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MHD/Pharm Block 6 > Block 6 drugs > Flashcards

Block 6 drugs Flashcards

1
Q

Zafirlukast, Montelukast: indication, MOA and adverse effects

A

Leukotriene inhibitor used for Prophylactic therapy for preventing bronchospasm MOA: Antagonist of LTD4 and LTE4 leukotriene receptors. Can cause Headache, nausea

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2
Q

Voriconazole indication, MOA and adverse effects

A

dermatophytes, candida, C. glabrata and C. krusei, cryptococcus, cocci/histo/blasto, pseudoallerischeri boydii, aspergillus, and fusarium MOA: Inhibition of ergosterol synthesis

Can have adverse effects: Photosensitivity, rash, periostitis, visual changes, hallucinations, seizures. DOC for invasive aspergillus/fusarium

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3
Q

What is the indication and MOA for Mycophenolate mofetil therapy?

A

Proliferation inhibitor used to Prevent graft rejection, off label used for autoimmune diseases (Pemphigus, SLE, myasthenia gravis, psoriasis). MOA: Reversible inhibitor of IMPDH type II, the rate limiting enzyme in de novo purine synthesis

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4
Q

Fexofenadine: indication, MOA and adverse effects

A

2nd generation antihistamine used for Allergic rhinitis, idiopathic chronic uticaria MOA: Blocks histamine H1 receptors. Can cause N/A

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5
Q

Terbinafine indication, MOA and adverse effects

A

Onchomycoses and superficial skin infections of candida albicans, dermatophytes MOA: Inhibits fungal squalene epoxidase resulting in formation of toxic products and inhibition of ergosterol synthesis

Adverse effects: generally well tolerated, but can cause hepatotoxicity, neutropenia, Stevens-Johnson syndrome.

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6
Q

What is the indication and MOA for Alemetzumab therapy?

A

Antibody used to Acutely inhibit T cell response at time of transplantation. MOA: Anti-CD52 causes antibody mediates lysis of lyphocytes

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7
Q

Loratidine: indication, MOA and adverse effects

A

2nd generation antihistamine used for Allergic rhinitis, allergic reactions to blood, adjunctive therapy in anaphylactic reactions MOA: Blocks histamine H1 receptors. Can cause Nausea, fatigue, headache

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8
Q

What is the indication and MOA for Iron therapy?

A

Iron therapy is used for patients with Increased iron requirements: premature infants, children, pregnant/lactating women; inadequate absorption; blood loss. Given orally or IM/IV to supplement missing Fe.

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9
Q

What is the indication and MOA for Fingolimod therapy?

A

MS drug used to Replasing-remitting multiple sclerosis. MOA: Sphingosine analog, sequesters lymphocytes in lymph node, preventing access to the CNS

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10
Q

What is the indication and MOA for Vitamin B12 therapy?

A

Vitamin B12 therapy is used for patients with Vitamin B12 deficiency (can have CNS deficiency). Parenteral injection of cyanocobalamin or hydroxycobalamin. Complexes with IF in the stomach and gets absorbed in the ileum

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11
Q

What is the indication and MOA for Erythropoietin therapy?

A

Erythropoietin therapy is used for patients with Chronic renal failure, aplastic anemia, leukemias, HIV, anemia of prematurity, post-phlebotomy. IV or SubQ injections stimulate release of reticulocytes from bone marrow, proliferation, differentiation of RBCs

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12
Q

Amphotericin B indication, MOA and adverse effects

A

Broad spectrum, covers all life threatening mycotic infections MOA: Binds to ergosterol in fungal plasma membrane forming pores that increases membrane permeability and permits loss of cytoplasmic K+

Can have adverse effects: Infusion related: fever, chills, spasms, vomiting. Also causes cumulative nephrotoxicity, hepatotoxicity and anemia. “Amphoterrible”. Only antifungal used in pregnant women

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13
Q

What is the indication and MOA for Cyclosporin therapy?

A

Calcineurin inhibitor used to Prevent solid organ rejection, GvH disease in BMT, autoimmune diseases (psoriasis, rheumatoid arthritis, SLE, IBD). MOA: Binds to cyclophilin, inhibits the activity of calcineurin, which prevents T cell activation by NFAT, IL2. Inhibits “signal 1” of T cell activation

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14
Q

What is the indication and MOA for Everolimus therapy?

A

mTor inhibitor used to Prevent graft rejection (not for liver, lungs), prevent GvH disease in BMT, included in coronary stents to prevent restenosis. MOA: Binds to FKBP, inhibits mTOR kinase, which prevents IL-2 mediated signals in T-cells “signal 2”, no T cell proliferation

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15
Q

What is the indication and MOA for Natalizumab therapy?

A

MS drug used to Replasing-remitting multiple sclerosis. MOA: Anti-alpha4 integrin blocks entry of lymphocytes into the CNS

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16
Q

What is the indication and MOA for Iplimumab therapy?

A

Immune checkpoint inhibitor used to Late stage melanomas (also clinical trials for NSCLC, SCLC, prostate cancer, bladder cancer). MOA: anti-CTLA4 antibody, prevents CTLA4 from delivering negative signal , leading to enhanced T-cell activation

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17
Q

What is the indication and MOA for IVIG therapy?

A

Passive immunization Ig used to Hypogammaglobulinemia and other immunodeficiency diseases.. MOA: Supplement Ig’s purified from pooled human plasma

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18
Q

What is the indication and MOA for Nivolumab therapy?

A

Immune checkpoint inhibitor used to Metastatic melanoma. MOA: anti-PD1 blocks PD1-PD-L1 interaction leading to enhanced T cell immune responses

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19
Q

Theophyline: indication, MOA and adverse effects

A

Bronchodilator used for Chronic asthma maintenance therapy MOA: Inhibits cAMP phosphodiesterases causing increased levels of cAMP. Narrow therapeutic window, convulsions, tachycardia, circulatory collapse

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20
Q

What is the indication and MOA for Pembrozilmab therapy?

A

Immune checkpoint inhibitor used to Metastatic melanoma. MOA: anti-PD1 blocks PD1-PD-L1 interaction leading to enhanced T cell immune responses

“PemDrozi1mab” PD1

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21
Q

Isoniazid HCl (INH) indication, MOA, and adverse effects

A

Indication: Tuberculosis first line drug, monotherapy for latent TB. MOA: Prodrug activated by catalase peroxidase (katG gene), targets the inhA gene product to prevent cell wall mycolic acid synthesis. Can cause Hepatotoxicity, neurotoxicity, hypersensitivity reaction.

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22
Q

Diphenhydramine: indication, MOA and adverse effects

A

1st generation antihistamine used for Allergic rhinitis, urticaria, and adjunctive therapy in anaphylactic reactions MOA: Blocks histamine H1 receptors. Can cause Sedation, agitation due to muscarinic receptor blockade

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23
Q

Beta 2 adrenergic agonists: indication, MOA and adverse effects

A

Bronchodilator used for Symptom relief of bronchospasm in acute asthma attacks MOA: Stimulate AC increasing cAMP, causes SM bronchodilation. Inhibits release of mediators from mast cells.. Can cause Skeletal muscle tremors, techycardia, anxiety/restlessness/apprehension

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24
Q

What is the indication and MOA for G-CSF (filgrastim) therapy?

A

G-CSF (filgrastim) therapy is used for patients with chemotherapy, congenital neutropenia, mobilization of peripheral blood stem cells for autologous transplant. Stimulates proliferation and differentiation of myeloid cells, release of HSCs from bone marrow into periphery

25
Q

Zileuton: indication, MOA and adverse effects

A

Leukotriene inhibitor used for Prophylactic therapy for preventing bronchospasm MOA: Inhibits 5-lipooxygenase to decrease leukotriene production. Can cause Contraindicated in patients with hepatic disease

26
Q

What is the indication and MOA for Basiliximab therapy?

A

Antibody used to Acutely inhibit T cell response at time of transplantation. MOA: Anti-CD25 (IL2R), inhibits T cell proliferation

27
Q

Ethambutol indication, MOA, and adverse effects

A

Indication: Tuberculosis first line drug, NTM. MOA: Inhibits TB arabinosyl transferase (embB gene) affects cell wall synthesis, bacteriostatic. Can cause Optic neuritis and peripheral neuropathy

28
Q

What is the indication and MOA for Prednisone therapy?

A

Glucocorticoid used to Used in combo for immunosupressive therapy. High dose IV pulses used to combat acute rejection, GvHD in BMT, cytokine storm. Also used in automimmune and inflammatory diseases. MOA: Bind to cytoplasmic receptors and inhibit immune regulatory genes to inhibit immune system and inhibit pro-inflammatory signals

29
Q

Pyrazinamide (PZA) indication, MOA, and adverse effects

A

Indication: Tuberculosis first line drug. MOA: Prodrug activated by TB pyrazinamidase (pncA), bactericidal. Can cause Hepatitis, skin rash and GI intolerance, increased serum uric acid levels

30
Q

Griseofulvin indication, MOA and adverse effects

A

Mycotic infections of skin, nail and hair due to dermatophytes MOA: Fungistatic. Binds microtubules and inhibits mitotic spindle. Accumulates in keratin producing cells

Can have adverse effects: CNS (headache, lethargy, vertigo), Skin (urticaria, photosensitivity, rash), hepatotoxic, leukopenia/neutropenia, fetal abnormalities. Strong P450 inducer

31
Q

Nystatin indication, MOA and adverse effects

A

Oral candidiasis MOA: Similar to amphotericin B. Binds ergosterol and forms pores in fungal membraneCan have adverse effects: Few adverse effects because drug is taken orally (swish/swallow) and is not absorbed.

32
Q

What is the indication and MOA for Galatriramer therapy?

A

MS drug used to Replasing-remitting multiple sclerosis. MOA: Mixture of polymers of 4 amino acids found in myelin basic protein. Promotes production of specific suppressor T cells that migrate to brain

33
Q

Streptomycin indication, MOA, and adverse effects

A

Indication: Tuberculosis second line drug. MOA: Aminoglycoside, inhibits protein synthesis by binding to the ribosome. Can cause Ototoxicity and nephrotoxicity

34
Q

Ceterizine: indication, MOA and adverse effects

A

2nd generation antihistamine used for Allergic rhinitis, idiopathic chronic uticaria MOA: Blocks histamine H1 receptors and blocks histamine release. Can cause Sedation, fatigue and dry mouth

35
Q

What is the indication and MOA for Sirolimus therapy?

A

mTor inhibitor used to Prevent graft rejection (not for liver, lungs), prevent GvH disease in BMT, included in coronary stents to prevent restenosis. MOA: Binds to FKBP, inhibits mTOR kinase, which prevents IL-2 mediated signals in T-cells “signal 2”, no T cell proliferation

36
Q

Chlorpheniramine: indication, MOA and adverse effects

A

1st generation antihistamine used for Allergic rhinitis, common in OTC medications MOA: Blocks histamine H1 receptors. Can cause Slight sedation, agitation due to muscarinic receptor blockade

37
Q

What is the indication and MOA for IL-11 (Oprelvekin) therapy?

A

IL-11 (Oprelvekin) therapy is used for patients with Thrombocytopenia from chemotherapy. Increases peripheral platelet counts by promoting proliferation of megakaryocyte progenitors

38
Q

Ketoconazole indication, MOA and adverse effects

A

Narrowest azole spectrum: dermatophytes, candida, cryptococcus, cocci/histo/blasto MOA: Inhibition of ergosterol synthesisCan have adverse effects: Endocrine effects.

39
Q

Caspofungin, Micafungin, Anidulafungin indication, MOA and adverse effects

A

Invasive candida and aspergillus. No activity against cryptococcus or dimorphic fungi MOA: Inhibits glucan synthase complex impairing membrane structure of fungal cell wallCan have adverse effects: Well tolerated. Can have histamine like effect with rapid infusion.

40
Q

Posaconazole indication, MOA and adverse effects

A

dermatophytes, candida, C. glabrata and C. krusei, cryptococcus, cocci/histo/blasto, pseudoallerischeri boydii, aspergillus, fusarium, mucor MOA: Inhibition of ergosterol synthesisCan have adverse effects: Well tolerated. Invasive candida, aspergillus. Salvage therapy for mucormycoses

41
Q

Corticosteroids: indication, MOA and adverse effects

A

Anti-inflammatory agent used for Chronic asthma maintenance therapy MOA: Decreased AA synthesis by PLA2 which inhibits the releases of LTs and PGs. Can cause Short term: increased energy, insomnea, hunger, agitation and mood alterations. Long term: osteoporosis, cataracts, myopathy, HPA suppression, depression

42
Q

What is the indication and MOA for Interferon therapy?

A

MS drug used to Replasing-remitting multiple sclerosis. MOA: Reduce entry of inflammatory cells into the CNS and reduced T cell activation

43
Q

Cromolyn: indication, MOA and adverse effects

A

Anti-inflammatory agent used for Prophylactic therapy for preventing bronchospasm MOA: Decreases release of histamine and leukotrienes. Can cause Occasional coughing

44
Q

Butenafine indication, MOA and adverse effects

A

C. albicans and dermatophytes (tinea cruris, corporis, pedis) MOA: Topical, inhibits squalene epoxidase (like terbinafine)Can have adverse effects: .

45
Q

What is the indication and MOA for Rho(D) Ig therapy?

A

Passive immunization Ig used to Prevent hemolytic disease of the newborn in Rh- women. MOA: Blocks maternal immune response to fetal RBCs by removing Rh+ fetal RBC from circulation.

46
Q

Itraconazole indication, MOA and adverse effects

A

dermatophytes, candida, C. glabrata and C. krusei, cryptococcus, cocci/histo/blasto, pseudoallerischeri boydii, aspergillus MOA: Inhibition of ergosterol synthesisCan have adverse effects: HTN/hypokalemia/peripheral edema. Contraindicated in CHF. DOC for dermatophytes and onchomycosis

47
Q

Fucytosine indication, MOA and adverse effects

A

Narrow spectrum: Cryptococcus neoformans MOA: Cytosine permease takes up and converts into compound that inhibits thymidylate synthase and RNA synthesisCan have adverse effects: Nausea, vommiting, diarrhea, bone marrow toxicity, teratogenic. Good CSF penetration. Used in combo with amphotericin B

48
Q

What is the indication and MOA for Folic acid therapy?

A

Folic acid therapy is used for patients with Folic acid deficiency (no CNS deficiency). Hydrolyzed to monoglutamate, stored in the liver

49
Q

What is the indication and MOA for Eltrombopag therapy?

A

Eltrombopag therapy is used for patients with Idiopathic throbocytopenic purpura, aplastic anemia. TPO receptor agonist

50
Q

What is the indication and MOA for Hyperimmune Ig therapy?

A

Passive immunization Ig used to Hepatitis B, CMV, Rabies, Tetanus, Botulism, Diptheria, Varicella-zoster, snake and scorpion toxins. MOA: Similar to IVIG, except purified from individuals with high titers against a specific antigen or organism

51
Q

What is the indication and MOA for Romiplostim therapy?

A

Romiplostim therapy is used for patients with Idiopathic throbocytopenic purpura. Binds TPO receptor

52
Q

Doxepin: indication, MOA and adverse effects

A

2nd generation antihistamine used for Chronic uticaria not responding to other H1 antagonists MOA: Blocks histamine H1 receptors. Can cause Disorientation, confusion in non-depressed patients

53
Q

Fluconazole indication, MOA and adverse effects

A

Narrow azole spectrum: dermatophytes, candida, C. glabrata and C. krusei, cryptococcus, cocci/histo/blasto MOA: Inhibition of ergosterol synthesisCan have adverse effects: Alopecia, nausea, skin rash, headach/GI. DOC for cryptococcal meningitis, CSF penetration

54
Q

What is the indication and MOA for GM-CSF (sargramostim) therapy?

A

GM-CSF (sargramostim) therapy is used for patients after chemotherapy, congenital neutropenia, mobilization of peripheral blood stem cells for autologous transplant. Stimulates proliferation and differentiation of myeloid cells. Less specific than G-CSF

55
Q

Ipratropium: indication, MOA and adverse effects

A

Bronchodilator used for Acute asthma with coexisting chronic bronchitis or cough MOA: Competitively blocks the muscarinic receptros in the airways. High dose may cause atropine like effects

56
Q

Rifampin indication, MOA, and adverse effects

A

Indication: Tuberculosis first line drug, monotherapy for latent TB, NTM. MOA: Inhibits DNA-dependent RNA polymerase (rpoB gene), bactericidal. Can cause Hepatotoxicity, red discoloration of body fluids, acute renal failure, influenza syndrome, thrombocytopenia

57
Q

What is the indication and MOA for Rabbit polyclonal anti-thymocyte globulin therapy?

A

Antibody used to Acutely inhibit T cell response at time of transplantation. MOA: Actively depletes lymphocytes from blood and lymphoid organs via Fc receptor mediated/complement dependent lysis and opsonization

58
Q

What is the indication and MOA for Azathioprine therapy?

A

Proliferation inhibitor used to Prevent graft rejection, autoimmune diseases (Rheumatoid, chrohn’s, MS). MOA: Prodrug of 6-mercaptopurine, which inhibits lymphocyte proliferation by blocking de novo purine synthesis, triggering apoptosis, and decreasing T cell response

59
Q

What is the indication and MOA for Tacrolimus therapy?

A

Calcineurin inhibitor used to Prevent solid organ rejection, GvH disease in BMT, autoimmune diseases (psoriasis, rheumatoid arthritis, SLE, IBD). MOA: Binds to FKBP, inhibits the activity of calcineurin, which prevents T cell activation by NFAT, IL2. Inhibits “signal 1” of T cell activation

MHD/Pharm Block 6 (4 decks)

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