Micro Summary: Drugs (For, Mechanism, & Side Effects) Flashcards
Polyenes:
Examples
For…
Mechanism
Side Effects
Amphotericin B
Systemic fungal infections
Nystatin
Topical candida
Binds sterols, increases permeability
Nephrotoxicity, infusion-related, hypokalemia, hypomagnesemia
Azoles:
Examples
For…
Mechanism
Side Effects
Ketoconazole, Fluconazole, Itraconazole, Voriconazole, Posaconazole
Systemic fungal infections
Imidazole, clotrimazole, miconazole
Topical/cutaneous fungal infections
Disrupts ergosterol biosynthesis
Liver toxicity
Echinocandins:
Examples
For…
Mechanism
Side Effects
Caspofungin, Micafungin, Anidulafungin
Systemic candida & aspergillus
Inhibits 1,3-beta-D-glucan synthesis in cell wall
Histamine-like reactions, liver metabolism
Antimetabolites:
Examples
For…
Mechanism
Side Effects
5-flucytosine
Systemic cryptococcus & candida
Interferes w/ DNA synthesis
Monotherapy induces resistance
Allylamines:
Examples
For…
Mechanism
Terbinafine
Systemic dermatophytes
Inhibits ergosterol biosynthesis
Griseofulvin
Systemic dermatophytes
Disrupts mitotic spindle function of growing hyphae, accumulates in keratinized tissues
Acyclovir
HSV-1 > HSV-2 > VZV, orolabial herpes, genital herpes, neonatal herpes, herpes encephalitis
Nucleoside Analogue: Requires intracellular phosphorylation & a viral thymidine kinase (TK) to inhibit viral DNA polymerase
Renal failure, neurologic
Valacyclovir
HSV, VZV
Nucleoside Analogue: Pro-drug of acyclovir, converted to ACV
Ganciclovir
CMV in immunocompromised (AIDS, organ/bone marrow transplant)
Nucleoside Analogue: Requires intracellular phosphorylation by UL97 to inhibit viral polymerase & DNA synthesis
Bone marrow suppression
Valganciclovir
CMV in immunocompromised (AIDS, organ/bone marrow transplant), especially post transplantation & CMV prophylaxis
Nucleoside Analogue: Requires intracellular phosphorylation by UL97 to inhibit viral polymerase & DNA synthesis, Prodrug of ganciclovir
Bone marrow suppression
Cidofovir
Ganciclovir resistant CMV in organ transplant pts
Nucleotide Analogue: requires phosphorylation
Nephrotoxicity
Foscarnet
HSV resistant to acyclovir, CMV resistant to ganciclovir
Pyrophosphage Analogue: inhibits DNA polymerase, not dependnet on viral TK
Nephrotoxicity, electorlyte abnormalities, penile ulcers
Adamantanes
Amantadine & Rimantadine
Influenza A only (pre-exposure prophylaxis & post-exposure preemptive therapy)
Ion channel blockers
Amantadine: seizures, dizziness, hallucinations,Rimantadine: dizziness, fatigue
Oseltamivir & Zanamivir
Influenza A (including H1N1) & Influenza B (strains resistant to adamantanes)
Sialic Acid Analogues (neuraminidase Inhibitors)
Oseltamivir: nausea & vomiting, Zanamivir: bronchospasm & cough (caution in pts w/ asthma or COPD), nausea & vomiting
Interferon-alpha
HCV w/ ribavirin
Cytokine leads to cellular responses
Flue like & neuropsychiatric symptoms
