Germone Shared "Infectious Disease Drugs, Exam 3" - 19 Picmonics
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Infectious Disease Drugs, Exam 3
Acyclovir (Zovirax)
- Mechanism
- Guanosine Analog
- Inhibits Viral Replication
- Thymidine Kinase Activation
- Indications
- Herpes Simplex Virus (HSV)
- Varicella Zoster Virus (VZV)
- Side Effects (Oral)
- Headache
- GI Distress
- Side Effects (IV)
- CNS Toxicity
- Nephrotoxicity (Crystalline Nephropathy)
- Considerations
- Prevents Recurrent Episodes
- Slow IV Infusion
2 mins
Ganciclovir
- Treat CMV for the Immunocompromised
- IV only
- Granulocytopenia and thrombocytopenia
- Teratogenic, handle with CARE. Leads to infertility.
- Monitor CBC & Platelets
- Report symptoms of infection
- Too toxic for other herpes family treatment--CMV only
- Beware: cyclovir meds are often confused with ciclovir meds (Valacyclovir versus Valgaciclovir)
Oseltamavir (Tamiflu)
- Also a prophylaxis for the young during outbreaks, etc.
- Interacts with LAIV- Live Active Influenza Vaccine
- Allergic reactions (rare) include: headache, nosebleed, red eyes, insomnia, cough
- Give within 2 days...
- Rare: hypersensitivity and neuropsychiatric effects.
Amphotericin B
- Indications
- Systemic Mycosis
- Fungal Meningitis
- Last Resort for Protozoan infections
- Mechanism
- Polyene
- Binds Ergosterol
- Forms Membrane Pores
1 min
Amphotericin B Side Effects & Toxicity
- Side Effects
- Fever/Chills "Shake and Bake"
- Nephrotoxicity
- Milder with Liposomes
- Hypotension
- Anemia
- IV Phlebitis
- Arrhythmias
1 min
Azoles (Ketoconazole)
- "-azole" suffix
- Indications
- Local and Less Serious Systemic Mycosis
- Mechanism
- Inhibits Ergosterol Synthesis
- Inhibits P450
- Side Effects
- Liver Dysfunction
- Inhibition of Testosterone Synthesis
1 min
Isoniazid (INH)
- Mechanism
- Interferes with DNA Metabolism
- Indications
- Tuberculosis (TB)
- Side Effects
- Optic Neuritis
- Nausea and Vomiting
- Hepatotoxicity
- Peripheral Neuropathy
- Considerations
- Vitamin B6 Prophylaxis
- Monitor AST/ALT
2 mins
Rifampin
- Most importantly: MANY MANY drug interactions (strong inducer of CYP450)
- Contraindicated for Protease Inhibitors
- Adverse reactions include hepatotoxicity (AJ FAN US!), pruritis, and flu symptoms.
- Avoid alcohol.
- Be aware of impending orange body fluids.
- Warfarin is dangerous.
- Contraindicated with oral contraceptives and delavirdine.
- Do not confuse with other Rifs: Rifapentine, Rifabutin.
Pyrazinamide
- Hepatoxicity and rash.
- Nongouty Polyarthralgias or precipitation of gouty attack
- Photosensitive Dermatitis
- Use NSAIDs for non-gout pain.
- Hepatotoxicity: AJ, FAN US! (Anorexia, Jaundice, Fatigue, Urine dark, Stool pale
- Avoid alcholol
Ethambutol (Myambutol)
- Mechanisms
- Inhibits RNA Synthesis
- Bacteriostatic
- Indications
- Tuberculosis (TB)
- Side Effects
- Optic Neuritis
- Red/Green Color Blindness
- Gouty Arthritis
- Consideration
- Monitor Vision Acuity
2 mins
Zidovudine-NRTI
- 2 NRTI's (with 1 PI & 1 Insti/PPI) are the backbone of HIV therapy.
- Used as prophylaxis before, during, and after HIV+ labor.
- Also treats HBV
- May lead to anemia or neutropenia.
- Metabolic effects include: hepatotoxicity, pancreatitis, lipoatrophy, or lactic acidosis.
- May lead to GI distress (NVD).
- Be careful of using with other nephrotoxic or meylosuppressive drugs
- You can take it with or without food.
NNRTIs: Efavirenz
- Falling out of favor as HIV treatment (often replaced by INSTIs).
- Directly binds and inhibits reverse transcriptase.
- Do not use with a history of mental illness.
- Do not use if pregnant or lactating.
- Watch for rash, Hepatotoxicity, and CNS effects (psychiatric changes, dizziness).
- Watch for Stevens Johnson and Lipodystrophy
- Effects include toxic epidermal necrolysis and macupapular rash.
- High risk for resistance, adherence is vital.
- Many drug interactions, more than NRTIs.
- NN is for no no
Protease Inhibitor: Lopinivir
- Always boosted with Ritonivir: the strongest PI know, but only used in combinations.
- Caution with newborns and cardiac patients.
- PIs have many, many drug interactions.
- Watch for the development of Diabetes.
- Adverse effects include hepatotoxicity and GI distress
- Lipohypertrophy is possible.
- Sometimes taken with food, sometimes not.
INSTI: Integrase Strand Transfer Inhibitor
- Drug therapy can fail if taken with Ca, Al, Mg, Iron, or Zinc.
- Less interactions than others in its class, but still watch for hypersensitivity, increased Cr, and insomnia.
- Rare, but watch for muscle breakdown.
- Prototype: Raltegravir. Modern therapy line includes 2 NRTIs, 1 PI, & an INSTI.
Fusion Inhibitor: Enfuvirtide
- CCR5 Antagonist
- Is considered a salvage therapy due to cost and the need to inject, BID.
- Injection site reactions.
- Signs and symptoms of pneumonia
Maraviroc: a CCR5 Antagonist
- Caution with strong CYP34A inducers/inhibitors
- Is considered salvage therapy: not all HIV strains need CCR5 receptors to bind to CD4 cells.
- Monitor closely: falls under black box warning.
- Tropism test is used to determine if eligible for therapy.
- Monitor for hypersensitvity.
- All HIV Therapy: Monitor for Vaccines...ie, HIP T...Hep B, Influenza, Pneumococcal, Tetanus
Morphine
- Mechanism
- Opioid Receptor Agonist
- Indications
- Pain
- Myocardial Infarction
- Side Effects
- Nausea and Vomiting
- CNS Depression
- Biliary Colic
- Constipation
- Increased Intracranial Pressure (ICP)
- Pupillary Constriction
- Hypotension
2 mins
Sumatriptan
- Mechanism of Action
- Short Half-Life
- 5-HT Agonist
- Inhibits Trigeminal Nerve Activation
- Induces Vasoconstriction
- Indications
- Migraine
- Cluster Headache
- Side Effects
- Increased Risk of Serotonin Syndrome
- Paresthesias
- Coronary Vasospasm
- Contraindication
- Prinzmetal's Angina
- Coronary Artery Disease (CAD)
3 mins
Promethazine (Phenergan)
- Mechanism
- Histamine H1 Receptor Antagonist
- Weak Dopamine Antagonist
- Indications
- Nausea and Vomiting
- Motion Sickness
- Side Effects
- Respiratory Depression
- Sedation
- Anticholinergic Effects
- Extrapyramidal Symptoms
- Considerations
- Use Large Bore IV
- Monitor for Tissue Necrosis
2 mins
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