug Class/Route:*** Active and latent TB ORAL Indication/Spectrum: Active use in combo latent mono ***MOA*** Inhibits DDRP ***Contraindications:*** Not recommended for HIV other antivirals will not work ***Adverse Effects:*** Hepatic enzyme induction(***Potent inducer of CYP***) ***Orange Urine*** Decreased birth control effects induces lover metabolism of progestins, GI and hypersensitivity ***Resistance:*** rpoB subunit mutation confer resistance ***Notes:***
45
Ethambutol
***Drug Class/Route:*** Only Active TB w/ combo Indication/Spectrum: TB ***MOA*** Inhibits arabinosyk transferase(embCAB) ***Contraindications:*** no one under 13 y/o ***Adverse Effects:*** decreased visual acuity loss of green and red perception ***Resistance:*** ***Notes:***
46
Pyrazinamide
***Drug Class/Route:*** Active TB only w/ combo oral Indication/Spectrum: TB active ***MOA*** MOA unknown but active at acidic PH, optimal for MTB within macrophages ***Contraindications:*** ***Adverse Effects:*** Nephron and hepatic toxic need LFTs ***Resistance:*** ***Notes:*** Critical first line drug responsible for reducing therapy to current standard of 6 months(from 9-12 months)
47
Amphotericin B
***Drug Class/Route:*** Anti-fungal IV Indication/Spectrum: Fungus ***Fungicidal*** broad ***DOC for SYSTEMIC*** ***MOA*** Interacts w/ sterol on fungal membrane and ergosterol leads to membrane lose. Ampho B binding leads to depol of membrane forming a pore, increased permeability. ***Contraindications:*** ***Adverse Effects:*** Toxicity reaction w/ other drgugs or reactions occurring over time Infusion rxn are immediate overtime nephrotoxic ***Irreversible Kidney damage*** ***Resistance:*** ***Notes:*** Poor CNS penetration excreted bye kidneys slowly so nephrotoxic
48
Flucytosine
***Drug Class/Route:*** Indication/Spectrum: Lower than Ampho B, ***Cryptoccus neoformas*** ***DOC w/ combo Ampho B for C. Neoformas*** ***MOA*** Metabolic antagonism of fungal DNA and RNA, converted to 5-FLurourical interferes w/ synth humans don’t have but bacteria does ***Contraindications:*** ***Adverse Effects:*** GI changes to nml flora, depresses Bone marrow, Elevated ALT/AST need to check labs ***Resistance:*** ***Notes:*** Penetrates CNS, renal elimination
49
Ketoconazole
***Drug Class/Route:*** Antifungal ORAL well distributed poor CNS Indication/Spectrum: Broad spectrum anti fungal ***MOA*** ***Fungistatic*** ***Contraindications:*** acute or chronic hepatic and men ***Adverse Effects:*** Potent ***Inhibtior*** of CYP, gynomastia and impotence, prolonged QT ***Resistance:*** ***Notes:***
50
Fluconazole
***Drug Class/Route:*** Oral and IV penetrates CF well Indication/Spectrum: Fungal meningitis, good for suppressive and prophylactic HIV pts ***MOA*** ***Contraindications:*** ***Adverse Effects:*** HA, NVD abd pain, rash ***Resistance:*** ***Notes:*** Less toxic than keto ***Poten CYP inhibitor*** Need LFT AST and ALT
51
Griseofulvin
***Drug Class/Route:*** Oral Indication/Spectrum: Dermatp[hytosis, infection of skin hair and nails ***MOA*** Binds to keratin prevents new infection in new skin ***Contraindications:*** No prego and men 6months prior ot father child ***Adverse Effects:*** Hepatotoxic, Penicillin hypersensitivity cross rxn, photosensitive, CNS(HA), Disulfiram like rxn, ***Resistance:*** ***Notes:***
52
Terinafine
***Drug Class/Route:*** Oral or topical Antifungal ***Fungicidial*** Indication/Spectrum: Onychomycosis ***MOA*** Interferes w/ sterol biosynthesis, inhibits squaller monooxygenase ***Contraindications:*** ***Adverse Effects:*** HA, Dermitisi, GI, Taste Change, liver enzyme abnormalities ***Resistance:*** ***Notes:*** less active in candida
53
Nystatin
***Drug Class/Route:*** Oral or topical Indication/Spectrum: Candial infection Oral for GI and Topical for others ***MOA*** Polyene antibiotic like anmpho B ***Contraindications:*** ***Adverse Effects:*** Mild NVD, s/p oral use ***Resistance:*** ***Notes:*** Not abs by GI, Skin or Mucusal membrane
54
Mechlorethamine(Nitrogen Mustard)
***Drug Class/Route:*** Alkylating Agent part of ***MOPP*** regimen Indication/Spectrum: Hodgkins Dz, leukemia, lymphosarcoma ***MOA*** Adds Alkyl group to DNA inhibiting ***proliferating*** cells ***Contraindications:*** Prego(teraogenic) ***Adverse Effects:*** NV, CNS, Bone marrow depression, immunesupression hematological(Myeloid) ***Resistance:*** ***Notes:*** Vesicant(tissue damage) at injection site
55
Cyclophosphamide
***Drug Class/Route:*** Alkylating agent Indication/Spectrum: ***MOA*** Activated by ***P-450*** ***Contraindications:*** ***Adverse Effects:*** ***Not vesicant***, immunosuppressive, alopecia, hematologic, hemorrhagic cystitis, inappropriate ADH ***Resistance:*** ***Notes:*** Use mensa for cystitis
56
Cisplatin
***Drug Class/Route:*** Indication/Spectrum: Effective in epithelial cancers, broad spectrum: testicular CA, Ovarian CA, Head, Neck, endometrium and Lung ***MOA*** cross link DNA, sensitizes cells to radiation(makes susceptible) ***Contraindications:*** ***Adverse Effects:*** Renal toxicity, acoustic nerve damage, anaphylaxis ***Resistance:*** ***Notes:***
57
Methotrexate
***Drug Class/Route:*** Antimetabolite Indication/Spectrum: Leukemia, choricarinoma, Burkitts lymphoma(EBV), Non-hodgkins lymphoma, solid tumors, immunosupreessive(can tx RA) ***MOA*** Blocks nml compound from binding, inhibits dihydroflotate reductase no DNA synthesis, Leucovorina bypass can help reduce toxicity of methotrexate ***Contraindications:*** TERATOGENIC=Sterility ***Adverse Effects:*** Preciptpiates in the renal tubule, need to hydrate, hepatotoxicity, myelosupresision, alopecia, GI, Pulm ***Resistance:*** Decreased uptake and increased expression of Dihydroxyfolate reductase ***Notes:***
58
5-Flurourical
***Drug Class/Route:*** topical for basal cell carcinoma(burned face chem peel) Indication/Spectrum: Broad spectrum solid tumors ***MOA*** Inhibits thymidylate synthase- blocks DNA synth cell cycle specific ***G1 and S phase*** ***Contraindications:*** ***Adverse Effects:*** ***Resistance:*** Decreased HGPRT ***Notes:***
59
6-Mercaptopurine
***Drug Class/Route:*** Purine Analogue Indication/Spectrum: Leukemia ***MOA*** ***Contraindications:*** ***Adverse Effects:*** Bone marrow depression and Jaundice(Cholestatsis) ***Resistance:*** Decreased HGPRT ***Notes:*** Allopurinol can help toxicity but also effectiveness
60
Doxorubicin
***Drug Class/Route:*** Indication/Spectrum: Hodgkins lymphoma, non-hodgkin lymphoma, sarcomas, breast, thyrpod, lung, endometrium, ovarian and testes, leukemia ***MOA*** Intercalates into DNA, generates a free radical(ROS) increased by Fe2+ ***Contraindications:*** ***Adverse Effects:*** Cardiotoxic but reversible, CHF, Chelator ***Resistance:*** ***Notes:*** Dexrazonxane may help w/ Fe2+
61
Bleomycin
***Drug Class/Route:*** Indication/Spectrum: Oral and Bladder, effective(testicular and ovarian) ***MOA*** Directly damages DNA, ***Cell Cycle Specific*** G2 and M ***Contraindications:*** ***Adverse Effects:*** min myleosupression, ***pulm fibrosis*** anaphylactoid(Allergy) ***Resistance:*** ***Notes:*** Lance Armstrong
62
Vincristine
***Drug Class/Route:*** Plant Indication/Spectrum: leukemia, M***O***PP ***MOA*** Binds to tubulin(M-Phase), no axonal transport ***Contraindications:*** neurotoxic, low myelosupression ***Adverse Effects:*** ***Resistance:*** ***Notes:*** Christ the Neurons
63
Vinblastine
***Drug Class/Route:*** Plant Indication/Spectrum: Testicular carcinoma, Hodgkins and Kaposi(HIV bad) ***MOA*** Binds to tubulin(M-Phase), no axonal transport ***Contraindications:*** neurotoxic, more myelosupression ***Adverse Effects:*** ***Resistance:*** ***Notes:*** Less neurogenic to Vincrestien Blast the bone marrow(Myeloid)
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Paclitaxel
***Drug Class/Route:*** Plant Indication/Spectrum: Advance breast, ovary, lung, head and neck CA ***MOA*** Binds to tubulin/microtubulin, arrest mitosis and distrusts axonal transport ***Contraindications:*** ***Adverse Effects:*** Peripheral neuropathy, myalgia, arthralgia, hypersensitivity, myleosupression ***Resistance:*** ***Notes:*** Active and very toxic
65
Prednisone
***Drug Class/Route:*** Hydrocortisone Indication/Spectrum: ***MOA*** ***Contraindications:*** ***Adverse Effects:*** ***Resistance:*** ***Notes:***
66
Tamoxifen
***Drug Class/Route:*** Estrogen specific inhibitor Indication/Spectrum: Breast CA ***MOA*** ***Contraindications:*** ***Adverse Effects:*** Hot flashes NV, decreased HDL and uterine effects ***Resistance:*** ***Notes:***
67
Trastuzumab
***Drug Class/Route:*** Indication/Spectrum: Breast CA ***MOA*** HER2 ABY ***Contraindications:*** ***Adverse Effects:*** Cardiotoxic ***Resistance:*** ***Notes:***
68
Flutamide
***Drug Class/Route:*** Antiandrogen Indication/Spectrum: Prostate CA ***MOA*** Prevent the last states of DHT ***Contraindications:*** ***Adverse Effects:*** ***Resistance:*** ***Notes:***
69
Imatinib
***Drug Class/Route:*** Indication/Spectrum:First line chronic myeolgenous leukemia(CML) ***MOA***Protein kinase inhibitor ***Contraindications:*** ***Adverse Effects:*** NVD, edema/rash and muscle pain ***Resistance:*** ***Notes:***

Pharm 2 Exam 4 (1 decks)

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