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Micro > Test 2 drugs > Flashcards

Test 2 drugs Flashcards

1
Q

amantadine

A

inhibits M2 protein (flu A), for flu treatment, CNS side effects

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2
Q

rimantadine

A

inhibits M2 protein for flu (A), better than amantadine, less CNS`

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3
Q

oseltamivir

A

flu - NA inhibitor, prevents release of viral particles, limited use, oral, *GI upset

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4
Q

peramivir

A

flu - NA inhibitor, prevents release of viral particles, limited use, rash, creatininte, CNS

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5
Q

zanamivir

A

flu - NA inhibitor, prevents release of viral particles, limited use, inhaled, *bronchospasm

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6
Q

indications for flu treatment

A

hospital, pregnancy, young and old, medical condition

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7
Q

acyclovir

A

analog of 2’ deoxyguanosine, requires phosphorylation by virus (X2), works for HSV1/2 and VZV, good CSF

nephrotoxic, CNS

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8
Q

valacyclovir

A

better available bioavailability

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9
Q

famcyclovir

A

better for VZV

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10
Q

cidofovir

A

does not require first phosphorylation step, active against resistant viruses, nucleotide analog, very nephrotoxic

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11
Q

mechanisms of resistance in acyclovir

A

kinase deficient mutant, mutant that cant phosphorylate, usually in cane hosts, cross resistant

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12
Q

foscarnet

A

does not require any phosphorylation step, active against resistant viruses, blocks DNA polymerase, CMV and HSV, worse than gancyclovir, nephrotoxic, electrolyte disturbances

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13
Q

gancyclovir

A

used for CMV, HSV1/2, guanosine derivative, phosphate added by CMV UL97

nephrotoxic, BM suppression

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14
Q

valganciclovir

A

prodrug of gancyclovir with better bioavailability, prophylaxis of CMV

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15
Q

chloroquine

A

ion trapping

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16
Q

quinidine

A

QT prolongation

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17
Q

primaquine

A

effective against liver stage hypnozoites, forms compounds acting as oxidants, cant be used in G6PD

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18
Q

artemisinin

A

free radical formation, alkylation, Hb degredation

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19
Q

HIV entry inhibitors

A

not great, prone to resistance, used in salvage regimens

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20
Q

NRTIs

A

DNA chain terminators, inhibit mitochondrial replication, lactic acidosis, peripheral neuropathy, lipoatrophy, need phosphorylation

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21
Q

NNRTIs

A

does not block chain elongation, vivid dreams, not active against HIV2

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22
Q

protease inhibitors

A

drug interactions, central fat gain, hyperlipidemia, diahrrea

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23
Q

integrase inhibitors

A

best first line, blocks integrase, few adverse effects

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24
Q

enfuvirtide

A

entry inhibitor (sounds like fusion, blocks with shield) binds gp41, not great, prone to resistance

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25
Q

maraviroc

A

entry inhibitor (mare - man on horse with CCR5 banner) binds to CCR5 on T cells, high resistance

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26
Q

abacavir

A

NRTI - some MI risk, hypersensitivity reaction in HLA-B5701

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27
Q

tenofovir

A

(Sir Tristan) NRTI - good first line, nephrotoxic and loss of bone marrow density, now delivered as prodrug

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28
Q

lamviudine

A

(sir lancelot dining) NRTI - treated for HepB, can react when discontinued - given with emtricitabine

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29
Q

efavirenz

A

NNRTI - (queen elf) - CNS, dizziness, dreams, hepatitis, teratogenic

30
Q

nevirapine

A

NNRTI - hepatitis, used to prevent transmission to child

31
Q

rilpivirine

A

NNRTI - taken with food, not with PPI, not with high viral load

32
Q

atazanavir

A

protease inhibitor (navir), hyperbilirubinemia, hepatotoxicity, lipids

33
Q

darunavir

A

protease inhibitor (navir) - rash, diarrhea, nausea

34
Q

ritonavir

A

protease inhibitor (navir - right on high fiving kids) - strongly inhibits P450, drug interactions

35
Q

cobicistat

A

enhancer, inhibits P450, slows metabolism of navirs

36
Q

dolutegravir

A

integrase inhibitor, potent, little resistance, recommended

37
Q

elvitegravir

A

integrase inhibitor, requires cobicistat, maybe hepatotoxic

38
Q

raltegravir

A

integrase inhibitor, hepatotoxic, rash

39
Q

o Chloroquine

A

o Stomach pain, itching, headache, retinopahy

o Ion trapping

40
Q

o Melfoquine

A

o Against erythrocytic statges

41
Q

o Primaquine

A

o Active against hypnozoites
o Forms oxidants
o Lysis of G6PD

42
Q

o Artemisinin

A

o Effective against schizonts
o Reduces gametocytes
o Free radical formation

43
Q

o Amphotericin B

A

o Polyenes
o Bind to ergosterol in cell membrane
o Infusion toxic
o Nephrotoxic – leads to electrolyte wasting

44
Q

o Nystatin

A

o Polyenes
o Bind to ergosterol
o Swish and swallow for candida

45
Q

o Caspofungin

A

o Echinocandin
o Inhibits cell wall synthesis (beta 1,3 glucan synthase)
o Candida and aspergillosis

46
Q

o Flucytocine

A

o Pyrimidine inhibitor
o Disruption of DNA/protein synthesis
o Treatment of cryptococcal meningitis

47
Q

o Terbinafine

A

o Allylamine
o Inhibits squalene epoxidase in ergosterol synthesis
o For dermatophyte infections

48
Q

o Azole

A 
o	Inhibit ergosterol synthesis
o	Hepatic P450
o	Fluconazole by kidney
o	Important in inducers of cyp 34A
o	Hepatitis
o	QT prolongation
o	Fluconazole not against aspergillis
49
Q

o Isoniazid

A

o Inhibits mycolic acid synthesis
o Slow acetylators
o Neuropathy
o Lfts, CNS, lupus, fever, rash

50
Q

o Rifampin

A

o Binds to RNA polymerase, prevents synthesis
o Sterilize cavitary disease
o OK in pregnancy
o Induces P450

51
Q

o Ethambutol

A

o Inhibits arabinogalactan synthesis

o Retrobulbar neuritis

52
Q

o Pyrazunamide

A

o Can lead to fatal hepatic necrosis

o Inhibits trans-translation

53
Q

o Aspirin

A

♣ Analgesic, antipyretic, anti inflammatory
♣ Inhibits COX
♣ GI, renal, hypersensitivity, tinnitus, reyes syndrome – avoid in children

54
Q

o NSAID

A

♣ Same as aspirin, reversible
♣ GI, bleeding, renal, hypersensitivity, pregnancy
♣ Use misoprostol for GI protective effects (PGE) – also for abortions

55
Q

o COX2

A

♣ Less GI, increase in CV effects

♣ Celebrex

56
Q

o Acetaminophen

A

♣ Not anti-inflammatory
♣ Liver toxic
♣ Requires glutathione for detoxification, give Nacetylcystein

57
Q

• GC

A

o Osteoporosis

o Forms annexin -1, blocking phospholipase and whole arachidonic acid pathway

58
Q

Codeine

A

o Uses P450 to be converted to morphine – CYP2D6 polymorphism

59
Q

• Methadone

A

o Long acting

o QT prolongation

60
Q

• Meperidine

A

o Short duration
o Metabolite can cause tremors and seizures, dose for kidney, avoid chronic
o Serotonin syndrome

61
Q

• Buprenorphine

A

o Mixed agonist/antagonist

o Use for withdrawal

62
Q

• Tramadol

A

o Weak agonist

o Inhibits serotonin and NE uptake

63
Q

• Methotrexate

A 
o	First line for RA
o	Liver, BM suppression, teratogenic
o	LFTs and creatinine
o	Weekly
o	Give with folic acid
64
Q

• Leflunomide and sulfasalazine

A

o Use in alcoholics
o LEF – daily, no folic acid
o SSZ – BM suppression in G6Pd
•

65
Q

• Hydroxychloroquine

A

o First line in SLE

o safe in pregnancy, only side effect is retinopathy

66
Q

• azathioprine

A

o second line for SLE
o blocks purine metabolism
o safe in pregnancy

67
Q

• mycophenolate

A

o for life threatening in SLE, others
o inhibits inosine mphosphate dehydrogenase
o heavy duty

68
Q

• cyclophosphamide

A

o for life threatening in SLE, others
o DNA cross linker
o Heavy duty

69
Q

• TNF

A

o Infliximab, adalimumab, golimumab, certolizumab, etanercept

70
Q

• Abatacept

A

o Targets CD80/86 from CTLA4

71
Q

• Tocilizumab

A

o Blocks IL6

Micro (7 decks)

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