Pharm Fina Flashcards by Alora Marshall

Prevent recurrence of Ovale or Vivax

Primaquine

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Restarting this drug can be FATAL!

Abacavir (HIV med)

Screen for HLA-B-5701

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CA tx that causes hearing loss

Cisplatin

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Gingival hyperplasia is a side effect of what drug

Cyclosporine

a T cell immunosuppressant drug. works via calcineuron inhibition

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Increased triglycerides is a side effect of what drug

Sirolimus

otherwise “sirus is nice”. This drug does NOT cause nephrotoxicity

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Hemorrhagic cystitis is a side effect of what drug

Cyclophosphamide (an alkylating agent CA drug)

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Drugs that benefit from a Leucovorin rescue

Methotrexate

6-Mercapto

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Drug that is enhanced by Leucovorin

5-Fluoruracil

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What should you give with Doxorubicin to decrease its cardiotoxic effects?

Dexrazoxane

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What should you give with Cisplatin to decrease its Renal effects?

Amifostine

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What do you always give with Cyclophosphamade to decrease its side effects

MESNA to prevent hemorrhagic cystitis

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Quinine and Quinidine gluconate side effect

QT prolongation

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Side effect of Primaquine

Hemolytic anemia

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Side effect of Chloroquine (DOC for Malaria)

Accumulation in skin and retina, QT, CNS

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Side effect of Mefloquine

last resort drug to use with ACT for Malaria

Cardiotoxic, seizures, psychoses, vidid treams, Teratogenic

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Side effect of Atovoquine-proguanl

add to ACT for Malaria tx

GI, rash, fever, new drug Leucovorin support

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DOC for Trich

Metronidazole

SE: disulfuram, disguiesia

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tx for CMV and Herpes co-infection

Valganciclovir

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CA drug that can cause SOB and high resting pulse rate

Doxorubicin

Give Dexrazoxane with it to reduce reactive oxygen radicals

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Side effect for roundworm treatment

fever

Drug: Albendazole, Mebendazole, Pyrantel pamoate

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DOC for Toxoplasmosis (and prophylactic for HIVpts)

Pyrimethamine + SulfadiaZine

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If you have Sulfa allergy, you cannot give this HIV medication bc it has a Sulfa Moiety

Darunavir and Tipranavir (both have sulfa moeiety)

“Tip over Darin” with the sulfa drug

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What is the point of using Ritonavir with other HIV drugs?

Inhibits 3A4, increasing the bioavailability of other drugs

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All protease inhibitors are metabolized by

CYP 3A4

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Which protease inhibitor do we NOT combine with "the boost" Ritonavir?

Saquinavir (bc of QT issues)

What do we not want to combine with "the boost" Ritonavir if there is concern for head injury?

Tipranavir! increased risk of intracranial hemorrage if you use this w head injury Tip over and have head injury, do not use Boost Ritonavir

Tissue (vivax and ovale) tx for Malaria

Primaquine | Tafenoquine (newer drug, treats both blood and tissue)

Ganciclovir can be given as part of transplant medicine regimen to prevent

CMV growth

What plasmodium (malaria) tx should you avoid if you have a familial hx of short QT?

Mefloquine

What plasmodium (malaria) tx should you avoid prophylactically if you have hx of short QT?

Quinine

Bleomycin is a good CA drug bc?

Little myelosuppression It does cause Pulmonary fibrosis and frequent Hypersensitivity though

Paclitaxel (CA drug) side effects

Severe myelosuppression, Anemia, Peripheral neurophathy

Bleomycin mechanism

G2-M phase

Mycolid acid

Isoniazid

Rifampin

RNA polymerase

Pyrazinamide

needs acidity

DOC for Aspergillosus

Vorizonazole and Ampho B

Mechanism for Vorizonazole and Ampho B

inhibits Ergosterol synthesis

What drug causes elevated AST and ALT enzymes?

Flucytosine

If you're going to use Imatinib (Gleevec), test for

Bcr-Abl mutation

Resistance to Acyclovir is caused by

thmidine kinase mutation Remember, Acyclovir requires phosphorylation via this enzyme

Test for HLA-B-5701 if giving this drug

Abacavir (NRTI, HIV drug)

CXR4/CCR5 receptor

Maraviroc (fusion inhibitor, HIV drug)

EGFR expression- test before using these 2 drugs

Cetuximab Erlotinib "EC"

Ampho B mechanism

pore formation in membranes

Paromomycin

protein synthesis inhibitor

Itraconazole

ergosterol synthesis inhibition

metronidazole

DNA inhibition

Flucytosine mechanism

antagonism of fungal RNA and DNA converted to 5-FU which interferes w viral RNA and DNA

Paclitaxel (CA drug) mechanism

M phase- inhibits MT depolymerization- affecting microtubules

Bevacizumab (CA drug) regimen

binds VEFG, inhibiting angiogenesis

What CA drug can cause excessive bleeding/ thromboembolism

Bevacizumab

DOC for Cryptococcus

Flucytosine and Ampho B

DOC for invasive Aspergillosus in refractory pts

Caspofungin

Mechanism for influenza DOC drugs

inhibits neuroaminidase- block release of virus from cell Drugs: Oseltamivir and Zanamavir

Tx for M. Leprae

Rifampin and Dapsone

Rifampin mechanism

inhibit RNA polymerase

Amphotericin B side effects

Severe nephrotoxic- can lead to irreversible kidney damage

Azathioprine side effects

Bone marrow suppression, liver toxic, Teratogenic

Prednisone side effects

Hyperglycemia, Curhsings, osteoporosis, Suppression PHA axis

Cyclosporine side effects

Renal toxic, gingival hyperplasia, CNS, hyperglycemia

Sirolumus good thing

no Renal toxicity

Inhibits 1,3 D-glucan

Caspofungin The PCNs of antifungals (and Micafungin and Anidulafungin)

Side effects of Rifampin

orange colored secretions, Decrease birth control effectiveness

Acyclovir fact

it is very selective to virally infected cells d/t phosphorylation by viral thymidine kinase

How do polyene antimicrobials (Ampho B and Nystatin) work?

interact with sterols in the cell membrane

DOC for Giardia, Amebiasis (E. histolytica), and Trich

Metornidazole Disulfuram and Disgueisa

If a pregnant pt has Malaria, current sx, but it is a tissue form, what do you do?

Treat with only Chloroquine until baby is born, then you can use Tissue shizonticide (primaquine or tafenoquine)

Zanamavir (flu drug)

given Nasal or Inhaler- may worsen airway disease

What HIV drug can cause high cholesterol?

Darunavir (all of the "avir" are protease inhibitors)

Side effects of "avir" drugs (protease inhibitors)

Altered body fat distribution Insulin resistance Increases cholesterol Spontaneous bleeding in those with Hemophilia A and B

What anti TB drug should you not use with HIV pts?

Rifampin, will decrease the effectiveness of their HIV meds

a safe alternate for Rifampin

Rifabutine

requires activation by thymidine kinase

Acyclovir

NNRTIs

bind directly to inhibit Viral Reverse transcriptase- do not require phosphorylation Efavirenz (DOC) Rilpivirine (for pregnant)

NRTIs TELAZ

Tenofovir and Emtricitibine: DOC combo Lamividuine: for HepB and HIV co infected Abacavir: restarting is fatal, test for HLA B Zidovudine: safe in pregnancy

DOC for Protease Inhibitor class (HIV) Hint: has a sulfa moiety

Darunavir

Drug of second choice for Protease Inhibitors

Atazenavir

For "treatment experienced" HIX

Tipranavir (Protease Inh) | Enfuvirtide (Fusion inh, gp41)

Maraviroc

only used for CCR5, test for this!

Only used in treatment-resistant HIV pts

Dolutegravir (integrase inhibitor)

DOC for Hep B

TENofovir ENTecavir excellent safety

Use for co infected HIV and Hep B

Lamivudine

Fungal med that is given to HIV pts Prophylactically or for Suppressive therapy, treats Fungal Meningitis

Fluconazole | the most highly prescribed of the azoles

Why is Caspofungin desirable tx?

NO renal toxicity | Few drug interactions

DOC for Onychomycosis Only available Orally

Griseofulvin (bc binds to Keratin and prevents new skin infection) Contra: Porphyria, Liver failure, PREG, and MEN 6 mo prior to fathering

Contra in men 6 mo prior to fathering, and women in pregnancy

Griseofulvin (DOC for onychomycosis)

Good for Onychomycosis but not DOC interferes with Sterol biosynthesis (inhibit squalene monooxygenase)

Terbinafine use this topically, combine with Oral Griseofulvin

Another Polyene abx that works by Ergosterol interaction (just like Ampho B) used for Candida infections

Nystatin

DOC for Pneumocystosis

Bactrim (+Leucovorin)

DOC for ToxoplaZmoZis

Pyrimeth + SulfadiaZine (+Leucovorin)

Back up treatment for Amebiasis, Giardia, and Trich in pts who cannot take Metronidazole

Tinidazole

When Metro does not work for SEVERE Amebiasis

Emetine and DH-emetine

Limite Emetine and DH-emetine bc of Serious Severe Side effects

Cardiotoxicity, GI, Teratogenic Contra: preg, cardiac or renal dz

Back up for Metro (when sx are present)

Tinidazole

Cyst treatment (when sx are not present but we want to prevent spread of Amebiasis)

Paromomycin or Iodoquinol

Rare side effects of Iodoquinol (a cyst/luminal tx)

``` thyroid enlargement OPTIC NEURITIS (--> blindness) ```

Paramomycin

luminal tx for Amebiasis Giardia Trich

Iodoquinol

Luminal tx used for Amebiasis only

Diloxanide Furoate

luminal tropho tx for amebiasis | not much info

Tetra and Erythro

alternates for Amebiasis and Giardia

An aminoglycoside that doesnt have normal toxic effects bc its not absorbed well

Paramomycin a luminal (Cyst) tx for Amebiasis, Giardia, Trich

DOC for Pneumocystosis (often taken prophylactically in HIV pts)

Bactrim

backup to Bactrim to treat and prophylaxis for HIV pts for Pneuomocytosis

Pentamidine

Docosanol

OTC cold sore (herpes) medication Inhibits Viral Fusion

Foscarnet and Cidofovir are similar in that:

They are both used for CMV Retinitis and Herpes if resistant to ganciclovir and acyclovir

Foscarnet is different from Cidofovir in that

it is combined with Ganciclovir to be used for CMV Encephalitis

DOC for Hep B

Tenofovir

Use with co infected Hep B and HIV

Lamividudine

DOC for CMV encephalitis

Foscarnet and Ganciclovir