Diseases and their drugs Flashcards by Angela Mitchell

B-lactam/B-lactamase inhibitor combos

Amoxicillin + Clavulanate
Piperacillin + Tazobactam
Ampicillin + Sulbactam

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Actinomyces Israelii medication

Penicillins, Carbapenems, Macrolides, Cephalosporins

Bactericidal - binds to PCP binding protein to stop crosslinking of NAG/NAM

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Strep Pyogenes medication

Penicillin V or amoxicillin

Cephalosporin or macrolide for PCN allergy

IV PCN + clindamycin for systemic infection

Bactericidal - binds to PCP binding protein to stop crosslinking of NAG/NAM

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Rickettsia Rickettsia medication

Tetracyclines

Bacteriostatic - Binds to 30S subunit - blocks exit tunnel to inhibit elongation

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Borrelia Burgodorferia medication

Doxycycline

Bacteriostatic - Binds to 30S subunit - blocks exit tunnel to inhibit elongation

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Moraxella Catarrhalis

Amoxicillin + Clavulanate

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Strep pneumoniae

Amoxicillin + Clavulanate

Vancomycin + Ceftriaxone

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Haemophilus influenzae

Less severe: amoxicillin

More severe: cephalosporins

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Influenza A/B

Oseltamavir - Neuraminidase Inhibitor - prevents NA from releasing virus from cell

Amantadine - uncoating inhibitor - prevents uncoating of virus

Baloxavir - prevents 5’ cap transfer - can only be used within 48 hrs of symptom onset

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Rabies virus

PEP or PrEP vaccine - human rabies immunoglobulin

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Bacillus anthracis

Ciprofloxicin - inhibits bacterial topoisomerase II and IV - prevents replication and transcription of DNA - bactericidal (Floroquinolone)

Doxycycline - binds to 30s subunit - bacteriostatic

Linezolid - binds 50s subunit - prevents protein synthesis

Meropenam - binds to PBP to prevent cell wall synthesis - bactericidal

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Bordatella pertussis

DTaP vaccine

Macrolides - binds to 50s subunit to prevent elongation of peptide chain

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Measles

Vitamin A - increase function of T cells

can give antivirals

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Varicella Zoster

Antiviral drugs - acycolvir, famciclovir, valacyclovir

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SARS-CoV-2

Antivirals - Remdesivir - adenoside nucleotide analogue –> inhibition of RNA replicase –> decreased viral replication

Corticosteroids - Dexamethasone

IL6 pathway inhibitor - Tocilizumab - monoclonal antibody against IL6 receptor

JAK inhibitor - Baricitinib

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RSV

Severe disease - Ribavirin - guanosine analog

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Corynebacterium diphtheriae

Diphtheria antitoxin - neutralizes endotoxin before entering cell

Penicillin - binds to PBP - or Erythromycin - binds to 50S subunit

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Mycobacterium tuberculosis

LTBI
Rifamipin - inhibits translation by inactivating RNA polymerase
INH (Isoniazid) - blocks mycolic acid synthesis - can’t make cell wall

TB Disease - RIPE for 2 months, RI for 4 months
Rifamipin
INH
Pyrazinamide
Ethambutol

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Aspergillus Fumigatus

Less serious: Voriconazole - inhibits fungal cytochrome P450 –> inhibits final step to convert lanosterol to ergosterol

Echinocandins - inhibits synthesis of B-1,3-glucan –> disruption of cell wall synthesis

More serious: Amphotericin B - binds to ergosterol and alters permeability of cell by forming pores in membrane

Seasonal Allergies

Antihistamines - Histamine receptor Agonists - inverse agonists that compete with histamine binding (H1) for opposite effect

Nasal steroids - glucocorticoid spray

Decongestants - Afrin or Sudafed - both cause vasoconstriction of nasal mucosa

Pneumocystis jjrovecii

TMP-SMX - inhibitions of PABA to DHF and DHF to THF

Histoplasma capsulatum, Coccidioides immitis, Blastomyces dermatitidis

Mild: azoles - prevents final step of coverting lanosterol to ergosterol

Systemic: Amphotericin B

Candida Albicans

Mild: fluconazole - prevents final step of coverting lanosterol to ergosterol

Echinocandins - inhibits synthesis of B-1,3-glucan –> disruption of cell wall synthesis

Systemic: Amphotericin B

Cryptococcus neoformans

Amphotericin B and Flucytosine - taken up by fungal cells via cytosine permease –> converted to 5-FU –> then to 5-fluorodeoxyuridine monophosphate (FdUMP) and dUTP –> inhibits DNA and RNA synthesis

Maintainance with Fluconazole

HIV

HAART - highly active antiretroviral therapy NNRTI - 'vir' in the middle - delaviridine, efavirenz, nevirapine NRTI - abacavir, emtricitabine, tenofovir INI - ends in 'gravir' - dolutegravir PI - ends in 'vir' - atazanavir, indinavir, nelfinavir EI - maraviroc - CCR5 entry inhibitor - prevents binding of gp120

Plasmodium (Malaria)

All - Quinine Uncomplicated - Chloroquine Vivax and Ovale - Primaquine - kills dormant parasites in liver Falciparum - Amodiaquine, Piperquine, Artesunate Schizonts - Atovaquone-Proguanil - disrupts ETC

Babesia

Atovaquone and Azythromycin

T. brucei

Gambiense (West Africa) - early - Fexinidazole - late - Eflornithine, Melarsoprol Rhodesiense (East Africa) - early - Suramin - late - Melarsoprol

T. cruzi (Chagas)

Nifurtimox

Yersinia Pestis

Aminoglycosides (streptomycin) with tetracycline ## Footnote The plague

Avoid giving NSAIDs or aspirin to pts with these diseases

CHIKV, West Nile, Yellow Fever, Dengue Risk of hemorrage high for these pts - blood thinners increase the risk More versions exposed to --> higher risk of hemorrhagic fever --> IgE response causes Type I hypersensitivity reaction

Leishmaniasis

Cutaneous - local treatment - fluconazole Complicated - amphotericin B Visceral - Amphotericin B, Sodium stibuogluconate - inhibits ADP phosphorylation, DNA topoisomerase I

Francisella Tularensis

Gentamicin - aminoglycoside - binds to 30S subunit - inhibits translation and translocation - causes miscoded polypeptides Doxycycline or ciprofloxacin for mild

Bartonella spp

B. henselase - **Azithromycin**, **Clarithromycin** B. quintana - **erthromycin**, doxycycline, **azithromycin** ## Footnote **Macrolides**- 50S subunit, prevents elongation

Giardia spp

Metronidazole - binds to proteins and DNA of the flagellate - or nitazoxanide

Klebsiella pneumoniae

Cephalosporins, Carbapenems, Fluoroquinolones ## Footnote Fluoroquinolones - inhibit tpopisomerase II and IV --> prevents replication and transcription

Mycoplasma pneumoniae

Eryhtromycin, Doxycyline, Newer Fluoroquinolones

First generation Antihistamines

Promethazine Diphenhydramine

Second generation Antihistamines

Cetirizine Loratadine

TMP-SMX is associated with delayed hypersensitivity reactions due to what factor?

Sulfa

Red man syndrome is caused by

Vancomycin - causes direct release of histamines from mast cells

Methotrexate

DMARD Blocks dihydrofolate reductase --> decrease DNA synthesis --> decrease lymphocyte proliferation

What is typically given with Methotrexate and why

Folic Acid - mitigates side effects

Methotrexate rescue drug

Leucovorin

How is hydroxychloriquine useful in the management of autoimmune disease

Inhibits locomotion of neutrophils and chemotaxis of eosinophils - imapired complement-dependent antibody reactions Stops antigen presentation on APCs

Distinguish the mechanism of tocilizumabfrom that of etanercept or adalimumab

Tocilizumab - Binds to IL6 receptors to inhibit IL6 mediated signaling Etanercept/adalimumab - IgG anti-TNF anyibody complexes w TNF and prevents interactions with TNF receptors --> downregulates macrophages and T cell function

How does Mycophenolate work

Blocks inosine monophosphate dehydrogenase --> inhibits lymphocyte proliferation and B/T cell function