general pharmacology Flashcards
TB major symptom? how to tell if active? latent vs active treatment?
1 - night sweats
- to see if active- chest x ray
- latent - monotherpy
- active combo therapy
which drugs are used for latent TB?
RI in RIPE
rifampin , Isoniazid
active TB drugs?
RIPE
rifampin , Isoniazid, pyrazinamide, ethambutol
RifamPin MOA, SE?
MOA: binds to B subunit of RNA polymerase -> stops mRNA transcription
SE: pink -> pink/orange discoloration of urine/tears , hepatotoxicity, exudative conjunctivitis
Isoniazid MOA, SE?
“used in isolation”
MOA: inhibits mycoloic acid synthesis -> stops cell wall synthesis
SE: hepatotoxicity, vitamin B6 (pyridoxine) deficiency-> peripheral neuropathy, optic neuritis/optic atrophy -> vision loss
name for vitamin B6
Pyridoxine
ethambutol MOA, SE
MOA: inhibits arabinosyl transferase -> stops cell wall synthesis
SE: retrobulbar & bilateral optic neuritis -> decreased VA (reversible, but takes months, some cases irreversible), color blindness
PATIENTS should get baseline and periodic testing for VA and reg/green color discrimination
what ending do antiviral drugs have?
- vir
what is used for influenza treatment?
oseltamivir
oseltamivir MOA, SE
MOA: inhibit viral neuraminidase for flu A&B -> prevents spread of virus along mucous lining of respiratory tract.
SE: conjunctivitis
HIV therapy drugs
retrovir, epivir-HBV, AZT
AZT used to present transmission to fetus during pregnancy as well
Atripla
MOA , SE of HIV drugs
MOA: nucleoside analogs of thymidine -> inhibit reverse transcriptase = RNA-dependent DNA polymerase
SE: Bone marrow supression (ie. decrease in blood, WBCs, platelets -> granulocytopenia, anemia, pancytopenia)
lactic acidosis/ muscle break down (myopathy, myositis), macular edema
what does reverse transcriptase do?
RNA virus -> DNA virus
HIV -Aids CD4 count
HIV < 200
AIDS < 50
HEP C treatment drugs
ribavirin + interferon!
Ribavirin MOA, SE
MOA: inhibit viral RNA polymerase
SE: conjunctivitis
RIBAViriN
- R-retinal detachment
- I - ischemia (CWS)
- B - Bleeding (retinal hemes)
- A - artery occlusions
- V - Vein occlusions
- N- optic neuritis
Need baseline testing + periodic testing esp for DM, HTN patients
*** everything stops once d/c drug
similar retinopathy SE for interferon. peginterferon
what viruses are in the herpes family? what type of viruses are these?
HSV 1&2
VZV
CMV
DNA virus
MOA of all anti-herpes virus agents?
inhibit DNA polymerase , to stop DNA synthase
What are anti-herpes meds? clinical indications
- viroptic - for HS keratitis
- acyclovir/valcylovir/famciclovir (ORALS) cold sores (HSV1), genital sores (HSV2), shingles (VZV), HZO, HSV keratitis, prophylactically for recurrent HSV.
- ir. all body and eye - ganciclovir - HSV keratitis, CMV (prescribed as an intraocular sustained release capsule)
- foscavir - CMV, when ganciclovir fails, acyclovir resistant HSV infection in AIDS
what preservative is in viroptic? why is it bad?
thimersol - > toxic to cornea
What are the 4 drugs that can cause optic neuritis?
D- Digioxin
I - Isoniazid
C - Chloraphenticol, contraceptives
E - Ethambutol
Penicillamine is not well tolerated, what three ocular SE can result from treating Wilson’s Dz with Penicillamine?
- Myasthetia (diplopia, ptosis)
- Optic Neuritis
- Ocular Pemphigoid (fluid filled blisters)
Idk what is worse, the copper or the SE from the drug to tx it.
Menier’s treatment
Avoid cats
Caffeine
Alcohol
Tabacco
Salts
Side effects of tamoxifen
“think of the C’s”
- Crystallin retinopathy
- Clots -> CRVO, BRVO
- Cornea -> Whorl Keratopathy
- Cataract
- Cancer -> can cause uterine cancer.
Alpha 2 blocker drugs
Flomax
Zosin , losin
Tamsulosin
Prazosin
Terazosin
what drug is used to treat latent TB?
isoniazid
acyclovir,valacyclovir,famcyclovir
- what are these used for?
- MOA
- side effects
oral anti-herpes drug
MOA: inhibit DNA polymerase
SE: Headaches, GI issues (nausea, diarrhea, stomach pain)
*** monitor in patients with kidney and liver disease - give lower doses
gangcyclovir
MOA
dosing
SE
MOA: inhibits DNA polymerase
dosing: 5x/day - more potent than others (9x/day dosing)
SE: blurry vision, irritation
- intravitreal implant -> temp decrease in VA; RD and vit heme
gangcyclovir preservative
BAK, less toxic than thimersol (viroptic) -
what is the most common ocular infection in patient’s with aids?
CMV
CMV treatments
- retrovir
- oral ganglcyclovir, valganciclovir
- cidofovir
- foscavir
cidofovir MOA, and route of administration
MOA: inhibit DNA polymerase
route of administration for CMV - IV
foscavir MOA, route of administration, and SE
MOA: DNA polymerase inhibitor
route of administration Intravitreal
SE: nephrotoxicity and seizures
ocular fungal infections risk factors
- tree branch
- immunocompromised
- chronic beat up cornea - ie. constant SPK
how do fungal medications typically work?
- target ergosterol (part of the fungal celldi membrane)
- inhibit fungal mitosis by inhibiting with microtubule formation during cell wall synthesis
Fungal drugs
- natamycin, amphoteracin B, nystatin
- azoles (ketoconazole, fluconazole, clotrimazole, voriconzaole)
griseofulvin
MOA of natamycin, amphoteracin B and Nystatin
indications
- MOA: bind to ergosterol and form pores in the cell membrane of the fungus-> contents leak out -> cell death
natamycin - fungal blepharitis, conjunctivits, and keratitis - fungal infections it works against - candida, aspergillum, and fusarium
amphoteracin B - ointment/drop (need a compounding pharmacy for topical forms) for keratitis, IV for systemic and intraocular fungal infections
nystatin - oral candida thrush and vaginal yeast infections (NOT INDICATED FOR OCULAR USE)
amphotericin B SE
nephrotoxicity only if IV
AZOLES
MOA
INDICATIONS
SE
MOA: inhibit ergosterol synthesis
indications:
- ketoconazole - first oral azole - used for treatment of severe fungal corneal ulcers, systemic infections, and acanthamoeba
- fluconazole - available in oral, topical, and sub conj injection forms, notes increase in resistance for endopthalmitis
SE: hepatoxicity
what should you culture fungal infections on?
sabauraud’s agar
griseofulvin
MOA
indication
MOA: inhibit fungal mitosis by inhibiting with microtubule formation during cell wall synthesis
indication - scalp, skin and fingerer and toenail infections
toxoplasmosis treatment
sulfadiazine and pyrimethamine
albendazole
indication
MOA
anti parasitic drug for pork/dog tapeworm, ocular inf.
MOA: inhibit tubulin polymerization -> loss of microtubules in the cytoplasm of tape worms
