Exam 2- Week 7

Question 1

Neuramidase Inhibitors (-vir)

Answer 1

Antiviral. Breaks the bond that attaches the viral particles of the host cell. Used as prophylaxis and treatment for flu A and B.

Side effects: HA, N/V, CNS

Ex: oseltamivir (tamiflu), zanamivir (relenza)

Question 2

Adamantane Derivatives (-tadine)

Answer 2

Antiviral

Bind to ion channel formed by membrane protein of viral envelope. High pKa- no stomach absorption.

Uses: Flu A prophylaxis

Side effects: CNS

Ex: amantadine, rimantadine

Question 3

Antivirals for Herpes Simplex or Varicella

Answer 3

Blocks an enzyme that is essential in the production of new viruses.

Side effects: HHA, nausea

Acyclovir, valcyclovir, famcyclovir

Question 4

Polyene Antifungals

Answer 4

Antiviral, limited to serious fungal infections d/t side effects. Limited to use on skin and mucus membranes.

Amphotericin B, nystatin

Question 5

Triazole antifungal (-nazole)

Answer 5

Inhibit critical enzyme which causes a buildup of a toxic substance and increased fungal membrane permeability.

Side effects: relatively minor, N/V

Precautions: hepatotoxicity

Drug interactions: CYP450

Ex: fluconazole, ketoconazole

Question 6

Imidazole antifungals

Answer 6

Same mechanism as triazole. Indicated for vulvovaginal candidiasis, oropharyngeal candidiasis, and times infections.

Miconazole (monistat, lotrimin)

Question 7

Allylamines

Answer 7

Work like azole antifungals, less active against candida.

Side effects: (many) skin, GI, liver tox

Ex: terbinafine (lamisil)

Question 8

Ciclopirox (Pen-Lax)

Answer 8

Atypical antifungal

Topical, for onychomycosis of finger and toenails

Acts by chelatijg cations. Results in inhibition of enzymes responsible for the breakdown of peroxides in fungal cells.

Question 9

Griseofulvin

Answer 9

Atypical antifungal

To for tinea infections.

Side effects: photosensitivity, possible reactivity to pcn

Question 10

Tolnaftate (Tinactin)

Answer 10

Miscellaneous antifungal

Used topically to treat tinea infections.

Question 11

Ethambutol

Answer 11

Anti tubercular

Inhibits synthesis of mycolic acids- an important part of the bacterial cell wall.

Not used as monotherapy.

Side effects: optic neuritis

Question 12

INH

Answer 12

Anti-tubercular
Well absorbed. Penetrates CSF.

Side effects: peripheral neuropathy, hepatitis

Precautions: hepatotoxicity, pregnancy,

Question 13

PZA

Answer 13

Anti-tubercular

Mechanism unknown. Bacteriostatic/ bactericidal

Widely distributed

Side effects: hepatotoxic

Question 14

Rifabutin

Answer 14

Anti-tubercular

Semisynthetic derivative of rifamycins. Inhibits DNA-dependent rna polymerase. Widely distributed.

Question 15

Rifampin

Answer 15

Anti-tubercular

Inhibits DNA-dependent RNA polymerase. Well absorbed but highly protein bound.

Uses: labeled for active TB. elimination of mengingococci from nasopharynx.

Side effects: N/V, red-orange discoloration of urine, salute, and tears.

Question 16

Valacyclovir

Answer 16

Antiviral

Side effects: CNS

Adverse effects: TTP, HUS in immunocompromised individuals

Monitoring: UA, LFTs, CBC

Question 17

Oseltamivir (tamiflu)

Answer 17

Antiviral

Indications: prophylaxis for influenza A or B over 1 yr, treatment of uncomplicated acute illness s/t influenza who have been symptomatic for no more than 48 hrs.

Recommended for prophylaxis: postexposure for family or close contacts at high risk or haven’t been vaccinated. Unvaccinated HC workers who had exposure without PPEs. Pre-exposure should only be used for persons at very high risk of flu complications who otherwise can’t be protected at times of high exposure. Prophylaxis can also be given to eligible residents of institutions who house patients at high risk when need to control outbreaks.

Question 18

Ethambutol

Answer 18

Antimycobacterial. Iswd to treat TB. Inhibits important component of cell wall.

Serious side effect: optic neuritis (decreased visual acuity, color blindness, diminished visual fields, loss of vision). Reversible if discontinued promptly.

Question 19

Ketoconazole

Answer 19

Azole antifungal

Topical cream or shampoo to treat tinea.

For vulvovaginal candidiasis, give 200-400 mg daily x5d

Take with food to promote absorption and decrease irritation.

Question 20

Hypochlorhydria

Answer 20

Low stomach acid.

Question 21

Antihelmintics

Answer 21

Benzimazoles (mebendazole) and pyrentel (pinworm) are drugs of choice to treat intestinal nematodes in the US.

ADminister with a fatty meal to aid in absorption.

Question 22

Permethrin

Answer 22

Treatment for scabies. Antiparasitic. Leave on from 8-14 hrs then wash off in the shower.