Anti-influenza + Anti-Hep + Misc. + Anti-protozoa Flashcards
What are the four drugs used to treat Influenza?
Amantadine, Rimantadine, Oseltamivir, Zanamivir
Which drugs are prophylaxis against Influenza A?
Amantadine, Rimantadine. Give within 48 hours of exposure. Cannot treat H3N2 or H1N1.
What is the mechanism of action of Amantadine and Rimantadine?
Prevent uncoating of virus by binding to protein M2, an ion channel required at the onset of infection to permit acidification of the viral core, which activates viral RNA transcriptase.
What are side effects of Amantadine and Rimantadine?
GI irritation, ataxia, dizziness, slurred speech.
What is the action of Oseltamivir and Zanamivir
Inhibits neuraminidase and viral spread. Neuraminidase is produced by influenza A and B and activate against H3N2 and H1N1 strands.
How are Oseltamivir and Zanamivir administered?
Oseltamivir is orally activated and Zanamivir is given in a nasal spray
What are the adverse effects associated with Osltamivir and Zanamivir?
Oseltamivir has GI disturbances and Zanamivir is associated with cough, through discomfort and bronchospasm (Be very careful with asthmatics)
Which drugs are used to treat viral hepatitis?
Interferon Alpha, Adefovir Dipivoxil, Entecavir, Ribavirin.
What is the action of Interferon Alpha?
Stimulates formation of antiviral proteins and activates host cell RNAse (ribonuclease) that degrades viral mRNA
What are the clinical uses for Interferon Alpha?
Suppressive for Hep B, curative for Hep C
What are the adverse effects of Interferon Alpha?
GI irritation, flu-like symptoms, confusion, depression, neutropenia, reversible hearing loss
What is the mechanism of Adefovir Dipivoxil?
Prodrug Inhibits Hep B DNA polymerase causing chain termination
What are the side effects of Adefovir Dipivoxil?
dose limited nephotoxicity, severe hepatomegaly with steatosis
What is the action of Entecavir?
inhibits DNA polymerase in Hep B
What are the adverse effects of Entecavir?
headache, dizziness, fatigue, and nausea
What is the mechanism of Ribavirin?
inhibits replication in numerous DNA and RNA viruses
What are the clinical uses of Ribavirin?
with Interferon alpha for chronic Hep C Virus treatment and in infants and children with severe RSV infection.
What are the adverse effects of Ribavirin?
dose-dependent hemolytic anemia
What is Metronidazole and Tinidazole used to treat?
Bacteroides, Clostridium, Gardnerella vaginalis, and H. Pylori. Give via IV due to GI irritation.
What is the mechanism of action of Tinidazole and Metronidazole?
bioactivated to reactive cytotoxic products that interfere with DNA synthesis
What are the adverse effects of Metronidazole and Tinidazole?
GI irritation, dark discoloration of urine, increased incidence of opportunistic infections
What are Nitrofurantoin, Nalidixic Acid, and Methenamine used to treat?
Many urinary pathogens EXCEPT proteus and pseudomonas.
What is the mechanism of Nitrofurantoin, Nalidixic Acid, and Methenamine?
suppress bacteruria
What are the adverse effects of Nitrofurantoin, Nalidixic Acid, and Methenamine?
GI irritation, rash, phototoxicity
What are the drugs used to treat malaria?
Chloroquine, Quinine, Primaquine, Mefloquine, Pyrimethamine, Artesunate, Aretmether, Dihydroartemisinin
What is the mechanism of Chloroquine?
Prevents the polymerization of heme to hemezoin which would normally protect the parasite. The accumulation of heme results in lysis of the parasite and RBC.
What are the clinical uses of Chloroquine?
nonfalciparum and sensitive falciparum malaria
What are the adverse effects of Chloroquine?
GI irritation, skin rash, headache, and in high doses can cause ocular and auditory impairments
What is the mechanism of Quinine?
complexes with dsRNA to prevent strand separation. Blocks DNA replication. Used for P. Falciparum resistant to chloroquine.
What are adverse effects of Quinine?
cinchonism (tinitus, GI distress, vertigo, and blurred vision)
How does Primaquine work?
metabolites produces oxidative stress, eradicating liver stage of P. vivax and P. ovale
What are adverse effects of Primaquine?
GI distress, pruritis (itching), headache, methemoglobinemia
What is the mechanism of Mefloquine?
prevents polymerization of hemoglobin to hemozoin.
What is the clinical use of mefloquine?
used as prophylaxis in areas resistant to chloroquin
What are adverse effects of Mefloquine?
High doses can cause cardiac conduction defects and neurotoxicity
What is mechanism of Pyrimethamine
Blocks exoerythrocytic formation via inhibition of protozoan dihydrofolate reductase
What is Pyrimethamine used to treat?
combined with sulfadoxine to treat chloroquine-resistant P. falciparum.
What are the adverse effects of Pyrimethamine?
folate deficiency, hemolysis, kidney damage
What are the artemisinins used for (and what are they)?
Artesunate, aretmether, dihydroartemisinin are activated to toxic free radicals. Oxidative stress kills multidrug resistant malaria.
What do the artemisinins treat?
multi-drug resistant malaria
What drugs are used to treat amebiasis?
Chloroquine, emitines, metronidazole, tinidazole
How do amebicides work?
block ribosomal movement along mRNA. Act on organisms in bowerl wall and liver.
What are adverse effects of amebicides?
GI distress, muscle weakness, arrhythmias, CHF
What amebicides only work in the lumen of the gut?
diloxanide furoate, iodoquinol, and paromycin
