CVS 9 Flashcards
examples of polyenes
ampho b nystatin
MOA of polyenes
pores
binds to ergosterol in cell membrane
polyenes acquire resistance by
decreasing the amount of ergosterol
leakage of K+ ions
synergistic action
1+1 = 3
NTG + sildenafil
pen+ aminoglycosides
amphob + flucytosine
permissive action of drugs
steroids + Epi
intrathecal amphob is given for
cryptococcal meningitis
which drugs MUST BE administered via slow infusion
ampho b
vancomycin
(increase histamine if given faster)
tryptophan is used to make ?
niacin
5HT serotonin
niacin synthesis requires which other factors
B2 B6
how does niacin affect lipid metabolism?
which other drug does this ?
decrease VLDL synthesis and increase HDL
fibrates
malignant PKU is caused by ?
phenylalanine hydroxylase def
tyrosine hydroxylase def
tryptophan hydroxylase def
all these require THB and DHBR for synthesis
SE of niacin
flushing due to prostaglandin release
hyperglycemia
hyperuricemia
def of B3 niacin
diarrhea
dementia
dermatitis (hallucinations)
death
other condition that has hallucinations + dementia
lewy body dementia
what happens in HARTNUPS disease
AR
transporters in PCT and intestines are effected
loss of neutral Amino Acids —– tryptophan
can ampho B cross BBB easily?
NO
what kind of supplementation is necessary with ampho B administration ?
K+ and Mg+
due to altered renal tubule permeability
causes of RTA type 1
ampho b
NSAIDS
SLE sjogern
obstructive uropathy
RTA type 1
defect?
symptom?
defected H+ pump at the lumen membrane
so H+ cannot be secreted
metabolic ACIDOS and hyPOkalemia
normally HYPERKALEMIA is assoc with M.ACIDOSIS
SE of ampho b
histamine/fever/chills/muscle rigor ---- shake n bake increase QT nephrotoxic --(HYDRATE) IV phlebitis ** dec EPO ---> anemia
why is nystatin not recommended orally
increases systemic toxicity
swish and swallow nystatin used for?
oral thrush
CD4 <500 in HIV
asthma (budesonide fluticasone)
treatment for diaper rash and vulvovaginitis
nystatin
azoles MOA
14 alpha demethyase (lan—> ergo)
desmolase (chols—-> pregnolone)
drugs that can cause gynecomastia
DISCKOR Digitalis Isoniazid Spirinolactone Cimetidine Ketoconazole Oestrogen Risperidone
which azole can cross BBB
fluuuuconazole
flucanozole used to treat ?
esophageal candidiasis (<100)
itraconazole variconazole can treat
SAB
Sporotrichosis
Aspergillus
Blastomyces
itraconazole absp increases with?
EATING food
ketoconazole is killed by
antacids **
Topical dermatophyte inf treated by
clotrimazole and miconazole
isavuconazole is used for
serious aspergillus inf and mucor
flucytosine MOA
inhibits DNA RNA synthesis by conversion to 5FU
conv to 5FU requires cytosine deaminase
5Fu inhibits thymidylate synthase
cytosine deamination makes
uracil
uracil methylation makes
thymine
IMP AMP stick together and make
hypoxanthine
GMP guanosine makes
xanthine
histones are +ve or _ve
+ve
euchromatin location
central
active
heterochromatin
periphery
inactive
DNA methylation can be seen in
imprinting
cancer (only tumor suppressor gene like p53)
aging
how is gene silencing done?
addition of methyl group to adenin or cytosin by SAM (methyl donor)
methylation of cytosine/guanine repeats CPG on promotor —– leads to gene silencing
gene silencing is seen in which condition
Fragile X CGG repeats
FMR 1 gene
histones are synthesized in which phase
S phase
what type of histone Is present in mitochondria
NO histone
linker DNA (packing of nucleosome)
H1
mechanism of allopurinol, febuxostat
xanthine oxidase inhibitor
adenonisne deaminase def seen in
SCID
MOA cladrinine pentostatin
inhibit adenosine deaminase
HGPRT def
XLR Hyperuricemia Gout Pissed offf Retardation T dystonia spastic cerebral palsy early daeth
sodium urate crystals in diaper
orange sand in diaper
HGPRT def
increase of PRPP
aspirin effects in LOW dose and HIGH dose
LOW = increase uric acid in body HIGH= uricosuric
rasburicase and pegloticase
break uric acid
transketolase requies
B1 thiamine
ribavirin mechanism of action
CHAIR Capping of mrna at 5' end - guanyl and methyltransf Hypermutating HCV Antagonises TH2/ increases TH1 (CMI) Imp dehydrogenase inhib RNA polymerase inhibitor
purine synthesis needs
glutamine
aspartate
glycine
pyramidine syhnthesis needs
glutamine + CO2
aspartate
uses CPS II
leflunomide MOA indication
dehydroorate dehydrogenase (carbomylphosphate to oorotic acid)
txt in Rheumatoid arthritis
hydroxyurea MOA
inhibits ribonucleotide reductase
targets S phase
txt for sickle cell anemia
myeloprolif disorders
