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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
maraviroc
entry inhibitor (mare - man on horse with CCR5 banner) binds to CCR5 on T cells, high resistance
26
abacavir
NRTI - some MI risk, hypersensitivity reaction in HLA-B5701
27
tenofovir
(Sir Tristan) NRTI - good first line, nephrotoxic and loss of bone marrow density, now delivered as prodrug
28
lamviudine
(sir lancelot dining) NRTI - treated for HepB, can react when discontinued - given with emtricitabine
29
efavirenz
NNRTI - (queen elf) - CNS, dizziness, dreams, hepatitis, teratogenic
30
nevirapine
NNRTI - hepatitis, used to prevent transmission to child
31
rilpivirine
NNRTI - taken with food, not with PPI, not with high viral load
32
atazanavir
protease inhibitor (navir), hyperbilirubinemia, hepatotoxicity, lipids
33
darunavir
protease inhibitor (navir) - rash, diarrhea, nausea
34
ritonavir
protease inhibitor (navir - right on high fiving kids) - strongly inhibits P450, drug interactions
35
cobicistat
enhancer, inhibits P450, slows metabolism of navirs
36
dolutegravir
integrase inhibitor, potent, little resistance, recommended
37
elvitegravir
integrase inhibitor, requires cobicistat, maybe hepatotoxic
38
raltegravir
integrase inhibitor, hepatotoxic, rash
39
o Chloroquine
o Stomach pain, itching, headache, retinopahy | o Ion trapping
40
o Melfoquine
o Against erythrocytic statges
41
o Primaquine
o Active against hypnozoites o Forms oxidants o Lysis of G6PD
42
o Artemisinin
o Effective against schizonts o Reduces gametocytes o Free radical formation
43
o Amphotericin B
o Polyenes o Bind to ergosterol in cell membrane o Infusion toxic o Nephrotoxic – leads to electrolyte wasting
44
o Nystatin
o Polyenes o Bind to ergosterol o Swish and swallow for candida
45
o Caspofungin
o Echinocandin o Inhibits cell wall synthesis (beta 1,3 glucan synthase) o Candida and aspergillosis
46
o Flucytocine
o Pyrimidine inhibitor o Disruption of DNA/protein synthesis o Treatment of cryptococcal meningitis
47
o Terbinafine
o Allylamine o Inhibits squalene epoxidase in ergosterol synthesis o For dermatophyte infections
48
o Azole
``` 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
o Isoniazid
o Inhibits mycolic acid synthesis o Slow acetylators o Neuropathy o Lfts, CNS, lupus, fever, rash
50
o Rifampin
o Binds to RNA polymerase, prevents synthesis o Sterilize cavitary disease o OK in pregnancy o Induces P450
51
o Ethambutol
o Inhibits arabinogalactan synthesis | o Retrobulbar neuritis
52
o Pyrazunamide
o Can lead to fatal hepatic necrosis | o Inhibits trans-translation
53
o Aspirin
♣ Analgesic, antipyretic, anti inflammatory ♣ Inhibits COX ♣ GI, renal, hypersensitivity, tinnitus, reyes syndrome – avoid in children
54
o NSAID
♣ Same as aspirin, reversible ♣ GI, bleeding, renal, hypersensitivity, pregnancy ♣ Use misoprostol for GI protective effects (PGE) – also for abortions
55
o COX2
♣ Less GI, increase in CV effects | ♣ Celebrex
56
o Acetaminophen
♣ Not anti-inflammatory ♣ Liver toxic ♣ Requires glutathione for detoxification, give Nacetylcystein
57
• GC
o Osteoporosis | o Forms annexin -1, blocking phospholipase and whole arachidonic acid pathway
58
Codeine
o Uses P450 to be converted to morphine – CYP2D6 polymorphism
59
• Methadone
o Long acting | o QT prolongation
60
• Meperidine
o Short duration o Metabolite can cause tremors and seizures, dose for kidney, avoid chronic o Serotonin syndrome
61
• Buprenorphine
o Mixed agonist/antagonist | o Use for withdrawal
62
• Tramadol
o Weak agonist | o Inhibits serotonin and NE uptake
63
• Methotrexate
``` o First line for RA o Liver, BM suppression, teratogenic o LFTs and creatinine o Weekly o Give with folic acid ```
64
• Leflunomide and sulfasalazine
o Use in alcoholics o LEF – daily, no folic acid o SSZ – BM suppression in G6Pd •
65
• Hydroxychloroquine
o First line in SLE | o safe in pregnancy, only side effect is retinopathy
66
• azathioprine
o second line for SLE o blocks purine metabolism o safe in pregnancy
67
• mycophenolate
o for life threatening in SLE, others o inhibits inosine mphosphate dehydrogenase o heavy duty
68
• cyclophosphamide
o for life threatening in SLE, others o DNA cross linker o Heavy duty
69
• TNF
o Infliximab, adalimumab, golimumab, certolizumab, etanercept
70
• Abatacept
o Targets CD80/86 from CTLA4
71
• Tocilizumab
o Blocks IL6

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