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AF/antivirals/HIV
chemo exam 3
| Question | Answer |
|---|---|
| Histoplasmosis capsulatum | DOC: itraconazole, amphotericin B; alternates: ketoconazole, fluconazole; in bird poop; pulmonary' sx after 10days |
| Coccidioidomycosis immitis | DOC: fluconazole, amphotericin B; alternatives: ketoconazole, itraconazole; pts can recover on their own; sx after 1-3 wks; recover wks/months |
| blastomycoses dermatitis | DOC: amphotericin B (serious), itraconazole (Mild); alternatives: ketoconazole, fluconazole, voriconizole, posaconazole; moist soil; flu-like sx, could go CNS; sx after 3-15 weeks; ALWAYS tx |
| cryptococcus neoformans | DOC: amphotericin B (w or w/o flucytosine); alternative: ketoconazole, fluconazole, itraconazole; tx w/immunorecovery; pneumonia-like illness, can go CNS; ALWAYS tx (progressive) |
| aspergillosis spp | A.fumigatis, flavis > most common; DOC: voriconazole; altnernatives: amphotericin B, itraconazoel, caspofungin, micafungin, posaconazole; v. common in environment; seen nosocomially; SEE DR IMMEDIATELY |
| amphotericin | -polyene; renally toxic; PO not absorbed; IV dissappears (revesably) into membranes; much intrinsic resistance |
| nystatin | polyene; v. similar to amphotericin (more toxic) |
| pimaricin | polyene; only ocular AF |
| flucytosine | it's own class; lots of resistance (single step mutation);inhibits DNA synthesis |
| miconazole | azole |
| econazole | azole |
| sulconazole | azole |
| tioconazole | azole |
| butoconazole | azole |
| clotrimazole | azole |
| terconazole | TRIazole; PO for nail infections |
| ketoconazole | azole; PO or IV; liver toxic |
| fluconazole | TRIazole; more for yeast spp; less liver toxic |
| itraconazole | TRIazole |
| voriconazole | TRIazole; 90% absorbed; IV or PO: for invasive spergillosis, fusarium/scedosproium, esophageal candidiases, andidemia; more AE's women than men |
| candida spp | DOC: amphotericin B (w or w/o flucystosine): alternates: ketoconazole, itraconazole |
| posaconazole | TRIazole; v. potent; PO susp; only DI CYP3A4 inhibition |
| ravuconazole | azole; never made it to market; advantages? |
| griseofulvin | exclusively nail bed (keratin cells); EMT; several months; 4 hours to get into nail bed |
| tonaftate | thiocarbamate; EMT |
| terbinafine | allylamine |
| naftifine | allylamine |
| cyclopriox olamine | EMT; nail lacquer; long duration w/50% efficacy |
| haloprogin | EMT; iodine probably kills fungus |
| undecyclenic acid | EMT, zinc |
| clioquinol | also antiprotozoal |
| butenafine | similar to allylamine; onychomycosis |
| amorolfine | nail lacquer; onychomycosis |
| caspofungin | echinocandin; mostly candida; increases immune system |
| micafungin | echinocandin; candida & aspergillus; esophageal candidiasis, prophylaxis of candida |
| anidulafungin | echinocandin; candida & aspergillus |
| acyclovir | Purine; HS1 & 2, VZ, EBV; general for topical use (as opposed to prodrug) |
| valacyclovir | Purine; acyclovir prodrug - used more; HS1 & 2, VZ, EBV; GI discomfort |
| gancyclovir | Purine; CMV; used in eyes (retinitis); mutagenic; bone marrow supression |
| valgancyclovir | Purine; gancyclovir prodrug; PO use; mutagenic |
| foscarnet | Simple structure; HSV & CMV; PO = amazing diarrhea; nephrotoxic; expensive; decreases calcium levels |
| cidofovir | Pyrimidine; 2nd choice for CMV; topical for anogenital warts; nephrotoxic; retina collapse/uveitis |
| maribavir | fast track by FDA; for CMV in transplantees |
| famciclovir | Purine; pro-pro-prodrug of penciclovir; PO preferred; for VZ; take ASAP |
| penciclovir | Purine; for HSV1 - sometimes 2; NOT for lesions |
| capsaicin | topical for shingles (unreliable); for muscle issues |
| urushiol | poison in poison ivy/oak/sumac; topical for shingles |
| docosanol | Abreva!; topical for shingles; use within 12hrs of tingly feeling |
| podophyllotoxin | lignan from May Apple; purgative PO; for anogenital warts |
| podofilox | for condylomata acuminate (wet anogenital warts); not on broken skin (burns) |
| imiquimod | for external anogenital warts; apply and wash out 8-10 hrs later; not on broken skin, apply evenly on wart |
| veregen | from green tea; sinecatechins (EC, EGC, ECG, EGCG); for external anogenital warts; can apply with finger; OTC |
| amantadine | completely ineffective (resistance) drug |
| rimantadine | completely ineffective (resistance) drug |
| oseltamiver | influnza A is now resistant |
| zanamivir | nasal inhalation for flu; less used initially, so now it still works |
| peramivir | US paid big bucks to company; neuraminidase inhibitor; for avian flue (maybe for other flu?) |
| entecavir | Purine; selective against HBV; NOT a cure/anti-transmission |
| tebivudine | Pyrimidine; against HBV |
| ribavirin | Purine; somewhat broad spec (pox, flu A&B, HSV 1&2, hep, RSV), first agent in really bad condition pts |
| idoxuridine | first viral ocular; little effect now |
| vidarabine | viral ocular; diminished effect |
| viroptic | Pyrimadine; viral ocular; little resistance; for lesions in eyes (keratoconjunctivitis); requires phosphorylation |
| abacavir | NRTI; Purine; for HIV; in combos; can result in hypersensitivity |
| lamivudine | NRTI; solo or in combos; for HIV; resistance via codon 184; |
| nevirapine | NNRTI; for HIV |
| delavirdine | NNRTI; for HIV; less common |
| efavirenz | NNRTI; for HIV; potentially teratogenic; inhibition of CYP3A4 |
| etravirine | NNRTI; for HIV; not initial drug tx |
| atazanavir | PI; for HIV; many DI's (CYPS); must be in a combo; low pill burden |
| prezista | PI; for HIV; sulfonaminde linkage (allergies) |
| fosamprenavir Ca | PI; for HIV; prodrug (active is amprenavir); many SE (NV & rash most); CYP3A4 substrate & inhibitor |
| amprenavir | PI; for HIV; active of fos-; many SE (NV & rash most); CYP3A4 substrate & inhibitor |
| indinavir | PI; for HIV; one of most potent; pt must drink lots of water to avoid kidney stones |
| lopinavir | PI; for HIV; pseudo-combo w/ritonavir; longer half life |
| nelfinavir | PI; for HIV; should be in combo; resistance mutation is D30N |
| tipranavir Na2 | PI; for HIV; good with PI-resistant HIV |
| T-20/Fuzeon | Fusion Inhibitor; for HIV/AIDs; does NOT cure; few allergies |
| maraviroc | chemokine receptor antagonist; for mulitple resistant HIV; NOT for CXCR4 virus (or any blend of); only in combos |
| isentress | integrase inhibitor; for HIV/AIDS; the LAST RESORT; only in combos; |
| combivir | lamivudine + zidovudine |
| keltra | lopinavir + ritonavir |
| truvada | emtricitabine + tenofovir |
| trizivir | abacavir + zidovudine + lamivudine |
| epzicom | abacavir + lamivudine |
| atripla | efavirenz + emtricitabine + tenofovir |
| didanosin | NRTI; Purine; for HIV |
| emtricitabine | NRTI; Pyrimidine; for HIV |
| stavudine | NRTI; Pyrimidine; for HIV |
| tenofovir | NRTI; Purine; for HIV |
| zidovudine | NRTI; Pyrimadine; for HIV |
| darunavir | PI; for HIV |
| ritonavir | PI; for HIV; often boosts others |
| saquinavir | PI; for HIV |
Created by:
blackybounce
Popular Pharmacology sets