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Pharm 840 Exam #1 > Dr. Hall > Flashcards

Dr. Hall Flashcards

1
Q

MoA of Echinocandins

A
  • Inhibits beta glucan synthesis
  • Fungicidal
  • IV formulations only
  • Penicillin of antifungals
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2
Q

MoA of Ployenes

A
  • Binds to ergosterol to weaken the cell membrane

- Leading to a leaky membrane, then cell lyses

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3
Q

MoA of Azoles

A
  • Inhibits the synthesis of ergosterol

- Inhibits 14 alpha demethylase

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4
Q

MoA of 5-flucytosine (5FC)

A
  • Prodrug converted to 5FU
  • Inhibits DNA synthesis
  • FdUMP inhibits DNA synthesis
  • FUTP inhibits RNA/ protein synthesis
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5
Q

Cancidas

A
  • Caspofungin

- Echinocandin

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6
Q

Mycamine

A
  • Micafungin

- Echinocandin

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7
Q

Eraxis

A
  • Anidulafungin

- Echinocandin

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8
Q

Mechanism of resistance to echinocandins

A
  • Mustations in FKS1 or FKS2
  • Decreased sensitivity to echinocandins
  • Biofilms
  • Increased chitin synthase
  • Upregulation of multidrug transporters
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9
Q

Nystop

A
  • Nystatin

- Polyene

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10
Q

Mechanism of resistance to Polyenes

A
  • Defective ERG2 or ERG3 genes
  • Reduced ergosterol content
  • Alterations in sterol to phospholipid ratio
  • Reorientation/masking of ergosterol
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11
Q

Monistat

A
  • Miconazole

- Topical Imidazole

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12
Q

Lotrimin AF

A
  • Clotrimazole

- Topical Imidazole

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13
Q

Lotrisone

A
  • Clotrimazole plus betamethasone

- Topical Imidazole

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14
Q

Jublia

A
  • Efinaconazole

- Topical Triazole

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15
Q

Diflucan

A
  • Fluconazole
  • PO/IV Triazole
  • Has the widest therapeutic index of the azoles
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16
Q

Sporonox

A
  • Itraconazole
  • DO NOT USE IN CHF pts
  • PO/IV Triazole
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17
Q

Vfend

A
  • Voriconazole
  • PO/IV Triazole
  • Can lead to visual disturbances
18
Q

Noxafil

A
  • Posaconazole
  • PO/IV Triazole
  • Take with food
  • Avoid with statins (prolonged QT interval)
19
Q

Cresemba

A
  • Isavuconazonium
  • PO/IV Triazole
  • Prodrug of isavuconazole
20
Q

Nizoral

A
  • Ketoconazole

- Topical Imidazole

21
Q

Mechanisms of resistance to Azoles

A
  • Point mutation in ERG11 gene
  • Over expression of ERG11
  • Alteration in ERG3
  • Increased efflux pumps
  • Changes in composition of fungal cell membrane (decreased permeability)
22
Q

Lamisil AT and Lotrimin Ultra MoA

A
  • Terbinafine and Butenafine
  • Non azole inhibitors of ergosterol synthesis
  • Inhibit squalene epoxidase
  • Fungicidal
23
Q

Ancobon

A
  • 5FC

- Bone marrow toxicity due to accumulation of 5FU

24
Q

Mechanism of resistance to 5FC

A
  • Loss of permease or deaminase activity
  • Then prodrug is never activated
  • Use in synergy with AmB to help decrease resistance rates
25
Q

Characteristics of TB

A
  • Slow growing
  • Rod shapped
  • aerobic bacteria
26
Q

LTBI signs and symptoms

A
  • No symptoms or physical findings of TB

- Smear and culture negative

27
Q

Active TB signs and symptoms

A
  • Fever, cough, weight loss, fatigue

- Positive culture OR smear

28
Q

Initiation phase

A
  • Bactericidal/ intensive phase
  • 4 drug therapy
  • 2 month duration
29
Q

Continuation phase

A
  • Sterilizing phase
  • 2 drug therapy
  • 4 to 7 month duration
30
Q

MoA of Isoniazid (INH, H)

A
  • Inhibits synthesis of mycolic acids
  • Prodrug
  • Activated by KatG
  • Bactericidal
31
Q

Mechanism of resistance to INH

A

-Mutations in KatG or inhA

32
Q

INH toxicities

A
  • More common in slow acetylators
  • Peripheral neuropathy
  • Hepititis
  • Rashes
33
Q

How to decrease the likely hood of neuropathy caused by INH

A
  • Supplement with pyridoxine (B6)

- Helps to increase GABA levels

34
Q

MoA of Ethambutol (Myambutol)

A
  • Inhibits cell wall synthesis by inhibiting arabinosyl transferase
  • Bacteriostatic
  • Helps increase the activity of RIF
35
Q

Most common side effects with Ethambutol (Myambutol)

A
  • Optic neuritis
  • leads to diminished visual acuity and loss of red/green discrimination
  • Do eye exam BEFORE starting this drug
  • Increased risk of gout too
36
Q

MoA of Pyrazinamide

A
  • Prodrug, activated by pcnA

- Can lead to liver injury

37
Q

MoA of Rifampin (Rifadin)

A
  • Inhibits mRNA and protein synthesis

- Bactericidal

38
Q

TB retreatment cases

A
  • Higher likely hood of resistance
  • 5 to 6 drug treatment in initiation phase
  • 3 drugs in continuation phase
39
Q

Situro (Bedaquiline)

A
  • 1st new TB drug in the last 40 years
  • Approved for MDR/XDR TB
  • Inhibits proton pump for ATP synthase
  • T1/2 is 5.5 months!
40
Q

Delaminid

A
  • Experimental TB drug
  • Approved for MDR TB in EU
  • Blocks mycolic acid synthesis
  • Prolongs QT interval
41
Q

Treatment of MAC

A

1) Macrolide (Azithromycin or Clarithromycin)
2) Ethambutol
3) +/- Rifampin or Rifabutin

Pharm 840 Exam #1 (5 decks)

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