Chemotherapeutic Agents ulit Pt. 2 Flashcards by Christine Casandra

Inhibits mycobacterial DNA-dependent RNA polymerase and suppresses protein synthesis

Rifabutin

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Used to prevent disseminated Mycobacterium avium complex (MAC) disease in clients with advanced HIV infection

Rifabutin

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Used to treat active MAC disease and tuberculosis in clients with HIV infection

Rifabutin

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Rifapentine
Side and adverse effects

a. Red-orange–colored body secretions
b. Hepatotoxicity

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Used only for pulmonary tuberculosis

Rifapentine

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Used to treat MDR-TB when significant resistance to other medications is expected

Capreomycin sulfate

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Capreomycin sulfate
Side and adverse effects

a. Nephrotoxicity
b. Ototoxicity
c. Neuromuscular blockade

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Other Anti-Biotics

Ketolides
- Telithromycin
Lincosamides
- Clindamycin
-Lincomycin
Lipoglycopeptides
- Televancin
Macrolides
- Azithromycin
- Clarithromycin
- Erythromycin
Monobactam
- Aztreonam

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binds to specific ribosome subunits, leading to cell death in susceptible bacteria, which includes several strains resistant to other antibiotics

Telithromycin

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These drugs are used in the treatment of severe infections when a less-toxic antibiotic cannot be used.

LINCOSAMIDES

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are semisynthetic derivatives of vancomycin

LIPOGLYCOPEPTIDES (TELEVANCIN)

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They inhibit bacterial cell wall synthesis by interfering with the polymerization and cross-linking of peptidoglycans

LIPOGLYCOPEPTIDES (TELEVANCIN)

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It is only approved for use in treating complicated skin and skin-structure infections in adults

LIPOGLYCOPEPTIDES (TELEVANCIN)

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LIPOGLYCOPEPTIDES (TELEVANCIN)
ADVERSE EFFECTS:
A transfusion reaction called _____________________ with flushing, sweating, and hypotension can occur with rapid infusion

red man syndrome

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is unique, and little cross-resistance occurs

MONOBACTAM (AZTREONAM)

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It is effective against gram-negative enterobacteria and has no effect on grampositive or anaerobic bacteria

MONOBACTAM (AZTREONAM)

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An infection caused by a fungus is called a

mycosis

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AZOLE ANTIFUNGALS

fluconazole (Diflucan), itraconazole (Sporanox), ketoconazole (Nizoral), posaconazole (Noxafi l), terbinafine (Lamisil), and voriconazole (Vfend)

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bind to sterols and can cause cell death (a fungicidal effect) or interfere with cell replication (a fungistatic effect)

AZOLE ANTIFUNGALS

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Many of the azoles are associated with

liver toxicity

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ECHINOCANDIN ANTIFUNGALS

anidulafungin, caspofungin, and micafungin

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work by inhibiting glucan synthesis

ECHINOCANDIN ANTIFUNGALS

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is an enzyme that is present in the fungal cell wall but not in human cell walls

Glucan

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OTHER ANTIFUNGALS

amphotericin B (Abelcet, AmBisome, Amphotec), fl ucytosine (Ancobon), griseofulvin (generic), and nystatin (Mycostatin, Nilstat)

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The drug binds to the sterols in the fungus cell wall, changing cell wall permeability AND can lead to cell death (fungicidal effect) or prevent the fungal cells from reproducing (fungistatic effect)

OTHER ANTIFUNGALS

TOPICAL ANTIFUNGALS

ketoconazole ( Nizoral,), sertaconazole nitrate (Ertaczo), sulconazole (Exelderm), terbinafine (Lamisil)

Fungi that cause mycoses

DERMATOPHYTES

mycoses include tinea infections such as

- athlete’s foot (tinea pedis), - jock itch (tinea cruris), - yeast infections of the mouth and vagina

work to alter the cell permeability of the fungus, causing prevention of replica and fungal death

TOPICAL ANTIFUNGALS

These drugs are not absorbed systemically and do not undergo metabolism or excretion in the body

TOPICAL ANTIFUNGALS

single-celled organisms that pass through several stages in their life cycles

Protozoa

thrive in tropical climates, but may also survive and reproduce in any area where people live in very crowded and unsanitary conditions

Protozoa

protozoal infections can be caused by insect bites

malaria trypanosomiasis leishmaniasis)

those that result from ingestion

amebiasis giardiasis trichomoniasis

is a parasitic disease through the bite of a female Anopheles mosquito, an insect that harbors the protozoal parasite

MALARIA

FOUR PROTOZOAL PARASITES

Plasmodium falciparum Plasmodium vivax Plasmodium malariae Plasmodium ovale

s considered to be the most dangerous type of protozoan

Plasmodium falciparum

causes a milder form of the disease, which seldom results in death.

Plasmodium vivax

is endemic in many tropical countries and causes very mild signs and symptoms in the local population

Plasmodium malariae

which is rarely seen, seems to be in the process of being eradicated.

Plasmodium ovale

are usually given in com bination form to attack the Plasmodium

ANTI-MALARIALS

ANTI-MALARIALS drugs can be:

schizonticidal gametocytocidal sporonticidal schizonts as prophylactic and antirelapse agents

-acting against the red-blood-cell phase of the life cycle,

schizonticidal

-acting against the gametocytes

gametocytocidal

acting against the parasites that are developing in the mosquito

sporontocidal

work against tissue

chizonts as prophylactic or antirelapse agents

is currently the mainstay of antimalarial therapy

Chloroquine

directly toxic to parasites that absorb it; it is acidic, and it decreases the ability of the parasite to synthesize DNA, leading to a blockage of reproduction.

Chloroquine

increases the acidity of plasmodial food vacuoles, causing cell rupture and death.

Mefloquine

disrupts the mitochondria of the Plasmodium, causes death of gametocytesan d prevents other forms from reproducing.

Primaquine

is used in combination to suppress malaria; it acts by blocking the use of folic acid in protein synthesis by the Plasmodium

Pyrimethamine

inhibits nucleic acid synthesis, protein synthesis, and glycolysis in P. falciparum

Quinine

ADVERSE EFFECTS ANTI-MALARIALS may occur with high levels of quinine or primaquinemay occur with high levels of quinine or primaquine

Cinchonism

an intestinal infection caused by Entamoeba histolytica, is often known as amebic dysentery

Amebiasis

Early signs of amebiasis include

mild to fulminate diarrhea

the protozoan can live for long periods outside the body or in the human intestine

Cystic, dormant stage

in the ideal environment—the human large intestine

Trophozoite stage

is a disease caused by a protozoan that is passed from sand fl ies to humans.

Leishmaniasis

fly injects an asexual form of this flagellated protozoan and digested by human macrophages

promastigote

formed inside the macrophages as the promastigote divides

amastigotes

is caused by infection with Trypanosoma

Trypanosomiasis

caused by Trypanosoma brucei gambiense, (transmitted by the tsetse fly)

African sleeping sickness

invades the CNS, leading to an acute inflammation that results in lethargy, prolonged sleep, and even death.

African sleeping sickness

which is caused by Trypanosoma cruzi

Chagas’ disease

his protozoan results in a severe cardiomyopathy that accounts for numerous deaths and disabilities in South American regions.

Chagas’ disease

Trichomonas vaginalis, is a common cause of vaginitis

Trichomoniasis

caused by Giardia lamblia, which survive outside the body and allow transmission through contaminated water or food, and trophozoites.

Giardiasis

- is an endemic protozoan that does not usually cause illness in humans. - immune system becomes suppressed because of acquired immune deficiency syndrome (AIDS) or AIDS-related complex

Pneumocystis jiroveci Pneumonia

Other antiprotozoals include

atovaquone (Mepron) metronidazole (Flagyl, MetroGel, Noritate) nitazoxanide (Alinia) pentamidine (Pentam 300, NebuPent) tinidazole (Tindamax)

OTHER PROTOZOAL AGENTS CONTRAINDICATIONS AND CAUTIONS _______________ should never be combined with alcohol and should be used with caution in patients with renal dysfunction

Tinidazole

infections in the gastrointestinal (GI) tract or other tissues due to worm infestation

HELMINTHIC INFECTIONS

is the disease caused by ingestion of the encysted larvae of the roundworm, Trichinella spiralis, in undercooked pork.

Trichinosis

refers to infection of the blood and tissues of healthy individuals by worm embryos, which enter the body via insect bites.

Filariasis

is a platyhelminthic infection by a fluke that is carried by a snail.

Schistosomiasis

act on metabolic pathways that are present in the invading worm but are absent or significantly different in the human host.

ANTI-HELMINTHIC DRUGS

albendazole (Albenza) ivermectin (Stromectol) mebendazole (Vermox) praziquantel (Biltricide) pyrantel (Antiminth, Pin-Rid, Pin-X, Reese’s Pinworm)

- particle is composed of a piece of DNA or RNA inside a protein. - replicates in the host cell

virus

act to prevent the replication of that particular virus

Interferons

Agents for Influenza A and Respiratory Viruses

amantadine oseltamivir ribavirin rimantadine zanamivir

invade the respiratory tract and cause the signs and symptoms of respiratory “flu. ”

Influenza A, B and RSV

AGENTS FOR INFLUENZA A AND RESPIRATORY VIRUSES Therapeutic Actions and Indications _________________ is the only antiviral agent that is effective in treating H1N1 and avian flu

Oseltamivir

Herpes viruses account for a broad range of conditions:

cold sores, encephalitis,shingles,genital infections

different since it can affect the eye, respiratory tract, and liver and reacts to many of the same drug

Cytomegalovirus (CMV)