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Pharmacology > Antivirals, Antifungals, Antiparasitics > Flashcards

Antivirals, Antifungals, Antiparasitics Flashcards

1
Q

Name 3 treatment options for HSV and VZV

A
  • Acyclovir
  • valaciclovir (prodrug)
  • famciclovir (prodrug of penciclovir)

Not ganciclovir! Reserved for CMV due to severe side effects

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2
Q

Moa acyclovir?

A

Inhibit DNA synthesis during viral replication by phosphorylation by viral thymidine kinase. Guanine analogue. Irreversible inactivation viral DNA polymerase.

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3
Q

Name 2 treatment options for CMV

A
  • Ganciclovir

* valganciclovir

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4
Q

Moa ganciclovir?

A

Synthetic nucleoside analogue structurally related to acyclovir.
Acts as substrate for viral DNA polymerase (inactivate) and as a chain terminator aborting virus replication.

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5
Q

Name 2 adverse effects ganciclovir

A
  • Neutropenia

* thrombocytopenia

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6
Q

Name 2 neuraminidase inhibitors

A

• Zanamivir inhalations
• oseltamavir oral
Antivirals for influenza A or B

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7
Q

Moa neuraminidase inhibitors ?

A

Inhibit release newly synthesized viruses from host cell by inhibit enzyme neuraminidase, responsible for cleaving peptide links between virus and host

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8
Q

Treatment of influenza A or B?

A

Neuraminidase inhibitors: oseltamivir or zanamivir

Must treat within 48 hours after onset symptoms for any patients when its endemic in community

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9
Q

Which drug classes can be used to treat chronic hepatitis c?

A
  • protease inhibitors (NS3 proteins)
  • NS5A inhibitors
  • polymerase inhibitors (ns5b)
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10
Q

Treatment chronic hepatitis B first line?

A

Tenofovir (NRTI)

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11
Q

What makes ketoconazole absorption better?

A

More acidic environment git

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12
Q

Name an antifungal class that targets cell wall with examples

A

Echinocandins (iv) - fungicidal
•Micafungin
• caspofungin
• anidulafungin

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13
Q

Name 3 antifungal that targets cytoplasmic membrane

A
  • Polyenes: nystatin, amphotericin B
  • azoles: fluconazole, itraconazole (target moulds)
  • allylamines: terbinafine
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14
Q

Name an antifungals that target nucleic acid synthesis

A

Flucytosine

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15
Q

Name 2 indications echinocandins

A

Eg micafungin
• Candida auris and parapsilosis bloodstream infections if mic high and any candidaemia in renal dysfunction
• all candida infections from sterile sites resistant to fluconazole and amphotericin B, and any patient with invasive candida and renal dysfunction

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16
Q

Indication amphotericin B?

A

Broad spectrum in potentially fatal systemic fungal infections

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17
Q

Indication nystatin?

A

Suppress candidiasis (thrush) on skin and mucous membranes: oral and vaginal

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18
Q

Name 2 adverse effects polyenes

A

Eg amphoterecin B
• thrombophlebitis
• nephrotoxicity

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19
Q

Indication fluconazole? (4)

A

Wide range, including second line cryptococcal meningitis
Endemic coccidioïdes immitis infection
Oropharyngeal candidiasis
Prophylaxis invasive candidiasis

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20
Q

Name 4 indications itraconazole

A
  • Candidiasis later line
  • blastomycosis
  • histoplasmosis
  • sporotrichosis
  • aspergillosis
  • mucorales (also fluconazole)
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21
Q

Treatment of choice for invasive aspergillosis?

A

Voriconazole

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22
Q

Flucytosine indications? (2)

A
  • Cryptococcal meningitis in combination with amphotericin B!
  • most active against yeasts: systemic candidiasis
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23
Q

Name 2 nb side effects flucytosine

A
  • Bone marrow suppression

* hepatotoxic

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24
Q

Which types parasites more resistant to drugs?

A

Protozoans.

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25
Allylamines indications?
Eg terbinafine | Dermatophyte infections including ringworm where oral therapy appropriate due to site and severity
26
Name 5 antifungals for nematodes
``` Aka roundworms • mebendazole! • albendazole • pyrantel pamoate • ivermectin • diethylcarbamazine ```
27
Name 3 antifungals for cestodes
• Praziquantel! • albendazole . Niclosamide
28
Name 2 antiprotozoals for trematodes
Aka flukes • praziquantel! • albendazOle
29
Name 2 indications bezimidazoles ( eg mebendazole, albendazole )
• Hydatid disease (echinococcus tapeworm cestode), tinea solium • many nematodes! (Roundworms) Microsporidiosis
30
Ivermectin moa?
Immobilise tapeworm onochocerca volvulus by causing tonic paralysis of peripheral muscle system. By potentiating GABA at cestode 's neuromuscular junction.
31
Ivermectin indications? (2)
• Drug of choice for onochocerca volvulus which causes river blindness • most effective for strongyloïdes Also filariasis, some gi helminth infections, ectoparasites (head lice and scabies) Preferred: moxidectin (related)
32
Name 3 adverse effects ivermectin and moxidectin
• ocular irritation . Transient ECG changes • mazzotti reaction: severe immediate immune reaction to dead microfilariae Somnolence
33
Diethylcarbamezine indications?
Drug of choice for lymphatic fibrosis caused by wucheria Bancrofti, loa loa and brugia malayia (all are filarioidea tissue species nematodes)
34
Praziquantel indications (4)
• Drug of choice all schistosome infections (blood flukes trematodes !) • Drug of choice for cysticercosis (rare cystode condition caused by encystation of larvae of tapeworm Taenia solium in human organs) . Other cestodes . Chlonorchiasis ( trematode) Not fasciola hepatica- one of few flukes treatment failure
35
Indications niclosamide?
Tapeworms (cestodes)
36
Name 5 classes drugs with examples for the treatment of malaria (sporozoa)
* quinolines: quinine, mefloquine, primaquine, chloroquine, amodiaquine * Halofantrine (mdr) * naphthoquinone: atovaquone * endoperoxides: artemisin, artemether, artesunate * antifolates: proguanil, pyrimethamine, sulfadoxine
37
Name 4 drugs for the treatment of non-malaria sporozoa: eg toxoplasmosis, cryptosporidia
* Pyrimethamine (anti folate) * sulphonamide * spiramycin * atovaquine
38
Name 2 antiprotozoan drugs for the treatment of rhizopods
Eg entamoeba . Metronidazole • diloxanide
39
Name 5 antiprotozoan drugs for the treatment of flagellates
``` Eg trichomonas vaginalis • melarspoprol • nifurtimox • allopurinol • pentamide • amphotericin B • Ketoconazole, itraconanzole • paramomycin • metronidazole ```
40
What causes resistance of plasmodium to the antimalarials?
Target mutations
41
Moa quinolone's?
Inhibition heme detoxification
42
Indication chloroquine?
Prophylaxis and treatment of all non-falciparum malaria first line. Safe in pregnancy
43
Indication quinine?
Acute clinical attack falciparum malaria resistant to chloroquine.
44
Indication mefloquine?
All species uncomplicated malaria treatment (with artesunate) or prophylaxis
45
Name 3 antimalarial antifolates
* Pyrimethamine * proguanil * sulfadoxine
46
Moa antimalarial antifolates?
Slow acting blood and tissue schizonticides and sporonticides. Inhibit formation folate compounds, thus inhibit DNA synthesis and cell division. All growing stages are affected.
47
Indications antifolates malaria? (3)
* Sulfadoxine pyrimethamine given together, with amodiaquine, for seasonal prophylaxis children * Sulfadoxine pyrimethamine given together to treat malaria pregnant women and children * acute uncomplicated malaria in combination with artesunate
48
Primaquine indication?
Radical cure of relapsing malarias: p.ovale, P. Vivax
49
Moa artemisinin, arsenate, artemether?
Generate free radicals, reactive species and alkylation parasite target biomolecules Blood schizontocide, including MDR p falciparum
50
Indications artemisinin, arsenate, artemether?
* Uncomplicated p falciparum * Mdr pf * combination with other drugs to prevent drug resistance
51
Nitroimidazoles anti-protozoal indications? (3)
* Trichomoniasis * invasive amebiasis * giardiasis
52
Beznidazole indication?
Chagas disease: American trypanosomiasis
53
Fexinidazole indication?
First line oral African trypanosomiasis (trypanosoma Brucei gambiense)
54
Miltefosine indication? (2)
Visceral and cutaneous • leishmaniasis • amoebic encephalitis
55
Name 3 drugs with activity against both HIV and hep B
• Tenofovir • emtricitabine • lamivudine All are nrti
56
Ribavirin indication?
(Nucleoside analogue ) • severe RSV bronchiolitis infants • Lassa fever • chronic hepatitis c
57
Treatment of choice for malaria in pregnancy, non-severe?
Oral quinine and clindamycin
58
Which species of candida is fluconazole inactive against?
C krusei
59
Name 4 adverse effects chloroQuine
• Neuropsychiatric • blurred vision . ECG changes . Git symptoms
60
What is cinchonism and what causes it? (5)
``` Quinine toxicity dose too high. Signs: • thrombocytopenia • hypoglycaemia . Haemolysis • agranulocytosis ```

Pharmacology (34 decks)

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