Drug list Flashcards
What is Zileuton and what is it used for?
Used in asthma.
Leukotriene receptor inhibitor which inhibits LTB4.
Monteleukast + Zafirlukast are used to treat what? Why?
Asthma.
Leukotriene receptor antagonists.
What is Sofosbuvir? what does it treat?
Treats HCV.
NS5B RNA polymerase inhibitor.
Shows antiviral activity against all genotypes and barrier to resistances.
What is Simeprivir?
Treatment for HCV.
NS3/4A protease inhibitor.
Faldaprevir is…
Treatment for HCV.
NS3/4A protease inhibitor.
Aunaprevir is…..
Treatment for HCV.
NS3/4A protease inhibitor.
ABT-450/R is what?
Treatment for HCV.
NS3/4A protease inhibitor.
NS5B RNA polymerase inhibitor.
Sofosbuvir:
Treat HCV: Shows antiviral activity against all genotypes and barrier to resistances.
Four inhibitors of the NS3/4A protease of HCV?
Simeprivir
Faldaprevir
Aunaprevir
ABT-450/R
Daclatasvir is….
NS5A protease inhibitor.
Blocks the replication complex formation and assembly.
Only recommended in combination with sofosbuvir +/- ribavirin.
Which anti-HCV medication is recommended in combination with sofosbuvir +/- ribavirin?
Daclatasvir.
NS5A protease inhibitor which blocks the replication complex formation and assembly.
ABT-267
NS5A protease inhibitor
Ledipasvir
NS5A protease inhibitor.
Block the replication complex formation and assembly.
Ribavirin
Nucleoside guanosine analogue that interferes with viral replication, dosing is weight based. Used to treat HCV.
ABT-333
NNRRIs. Act at a number allosteric sites on the RNA replicase enzyme.
What is one non-specific agent/ immunomodulator that an inert glycol has been added to?
PEG-IFN2a.
Used to treat HCV.
A cytokine.
PEGylation can be used to increase the circulating half-life and hide from the immune system.
Three NS5A protease inhibitors:
Daclatasvir.
Ledipasvir.
ABT-267
Imidazoles
Inhibition of CYP450 enzymes. (CYP51A1) the ERG11 gene product.
Prevent effective ergosterol production and damage accrues to cell wall of fungus.
Fluconazole.
nhibition of CYP450 enzymes. (CYP51A1) the ERG11 gene product.
Prevent effective ergosterol production and damage accrues to cell wall of fungus.
Hepatic derangement and QT prolongation.
Orally active.
Terbinafine
Squalene epoxidase inhibitor leading to decreased ergosterol production and changed cell permeability causing lysis.
Avoid in pregnancy, LF and renal toxicity.
Griseofulvin
Only active against dermatophyte infections.
Should take with or after fatty food.
Accumulates in keratinous tissues and prevents tubulin reorganisation needed for fungal cell to move etc.
Sensitivity testing recommended by PHE.
Caspofungin
Echinocandin inhibitor of B-1,3- glucan synthesis in the cell wall.
Anidulafungin
Echinocandin inhibitor of B-1,3- glucan synthesis in the cell wall.
Limited license: invasive candidiasis only.
Can be used in renal/hepatic failure patients.
Amphotericin
Serious fungal infections.
Targets ergosterol in the membrane and will causes creation of pores.
Fungicidal.
IV use only.
Polyenes lead to renal toxicity, electrolyte disturbances, infusion reactions, cardiotoxicity and hepatotoxicity,
Test dose needed, 1mg over 10mins, crash cart on standy.
Flucytosine
Systemic fungal infections.
Resistance develops if used as single agent.
Nucleoside analogue.
Synergises well with amphotericin.
Converted to 5-FU leading to inhibition of DNA/RNA synthesis in the nucleus.
Can lead to bone marrow suppression.
Quinine
Malaria treatment followed by doxycycline or clindamycin
Atavaquone - Proguanil (malarone)
Malaria prophylaxis or treatment.
Inhibits mitochondrial metabolism and anti-folate.
Doxycycline (malaria)
Malaria prophylaxis in areas of resistance.
Tetracycline class.
Mefloquine
An antimalarial drug consisting of a fluorinated derivative of quinoline. Malaria prophylaxis in areas with resistance.
Inhibits haem detoxification.
Half-life = 2-4 weeks.
Proguanil
Malaria prophylaxis in areas with no resistance.
Anti-folate.
12-21 hr half-life.
Chloroquine
Malaria prophylaxis in areas with no resistance.
Inhibits haem detoxification.
Half-life: 1-2 months.
Chloroquine + Proguanil are used together in areas with little to no resistance.
Oseltamivir
NAi.
Influenza.
NA cleaves sialic acid which facilitates the release of viral particles.
Oral. >1 year olds.
Better absorption than Zanamivir due to addition of hydrophobic groups.
Zanamivir
NAi.
Influenza.
NA cleaves sialic acid which facilitates the release of viral particles.
Why are NAi preferred over M2 inhibitors?
They are active against all strains of influenza and all serotypes including H5N1.
They are transition state analogues which are administered via Diskhaler
Rimantidine
M2 inhibitor. Influenza. Interferes with function of the TM domain of the M2 proteins of influenza A virus.
Less toxic than amantadine.
Amantadine
M2 inhibitor. Influenza. Interferes with function of the TM domain of the M2 proteins of influenza A virus.
Resistance is an issue with all M2 inhibitors, neither are NICE recommended any longer.
Raltegravir
Integrase inhibitor, HIV treatment.
HIV uses host genetic material to make it’s own DNA (reverse transcriptase) viral DNA has to integrate into the genetic material of host cells with an enzyme known as integrase.
Integrase inhibitors block this entry and prevent the virus from adding its DNA into CD4+ T-cells.
Maraviroc
CCR5 antagonist/receptor inhibitor.
For the treatment of CCR5 tropic HIV-1.
Used in combination with other retroviral treatments.
Fuzeon
Fusion inhibitor of HIV.
Rationally designed to mimic gp41.
Lopinavir
Protease inhibitor.
Stops GAG + POL from being processed into mature proteins needed for HIV function.
Efavirenz + Nevirapine
NNRTI: inhibit viral DNA replication by binding at the allosteric site, causing a conformational change of the binding site.
AZT / Tenofovir / Emictabine
NRTIs: chain terminators of the binding site who lack the ‘3-OH needed for chain elongation.
Glybera
Treatment for familial LPL deficiency. Delivered via adeno-associated virus carrying the gene for LPL.
Restores function. No more accumulation of chylmicrons and triglycerides in plasma.
Clopidogrel
Pro-drug atherosclerosis treatment. Block ADP induced platelet activation by blocking the P2Y12 receptor.
Additive effects with aspirin.
Bile Acid Resins
ATS. Anion exchange resins.
Sequester bile acids and decrease the reabsorption of bile acids.
Decrease the absorption of cholesterol and increase the use of cholesterol in the synthesis of new bile acids.
Leads to increased expression of LDL receptors also.
Bind to other lipid drugs and taste horrible + give diarrhoea.
Colestyramine
ATS. Anion exchange resins.
Sequester bile acids and decrease the reabsorption of bile acids.
Decrease the absorption of cholesterol and increase the use of cholesterol in the synthesis of new bile acids.
Leads to increased expression of LDL receptors also.
Bind to other lipid drugs and taste horrible + give diarrhoea.
Cholestipol
ATS. Anion exchange resins.
Sequester bile acids and decrease the reabsorption of bile acids.
Decrease the absorption of cholesterol and increase the use of cholesterol in the synthesis of new bile acids.
Leads to increased expression of LDL receptors also.
Bind to other lipid drugs and taste horrible + give diarrhoea.
Fibrates
ATS.
Agonists at the gene regulatory elements (PARR). PPARalpha esp.
Increase gene expression for Lipoprotein Lipase (LPL) ApoA1 and ApoA5.
Decrease VLDL secretion, increase hepatic uptake of LDL, decrease CRP + fibrinogen levels, increase glucose tolerance and limit smooth muscle inflammation.
Statins.
HMG-CoA reductase inhibitors.
Prevents mevalonate being converted into cholesterol and prevents LDL uptake.
Cell adhesion molecule expression is reduced, decreased ashesion and transendothelial migration, inhibition of chemokine and
MMP secretion.
Effect of statins on the cytoskeleton also alters leukocyte migration.
Amiloride.
CF. Blocks sodium resorption.
Others may be more effective but they pose a hyperkalaemia risk.
Ivacaftor
CF. Class 3 regualtion (G551D) and class 4 regulation (R117H)
Potentiator.
Denufosol
P2Y12 agonist, not effective at maintaining lung function and a risk of enhancing the mucus secretion by activating goblet cells.
Ezetimibe
ATS/Anti-cholesterol drug.
Targets Nieman Pick C1 cholesterol absorption channels at the enterocyte jejunal brush border.
Penicillins
Inhibitors of cell wall synthesis.
Bind to PBPs a type of transpeptidase involved in crosslinking.
Mimic the D-ala D-ala residues on the peptide chain and stimulate autolysins to break down the cell wall.
Cephalosporins.
Inhibitors of cell wall synthesis, contain a beta-lactam ring just like penicillins.
Increased activity against gram negative bacteria.
Affinity for PBPs and resistance to beta-lactamases.
Penetration through the outer membrane gives rise to the activity against gram negative bacteria.
Monobactams
Inhibitors of cell wall synthesis.
Beta-lactam containing.
Less likely to cause hypersensitivity.
Vancomycin
Glycopeptide. Inhibitor of cell wall synthesis. Binds to terminal D-ala-D-ala. Resistance arises due to D-ala --> D-lactate. 5hbonds vs 4 hbonds.