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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
Q

Allylamines indications?

A

Eg terbinafine

Dermatophyte infections including ringworm where oral therapy appropriate due to site and severity

26
Q

Name 5 antifungals for nematodes

A 
Aka roundworms
• mebendazole!
• albendazole
• pyrantel pamoate
• ivermectin
• diethylcarbamazine
27
Q

Name 3 antifungals for cestodes

A

• Praziquantel!
• albendazole
. Niclosamide

28
Q

Name 2 antiprotozoals for trematodes

A

Aka flukes
• praziquantel!
• albendazOle

29
Q

Name 2 indications bezimidazoles ( eg mebendazole, albendazole )

A

• Hydatid disease (echinococcus tapeworm cestode), tinea solium
• many nematodes! (Roundworms)
Microsporidiosis

30
Q

Ivermectin moa?

A

Immobilise tapeworm onochocerca volvulus by causing tonic paralysis of peripheral muscle system.
By potentiating GABA at cestode ‘s neuromuscular junction.

31
Q

Ivermectin indications? (2)

A

• 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
Q

Name 3 adverse effects ivermectin and moxidectin

A

• ocular irritation
. Transient ECG changes
• mazzotti reaction: severe immediate immune reaction to dead microfilariae
Somnolence

33
Q

Diethylcarbamezine indications?

A

Drug of choice for lymphatic fibrosis caused by wucheria Bancrofti, loa loa and brugia malayia (all are filarioidea tissue species nematodes)

34
Q

Praziquantel indications (4)

A

• 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
Q

Indications niclosamide?

A

Tapeworms (cestodes)

36
Q

Name 5 classes drugs with examples for the treatment of malaria (sporozoa)

A
  • quinolines: quinine, mefloquine, primaquine, chloroquine, amodiaquine
  • Halofantrine (mdr)
  • naphthoquinone: atovaquone
  • endoperoxides: artemisin, artemether, artesunate
  • antifolates: proguanil, pyrimethamine, sulfadoxine
37
Q

Name 4 drugs for the treatment of non-malaria sporozoa: eg toxoplasmosis, cryptosporidia

A
  • Pyrimethamine (anti folate)
  • sulphonamide
  • spiramycin
  • atovaquine
38
Q

Name 2 antiprotozoan drugs for the treatment of rhizopods

A

Eg entamoeba
. Metronidazole
• diloxanide

39
Q

Name 5 antiprotozoan drugs for the treatment of flagellates

A 
Eg trichomonas vaginalis
• melarspoprol
• nifurtimox
• allopurinol
• pentamide
• amphotericin B
• Ketoconazole, itraconanzole
• paramomycin
• metronidazole
40
Q

What causes resistance of plasmodium to the antimalarials?

A

Target mutations

41
Q

Moa quinolone’s?

A

Inhibition heme detoxification

42
Q

Indication chloroquine?

A

Prophylaxis and treatment of all non-falciparum malaria first line.
Safe in pregnancy

43
Q

Indication quinine?

A

Acute clinical attack falciparum malaria resistant to chloroquine.

44
Q

Indication mefloquine?

A

All species uncomplicated malaria treatment (with artesunate) or prophylaxis

45
Q

Name 3 antimalarial antifolates

A
  • Pyrimethamine
  • proguanil
  • sulfadoxine
46
Q

Moa antimalarial antifolates?

A

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
Q

Indications antifolates malaria? (3)

A
  • 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
Q

Primaquine indication?

A

Radical cure of relapsing malarias: p.ovale, P. Vivax

49
Q

Moa artemisinin, arsenate, artemether?

A

Generate free radicals, reactive species and alkylation parasite target biomolecules
Blood schizontocide, including MDR p falciparum

50
Q

Indications artemisinin, arsenate, artemether?

A
  • Uncomplicated p falciparum
  • Mdr pf
  • combination with other drugs to prevent drug resistance
51
Q

Nitroimidazoles anti-protozoal indications? (3)

A
  • Trichomoniasis
  • invasive amebiasis
  • giardiasis
52
Q

Beznidazole indication?

A

Chagas disease: American trypanosomiasis

53
Q

Fexinidazole indication?

A

First line oral African trypanosomiasis (trypanosoma Brucei gambiense)

54
Q

Miltefosine indication? (2)

A

Visceral and cutaneous
• leishmaniasis
• amoebic encephalitis

55
Q

Name 3 drugs with activity against both HIV and hep B

A

• Tenofovir
• emtricitabine
• lamivudine
All are nrti

56
Q

Ribavirin indication?

A

(Nucleoside analogue )
• severe RSV bronchiolitis infants
• Lassa fever
• chronic hepatitis c

57
Q

Treatment of choice for malaria in pregnancy, non-severe?

A

Oral quinine and clindamycin

58
Q

Which species of candida is fluconazole inactive against?

A

C krusei

59
Q

Name 4 adverse effects chloroQuine

A

• Neuropsychiatric
• blurred vision
. ECG changes
. Git symptoms

60
Q

What is cinchonism and what causes it? (5)

A 
Quinine toxicity dose too high. Signs:
• thrombocytopenia
• hypoglycaemia
. Haemolysis 
• agranulocytosis

Pharmacology (34 decks)

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