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Antifungals, Antivirals (Including HIV) Flashcards

1
Q

List some pharmacologic challenges with tuberculosis

A

resistance
bacteria exists in active & dormant phases
- need drugs for a long time to “wait” for active phase
d/t long drug therapy, adherence can be an issue

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2
Q

length of treatment for TB

A

6-24 months +

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3
Q

How many different anti-infective drugs should be used at once in the treatment of TB

A

2-7

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4
Q

Most TB drugs can result in toxicity to:

A

liver

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5
Q

adverse effects of isoniazid

A

hepatotoxicity
peripheral neuropathy
CNS symptoms

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6
Q

adverse effects of rifampin

A

hepatotoxicity
harmless discoloration of body fluid
GI disturbances

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7
Q

adverse effects of pyrazinamide

A

hepatotoxicity (the MOST)
polyarthralgia

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8
Q

adverse effects of ethambutol

A

optic neuritis (most significant)
allergic reactions
GI upset

rarely
- peripheral neuropathy
- renal damage
- thrombocytopenia

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9
Q

mechanism of action of amphotericin B

A

binds fungal cell membrane, results in increased leakage of electrolytes & cell death

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10
Q

length of treatment required with amphotericin B

A

1.5-4 months

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11
Q

amphotericin B drug elimination

A

unknown… drug can be detected in the body up to a year later

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12
Q

adverse effects of amphotericin B

A

infusion reactions
phlebitis
nephrotoxicity
hypokalemia
bone marrow suppressio n

**preferable to observe patients in the hospital during treatment

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13
Q

Alternatives to amphotericin B

A

azoles

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14
Q

Adverse effect of azoles

A

cardiosuppression
liver injury

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15
Q

mechanism of action of echinocandins

A

disrupt fungal cell wall

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16
Q

list a echinocandin

A

micafungin

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17
Q

definition: antiseptic

A

agent applied to living tissues

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18
Q

definition: disinfectant

A

applied to objects (too harsh for living tissues)

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19
Q

definition: sterilization

A

complete destruction of all microorganisms

20
Q

definition: germicide

A

drug that kills microorganisms

21
Q

definition: germistatic

A

suppression of microorganism growth & replication (doesn’t kill)

22
Q

most important measure to prevent spread of infection in healthcare facilities

A

handwashing

23
Q

What are some ways antivirals can work?

A
  1. block entry of virus into host cell
  2. block replication of viral DNA
  3. block production of viral proteins
24
Q

Drugs for HSV & VZV

A

acyclovir
valcyclovir

25
mechanism of action of acyclovir
inhibition of viral replication (suppresses viral DNA synthesis)
26
adverse effect of acyclovir
IV = nephrotoxicity PO = N/V/diarrhea
27
What is ganciclovir used for?
CMV
28
mechanism of action of ganciclovir
prevents replication of viral DNA
29
adverse effects of ganciclovir
bone marrow suppression teratogenesis
30
adverse effects of PEG-IFA
flulike symptoms neuropsych effects (SI) various organ dysfunction hemolytic anemia teratogenic
31
mechanism of action of sofosbuvir
blocks transcription of HCV RNA
32
does PEG-IFA cure hepC? Does sofosbuvir cure hepC?
PEG-IFA = no sofosbuvir = yes
33
list two drugs to treat hepatitis B
lamivudine entacavir
34
adverse effects of antivirals used to treat HepB
minimal
35
how long is treatment for HIV required?
for life
36
How many different medications are utilized in HAART therapy
3 or more
37
What are the 5 drug categories in HAART therapy?
- nucleoside reverse transcriptase inhibitors - nonnucleoside reverse transcriptase inhibitors - protease inhibitors - fusion inhibitors - integrase inhibitors
38
mechanism of action of NRTIs
prevent further DNA replication
39
adverse effects of NRTIs
lactic acidosis hepatic steatosis
40
mechanism of action of NNRTIs
binds reverse transcriptase preventing DNA replication
41
adverse effects of NNRTIs
CNS = dizziness, insomnia, nightmares severe rash liver damage
42
mechanism of action of protease inhibitors
block protease which is required for HIV maturation
43
adverse effects of protease inhibitors
hyperglycemia elevated LFTs PR prolongation
44
mechanism of action of fusion inhibitors
block HIV viral entry into host cells
45
adverse effects of fusion inhibitors
injection site reactions
46
mechanism of action of integrase inhibitors
terminate integration of HIV into DNA (prevents viral replication)
47
adverse effects of integrase inhibitors
(rare) rash liver failure

Pharm (27 decks)

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