Pharm final
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| Sulfonamides and trimethoprim | Broad spec antibio; 1st avail for systemix bact infec; supresses bact growth by inhib folic; less toxic alt, bact resist; trim used for urinary tract infec, sulfa used in combi, topica= hyper sensitivity, not used routinely
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| Sulfonamides adv eff | Hypersens rxn: rash, fever, photosens, stevens-johnson synd: skin lesions, fever, etc. 25% mort; hematologic eff:hemoltic anem, G-6-PD; Kernicterus: displace billirubin>plasma protien>brain; crystalluria: 10glasswater/day
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| Trimethoprim | (Proloprim and Trimpex) 40k loer conc for bact vs mama; micron resist: inc dihydrofolate reductase, altered dihydrofolatered, red cell perm, resist uncommon in us; UTI as stand alone; hematologic: complete blood counts (anemia); oral (100&200mg tabs)
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| Trimethoprim-Sulfamethoxazole | Co-Trimoxazole(gen outside US) inhib seqquential steps in bact folate synth; uncomp UTI; pneimocustis carinii: common in immuno-comp; GI & other infects; adv eff: GI, Rash crystallurra; oral & iv infusion routes
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| Nitrofurantoin | (Furandantin) Bacteriostatic-low conc, bactericidal-high conc; theuropeutic levels in urine; activate inside bact, targets DNA; uses: lower UTIs, prohylaxis, reccurent UTI; adv eff: GI(brown urine), pulm rxn, hemato eff(anemia), preipheral neuropathy
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| Methenamine | (Mandelamine) DEcomp into amina and foraldehyde> denatur bact; acidic urine(vpH5.5), enteric coating; use:chronic lower UTIs; adv eff: safe, well tol, contradindicated: renal patient-crystalluria, liver dysfunction - ammonia
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| Nalidixic Acid | (NegGram)Targets DNA gyrase, only approved for UTIs; multiple adv eff: low incidence of sever, other drugs usually prefferred
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| Isoniazid | (nydrazid) Prim agent, treat&proph; bactcidal-active, bactstatic-resting;inhibs mycolic acid for cell wall; resist from spont mutations;used in combi for active TB; adv eff: periph neuro(pyridoxine vit B6), hepatox, CNS eff optic neuritis, dizzy; anemia
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| Rifampin | (Rifadin) broad spec anti; inhib DNA-depen RNA polym: v RNA syn,prot syn; use: TB, leprosy, H. INflue, legionella; adv eff: well tol, hepatox, jaudice $ hepatitis; discolor Body fluid;DI: oral contra, warfarin, HIV drug
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| Ethambutol | (myambutol) bactstatic, cell wall of mycobact; use: TB, multi drug therap; adv eff: optic neuritis(swell los color) allergy, hyperuricemia, uric acd retained in kidny
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| Fluoroquinolones | closely related to nalidixic acid; generally a broad spectrum antibacterial drug
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| Ciprofoxacin | (cipro) Fluoroquinolones; wide variety of infect;oral,iv;inhibits bacterial DNA gyrase;Drug of choice anthrax, not useful agnst anaerobes;adv eff:gen mild;GI;headache;CNA;candida:pharynx and vagina;drug and food inter:cationic comp;theophylline;warfarin
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| Ofloxacin | Fluoroquinolones; broad spec antibact; abs reduc: aluminum antacids; mg antacid; iron salts; zn salts; sucralfate; milk and dairy products
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| Metronidazole | (Flagyl) Bactcidal to anaerobe, DNA strand break; use: protozoal infect; infect by obligate anareobe; h pylori(combo therapy); adv eff: neuortox, allergy, superinfections
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| Amphotericin B | (Fungizone) Broad spec fungal; leakage of cell mem; binds to ergosterol, bact lack sterols; highly toxic, 1mg test dose IV, use: systemic Myc; adv eff: infusion rxn,nephrotox,hypokalemia
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| Intraconazole | (Sporanox) Azole group of antifung; lower tox level, PO,IV; use: systemic myc; SE: cardiosupp, liver dam, GI
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| Ketoconazole | (Nizoral) azole antifung; fungistatic, inhib syn of ergosterol; 200 mg tab; adv eff: hepatox, eff on sex hormone, nausea, headahce, vomit, ab pain
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| Griseofulvin | (fulvicin) superficial myc; ineff systemic myc; inhib mitosis; oral, dematophye not condida; adv eff: transient headache; rash; GI; insomnia; tired
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| Acyclovir | (Zovirax) Purine nucleoside analogs, DNA polymerase inhibs; suppress syn of viral DNA; resist, use: herpes simplex, Varicella zoster; adv ef: IV phlebitis revers nephrotox; PO-GI, VERtigo; top-stinging
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| Ganiciclovir | (cytovene, vitrasert) syn antiviral-IV, oral&intraocular; use: herpes simp, epstein-Barr virus, CMV infect in immunocomp; SI: granulo thrombo cytopenia
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| Hep B | tranmit: blood and semen; HBV vaccine; drugs: interferon alfa-2b(peg-intron), Lamivudine (Epivir-HBV); adefovir(HEpsera)
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| Hep C | Trans - blood semen; no symptoms(most patients); leading reason fro liver trans; drugs: Interferon alfa(PEG-intron) amd ribavirin(synergistic MOA unclear, no effect alone)
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| Vaccines for inlfuenza | Flushield, Fluzone, FLuvirin=inactive IM;flumist, intranasal inactive; precautions and contradictions: egg allergy
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| Drugs for Influenza | 1st gen(1999)-MOA?:Amantadine(symmetrel), Rimantadine(Flumadine); adv eff: CNS; 2nd gen viral Neuraminidase inhib; Oseltamivir(tamiflu)&Zanamivir(Relenza); inhib viral replicate; halucinations in jap kids
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| Enfuvirtide | (Fuzeon, T-20) Hiv fusion inhib to cd-4; 2/dailt SC injec; complex syn, many steps $$$; approved in march 2003, resist already; inject sote pain&tender; possilbe pneumonia; hypersens rxn; no drug interxn
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| Zidovudine | (retrovir, AZT);(nucleoside reverse transcriptase inhib) inhibs HIV rep; adv eff: anemia, neutropenia, lactic acidosis, GI, CNS
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| Other nucleoside revers transcriptase inhibitors | Didanosine(videx); ZalciLamivudine (Epivir)tabine (Hivid); Stavudine (Zerit);Abacavir (Ziagen) ; Tenofovir disoproxil fumarate (Viread) ;Trizivir ;Didanosine(videx); ZalciLamivudine (Epivir)tabine (Hivid); Stavudine (Zerit);Abacavir (Ziagen) ; Tenofovir d
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| Nevirapine | Didanosine(videx); ZalciLamivudine (Epivir)tabine (Hivid); Stavudine (Zerit);Abacavir (Ziagen) ; Tenofovir disoproxil fumarate (Viread) ;Trizivir ;Combivir
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| Efavirenz | (Sustiva) NNRTI; preferred over Nevirapine (Viramune); 1/day dosing; admin on empty stomach with high-fat meal
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| Protease Inhibitors | Saquinavir (Invirase, Fortovase) = prototype; Indinavir (Crixivan); Ritonavir (Norvir); Nelfinavir (Viracept); Amprenavir (Agenerase); Lopinavir/ritonavir (Kaletra)
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| Protease Inhibitors | hyperglycemia/diabetes; fat redistribution; hyperlipidemia; reduced bone dense; hepatox; increase bleed in hemop; elevation of serum transaminase; DI
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