Exam 2- Week 7 Flashcards
Neuramidase Inhibitors (-vir)
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)
Adamantane Derivatives (-tadine)
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
Antivirals for Herpes Simplex or Varicella
Blocks an enzyme that is essential in the production of new viruses.
Side effects: HHA, nausea
Acyclovir, valcyclovir, famcyclovir
Polyene Antifungals
Antiviral, limited to serious fungal infections d/t side effects. Limited to use on skin and mucus membranes.
Amphotericin B, nystatin
Triazole antifungal (-nazole)
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
Imidazole antifungals
Same mechanism as triazole. Indicated for vulvovaginal candidiasis, oropharyngeal candidiasis, and times infections.
Miconazole (monistat, lotrimin)
Allylamines
Work like azole antifungals, less active against candida.
Side effects: (many) skin, GI, liver tox
Ex: terbinafine (lamisil)
Ciclopirox (Pen-Lax)
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.
Griseofulvin
Atypical antifungal
To for tinea infections.
Side effects: photosensitivity, possible reactivity to pcn
Tolnaftate (Tinactin)
Miscellaneous antifungal
Used topically to treat tinea infections.
Ethambutol
Anti tubercular
Inhibits synthesis of mycolic acids- an important part of the bacterial cell wall.
Not used as monotherapy.
Side effects: optic neuritis
INH
Anti-tubercular
Well absorbed. Penetrates CSF.
Side effects: peripheral neuropathy, hepatitis
Precautions: hepatotoxicity, pregnancy,
PZA
Anti-tubercular
Mechanism unknown. Bacteriostatic/ bactericidal
Widely distributed
Side effects: hepatotoxic
Rifabutin
Anti-tubercular
Semisynthetic derivative of rifamycins. Inhibits DNA-dependent rna polymerase. Widely distributed.
Rifampin
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.
Valacyclovir
Antiviral
Side effects: CNS
Adverse effects: TTP, HUS in immunocompromised individuals
Monitoring: UA, LFTs, CBC
Oseltamivir (tamiflu)
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.
Ethambutol
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.
Ketoconazole
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.
Hypochlorhydria
Low stomach acid.
Antihelmintics
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.
Permethrin
Treatment for scabies. Antiparasitic. Leave on from 8-14 hrs then wash off in the shower.
