Micro Summary: Drugs (For, Mechanism, & Side Effects) Flashcards Preview

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Flashcards in Micro Summary: Drugs (For, Mechanism, & Side Effects) Deck (21):
1

Polyenes:

Examples

For...

Mechanism

Side Effects

Amphotericin B
Systemic fungal infections

Nystatin
Topical candida

Binds sterols, increases permeability

Nephrotoxicity, infusion-related, hypokalemia, hypomagnesemia

2

Azoles:

Examples

For...

Mechanism

Side Effects

Ketoconazole, Fluconazole, Itraconazole, Voriconazole, Posaconazole
Systemic fungal infections

Imidazole, clotrimazole, miconazole
Topical/cutaneous fungal infections

Disrupts ergosterol biosynthesis

Liver toxicity

3

Echinocandins:

Examples

For...

Mechanism

Side Effects

Caspofungin, Micafungin, Anidulafungin

Systemic candida & aspergillus

Inhibits 1,3-beta-D-glucan synthesis in cell wall

Histamine-like reactions, liver metabolism

4

Antimetabolites:

Examples

For...

Mechanism

Side Effects

5-flucytosine

Systemic cryptococcus & candida

Interferes w/ DNA synthesis

Monotherapy induces resistance

5

Allylamines:

Examples

For...

Mechanism

Terbinafine

Systemic dermatophytes

Inhibits ergosterol biosynthesis

6

Griseofulvin

Systemic dermatophytes

Disrupts mitotic spindle function of growing hyphae, accumulates in keratinized tissues

7

Acyclovir

HSV-1 > HSV-2 > VZV, orolabial herpes, genital herpes, neonatal herpes, herpes encephalitis

Nucleoside Analogue: Requires intracellular phosphorylation & a viral thymidine kinase (TK) to inhibit viral DNA polymerase

Renal failure, neurologic

8

Valacyclovir

HSV, VZV

Nucleoside Analogue: Pro-drug of acyclovir, converted to ACV

9

Ganciclovir

CMV in immunocompromised (AIDS, organ/bone marrow transplant)

Nucleoside Analogue: Requires intracellular phosphorylation by UL97 to inhibit viral polymerase & DNA synthesis

Bone marrow suppression

10

Valganciclovir

CMV in immunocompromised (AIDS, organ/bone marrow transplant), especially post transplantation & CMV prophylaxis

Nucleoside Analogue: Requires intracellular phosphorylation by UL97 to inhibit viral polymerase & DNA synthesis, Prodrug of ganciclovir

Bone marrow suppression

11

Cidofovir

Ganciclovir resistant CMV in organ transplant pts

Nucleotide Analogue: requires phosphorylation

Nephrotoxicity

12

Foscarnet

HSV resistant to acyclovir, CMV resistant to ganciclovir

Pyrophosphage Analogue: inhibits DNA polymerase, not dependnet on viral TK

Nephrotoxicity, electorlyte abnormalities, penile ulcers

13

Adamantanes

Amantadine & Rimantadine

Influenza A only (pre-exposure prophylaxis & post-exposure preemptive therapy)

Ion channel blockers

Amantadine: seizures, dizziness, hallucinations,Rimantadine: dizziness, fatigue

14

Oseltamivir & Zanamivir

Influenza A (including H1N1) & Influenza B (strains resistant to adamantanes)

Sialic Acid Analogues (neuraminidase Inhibitors)

Oseltamivir: nausea & vomiting, Zanamivir: bronchospasm & cough (caution in pts w/ asthma or COPD), nausea & vomiting

15

Interferon-alpha

HCV w/ ribavirin

Cytokine leads to cellular responses

Flue like & neuropsychiatric symptoms

16

Ribavirin

Many RNA viruses (HCV, RSV, Lassa virus)

Viral mRNA synthesis inhibitor

Hemolytic anemia

17

Boceprevir

HCV genotype 1 w/ PegIFN & ribavirin

1st generation NS3/4A protease inhibitor

Anemia, fatigue, & dysgeusia

18

Teleprevir

HCV genotype 1 w/ PegIFN & ribavirin

NS3/4A protease inhibitor

Rash, pruritis, & multiple drug-drug interactions

19

Sofosbuvir

HCV genotype 1 w/ PegIFN & ribavirin, HCV genotypes 2 & 3 w/ ribavirin

Inhibits the NS5B polymerase

None

20

Simeprevir

HCV genotype 1 w/ PegIFN & ribavirin

NS3/4A protease inhibitor

Transient mild elevations of bilirubin & photosensitivity

21

Lamivudine, Adefovir, Entecavir, Telbivudine, Emtricitabine and Tenofovir

Chronic active Hepatitis B infection

Nucleoside/Nucleotide analogues

Stopping lamivudine can cause a flare-up of hepatitis