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Pharmacology > Infectious Disease Drugs > Flashcards

Infectious Disease Drugs Flashcards

1
Q

what is an anti-viral drug

A

acyclovir

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2
Q

what is the role of acyclovir

A

inhibits herpes-specific DNA polymerase

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3
Q

what are 4 common side effects of antiviral drugs

A
  • Dizziness
  • GI disturbance
  • Headache
  • Skin rash
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4
Q

what can IV infusion of acyclovir cause

A

Thrombophlebitis

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5
Q

what can IV infusion of acyclovir also cause and why

A
  • High concentrations may precipitate in the kidney and lead to renal failure
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6
Q

what are 3 macrolides

A
  • Clarithromycin
  • Erythromycin
  • Azithromycin
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7
Q

what is first-line for chlamydia

A

One-off dose azithromycin

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8
Q

what is the spectrum of activity of erythromycin

A

Broad: gram negative and positive

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9
Q

what is the spectrum of activity of clarithromycin and azithromycin

A

Increasingly gram negative - particularly effective against H. Influenza

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10
Q

what is used to treat infective exacerbation of COPD

A

Clarithromycin/ Amoxicillin or Doxycycline

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11
Q

what is the MOA of macrolides

A

Bind to 50s subunit and prevent translocation = bacteriostatic

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12
Q

which macrolide is associated with worst effects

A

erythromycin

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13
Q

what gastric abnormalities can macrolides cause

A

antibiotic-associated colitis

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14
Q

what liver abnormalities can macrolides cause

A

cholestatic jaundice

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15
Q

what cardiac abnormalities can macrolides cause

A

Prolong QT interval - lead to tornadoes de pointes

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16
Q

what side effect can macrolides cause affecting the ears

A

ototoxic

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17
Q

when are macrolides useful

A

can be used in patients with penicillin allergies - as they have no similarity

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18
Q

what do erythromycin and clarithromycin do to CYP450

A

inhibit it

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19
Q

what does inhibiting CYP450 mean

A

increases serum concentration and hence SEs of drugs metabolised by CYP450

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20
Q

what can clarithromycin and warfarin result in and why

A

clarithromycin inhibits CYP450 - increases warfarin can lead to bleeding

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21
Q

what can clarithromycin and statins result in and why

A

clarithromycin inhibits CYP450 - increases statins = lead to rhabdomyolysis

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22
Q

what drugs should macrolides not be prescribed with

A

other drugs that prolong CYP450

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23
Q

name 5 drugs that prolong the QT interval

A
  • SSRI
  • Quinolones
  • Quinines
  • amiodarone
  • antipsychotics
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24
Q

explain IV infusion of macrolides

A

dilute in large volume and inject into large proximal vein to avoid thrombophlebitis over 60-min to avoid QT prolongation

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25
Q

what is metronidazole effective against

A

gram negative anaerobic bacteria

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26
Q

what is MOA of metronidazole

A

passively diffuses into cells and then is reduced to produce a nitro free-radical, which can bind to and degrade DNA leading to cell-death (bactericidal)

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27
Q

what is a common side effect of metronidazole

A

GI disturbance

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28
Q

if used for a prolonged time what may metronidazole cause

A

neurological disorders:

  • peripheral neuropathy
  • optic neuropathy
  • encephalopathy
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29
Q

what is the one absolute CI to metronidazole

A

alcohol

30
Q

why is alcohol contraindicated in metronidazole

A

metronidazole inhibits acetaldehyde dehydrogenase, meaning if individual has alcohol there is an accumulation of acetaldehyde which can cause hangover like effects including flushing, headache, nausea and vomiting

31
Q

what is the effect of metronidazole on CYP450

A

Inhibitor

32
Q

what drug does metronidazole increase toxicity of

A

Lithium

33
Q

what antibiotics may alcohol reduce effectiveness of

A
  • Erythromycin

- Doxycycline

34
Q

what is nitrofurantoin effective for

A

UTI

35
Q

what is the MOA of nitrofurantoin

A

Enters cells and is reduce to nitrate free radical where it damages DNA

36
Q

what is a common SE of nitrofurantoin

A

GI Upset

37
Q

what can nitrofurantoin do to urine

A

Turns urine dark yellow or brown

38
Q

what are 3 rare SEs of nitrofurantoin

A
  • Pneumonitis
  • Hepatitis
  • Peripheral Neuropathy
39
Q

when does the risk of hepatitis, pneumonitis and peripheral neuropathy with nitrofurantoin increase

A

Prolonged-used

40
Q

if given in the third trimester what happens

A

nitrate free radicals damage DNA or RBC leading to haemolysis causing a haemolytic anaemia

41
Q

what are 3 absolute CI to nitrofurantoin

A
  • Third-trimester
  • First 3 months of neonatal life
  • Renal impairment
42
Q

why should nitrofurantoin not be prescribed in renal impairment

A

leads to toxicity

43
Q

name two narrow penicillins

A

benzylpenicillin

phenoxymethylpenicillin

44
Q

what are narrow spectrum penicillins not effective against

A

gram negative rods

45
Q

what is MOA of penicillins

A

inhibit cross-linking of peptidoglycan cell walls causing osmotic lysis

46
Q

how can bacteria gain resistance to penicillins

A

B-lactamases break down penicillin

47
Q

how does penicillin allergy usually manifest

A

Rash 7-10d after first exposure

Or, 1-2d after repeat exposure

48
Q

what is penicillin allergy mediated by

A

IgG

49
Q

what is anaphylactic reaction to penicillin caused by

A

IgE

50
Q

how does anaphylaxis present clinically

A
  • facial oedema
  • laryngeal oedema
  • hypotension
51
Q

what can high doses of penicillin cause

A

neurological toxicity

52
Q

what is an absolute CI to penicillin

A

penicillin allergy

53
Q

if a patient has a history of penicillin allergy, what antibiotic should they also not be prescribed and why

A

take care prescribing cephalosporins - as they also have a B-lactam ring

54
Q

what drug to penicillins reduce renal excretion of leading to toxicity

A

methotrexate

55
Q

what is phenoxymethylpenicillin called

A

penicillin V

56
Q

what is the spectrum of activity of vancomycin

A

gram-positive

57
Q

what is the MOA of vancomycin

A

inhibits cross-linking peptidoglycan cell wall causing death by osmotic lysis

58
Q

what is the most common SE of vancomycin

A

thrombophlebitis

59
Q

what is thrombophlebitis

A

painful inflammation of veins

60
Q

what happens if vancomycin is infused rapidly

A

red-man syndrome

61
Q

what is red man syndrome

A

erythema over face, chest and arms

62
Q

what causes red man syndrome

A

vancomycin degranulation of mast cells

63
Q

what can IV vancomycin cause

A
  • Ototoxicity
  • Nephrotoxocity
  • Neutropenia
  • Thrombocytopenia
64
Q

when used with what drugs does vancomycin increase risk of ototoxicity and nephrotoxocity

A
  • Ciclosporin
  • Aminoglycoside
  • Loop diuretics
65
Q

name 3 anti-fungal drugs

A
  • Nystatin
  • Fluconazole
  • Co-trimazole
66
Q

what are the topical anti-fungal drugs

A

Nystatin

Co-trimazole

67
Q

what are the oral anti-fungal drugs

A

Fluconazole

68
Q

what are 3 side effects of fluconazole

A
  • Headache
  • Hypersensitivity
  • Hepatitis
69
Q

what is a severe side effects of fluconazole

A

Sever liver impairment

Prolong QT

70
Q

when should fluclonazole be prescribed with caution

A

Someone with liver disease - due to risk adverse effects

71
Q

in what condition should fluconazole be completely avoided

A

Pregnancy - due to teratogenic

72
Q

explain interaction of fluclonazole and CYP450

A

fluconazole inhibits CYP450

Pharmacology (12 decks)

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