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Pharmocology > Chapter 8 > Flashcards

Chapter 8 Flashcards

1
Q

What is the spectrum of organisms that antibiotics and antiinfectives are effective against?

A

Bacteria, protozoa, rickettsia, amoebas, and spirochetes

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2
Q

Are antibiotics and antiinfectives effective against either fungal or viral infections?

A

NO

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3
Q

Common fungal infections

A

Pseudomembraneous candidiasis

Erythemateous candidiasis

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4
Q

What are some antifungal agents?

A

Nystatin (Mycostatin, Nilstat)

Imidazoles

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5
Q

What are some Imidazoles?

A

Clotrimazole (Mycelex)
Ketoconazole (Nizoral)
Fluconazole (Diflucan)

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6
Q

This antifungal agent is for systemic infection?

A

Diflucan

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7
Q

This antifungal agent is for localized infection?

A

Nystatin

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8
Q

Other antifungal agents

A

Amphotericin B

Griseofulvin

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9
Q

Mechanism of action for Nystatin

A

Binding sterols in the fungal cell membrane

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10
Q

Nystatin

A

Not absorbed from mucous membrane or intact skin
Poorly absorbed from GI tract
Excreted unchanged in the feces
Fungicidal and fungistatic

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11
Q

Higher doses or Nystatin

A

Nausea, vomiting, and diarrhea

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12
Q

How is Nystatin administered?

A

Topically or orally: Little absorption occurs

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13
Q

What is Nystatin used for?

A

Both treatment and prevention of oral candidiasis in susceptible cases

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14
Q

Can be cariogenic

A

Nystatin

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15
Q

Imidazoles useful in dentistry

A

Clotrimazole (Mycelex)

Ketoconazole (Nizoral)

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16
Q

Other Imidazoles:

A

Fluconazole (Diflucan)

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17
Q

A synthetic antifungal agent

A

Clotrimazole

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18
Q

Availability of Clotrimazole

A

Oral lozenge and topical cream

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19
Q

Mechanism of action for Clotrimazole

A

Alteration of cell membrane permeability

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20
Q

Spectrum of action of Clotrimazole

A

Primarily against the Candida species

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21
Q

Adverse reactions of Clotrimazole

A

Involves the GI tract; produce elevated liver enzyme

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22
Q

Ketoconazole

A

Alters cellular membranes and interferes with intracellular enzymes

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23
Q

Pharmacokinetics for Ketoconazole

A

Requires acidic environment

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24
Q

Uses for Ketoconazole

A

Treatment of mucocutaneous and oropharyngeal candidiasis

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25
Adverse reactions of Ketoconazole
Nausea, vomiting, hepatotoxicity; react with warfarin
26
Fluconazole
Prevents synthesis of ergosterol in cell membranes
27
Fluconazole is used for the treatment of..
``` Oropharyngeal and esophageal candidiasis Systemic fungal infections Vaginal candidiasis Prophylactically in immunocompromised Non-responsive candidal infections ```
28
Variety of formulations available for anti-fungal medications
Tablets, Aqueous suspension, Ointment, Cream, Powder, Lozenge
29
Common viral infections
Herpes Labialis | Recurrent herpes simplex
30
Antiviral agents for herpes simplex
Acyclovir (Zovirax) Docosano 10% (Abreva) Penciclovir (Denavir) Famciclovir (Valtrex)
31
Antiviral agents for AIDS
Nucleoside reverse transcriptase inhibitors Nonnucleoside reverse transcriptase inhibitors Protease inhibitors Combinations Other antiviral agents
32
Adverse reactions of Acyclovir
Topical; burning, stinging, or mild pain Headache Sore throat CNS Lymphadenopathy GI effects Thrombophlebitis Anorexia Edema Funny taste Muscle cramps Acne Leg pain Accelerated hair loss Palpitation Menstrul abnormalites Arthralagia Fever
33
Uses of Acyclovir
Limited non-life threatening initial and recurrent mucocutaneous herpes simplex virus 1 and 2 (HSV-1 and HSV-2) in immunocompromised persons
34
Docosanol 10% (Abreva)
Avaliable topically Avaliable without prescription Reduce healing time by 1/2 day
35
Penciclovir (Denavir)
Reduces both the duration of the lesion and the pain of the lesions
36
Advantages of Penciclovir (Denavir)
Higher concentration within cell | Drug duration in cells is longer
37
Herpes simplex: Famciclovir and Valacyclovir
Famciclovir (Prodrug) > penciclovir | Valacyclovir (Prodrug) > acyclovir
38
Uses of Famciclovir and Valacyclovir
Treatment of recurrent episodes of genital herpes | Treatment of acute localized varicella-zoster infections
39
Acquired immunodeficiency syndrome
Nucleoside reverse transcriptase inhibitors (NRTIs) Nonnucleoside reverse transcriptase inhibitors (NNRTIs) Protease inhibitors Fusion/entry inhibitors Integrase inhibitors
40
Azidothymidine (AZT) > Nucleoside Reverse transcriptase inhibitors Zidovudine
``` Well absorbed orally Metabolized by the liver Excreted by the kidneys Inhibits HIV synthesis Reduces the morbidity ```
41
Toxicity of Zidovudine
Related to bone marrow depression
42
CNS effects of Zidovudine
Headache, agitation, and insomnia
43
Oral manifestations of Zidovudine
Taste perversion, edema of the tongue, bleeding gums, and mouth ulcers
44
Can inhibit AZTs metabolism and potentiate the toxicity of both drugs
Acetaminophen, indomethacin, and aspirin
45
This non nucleoside reverse transcriptease inhibitors is specific for HIV-1
Nevirapine
46
Nonnucleoside reverse transcriptease inhibitors Nevirapine
These agents inhibit the same enzymes as the nucleoside analogues but do not require bioactivation
47
Adverse reactions of nonnucleoside reverse transcriptease inhibitors Nevirapine
CNS effects Rash GI effects Elevated liver function tests
48
Interferes with the action of the HIV infected cells
Saquinavir
49
Adverse reactions of Saquinavir
``` Rash hyperglycemia paresthesia GI effects buccal mucosal ulceration ```
50
Fusion/Entry inhibitors
Block the progression from HIV infection to AIDS
51
Integrase inhibitors
Designed to block or inhibit the action of integrates, which is a viral enzyme that inserts the viral genome into the DNA of the host cell
52
Highly Active Antiretroviral Therapy (HAART)
Cocktails = 3 drugs > A nucleoside > A nonnucleoside reverse transcriptease inhibitor > A protease inhibitor
53
Nucleoside analogues
Didanosine (ddl) (Videx) Zalcitabine (ddC) (Hivid) Zidovudine (AZT, ZVD) (Retrovir)
54
Nonnucleoside analogues
Delavirdine (Rescriptor) | Nevirapine (NVP) (Viramune)
55
Protease inhibitors
Indinavir (Crixivan) Nelfinavir (Viracept) Ritonavir (Norvir) Saquinavir (Invirase, Fortovase)
56
Adverse effect associated with drugs used to treat HIV
Bone marrow suppression, leading to anemia and thrombocytopenia (decrease in the number of platelets) This may lead to bleeding gingiva and ulcers
57
Chronic hepatitis
Lasts for more than 6 months Inflammation in the liver Present with no symptons or very few
58
Symptoms of chronic hepatitis
Jaundice Anorexia Malaise
59
Interferons
Antiviral, cytotoxic, and immunomodulating action
60
Adverse reactions; Interferons
``` Myalgias Fatigue Headache Arthralgia CNS effects; Fatigue, fever, headache, depression, chills GI effects; Nausea, vomiting, diarrhea Rash Reactivation of herpes labials Excessive salivation ```

Pharmocology (12 decks)

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