Antivirals and Antifungals Flashcards
What is the MOA of Oseltamovir and Zanamovir?
Inhibit neurominidase A
What is the MOA of Ribavirin?
Inhibit RNA & DNA virus
d/t alteration of nucleotide pool and inhibit viral messenger RNA
What are the contraindications of Ribavirin?
TERATOGENIC
How do azole drugs work?
Fungistatic;
-Mechanism: stop growth/replication by interfering w/ CYP450s; dec ergosterol synthesis
Discuss the PKs of Fluconazole
Great body fluid penetrator
What are the uses of Fluconazole?
First line of defense against Candidiasis; Can be used prophylaticly
SEs and CCIs of Fluconazole?
Rash; Decreases rifampin concentration
What is the PKs of Itraconazole?
Lipophilic -not CSF/urine (meninges/UTI) -poor oral bioavailability: -oral capsule; oral solution are NOT interchangeable (oral capsule w/ food, oral solution on empty stomach) -Metabolized by CYP3A4
What are the SEs of Itraconazole?
- unpleasant taste
- Black box warning: rare cases of cardio events (death,)
What are the contraindications and DDIs of Itraconazole?
Not for meninges or urinary tract -Caution w/ liver dysfunction -Many DDI contraindications (fluconazole does NOT) -Dec by: antacid, H2 antagonist,
What are the PKs of Voriconazole?
Hepatic metabolism:
- inhibits 3A4, 2C9
- 2C9 and 2C19 inducers decreases Voriconazole conc’n
What are the contraindications of Voriconazole?
TERATOGENIC
What are the PKs of Pozaconazole?
Great penetration into tissues
No dose adjustment w/ renal
impairment
-glucuronidation metabolism
What are the uses of Voriconazole? contraindications?
Fluconazole resistant Candida;
Increases voriconazole dose w/ St. johns wort
What are the side effects of Pozaconazole?
Ocular changes -hepatotoxicity: monitor LFTs -Cholestasis: bilirubin and AlkPhos -QT prolongation TERATOGENIC
