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Week 3 Drug list Flashcards

1
Q

Nucleoside Analogues MOA

A

Inhibit viral DNA synthesis by interfering with DNA polymerase

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2
Q

Valacyclovir Major ADR

A

Higher incidence of TTP/HUS in immunocompromised patients

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3
Q

Famciclovir MOA

A

Converted to penciclovir, Inhibits viral DNA synthesis

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3
Q

Paxlovid

A

Is a strong inhibitor of CYP3A4

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4
Q

Azoles are

A

Concentration-dependent antifungals that can be fungistatic or cidal

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5
Q

Azoles

A

Fluconazole
Itraconazole
Posaconazole
Voriconazole
Isavuconazole

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6
Q

Azole MOA

A

Reduce ergosterol production by inhibition of 14-ademethylase (Fungal CYP450)
Will cross the BBB

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7
Q

Azoles are

A

Fungicidal at Higher concentrations, fungistatic at lower concentrations

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8
Q

Fluconazole indications

A

Cryptococcus
Candida
Dematophytes

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9
Q

Fluconazole has less

A

Inhibition of CYP3A4 and 2C9 compared to other Azoles

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10
Q

Azole ADR

A

Hepatotoxicity- Use cautiously with hepatic impairment
QT prolongation

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11
Q

Ketoconazole ADR

A

Black Box hepatotoxicity- Can lead to death or liver transplant

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12
Q

Fluconazole dose should be reduced by

A

50% when CrCl<50ml/min

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13
Q

Itraconazole ADR

A

HF development
Use cautiously with preexisting HF/Vent dysfunction

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14
Q

voriconazole ADR

A

Visual Disturbances
Toxic Levels- neurological s/s
Hallucinations, confusion, agitation, myoclonus

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15
Q

Itraconazole DI

A

H2/PPI blockers
Itraconazole requires more acidic GI for absorption
These will reduce bioavaliability

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16
Q

Fluconazole Indications

A

Cryptococcus- Cryptococcal Meningitis
Candida-Vaginal
Dermatophytes

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17
Q

Azoles DI

A

All azoles are varying level inhibitors of CYP3A4

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18
Q

Itraconazole Indications

A

Histoplasmosis
Blastoplasmosis
Aspergillus

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19
Q

Posconazole Indication

A

Aspergillus

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20
Q

Posconazole Use

A

BMT prophylaxis

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21
Q

Posconazole DI

A

High fat meals, increase absorption

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22
Q

Voriconazole Indication

A

Broad spectrum: main treatment for invasive aspergillus
Fluconazole resistant candida- candidemia
Zygomyces

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23
Q

Allylamine

A

Terbinafine

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24
Q

Terbinafine MOA

A

Inhibition of squalene epoxide, preventing down chain formation of ergosterol

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25
Q

Terbinafine Cidal/Static?

A

Cidal against dermaphytes
Static against C albicans

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26
Q

Terbinafine Use

A

Approved for Onychomycosis

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27
Q

Terbinafine Metabolism

A

Lipophillic, Concentartion higher in stratum corneum
High first pass metabolism in liver enzymes other than CYP450

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28
Q

Terbinafine ADR

A

Hepatotoxicity

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29
Q

Antiethlmintics Classes

A

Benzimidazoles
Pryantel Pamoate
Ivermectin

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30
Q

Benzimidazoles

A

Mebendazole
Albendazole

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31
Q

Benzimidazole MOA

A

Bind to B-tubulin of microtubulin, inhibit mitosis/polymerization

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32
Q

Mebendazole Indication

A

Intestinal/tissue nematode

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33
Q

Mebendazole ADR

A

Hepatotoxic
Transient elevation of liver enzymes
BM suppression

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34
Q

Mebendazole DI

A

Carbamazipine
Phenytoin

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35
Q

Albendazole Indication

A

Tissue Nematode

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36
Q

Albendazole ADR

A

BM suppression

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37
Q

Pyrantel Pamoate MOA

A

Depolarizing Neuromuscular Blocker- Causes spastic paralysis of worm

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38
Q

Pyrantel Pamoate Indication

A

Intestinal Nematodes-Pinworm

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39
Q

Ivermectin MOA

A

Binds to glutamate gated channels, paralyze worm

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40
Q

Ivermectin Indications

A

Tissue Nematodes
Do not use for children <15kg

41
Q

Ivermectin Metabolism

42
Q

Ivermectin ADR

A

Mazotti reaction (Urticaria, tender/swollen lympnodes - Use corticosteroids to treat

43
Q

Metronidazole (Flagyl) MOA

A

Disrupts DNA/Protein synthesis by formation of free radicals that bind nonspecifically

44
Q

Ketoconazole DI

A

Increased cyclosporine levels
Inhibition of testosterone- Gynecomastia/impotence
H2/PPI- Requires more acidic GI for absorption, these will reduce bioavailability

45
Q

Voriconazole safe for prenat?

A

No, Category D

46
Q

Voriconazole DI

A

H2/PPI- Requires more acidic GI for absorption. These will reduce bioavaliability

46
Q

Metronidazole indication

A

Bacterial infections
Protozoal infections

47
Q

Metronidazole ADME

A

Metabolism- CYP450
Renally eliminated

48
Q

Metronidazole ADR

A

Seizure
Decreased plasma clearance with hepatic dysfunction

49
Q

Metronidazole/Tinidazole DI

A

Warfarin- Reduced anticoag
Alcohol
Disulfiram- Psychotic reaction
Lithium/Disuldan- increased levels

50
Q

Tinidazole MOA

A

Disrupt DNA/Protein synthesis by binding nonspecifically as free radicals

51
Q

Tinidazole Indication

A

Trichomoniasis- T vaginalis, giardiasis
Bacterial Vaginosis- Intestinal amebiasis, amebic liver abcess

52
Q

Tinidazole ADME

A

M- CYP3A4
E- In liver/urine (unchanged in urine)

53
Q

Tinidazole ADR

A

Metallic taste

54
Q

Isoniazid ADR

A

Black box- severe/fatal hepatitis

55
Q

Zanamivir DI

A

Vaccines will NOT effect drug administration, good to use
Contraindicated with (milk protein allergy)

56
Q

Ketoconazole Indications

A

Fungal infection
Prostate Cancer- inhibit testosterone production

57
Q

Influenza Vaccine

A

Attenuated- Flumist (intranasal)
Inactive- IM

58
Q

MMR Vaccine

A

Attenuated SQ

59
Q

Influenza Vaccine DI

A

Aspirin- Reyes Syndrome

60
Q

Influenza Vaccine CI

A

Live- Asthma, reactive airway, chronic pulm/CV, DM, Immunocompromised, Egg allergy, pregnant, <2yo
Inactive- Anaphylactic reaction to eggs, influenza

61
Q

MMR Vaccine DI

A

Immunosuppressants

62
Q

MMR Vaccine CI

A

Prior anaphylactic to MMR vaccine/neomycin/gelatin

63
Q

Rotavirus Vaccine

A

Attenuated

64
Q

Rotavirus Vaccine CI

A

Hx of Intussusception

65
Q

Varicella Vaccine

A

Attenuated

66
Q

Varicella CI

A

Neomycin/Gelatin hypersensitive
Immunocompromised
Pregnant

67
Q

Diptheria/Tetanus/Pertussis Vaccine

A

Inactive
Dtap and Tdap

68
Q

Dtap/Tdap CI

A

Anaphylaxis to first dose

69
Q

Hep B Vaccine

70
Q

Hep B DI

A

Renal disease requiring HD/Fluids- may require higher dose of vaccine

71
Q

Hep B CI

A

Hypersensitivity

72
Q

HPV Vaccine

73
Q

HPV Vaccine CI

A

Allergy to components including yeast

74
Q

Pneumococcal Vaccine

75
Q

Pneumococcal Vaccine Considerations

A

Give 10-14 days prior to elective splenectomy/organ tx/immunosuppressive therapy/chemo

76
Q

Polio Vaccine

A

Attenuated-OPV (No longer used in the US)
Inactive (IPV)

77
Q

Polio OPV CI

A

Type 1 rxn to previous dose
Neomycin/streptomycin hypersensitivity
Immunodeficiency
Risk of vaccine acquired paralytic poliomyelitis (VAPP)

78
Q

Polio (IVP) CI

A

Neomycin/streptomycin, poymixin B
Hypersensitivity
CAN be given to immunosuppressed, HIV, pregnant, >6weeks

79
Q

Meningococcal Vaccine

80
Q

Zoster Vaccine

A

Attenuated

81
Q

Zoster Vaccine DI

A

Hold antivirals 24hours prior, 2 weeks after administration

82
Q

Zoster Vaccine CI

A

Neomycin/Gelatin hypersensitivity
Immunocompromised, pregnant

83
Q

Neruamidase Inhibitor MOA

A

Prevent enzyme from cleaving viral attachment from cell and spreading

Can be used to prevent spread in healthcare areas

84
Q

Ritonavir MOA

A

HIV-1 protease inhibitor, inhibiting CYP3A4 metabolism of nirmatrelvir

85
Q

Neuramidase Inhibitor’s work on

A

Influenza A and B

86
Q

Paxlovid ADR

A

Anaphylaxis
Hepatotoxicity (Strong CYP3A inhibitor)
Hypertriglyceridemia

87
Q

Vaccinated individuals will have

A

No different effect from neuramidase inhibitors

88
Q

Drugs for Covid-19

A

Nirmatrelvir/Ritonavir (paxlovid)
Remdesivir (Veklury)

89
Q

Remdesivir MOA

A

Prodrug, Converts to inhibit covid RNA dependent RNA polymerase

90
Q

Neuramidase inhibitors

A

Zanamivir
Oseltamivir

91
Q

Major ADR with Nucleoside Analogues

A

Renal Failure

92
Q

Remdesivir ADR

A

Elevated liver enzymes
Hypersensitivity rxn

93
Q

Nirmatrelvir MOA

A

Peptidomimetic inhibitor of main protease, preventing viral replication

94
Q

Nuceloside Analogues MOA

A

Inhibit Viral DNA synthesis by interfering with DNA polymerase

95
Q

Remdesivir DI

A

Chloroquine/Hydrochloroquine- Antagonist
Warfarin- May have reduced anticoagulation effect

96
Q

Valacyclovir Major ADR

A

Higher incidence of TTP/HUS in immunocompromised patients

97
Q

Famciclovir MOA

A

Converted to penciclovir, Inhibits viral DNA synthesis

98
Q

Valacyclovir Is converted to

A

Acyclovir but has higher serum concentrations

99
Q

Antivirals for Herpes are

A

Acyclovir
Famciclovir
Valacyclovir

100
Q

Valacyclovir and Famciclovir are both

Advanced Pharm (50 decks)

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