Part 10 Flashcards
Amphotericine B mechanism of action
Bind ergosterol and disrupt fungal cell membrane by making it leak intracellular content especially K+
Azoles mech of action and ADR’s
Inhibit synthesis of ergosterol disrupting fungal cell wall, inhibit hepatic p450 enzyme increasing serum concentration of other drugs
echinocandin drugs (3) and their MOA and use
- anidulafungin
- caspofungin
- microfungin
disrupt cell wall, used in IV for invasive aspergillosis and candida
Herpesvirus group and ones there is treatment for
- Herpes simplex
- Varicella zoster
- cytomegalovirus
- epstein barr (no treatment)
Acyclovir
Agent of choice for herpes symplex and varicella zoster virus functions to inhibit viral DNA poly and incorporate into strand of viral DNA blocking further growth through cell conversion into acyclo-GMP
valacyclovir use and ADR (rare) and advantage of acyclovir
More popular prodrug form of acyclovir, approved for PO therapy in immunocompetent host, can cause thrombocytopenic purpura/hemolytic uremic syndrome (TTP/HUS) in very immunocompromised hosts, advantage is dosing is less often (2x per day opposed to 5 for acyclovir
Docosanol
OTC treatment for herpes labialis, inhibits fusion btwn plasma membrane and viral envelope increasing healing with first sign of coldsore
Ganciclovir and the prodrug version valgancyclovir that can be used oral has use against what?
cytomegaolvirus,particularly CMV retinitis
Direct acting antivriral drugs (DAAs)
Target specific steps in HCV replication without damage to healthy cells, often used in combination to decrease viral resistance
Triple therapy regimen
Original standard of care for HepC until DAA development, includes pegylated interferon alfa (notorious for causing damage to host cell), protease inhibitor, and ribavirin
Unlike Hep C, for Hep B and A we have a preventative …
..vaccine
Neuraminidase Inhibitors and most common example and how soon does this need to be started
Modestly suppress influenza A AND B, prophylacitc and treatment, oseltamivir, within 48 hours
amantadine and rimantidine MOA and function
dopaminergic agonist and noncompetitive NDMA antagonist, and antagonistm against release of viral injection of material by influenza A but most have resistance now, indicated for drug induced parkinsonism, tardive dyskinesthia, and parkinsons
HART therapy for HIV can be hard on this drug metabolizing system
cytochrome p450 causing toxicity with other drugs
Gram + cocci catalase test results
Positive is staph, negative is strep
Gram + cocci coagulase test results
Positive is staph aureus, negative is staph epidermidis
Localized staph aureus infections with systemic effects (2)
- Scalded skin syndrome
- toxic shock syndrome
MRSA outpatient options (3) and inpatient treatment
Outpatient - clindamycin, bactrim, doxycycline
inpatient - vancomycin
Staph saprophyticus is a common cause of this….
….UTIs in young women
S. pyogenes common localized infections
Impetigo (not as common as with s. aureus), necrotizing fasciitis, gangrene, erysipelas
S. pyogenes common invasive infections
Bacterial pharyngitis Scarlett fever throat abscesses Rheumatic fever Glomerulonephritis
S. agalactiae medical significance
Group B B hemolytic strep number one cause of death in newborns causing neonatial sepsis and postpartum infections, rarely adult infections
Strep pneumoniae common invasive infections
Pneumonia, ottitis media, sinusitis, meningitis
Strep viridans is known to be a causative agent of these 2 things…
Bacterial endocarditis and dental caries