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Pharmacology > antimycobacterials, antifungals, and antivirals > Flashcards

antimycobacterials, antifungals, and antivirals Flashcards

1
Q

what are 4 antimycobacterials?

A

pyrazinamide (PAZ)
isoniazid (INH)
ethambutol (EMB)
rifampin (RIF)

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2
Q

is PAZ bacteriostatic or bactericidal?

A

bacteriostatic

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3
Q

pyrazinamide (PAZ) MOA

A

uncertain, requires activation via hydrolytic enzymes to form pyrazoic acid

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4
Q

PAZ use

A

active TB (m. tuberculosis only)

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5
Q

is INH bacteriostatic or bactericidal?

A

bactericidial

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6
Q

MOA of INH

A

inhibits mycolic acid synthesis

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7
Q

ADR/ DIs of INH

A

peripheral neuropathy
weak MAOI
must take pyridoxine (B6)

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8
Q

use of INH

A

active and latent TB

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9
Q

is EMB bacteriostatic or bactericidal?

A

bacteriostatic

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10
Q

MOA of EMB

A

inhibits formation of arabinogalactan (component of cell wall)

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11
Q

ADR of EMB

A

visual disturbances–> can’t tell red from green

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12
Q

use of EMB

A

active TB and MAC infections

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13
Q

is RIF bacteriostatic or bactericidal?

A

bactericidal

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14
Q

MOA of RIF

A

inhibits DNA dependent RNA polymerase

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15
Q

ADR/ DI of RIF

A

extremely potent CYP450 INDUCER
orange-red secretions

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16
Q

use of RIF

A

rifampin- TB
rifabutin- MAC
MRSA

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17
Q

list 3 types of antifungals

A

polyenes
azoles
echinocandins

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18
Q

polyene examples

A

amphotericin B and nystatin

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19
Q

MOA of polyenes

A

binds ergosterol in fungal cell membranes–> leaky pores

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20
Q

ADR of polyenes

A

nephrotoxicity
infusion rxns
electrolyte abnormalities (hypokalemia)

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21
Q

azole MOA

A

inhibits fungal P450 dependent enzymes blocking ergosterol synthesis

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22
Q

ADR/ DI of azoles

A

QT prolongation
inhibits CYP450!!!!!

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23
Q

what does fluconazole NOT treat

A

candida krusei

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24
Q

how to take itraconazole

A

caps- with means
solution- empty stomach
take with soda

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25
Q

how should you take voriconazole

A

take 1 hr after meal (food decreases absorption)

26
Q

how should you take posaconazole

A

PO- take with food or soda

27
Q

echinocandins MOA

A

inhibits glucan synthase–> decreased cell wall synthesis

28
Q

ADR of echinocandins

A

GI effects
hepatotoxicity

29
Q

NRTI MOA

A

inhibits HIV reverse transcriptase after phosphorylation by cellular enzymes

30
Q

list 5 NRTIs

A

abacavir (ABC)
emtricitabine (FTC)
lamivudine (3TC)
tenofovir (TDF)
zidovudine (AZT, ZDV)

31
Q

the NRTI ABC has what ADR

A

hypersensitivity HLA B*5701

32
Q

uses of NRTIs

A

HIV
Hep B- TDF, FTC, 3TC

33
Q

list 4 NNRTIs

A

efavirenz (EFV)
etravirine (ETR)
nevirapine (NVP)
rilpivirine (RPV)

34
Q

NNRTI MOA

A

inhibits same enzyme as NRTIs but work through different mechanism

35
Q

NNRTI drug that is pregnancy category D

A

EFV- efavirenz

36
Q

NNRTI inducers

A

NVP- nevirapine
ETR- etavirine

37
Q

NNRTI with mixed inducer/ inhibitor profile

A

EFV

38
Q

use of NNRTIs

A

HIV

39
Q

list 4 protease inhibitors

A

atazanavir (ATV)
darunavir (DRV)
Lopinavir (LPV)
Ritonavir (RTV)

40
Q

protease inhibitor MOA

A

inhibits viral protein processing by binding to site of protease activity on HIV

41
Q

ADR of protease inhibitors

A

severe n/v/d–> take with food

42
Q

DI of protease inhibitors

A

strong CYP450 INHIBITORS

43
Q

this refers to using potenent inhibition of drug metabolizing enzymes of ritonavir to increase concentrations and half-lives of other PIs

A

boosting

44
Q

what is the only PI used without boosting?

A

ATV

45
Q

use of PIs

A

HIV

46
Q

list 3 integrase inhibitors

A

raltegravir (RAL)
Elvitegravir (EVG)
dolutegravir (DTG)

47
Q

integrase inhibitor MOA

A

blocks integration of proviral gene into human DNA

48
Q

this class of antivirals are the newest class of ART and are very well tolerated and have now become 1st line tx of HIV

A

integrase inhibitors

49
Q

name a CCR5 inhibitor

A

maraviroc (MVC)

50
Q

maraviroc MOA

A

inhibits CCR5 receptors on cell membrane and prevent entry of HIV into cell

51
Q

ADR of CCR5 inhibitors

A

hepatotoxicity–> black box warning

52
Q

genetic testing is REQUIRED for what antiviral?

A

maraviroc (MVC)

53
Q

what test must be taken before starting maraviroc?

A

HIV tropism w/ trofile test
must be CCR5 + !!!!

54
Q

name 3 antiretrovirals for COVID

A

paxlovid
remdesivir
malnupiravir

55
Q

MOA of paxlovid

A

protease inhibitor binding to enzyme to prevent replication

56
Q

remdesivir MOA

A

RNA polymerase inhibitor

57
Q

malnupiravir MOA

A

acts as ribonucleoside analog for viral RNA polymerase increasing mutations

58
Q

these 2 antivirals for herpes are prodrugs

A

valacyclovir
famciclovir

59
Q

herpes antivirals MOA

A

inhibits viral DNA polymerase

60
Q

list 2 neuraminidase inhibitors

A

oseltamivir
zanamivir

61
Q

neuraminidase inhibitor MOA

A

prevents viral neuraminidase enzyme from releasing new virions from host cell, preventing further replication

62
Q

ADR of zanamivir

A

pulmonary effects–> AVOID IN ASTHMA or other respiratory disease

Pharmacology (9 decks)

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