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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
Terbinafine MOA
Inhibition of squalene epoxide, preventing down chain formation of ergosterol
25
Terbinafine Cidal/Static?
Cidal against dermaphytes Static against C albicans
26
Terbinafine Use
Approved for Onychomycosis
27
Terbinafine Metabolism
Lipophillic, Concentartion higher in stratum corneum High first pass metabolism in liver enzymes other than CYP450
28
Terbinafine ADR
Hepatotoxicity
29
Antiethlmintics Classes
Benzimidazoles Pryantel Pamoate Ivermectin
30
Benzimidazoles
Mebendazole Albendazole
31
Benzimidazole MOA
Bind to B-tubulin of microtubulin, inhibit mitosis/polymerization
32
Mebendazole Indication
Intestinal/tissue nematode
33
Mebendazole ADR
Hepatotoxic Transient elevation of liver enzymes BM suppression
34
Mebendazole DI
Carbamazipine Phenytoin
35
Albendazole Indication
Tissue Nematode
36
Albendazole ADR
BM suppression
37
Pyrantel Pamoate MOA
Depolarizing Neuromuscular Blocker- Causes spastic paralysis of worm
38
Pyrantel Pamoate Indication
Intestinal Nematodes-Pinworm
39
Ivermectin MOA
Binds to glutamate gated channels, paralyze worm
40
Ivermectin Indications
Tissue Nematodes Do not use for children <15kg
41
Ivermectin Metabolism
CYP450
42
Ivermectin ADR
Mazotti reaction (Urticaria, tender/swollen lympnodes - Use corticosteroids to treat
43
Metronidazole (Flagyl) MOA
Disrupts DNA/Protein synthesis by formation of free radicals that bind nonspecifically
44
Ketoconazole DI
Increased cyclosporine levels Inhibition of testosterone- Gynecomastia/impotence H2/PPI- Requires more acidic GI for absorption, these will reduce bioavailability
45
Voriconazole safe for prenat?
No, Category D
46
Voriconazole DI
H2/PPI- Requires more acidic GI for absorption. These will reduce bioavaliability
46
Metronidazole indication
Bacterial infections Protozoal infections
47
Metronidazole ADME
Metabolism- CYP450 Renally eliminated
48
Metronidazole ADR
Seizure Decreased plasma clearance with hepatic dysfunction
49
Metronidazole/Tinidazole DI
Warfarin- Reduced anticoag Alcohol Disulfiram- Psychotic reaction Lithium/Disuldan- increased levels
50
Tinidazole MOA
Disrupt DNA/Protein synthesis by binding nonspecifically as free radicals
51
Tinidazole Indication
Trichomoniasis- T vaginalis, giardiasis Bacterial Vaginosis- Intestinal amebiasis, amebic liver abcess
52
Tinidazole ADME
M- CYP3A4 E- In liver/urine (unchanged in urine)
53
Tinidazole ADR
Metallic taste
54
Isoniazid ADR
Black box- severe/fatal hepatitis
55
Zanamivir DI
Vaccines will NOT effect drug administration, good to use Contraindicated with (milk protein allergy)
56
Ketoconazole Indications
Fungal infection Prostate Cancer- inhibit testosterone production
57
Influenza Vaccine
Attenuated- Flumist (intranasal) Inactive- IM
58
MMR Vaccine
Attenuated SQ
59
Influenza Vaccine DI
Aspirin- Reyes Syndrome
60
Influenza Vaccine CI
Live- Asthma, reactive airway, chronic pulm/CV, DM, Immunocompromised, Egg allergy, pregnant, <2yo Inactive- Anaphylactic reaction to eggs, influenza
61
MMR Vaccine DI
Immunosuppressants
62
MMR Vaccine CI
Prior anaphylactic to MMR vaccine/neomycin/gelatin
63
Rotavirus Vaccine
Attenuated
64
Rotavirus Vaccine CI
Hx of Intussusception
65
Varicella Vaccine
Attenuated
66
Varicella CI
Neomycin/Gelatin hypersensitive Immunocompromised Pregnant
67
Diptheria/Tetanus/Pertussis Vaccine
Inactive Dtap and Tdap
68
Dtap/Tdap CI
Anaphylaxis to first dose
69
Hep B Vaccine
Inactive
70
Hep B DI
Renal disease requiring HD/Fluids- may require higher dose of vaccine
71
Hep B CI
Hypersensitivity
72
HPV Vaccine
Inactive
73
HPV Vaccine CI
Allergy to components including yeast
74
Pneumococcal Vaccine
Inactive
75
Pneumococcal Vaccine Considerations
Give 10-14 days prior to elective splenectomy/organ tx/immunosuppressive therapy/chemo
76
Polio Vaccine
Attenuated-OPV (No longer used in the US) Inactive (IPV)
77
Polio OPV CI
Type 1 rxn to previous dose Neomycin/streptomycin hypersensitivity Immunodeficiency Risk of vaccine acquired paralytic poliomyelitis (VAPP)
78
Polio (IVP) CI
Neomycin/streptomycin, poymixin B Hypersensitivity CAN be given to immunosuppressed, HIV, pregnant, >6weeks
79
Meningococcal Vaccine
Inactive
80
Zoster Vaccine
Attenuated
81
Zoster Vaccine DI
Hold antivirals 24hours prior, 2 weeks after administration
82
Zoster Vaccine CI
Neomycin/Gelatin hypersensitivity Immunocompromised, pregnant
83
Neruamidase Inhibitor MOA
Prevent enzyme from cleaving viral attachment from cell and spreading Can be used to prevent spread in healthcare areas
84
Ritonavir MOA
HIV-1 protease inhibitor, inhibiting CYP3A4 metabolism of nirmatrelvir
85
Neuramidase Inhibitor's work on
Influenza A and B
86
Paxlovid ADR
Anaphylaxis Hepatotoxicity (Strong CYP3A inhibitor) Hypertriglyceridemia
87
Vaccinated individuals will have
No different effect from neuramidase inhibitors
88
Drugs for Covid-19
Nirmatrelvir/Ritonavir (paxlovid) Remdesivir (Veklury)
89
Remdesivir MOA
Prodrug, Converts to inhibit covid RNA dependent RNA polymerase
90
Neuramidase inhibitors
Zanamivir Oseltamivir
91
Major ADR with Nucleoside Analogues
Renal Failure
92
Remdesivir ADR
Elevated liver enzymes Hypersensitivity rxn
93
Nirmatrelvir MOA
Peptidomimetic inhibitor of main protease, preventing viral replication
94
Nuceloside Analogues MOA
Inhibit Viral DNA synthesis by interfering with DNA polymerase
95
Remdesivir DI
Chloroquine/Hydrochloroquine- Antagonist Warfarin- May have reduced anticoagulation effect
96
Valacyclovir Major ADR
Higher incidence of TTP/HUS in immunocompromised patients
97
Famciclovir MOA
Converted to penciclovir, Inhibits viral DNA synthesis
98
Valacyclovir Is converted to
Acyclovir but has higher serum concentrations
99
Antivirals for Herpes are
Acyclovir Famciclovir Valacyclovir
100
Valacyclovir and Famciclovir are both
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