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67 Cards in this Set
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- Back
- 3rd side (hint)
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Which fungi are dimorphic?
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H. Capsulatum
B. dermatitidis S. Schenckii |
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Name 2 Polyene antifungals
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Amphotericin
Nystatin |
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What is the hardest fugus to erradicate? (the pseudomonas of fungus)
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Aspergillus
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Which antifungal is a potent 3A4 inhibitor?
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Ketoconazole
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Which antifungal is a "supercharged fluconazole"?
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voriconazole
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What class of antifungal are caspofungin, anidulafungin, and micafungin?
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Echinocandins
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What infxns can be treated with amphotericin B (although realistically are not always treated with it)
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Aspergillosis
Blastomycosis Candidiasis Coccidiomycosis Cryptococcus Histoplasmosis Sporotrichosis Zygomycosis |
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What infection is characterized by a peripheral "halo sign" or "crescent sign"?
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aspergillus
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How might it be possible to avoid some of the ADRs associated with Amphotericin B?
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pretreat with acetominophen (or ASA), diphenhydramine, meperidine, +/- hydrocortisone
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What is the major dose-limiting toxicity associated with Amphotericin B?
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nephrotoxicity
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sometimes you can't give as much ampho as you want b/c it will knock out the ___________ |
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What is the difference between liposomal amphotericin B and regular amphotericin B?
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Liposomal formulation has less toxicity b/c it accumulates in the organs of the reticuloendothelial system instead of the kidney
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What is fluconazole used most often to treat?
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candida albicans (and other species, but there is resistance of other species)
and cryptococcus |
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What are the cytochrome interactions associated with fluconazole?
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Inhibitor of 2C9
--> increase in warfarin and phenytoin levels |
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What is cryptococcus associated with?
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fungal meningitis (#1 cause)
worry when AIDS pt has CD4 of 50-100 worry about pt on >15mg of prednisone |
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What drugs will lead to decreased absorption of itraconazole?
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PPIs
H2 blockers, etc |
needs to be absorbed in acidic environment |
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What is the cytochrome interaction involving itraconazole?
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inhibitor of 3A4
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What is voriconazole good for treating?
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Aspergillosis
Candidiasis Zygomycetes |
difficult fungal infections |
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What is the most common side effect associate with voriconazole?
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blurred vision, photophobia, altered color perception, "tunnel vision" "lightening bolts"
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What formulation is available for caspofungin?
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IV
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What is caspofungin used to treat?
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Candida (non albicans species)
Aspergillus |
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Which antifungal(s) can be used for deep fungal infections in pregnancy?
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amphotericin B
*but must consider trimester and severity of infxn |
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Which patients are more susceptible to developing peripheral neuropathy or drug-induced lupus after taking INH (isoniazid)?
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Slow acetylators
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Acetylation (NAT) |
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How can you decrease the likelyhood a patient will develop peripheral neuropathy on INH?
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vitamin B6
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What is the cytochrome interaction of rifampin?
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inducer of 3A4
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Which antimycobacterial agent penetrates prosthetic material?
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Rifampin
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What are the 2 drugs that cause a "flu-like illness"
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#1-rifampin
#2-interferon |
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Which TB drug is associated with optic neuritis (and possibly irreversible blindness)?
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Ethambutol
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What other drug is associated with optic neuritis?
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Amiodarone
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What is the problem with HAART and TB treatment at the same time?
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rifampin induces 3A4 --> accelerated metabolism of PIs and some NNRTIs --> dec serum concentration --> HAART failure
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HHV-8 is what?
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Etiology of Kaposi sarcoma?
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What is acyclovir active against?
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HSV1 and 2
VZV |
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What can be a side effect of large IV doses of acyclovir?
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crystalline arthropathy and acute renal failure (from precipitation of drug in kidneys)
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Which drug is a prodrug of acyclovir?
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Valacyclovir
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What viruses are covered by valacyclovir?
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primary or recurrent genital HSV
Herpes zoster |
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What viruses are covered by Famciclovir?
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HSV 1 and 2
Herpes zoster |
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When would you tend to use famciclovir?
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when you would use valacyclovir
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What is Ganciclovir used to treat?
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CMV (retinitis, esophagitis)
EBV HSV VZV |
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What is a prodrug of ganciclovir?
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valganciclovir
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What two drugs are used for prophylaxis and tx of influenza?
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oseltamavir
zanamivir |
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Which influenza tx is inhaled?
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zanamivir
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What does "pegylation" mean?
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hooking it to polyene glycol - can give fewer doses b/c it will have longer half life than original product
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Which HIV drugs are associated with pancreatitis and peripheral neuropathy?
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DDI (didanosine)
d4T (stavudine) ddC (zalcitabine) - useless |
the "d" drugs |
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Which anti HIV drug is clasically associated with a hypersensitivity rxn?
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ABC (abacavir)
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Which NRTIs should not be combined b/c they compete for activation?
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d4T and AZT
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Which NRTI increases the MCV?
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AZT
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Which drug if a nucleoTIDE RTI?
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Tenofovir (TDF)
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Which anti-HIV drug will precipitate in the kidney if pt doesn't drink enough water?
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Indinavir
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What other drugs (besides indinavir) will precipitate in the kidney if pt does not drink enough water?
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Acyclovir
Triamterene |
an antiviral and a HTN med |
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Which PI is not associated with as much lipodystorphy?
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Atazanavir
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Which PIs have 3A4 interactions?
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ALL of them
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Which drug is a fusion inhibitor?
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Enfuviritide
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Examples of good drug regimens for HIV?
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2NRTIs +1PI
2NRTIs +1NNRTI 2NRTIs + ritonavir + another PI |
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Which antiviral may lead to crystalline arthropathy and ARF?
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acyclovir
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Which antiviral(s) leads to bone marrow suppression (neutropenia)?
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ganciclovir
interferon alpha Zidovudine (AZT) |
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what is interferon alpha used to treat?
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hep B and C
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Which NRTIs have HepB activity?
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Lamivudine (3TC) and Emtricitabine (FTC)
Tenofovir (TDF) - actually a nucleoTide RTI |
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Which NRTI is associated w/hyperpigmentation of oral mucosa/nailbeds and myopathy?
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Zidovudine
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Which NRTI raises the MCV?
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Zidovudine (AZT)
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What drug besides the NRTIs turns off host mitochondrial enzymes?
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Bactrim
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What HIV drug has Hep B activity against strains that are resistant to 3TC and FTC?
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TDF (Tenofovir) - a nucleoTide RTI
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WHat can't TDF be used with?
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ABC/3TC or ddI/3TC
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In which class of HIV drugs does resistance to one confer resistance to all in the class?
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NNRTIs
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which NNRTI commonly causes a rash?
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Nevirapine (NVP)
Delviradine (but it's useless anyways) Efavirenz (most potent NNRTI) |
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Which HIV drug causes vivid dreams (CNS disengagement)?
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Efavirenz
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WHich anti HIV drug is associated with stones?
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Indinavir
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What PI is usually started?
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lopinavir (tipranavir if resistant)
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which anti HIV drug is only available SC?
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Enfuviritide (fusion inhibitor)
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