Staying on Track Quiz 2 Flashcards
meropenem
Brand: Merrem
Class: Carbapenem
Indication: abd infections, meningitis, SSTIs
MOA: Inhibits bacterial cell wall synthesis by binding to PBPs, eventually leading to cell lysis
BBW: N/A
SE: Nausea, HA, painq
ertapenem
Brand: INVanz
Class: Carbapenem
Indication: pelvic infections, CAP, abd infections, SSTIs, UTI, ppx in colorectal surgery
MOA: Inhibits bacterial cell wall synthesis by binding to PBPs, eventually leading to cell lyses
BBW: N/A
SE: N/V/D
valacyclovir
Brand: Valtrex
Class: Antiviral Agent
Indication: Herpes zoster (shingles); genital herpes; varicella, herpes labialis (cold sores)
MOA: Converted to acyclovir. Acyclovir is converted to acyclovir monophosphate by viral thymidine kinase then further converted to acyclovir triphosphate by other cellular enzymes. Acyclovir triphosphate inhibits DNA synthesis and viral replication by competing with deoxyguanosine triphosphate for viral DNA polymerase and being incorporated into viral DNA
BBW: N/A
SE: abd pain, nausea, HA, nasopharyngitis, increased AST/ALT
valganciclovir
Brand: Valcyte
Class: Antiviral Agent
Indication: CMV
MOA: Metabolized to ganciclovir, gets phosphorylated, competitively inhibits the binding of deoxyguanosine triphosphate to DNA polymerase, gets incorporated into DNA, inhibits viral DNA synthesis
BBW: can cause leukopenia, neutropenia, anemia, thrombocytopenia, pancytopenia, bone marrow aplasia and aplastic anemia; can be teratogenic, carcinogenic, & aspermatogenic
SE: HTN, headache, insomnia, D/N/V, abd pain, anemia, thrombocytopenia, neutropenia, graft rejection, tremor, retinal detachment, increased SCr, fever
acyclovir
Brand: Zovirax
Class: Antiviral Agent
Indication: genital herpes, herpes simplex, herpes zoster, herpes labialis, varicella
MOA: Acyclovir is converted to acyclovir monophosphate by virus-specific thymidine kinase then further converted to acyclovir triphosphate by other cellular enzymes. Acyclovir triphosphate inhibits DNA synthesis and viral replication by competing with deoxyguanosine triphosphate for viral DNA polymerase and being incorporated into viral DNA.
BBW: N/A
SE: malaise
dapsone
Brand: Aczone
Class: Miscellaneous antibiotic
Indication: acne vulgaris, dermatis herpetiformis, leprosy
MOA: Competitive antagonist of PABA & prevents normal bacterial utilization of PABA for the synthesis of folic acid
BBW: N/A
SE: Dryness, redness, peeling of skin
ritonavir
Brand: Norvir
Class: Protease Inhibitor
Indication: HIV
MOA: Binds to the site of HIV protease activity & inhibits cleavage of viral Gag-Pol protein precursors into individual functional proteins required for infectious HIV, resulting in the formation of immature, noninfectious viral particles
BBW: Coadministration with sedative hypnotics, antiarrhythmics, or ergot alkaloid preparations may result in potentially serious and/or life-threatening adverse reactions (hepatic metabolism effects)
SE: increased gamma-glutamyl transferase, flushing, raised serum cholesterol/tigylcerides, D/N/V, dyspepsia, dysgeusia, asthenia, paresthesia, dizziness, arthralgia, skin rash, pruritis, cough, oropharyngeal pain, fatigue
tenofovir + emtricitabine + elvitegravir + cobicistat
Brand: Stribild
Class: nuceotide RTI + nuceloside RTI + integrase inhibitor + CYP450 inhibitor
Indication: HIV
MOAs: Elvitegravir inhibits the catalytic activity of integrase, thus preventing integration of the proviral gene into human DNA. Cobicistat inhibits enzymes of the CYP3A subfamily and enhances systemic exposure to elvitegravir. Emtricitabine and tenofovir interfere with HIV viral RNA dependent DNA polymerase activities resulting in inhibition of viral replication.
BBW: lactic acidosis, severe hepatomegaly, postreatment exacerbation of hepatitis B
SE: proteinuria, N/D, increased SCr
atazanavir
Brand: Reyataz
Class: Protease Inhibitor
Indication: HIV
MOA: Binds to the site of HIV-1 protease activity and inhibits cleavage of viral Gag-Pol polyprotein precursors into individual functional proteins required for infectious HIV. This results in the formation of immature, noninfectious viral particles.
BBW: N/A
SE: increased bilirubin, cholesterol, creatine phosphokinase & serum amylase, rash, abdominal pain, jaundice, N/V/D, cough, fever
atazanavir + cobicistat
Brand: Evotaz
Class: protease inhibitor + CYP450 inhibitor
Indication: HIV
MOA: Atazanavir prevents the formation of mature virions by selectively inhibiting viral Gag and Gag-Pol polyproteins in HIV-1 infected cells. Cobicistat boosts atazanavir exposure.
BBW: N/A
SE: abnormal bilirubin, jaundice, scleral icterus
lopinavir + ritonavir
Brand: Kaletra
Class: Protease Inhibitors (but here ritonavir used as CYP450 inhibitor)
Indication: HIV
MOA: Lopinavir- binds to site of HIV-1 protease activity and inhibits cleavage of viral Gag-Pol polyprotein precursors into individual functional proteins required for infectious HIV, resulting in immature, noninfectious viral particles
Ritonavir- inhibits CYP3A metabolism of lopinavir, allowing increased levels of lopinavir
BBW: N/A
SE: increased serum cholesterol/TG/ALT/GGT, D/V/N, dysgeusia, abd pain, URTI,
tenofovir + emtricitabine
Brand: Truvada
Class: nucelotide RTI + nucleoside RTI
Indication: HIV; pre-exposure prophylaxis (PEP) of HIV
MOA: each drug interferes with reverse transcriptase by getting incorporated into DNA, resulting in inhibition of viral replication
BBW: Lactic acidosis/severe hepatomegaly with steatosis; post-treatment acute exacerbation of Hep B; risk of drug resistance with use for PEP
SE: abnormal dreams & rash; insomnia, depression, diarrhea, dizziness, fatigue, headache, nausea
tenofovir alafenamide + emtricitabine
Brand: Descovy
Class: nucelotide RTI + nucleoside RTI
Indication: HIV (in combo w/ other antiretrovirals)
MOA: each drug interferes with reverse transcriptase by getting incorporated into DNA, resulting in inhibition of viral replication
BBW: Lactic acidosis/severe hepatomegaly with steatosis; post-treatment acute exacerbation of Hep B
SE: nausea
tenofovir alafenamide + emtricitabine + rilpivirine
Brand: Odefsey
Class: nucelotide RTI + nuceloside RTI + NNRTI
Indication: HIV
MOA: Tenofovir alafenamide & emtricitabine - compete with natural substrates and incorporate into viral DNA, resulting in termination of the DNA chain. Rilpivirine - binds to reverse transcriptase, blocking the RNA-dependent and DNA-dependent DNA polymerase activities, including HIV-1 replication.
BBW: Lactic acidosis/severe hepatomegaly with steatosis; post-treatment acute exacerbation of Hep B
SE: nausea, HA, somnolence
tenofovir alafenamide + emtricitabine + elvitegravir + cobicistat
Brand: Genvoya
Indication: HIV
Class: nucleotide RTI + nuceloside RTI + integrase inhibitor + CYP450 inhibitor
MOA: Tenofovir alafenamide & emtricitabine - compete with natural substrates and incorporate into viral DNA, resulting in termination of the DNA chain. Elvitegravir - inhibits the catalytic activity of integrase, preventing integration of the proviral gene into human DNA. Cobicistat - inhibits enzymes of the CYP3A subfamily & enhances systemic exposure to elvitegravir.
BBW: lactic acidosis, severe hepatomegaly, postreatment exacerbation of hepatitis B
SE: decreased bone mineral density, nausea
abacavir + lamivudine
Brand: Epzicom
Class: both are nucleoside RTIs
Indication: HIV
MOA: each drug interferes with reverse transcriptase by getting incorporated into DNA, resulting in inhibition of viral replication
BBW: Hypersensitivity reactions (esp. w/ HLA-B*5701 allele); Lactic acidosis/severe hepatomegaly with steatosis; post-treatment exacerbations of Hep B
SE: depression, headache, insomnia
abacavir + lamivudine + dolutegravir
abacavir + lamivudine + dolutegravir Brand: Triumeq
Class: nucleoside RTI + nucleoside RTI + integrase inhibitor
Indication: HIV
MOA: Abacavir & lamivudine - inhibit HIV-1 reverse transcriptase; they get incoporated into viral DNA and halt replication. Dolutegravir - inhibits the catalytic activity of integrase, thus preventing integration of the proviral gene into human DNA.
BBW: Hypersensitivity reactions (esp. in pts. w/ HLA-B*5701 allele); Lactic acidosis/severe hepatomegaly with steatosis; post-treatment exacerbations of Hep B
SE: hypersensitivity rxn to abacabvir component
lamivudine + zidovudine
Brand: Combivir
Class: both are nucleoside RTIs
Indication: HIV
MOA: both act synergistically to inhibit reverse transcriptase b/c they are phosphorylated in the cell & are incorporated into the DNA chain
BBW: hematologic toxicity in advanced HIV-1; Lactic acidosis/severe hepatomegaly with steatosis; post-treatment exacerbations of Hep B
SE: HA, N/V/D, nasal symptoms, cough dizziness, insomnia, neuropathy, sleep disorder, musculoskeletal pain,