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Pharmacology Unit7&8

Pharm Notes(Antifungal/Antiviral)

Antifungal Drugs? selectively eliminates fungal pathogens from a host with minimal toxicity to the host.
Systemic Fungal Infections? Treatment? fungal infections that infect the entire body. Can affect immunocompromised or any host. Treatment is difficult and prolonged. Three types of drugs.
Amphotericin B? Use?(1) Toxic(1) Action?(1) Adverse Reactions?(2) Amp: important but dangerous.(systemic) Use: fatal infections. Toxic:renal damage. Act:acts on fungi cell membranes. no bacteria. ADR: Shake and Bake(fever/chills).
Ketoconazole? Use?(1) Adverse Effects?(2) Drug-Drug Interaction?(1) Nizoral: safer and less toxic.(systemic) Use: alternative for Amphotericin B. ADR: Hepatotoxicity and effects of sex hormones. Drug-Drug: Rifampin(tx TB) reduces levels.
Flucytosin? Combination? Adverse Effects?(2) Anocobon: resistance is common. Combo: almost always with Amphotericin B. ADR: Hematologic and Hepatoxicity.
Superficial Fungal Infections? Fungal infections that infect the mucous membranes, skin, scalp, hair and nails. can be caused by Candida. Five Types of drugs.
Dermatophytes? skin, hair and nails.
Dermatophytic Infections? Treatment? ringworm in skin, hair and nails. Tx: Griseofulvin.
Vulvovaginal Candidiasis? Treatment? vaginal yeast. TX:topical meds used for 1-3 days
Oral Candidiasis? Treatment? Thrust. TX: if pt has thrust and is immunocompromised will need systemic drugs.
Onychomycosis? Treatment? yeast in nails. TX: difficult and prolong treatment. may take 3-6 months.
Azoles? Use?(2) Adverse Effects?(4) used for superficial and systemic. ADR: erythema, edema peeling and itching.
Griseofulvin? Administration?(1) Use?(1) Adverse Effects?(4) Admin: given oral for superficial fungus. Use: for dermatophytic infections. ADR: ha, rash, insomnia and GI.
Polyene Antibiotics(Amphotericin B)? Use?(1) Use: candida of the skin.
Nystatin? Use? drug of choice for intestinal candida and candida infections of skin, mouth, esophagus and vagina.
Butenafine? Use? Mentax: topical for Tinea Pedis(athlete's foot)
Antiviral Drugs? ability to treat viruses. however its difficult to suppress virus without harming the host.
Acyclovir? Use?(4) Administration?(3) Zovirax: #1 choice for Herpes Virus. Use: genital herpes, Lip herpes(oral), Shingles(high dose) and Chicken Pox(24hr on onset). Admin:1.topical(initial not recurrent), 2.Oral(recurrent), 3.IV(severe).
Ganciclovir? Use?(1) Adverse Reaction?(1) Cytovene/Viutrasert: Restricted. Use: only for prevention and treatment of Cytomegalovirus(CMV) in immunocompromised patients and prevention for patients with transplant risk. ADR: bone marrow Suppression.
Interferon Alfa? Use?(2) Side Effect?(2) Use: Hepatitis B and C. SE: flu-like symptoms and depression.
Lamivudine? Use?(1) Side Effect?(3) Education?(1) Adverse Effects?(1) Epivir HBV: treats infections caused by HIV and HBV. SE: reduce Serum ALT, liver inflammation and fibrosis. Edu: resistance is emerging. ADR: Lactic Acidosis is rare but dangerous. D/C in continues.
Rebetron? Administration?(2) Use?(1) Adverse Effects?(4) Monitor?(1)Education?(1) Ribavirin. Admin:can be taking oral (solo) or SubQ (combo Interferon Alfa). Use: Hepatitis C. ADR:Flu-like symptoms, depression, hemolytic anemia, and birth defects. Mon:take blood counts before, 2 wks after and 4wks therapy. Edu: avoid pregnancy.
Influenza? managed by vaccination and drugs. the two categories are first gen(A) and second gen(a&b)
Influenza Vaccines? Duration?(1) Administration?(2) Side Effects?(4) Vaccine: best protection. Dura:1-2 wks after receiving and last for 6mths. Admin: Flumist(nasal) and IM. SE:soreness, fever, myalgia(muscle pain) and malaise(discomfort).
Amantadine and Rimantadine? Use?(1) Side Effects?(3) Symmetrel/Flumadine: First Gen. Use: used for prophylaxis and treatment of Influenza A. SE: CNS, CV, and Teratogenic(disrupt growth of embryo and fetus).
Neuraminidase Inhibitors? Types?(2) Side Effects?(4) Inhibitors: treat influenza A and B. Types:Oseltamivir(older than 18) and Zanamivir(older than 12). SE: N/V cough and sore throat.
Ribavirin? Use? Administration? Contraindicated? Use:Severe Viral Pneumonia caused by RSV. Admin: inhaled. Contra: pregnancy.
Palivizumab? Use? Education? Use:prevent RSV in premature and young children with chronic lung disease. Edu: expensive.
Created by: aneshia



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