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Flashcards in ID 19 Deck (50):
1

griseofulvin uses

1) oral treatment of superficial infections
2) inhibits growth of dermatophytes (tinea, ringworm)

2

other griseofulvin AE

metabolizes Warfarin

3

permethrin MOA

blocks sodium channels (*thus neurotoxic)

4

malathion mechanism

acetylcholisterase inhibitor

5

lindane mechanism

blocks GABA channels (*thus neurotoxic)

6

chloroquine MOA

blocks detoxification of heme into hemozoin --> heme accumulates and is toxic to plasmodia

7

resistance to chloroquine?

membrane pump that decreases intracellular concentration of drug.

8

only drug you can't use chloroquine for?

p falciparum

9

p falciparum treatment options

1) artemether/lumefantrine
2) atovaquone/proguanil

10

life-threatening malaria treatment

artesunate
*quinidine in US (quinine elsewhere)

11

chloroquine AE's

retinopathy
pruritus (especially in dark-skinned individuals)

12

drug like oseltamivir...

zanamivir

13

oseltamivir/zanamivir uses

treatment and prevention of both influenza A and B

14

Why do acyclovir/valacyclovir have few adverse effects in uninfected cells?

not phosphorylated

15

acyclovir/valacyclovir usage caveat

no effect on latent forms of HSV and VZV

16

difference between valacyclovir and acyclovir?

valacyclovir is a prodrug of acyclovir that has better oral bioavailability

17

acyclovir/valacyclovir MOA of resistance

mutated viral thymidine kinase

18

acyclovir/valacyclovir AE's

1) Obstructive crystalline nephropathy
2) ARF

19

Ganciclovir MOA

5-monophosphate formed by a CMV viral kinase. Guanosine analog. Triphosphate formed by cellular kinase. Preferentially inhibits viral DNA polymerase.

20

ganciclovir prodrug

valganciclovir, better oral bioavailability.

21

ganciclovir MOA of resistance

mutated viral kinase

22

Foscarnet MOA

Viral DNA/RNA polymerase inhibitor and HIV reverse transcriptase inhibitor.
*binds to pyrophosphate-binding site of enzyme (pyrophosphate analog)

23

foscarnet vs. ganciclovir/acyclovir

foscarnet doesn't require kinase activation.

24

foscarnet uses

1) CMV retinitis in immunocompromised patients when ganciclovir fails
2) acyclovir-resistant HSV

25

foscarnet AE's

1) nephrotoxicity
2) electrolyte abnormalities (hypo or hypercalcemia, hypo or hyperphosphatemia, hypokalemia, hypomagnesemia)
3) seizures

26

MOA of resistance with foscarnet

mutated DNA polymerase

27

Cidofovir and phosphorylation?

doesn't require phosphorylatoin

28

cidofovir MOA

inhibits viral DNA polymerase

29

cidofovir pharmacokinetics

long half-life

30

cidofovir uses

1) CMV retinitis in immunocompromised patients
2) acyclovir-resistant HSV

31

cidofovir AE's

nephrotoxic

32

how to reduce cidofovir toxicity?

coadminster with probenecid and IV saline

33

HAART composition

2 NRTIs + integrase inhibitor

34

NRTIs

Abacavir (ABC)
Didanosine (ddl)
Emtricitabine (FTC)
Lamivudine (3TC)
Stavudine
Tenofovir (TDF)
Zidovudine (ZDV, formerly AZT)

35

NRTI MOA

competitively inhibit nucleotide binding to reverse transcriptase and terminate DNA chain (lack a 3' OH group)

36

What is unique about Tenofovir?

nucleo"T"ide, unlike nucleoside, and needs to be phosphorylated.

37

NRTI AE's

1) bone marrow suppression (reverse with G-CSF and ego)
2) peripheral neuropathy
3) lactic acidosis (nucleosides)
4) anemia (ZDV)
5) pancreatitis (didanosine)

38

thing to remember about abacavir

contraindicated if patient has a HLA-B5701 mutation

39

NNRTIs

Delaviridine
Efavirenz
Nevirapine

40

NNRTI mechanism

bind reverse transcriptase at site different from NRTIs.
*no phosphorylation required.

41

NNRTI AE's

1) rash
2) hepatotoxic
3) efavirenz -- vivid dreams + CNS symptoms
4) delavirdine and efavirenz contraindicated in pregnancy

42

protease inhibitors

all the -navirs

43

protease inhibitor that's a CYP-45O inhibitor...

ritonavir

44

protease inhibitor AE's

Hyperglycemia
GI intolerance (nausea, diarrhea)
lipodystrophy (Cushing-like syndrome
Nephropathy, hematuria (indinavir)

45

protease inhibitor contraindicaion

rifampin (potent CYP/UGT inducer) that can decrease concentration.

46

integrase inhibitors

raltegravir
elvitegravir
dolutegravir

47

integrase inhibitor AE

increase creatine kinase

48

enfuvurtide AE

skin reaction at injection sites

49

enfuvirtide MOA

Binds gp41, inhibiting viral entry

50

maraviroc MOA

binds CCR-5 on surface of T cells/monocytes inhibiting interaction with gp120