Antifungals, Antivirals (Including HIV) Flashcards

1
Q

List some pharmacologic challenges with tuberculosis

A

resistance
bacteria exists in active & dormant phases
- need drugs for a long time to “wait” for active phase
d/t long drug therapy, adherence can be an issue

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2
Q

length of treatment for TB

A

6-24 months +

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3
Q

How many different anti-infective drugs should be used at once in the treatment of TB

A

2-7

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4
Q

Most TB drugs can result in toxicity to:

A

liver

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5
Q

adverse effects of isoniazid

A

hepatotoxicity
peripheral neuropathy
CNS symptoms

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6
Q

adverse effects of rifampin

A

hepatotoxicity
harmless discoloration of body fluid
GI disturbances

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7
Q

adverse effects of pyrazinamide

A

hepatotoxicity (the MOST)
polyarthralgia

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8
Q

adverse effects of ethambutol

A

optic neuritis (most significant)
allergic reactions
GI upset

rarely
- peripheral neuropathy
- renal damage
- thrombocytopenia

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9
Q

mechanism of action of amphotericin B

A

binds fungal cell membrane, results in increased leakage of electrolytes & cell death

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10
Q

length of treatment required with amphotericin B

A

1.5-4 months

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11
Q

amphotericin B drug elimination

A

unknown… drug can be detected in the body up to a year later

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12
Q

adverse effects of amphotericin B

A

infusion reactions
phlebitis
nephrotoxicity
hypokalemia
bone marrow suppressio n

**preferable to observe patients in the hospital during treatment

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13
Q

Alternatives to amphotericin B

A

azoles

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14
Q

Adverse effect of azoles

A

cardiosuppression
liver injury

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15
Q

mechanism of action of echinocandins

A

disrupt fungal cell wall

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16
Q

list a echinocandin

A

micafungin

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17
Q

definition: antiseptic

A

agent applied to living tissues

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18
Q

definition: disinfectant

A

applied to objects (too harsh for living tissues)

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19
Q

definition: sterilization

A

complete destruction of all microorganisms

20
Q

definition: germicide

A

drug that kills microorganisms

21
Q

definition: germistatic

A

suppression of microorganism growth & replication (doesn’t kill)

22
Q

most important measure to prevent spread of infection in healthcare facilities

A

handwashing

23
Q

What are some ways antivirals can work?

A
  1. block entry of virus into host cell
  2. block replication of viral DNA
  3. block production of viral proteins
24
Q

Drugs for HSV & VZV

A

acyclovir
valcyclovir

25
Q

mechanism of action of acyclovir

A

inhibition of viral replication (suppresses viral DNA synthesis)

26
Q

adverse effect of acyclovir

A

IV = nephrotoxicity
PO = N/V/diarrhea

27
Q

What is ganciclovir used for?

A

CMV

28
Q

mechanism of action of ganciclovir

A

prevents replication of viral DNA

29
Q

adverse effects of ganciclovir

A

bone marrow suppression
teratogenesis

30
Q

adverse effects of PEG-IFA

A

flulike symptoms
neuropsych effects (SI)
various organ dysfunction
hemolytic anemia
teratogenic

31
Q

mechanism of action of sofosbuvir

A

blocks transcription of HCV RNA

32
Q

does PEG-IFA cure hepC? Does sofosbuvir cure hepC?

A

PEG-IFA = no
sofosbuvir = yes

33
Q

list two drugs to treat hepatitis B

A

lamivudine
entacavir

34
Q

adverse effects of antivirals used to treat HepB

A

minimal

35
Q

how long is treatment for HIV required?

A

for life

36
Q

How many different medications are utilized in HAART therapy

A

3 or more

37
Q

What are the 5 drug categories in HAART therapy?

A
  • nucleoside reverse transcriptase inhibitors
  • nonnucleoside reverse transcriptase inhibitors
  • protease inhibitors
  • fusion inhibitors
  • integrase inhibitors
38
Q

mechanism of action of NRTIs

A

prevent further DNA replication

39
Q

adverse effects of NRTIs

A

lactic acidosis
hepatic steatosis

40
Q

mechanism of action of NNRTIs

A

binds reverse transcriptase preventing DNA replication

41
Q

adverse effects of NNRTIs

A

CNS = dizziness, insomnia, nightmares
severe rash
liver damage

42
Q

mechanism of action of protease inhibitors

A

block protease which is required for HIV maturation

43
Q

adverse effects of protease inhibitors

A

hyperglycemia
elevated LFTs
PR prolongation

44
Q

mechanism of action of fusion inhibitors

A

block HIV viral entry into host cells

45
Q

adverse effects of fusion inhibitors

A

injection site reactions

46
Q

mechanism of action of integrase inhibitors

A

terminate integration of HIV into DNA (prevents viral replication)

47
Q

adverse effects of integrase inhibitors

A

(rare)
rash
liver failure