anti-fungals

Question 1

Foscarnet MOA?

Answer 1

pyrophosphate analogue DNA polymerase inhibitor

S/E include nephrotoxicity and seizures

Question 2

HIV antifungal prophylaxis?

Answer 2

fluconazole - against candida

long term or short term - those on HAART with viral suppression don’t require it

Question 3

Cidofovir MOA?

Answer 3

DNA polymerase inhibitor

anti-CMV agent

Question 4

how to treat P. jiroveci infection ?

Answer 4

timethoprim-sulfamethoxazole - high dose IV

Question 5

Amantadine MOA?

Answer 5

interferes with function of viral M2 protein

Question 6

Oseltamivir MOA ?

Answer 6

neuraminidase inhibitor

used for influenza A and B neuraminidase

Question 7

Ribavirin MOA ?

Answer 7

Nucleoside analogue -

Question 8

Azoles (like fluconazole) MOA

Answer 8

inhibiting ergosterol biosynthesis which causes leakage of cellular constituents

toxicity: hepatotoxicity

works on candida but no activity against moulds

Question 9

Terbinafine MOA

Answer 9

intereferes with ergosterol synthesis

accumulates in keratin so good for treating dermatophyte infections

few interactions and generally well tolerated

for treatment of tinea

Question 10

Aciclovir MOA ?

Answer 10

analogue of guanosine

phosphorylated and activated by viral thymidine kinase - therefore no activity against our own cells

when incorporated into growing viral DNA chain, it leads to chain termination

valciclovir - is converted to acyclovir after first pass intestinal and hepatic hydrolysis

Question 11

Echinocandins like caspofungin MOA

Answer 11

interfere with synthesis of glucan in cell wall

works on all candida and all aspergillus

toxicity - hepatotoxicity

Question 12

Hepatitis C treatment?

Answer 12

use protease inhibitor like (Telaprevir, Boceprevir, and Simeprevir) +/- pegylated interferon and ribavirin

Question 13

Polenes (like amphotericin B) MOA

Answer 13

increase cell membrane permeability and leakage of contents

toxicity = renal toxcity

*lipid formulations have fewer side effects - liposomal amphotericin B

broad spectrum against yeasts, aspergillus, and mucorales

Question 14

Ganciclovir MOA?

Answer 14

*first antiviral against CMV

MOA = derivative of acyclovir - it is an analogue of guanosine and a DNA polymerase inhibitor - also activated by intracellular phosphorylation

resistance developed due to thymidine kinase deficient HSV and VZV

Question 15

Treatment of viral hepatitis?

Answer 15

interferon - used to boast host response

part of human cytokine response - and produced in response to infectious and immune stimuli

pegylated interforn alpha has a longer half life

S/E = flu like symptoms

Question 16

Zanamivir MOA

Answer 16

neuraminidase inhibitor