Thomas Flashcards
binds to beta-tubulin subunit of tubulin and blocks DISSASEMBLY of microtubule bundles. Treats esophageal cancer
Paclitaxel and Doxitaxel
Major Contraindication for Gemcitabine
radiation therapy
First choice agent for metastatic pancreatic cancer; Also for esophageal cancer. Active against dividing and non-dividing cells.
Gemcitabine
Oral prodrug for 5FU
Capecitabine
Blocks thymidilate synthase .:. prevents production of thymidine
5FU (.:. Capecitabine also)
Give 5FU with
Leucovorin and Methotrexate, Oxaliplatin, or irinotecan
Orally active reversible inhibitor of EGFR - tyrosine kinase.
Erlotinib
chimeric mab that binds to EGFR AND has Ab dependent cellular cyotoxicity
Cetuximab
Humanized mab that blocks binding of EGFR
Panitumumab
It’s a trap!
Bevacizumab
humanized mab against VEGF; Use with FolFIri
Bevacizumab
Activated by water
alkylator of guanines
MAJOR N/V
Resistance: Mutated mismatch repair
Cisplatin
Resistance to Cisplatin
1 - over expression of glutathione
2 - Overactive NT excision repair
3 - mutated MMR
oxaliplatin is for treatment of
colon cancer
Oxaliplatin is not susceptible to what mechanism of resistance
mutated MMR
Indication For Streptozocin
treatment of pancreatic carcinoma, stomach, and small intestine
Why is Streptozocin good for pancreatic carcinoma?
glucose binds to islets of langerhans
Which is less toxic: streptozocin or carmustine?
streptozocin
tricyclic glycopeptide that binds to D-Ala-D-Ala precursor to inhibit transglycosylase. Administered IV only. Poorly absorbed orally
Vancomycin
tricyclic glycopeptid. Administered IM and IV. Poorly absorbed orally.
Teicoplanin
polypeptide that inhibits bacterial cell wall synthesis. Used topically in dermatologic and ophthalmic ointments. It interferes with the dephosphorylation of a lipid transport molecule, which carries the building blocks of the peptidoglycan bacterial cell wall. Not absorbed orally
bacitracin
Which lasts longer: vancomycin or teicoplanin?
teicoplanin
What allows an antibiotic to be oral?
ether group - confers H+ resistance
most popular 2nd generation oral cephalosporin
cefaclor
Only 3rd gen oral cephalosporin
cefpodoxime
Problem with dairy, antacids and tetracyclines
chelation = less absorption
Which antibiotic group stay in the system for weeks and why?
tetracyclines; Enterohepatic circulation and bile
Major tetracycline tox
nepherotox
glycycline, which is a butyl-glycylamido derivative of the tetracycline, minocycline. It is not absorbed orally. Parenteral use only with rapid and wide distribution into tissues. Effective against tetracycline-resistant bacteria.
tigecycline
Benefits of tigecycline over tetracyclines (2)
1 - less affinity for efflux pumps
2 - less nepherotox
can be administered orally as the active drug. It affects the hematopoietic system in two ways: a dose-related toxicity that presents as anemia, leukopenia, or thrombocytopenia; and an idiosyncratic response manifested by aplastic anemia, leading in many cases to fatal pancytopenia. Fetuses and young children cannot glucuronidate the drug causing gray baby syndrome.
Chloramphenicol
Gray baby syndrome
Chloramphenicol
When do you use Chloramphenicol
preggo with Rocky Mountain Spotted Fever
3rd world meningitis
antibiotic class that causes crystaluria
sulfonamides
MOA of sulfonamides
inhibits production of folate, which is made by bacteria and not ppl
sulfonamide that can be used solo
sulfisoxazole
benefit of sulfisoxazole
v. soluble .:. no crystaluria
Bactrim is made of (2)
sulfamethoxazole - trimethaprim
Tx of Nontyphoid salmonella
ciprofloxin
levofloxin
(For Typhoid: cipro or cetriaxone)
Typhoid fever tx
Ciprofloxin
ceftriaxone
(For non-typhoid: fluoroquinolones)
Shigella tx
Ciprofloxin
Levoquin
TMX-sulfa
C. jejuni tx
Azithromycin
Cipro
E. coli tx
Ciprofloxin
Levofloxin
Yersinia tx
Doxycyclin + gentamycin
C. Difficile (moderate) tx
Metronidazole
2ndary is Nitazoxanide
C. dif (severe) tx
vancomycin
in TMX-Sulfa, where does tox come from?
sulfamethoxazole
If in doubt, for severe diarrhea, give
Cipro or Levafloxin
not a macrolide, but binds 50S and inhibits translocation step
clindamycin
ketolide that is less susceptible to methylase-mediated and efflux-mediated resistance than macrolides like erythromycin or clarithromycin
Telithromycin
Giardia tx
Metronidazole
Tinidazole
paramomycin
Entamoeba tx
Metronidazole
Tinidazole
paramomycin
iodoquinol
Cryptosporidium tx
Nitazoxanide
stops PFOR rxn
Same MOA as metronidazole, but less GI tox
tinidazole
interferes with the ferredoxin oxidoreductase (PFOR) enzyme-dependent electron-transfer reaction, which is essential in anaerobic metabolism. No resistance, little toxicity.
Nitazoxanide
For cryptosporidium
Nematodes tx
(Round Worms)
Benzimidazoles
Ivermectin
Hookworms tx
Benzimidazoles
Ivermectin
Trematodes tx
(Flukes)
Praziquantel
Metrifonate
Cestodes tx
(Tape Worms)
Praziquantel
In parasites, inhibit microtubule polymerization by binding to parasite beta tubulin; not toxic
Benzimidazoles
for nematodes
In parasites, causes influx of Ca to produce paralysis of the musculature. Toxcity: dose-related transient abdominal distress.
Praziquantel
For cestodes and trematodes
In parasites, tonic paralysis of the worm musculature by activating glutamate-gated Cl channels and is well tolerated.
Ivermectin
for nematodes
In parasites, organophosphate converted to dichlorvos, a cholinesterase inhibitor.
Metrofinate
Which of these is for HBV:
Adefovir
Oseltamivir
Zidovudine
Adefovir
Which of these is for HBV:
Fomivirsen
Lamivudine
Nelfinavir
Fomivirsen
Which of these is for HBV:
Maraviroc
Tenefovir
Zanamivir
Tenefovir
Which of these is for HBV:
Entecavir
Lopinavir
Vivecon
Entecavir
Which of these is for HBV:
Amantadine
Bevirimat
Telbivudine
Telbivudine
Indication for IFN alpha and ribavirin
HCV
What is VEGF?
Vascular endothelial growth factor
What is EGFR?
epidermal growth factor receptor
Name 3 drugs that stop the action of EGFR
Erlotinib (oral, via EGFR-TK)
Cetuximab
Panitumumab
