The Pharm of Old McDonald 2

  1. amphotericin B
    • binds ergosterol making pore. Systemic mycoses (cryptococcus, blastomyces, cocidiodes, histoplasma, candida, mucor), intrathecal for fungal meningitis
    • fever, chills, hypotension, nephrotox (distal tubular acidosis, reduced by hydration, give with K and Mg b/c altered renal tubule permeability), arrhythmias, anemia, IV phelbitis (liposomal amphotericin B reduces toxicities)
    • terbazole ergosterol nymphotear-a-hole (terbafine early ergosterol synth, azoles last step in ergosterol synth, nystatin/amphotericin B makes pore at ergosterol)
    • my amp drips (drops) hot beats that pale kids can't follow (amphotericin B, IV phlebitis, fever/chills, anemia, nephrotox, arrhythmia)
  2. nystatin
    • binds ergosterol making pore. Oral candidiasis (thrush) (swish and swallow), diaper rash/vaginal candidiasis (topical)
    • too toxic for systemic use
    • New York satan too evil for systemic use (topical, oral only)
    • terbazole ergosterol nympho-a-hole (terbafine early ergosterol synth, azoles last step of ergosterol synth, nystatin/amphotericin B makes pore at ergosterol)
  3. flucytosine
    • conversion to 5-fluorouracil by cytosine deaminase reduces DNA and RNA biosynthesis. Systemic fungal infections especially cryptococcus meningitis with amphotericin B
    • bone marrow supression
    • amphotericin B makes pore for entry b/c this works in nucleus
  4. azoles
    • clotrimazole, fluconazole, itraconazole, ketoconazole, miconazole, voriconazole
    • inhibit the P-450 that converts lanosterol to ergosterol. local/less serious systemic mycoses
    • inhibits P-450 (liver dysfunction), testosterone synthesis inhibition (gynecomastia with ketoconazole)
    • kitty-titty-conazole (ketoconazole, gynecomastia)
    • terbazole ergosterol nympho-a-hole (terbafine early ergosterol synth, azoles last step of ergosterol synth, nystatin/amphotericin B makes pore at ergosterol)
  5. clotrimazole (class/special?)
    • azole
    • topical fungal infections
    • inhibits P-450 (liver dysfunction)
    • terbazole ergosterol nympho-a-hole (terbafine early ergosterol synth, azoles last step of ergosterol synth, nystatin/amphotericin B makes pore at ergosterol)
  6. miconazole (class/special?)
    • azole
    • topical fungal infections
    • inhibits P-450 (liver dysfunction)
    • terbazole ergosterol nympho-a-hole (terbafine early ergosterol synth, azoles last step of ergosterol synth, nystatin/amphotericin B makes pore at ergosterol)
  7. itraconazole (class/special?)
    • azole
    • blastomyces, coccidiodes, histoplasma
    • inhibits P-450 (liver dysfunction)
    • terbazole ergosterol nympho-a-hole (terbafine early ergosterol synth, azoles last step of ergosterol synth, nystatin/amphotericin B makes pore at ergosterol)
  8. ketoconazole (class/special?)
    • azole
    • also inhibits 17,20 desmolase, reducing testosterone synthesis inhibition. Used in PCOS to reduce androgenic symptoms
    • gynecomastia, inhibits P-450 (liver dysfunction)
    • kitty-titty conazole (gynecomastia)
    • terbazole ergosterol nympho-a-hole (terbafine early ergosterol synth, azoles last step of ergosterol synth, nystatin/amphotericin B makes pore at ergosterol)
  9. fluconazole (class/special?)
    • azole
    • candidal infections, chronic suppression of cryptococcal meningitis in AIDS patients
    • inhibits P-450 (liver dysfunction)
    • terbazole ergosterol nympho-a-hole (terbafine early ergosterol synth, azoles last step of ergosterol synth, nystatin/amphotericin B makes pore at ergosterol)
  10. voriconazole (class/special?)
    • azole
    • inhibits P-450 (liver dysfunction)
    • terbazole ergosterol nympho-a-hole (terbafine early ergosterol synth, azoles last step of ergosterol synth, nystatin/amphotericin B makes pore at ergosterol)
  11. terbinafine
    • inhibits squalene epoxidase at the beginning of the ergosterol synthesis pathway. Dermatophytes, especially onychomycosis (finger/toe nail fungus)
    • GI upset, headache, hepatotoxicity, taste disturbance
    • a GI got a taste for live action when he nailed a guy with a turbin on his head (GI upset, taste disturbance, liver tox, nail fungus, terbinafine, headache)
    • terbazole ergosterol nympho-a-hole (terbafine early ergosterol synth, azoles last step of ergosterol synth, nystatin/amphotericin B makes pore at ergosterol)
  12. echinocandins
    • anidulafungin, caspofungin, micafungin
    • inhibit beta-glucan, reducing cell wall synthesis. Invasive aspergillosis, candida
    • GI upset, flushing
    • Asian echidna had too much fun and got sick (flushing, echinocandins, -fungin, GI upset)
  13. anidulafungin (class)
    • echinocandin
    • GI upset, flushing
    • Asian echidna had too much fun and got sick (flushing, echinocandins, -fungin, GI upset)
  14. caspofungin (class)
    • echinocandin
    • GI upset, flushing
    • Asian echidna had too much fun and got sick (flushing, echinocandins, -fungin, GI upset)
  15. micafungin (class)
    • echinocandin
    • GI upset, flushing
    • Asian echidna had too much fun and got sick (flushing, echinocandins, -fungin, GI upset)
  16. griseofulvin
    • microtubule dysfunction dirsupting mitosis in keratin containing tissues (nails/hair). Oral treatment for dermatophytes: tinea (ringworm)
    • induces P-450, teratogen, carcinogen, confusion, headache
    • greasy hair stands up (griseofulvin, hair/nail/skin/microtubules, increased risk of cancer/birth defect/P-450 inducer)
  17. pyrimethamine (class/special?)
    antiprotozoan for toxoplasmosis
  18. suramin (class/special?)
    antiprotozoan for trypanosoma brucei
  19. melarsoprol (class/special?)
    antiprotozoan for trypanosoma brucei
  20. nifurtimox (class/special?)
    antiprotozoan for trypanosoma cruzi (chagas)
  21. sodium stibogluconate (class/special?)
    antiprotozoan for leishmaniasis
  22. permethrin
    • blocks Na channels. Use with malathion and lindane to treat scabies and lice (pediculus, pthirus)
    • neurotoxicity (Na block)
    • Pesty Mites and Lice NAG you (PML for scabies and lice, permethrin blocks Na, malathion inhibits AChE, lindane blocks GABA)
  23. malathion
    • inhibits acetylcholinesterase. Use with malathion and lindane to treat scabies and lice (pediculus, pthirus)
    • Pesty Mites and Lice NAG you (PML for scabies and lice, permethrin blocks Na, malathion inhibits AChE, lindane blocks GABA)
  24. lindane
    • blocks GABA channels. Use with malathion and lindane to treat scabies and lice (pediculus, pthirus)
    • Pesty Mites and Lice NAG you (PML for scabies and lice, permethrin blocks Na, malathion inhibits AChE, lindane blocks GABA)
  25. chloroquine
    • blocks heme to hemozoin detoxification, heme buildup kills plasmodia. Treats plasmodial other than P falciparum (resistant)
    • membrane pump resistance (use artemether/lumefantrin or atovaquone/proguanil for P falciparum), quinidine or artesunate for life threatening malaria
    • retinitis, pruritis (esp if dark-skin)
    • I itch when I see mosquitos (pruritis, retinitis, malaria)
  26. artemether (class/special?)
    used with lumefantrine for P falciparum
  27. lumefantrine (class/special?)
    used with artemether for P falcipartum
  28. atovaquone (class/special?)
    used with proguanil for P falciparum
  29. proguanil (class/special?)
    used with atovaquone for P falciparum
  30. quinidine
    • antimalarial and class 1A antiarrhythmic
    • slow Na conduction in frequently depolarized (tachycardic) tissue causing medium flattened phase 0 and prolonged AP, which increases the refractory period and QT interval. Re-entrant and both ectopic atrial and ventricular tachycardia/arrhythmias
    • life-threatening malaria
    • headache and tinnitus, torsades de pointes, thrombocytopenia
    • the queen proclaims Diso's pyramid (Queen is 1st [1A], procainamide, disopyramide)
  31. artesunate (class/special?)
    life-threatening malaria
  32. mebendazole (class/special?)
    inhibits microtubules. Antihelminthic
  33. pyrantel pamoate (class)
    antihelminthic
  34. ivermectin (class)
    antihelminthic
  35. diethylcarbamazine (class)
    antihelminthic
  36. praziquantel (class)
    antihelminthic
  37. oseltamivir
    • inhibit neuraminidase so virus can't leave. Treatment and prevention for influenza A and B
    • adios AMIgo (can't leave oseltAMIvir, zanAMIvir)
  38. zanamivir
    • inhibit neuraminidase so virus can't leave. Treatment and prevention for influenza A and B
    • adios AMIgo (can't leave oseltAMIvir, zanAMIvir)
  39. acyclovir
    • HSV/VSV-thymidine-kinase activated guanosine analog becomes triphosphate to inhibit DNA polymerase. HSV and VSV skin or encephalitis (weak against EBV)
    • no effect on latent virus
    • mutated viral thymidine kinase resistance
    • if not hydrated causes obstructive crystalline nephropathy and acute renal failure
    • use your mouth for drinking not kissing (hydration important)
  40. valacyclovir
    • prodrug of acyclovir
    • HSV/VSV-thymidine-kinase activated guanosine analog becomes triphosphate to inhibit DNA polymerase. HSV and VSV skin or encephalitis (weak against EBV)
    • better oral bioavailability
    • no effect on latent virus
    • mutated viral thymidine kinase resistance
    • if not hydrated causes obstructive crystalline nephropathy and acute renal failure
    • use your mouth for drinking not kissing (hydration important)
  41. famciclovir
    • HSV/VSV-thymidine-kinase activated guanosine analog becomes triphosphate to inhibit DNA polymerase. Herpes zoster
    • no effect on latent virus
    • mutated viral thymidine kinase resistance
    • if not hydrated causes obstructive crystalline nephropathy and acute renal failure
    • lasting FAMe of VSV (for shingles [zoster] use famciclovir)
    • use your mouth for drinking not kissing (hydration important)
  42. ganciclovir
    • CMV-viral-kinase activated 5'-monophosphate guanosine analog becomes triphosphate to inhibit DNA polymerase. CMV
    • mutated viral kinase resistance
    • bone marrow suppression, renal toxicity
    • a giant crushed a kids bones (cytoMEGAlo virus/GiANciclovir, renal tox, marrow suppression)
  43. foscarnet
    • pyrophosphate analog inhibiting DNA/RNA polymerase and HIV reverse trascriptase (no kinase needed). CMV retinitis when ganciclovir fails and acyclovir-resistant HSV
    • mutated DNA polymerase resistance
    • nephrotox, electrolyte abnormalities->seizures
    • clumsy kid knocked the salt shaker under the faucet (nephro, electrolyte abnormality, seizures, foscarnet)
    • faux pyropho (FOscarnet, cidoFOvir, tenoFOvir [NRTI nucleotide, not -side], phosphate+something analog)
  44. cidofovir
    • nucleotide-esque inhibiting DNA polymerase (no kinase needed). CMV retinitis and acyclovir-resistant HSV
    • nephrotox (give with probenecid and IV saline)
    • cider is for kids to drink (cidofovir, nephrotox, give with saline)
    • faux pyropho (FOscarnet, cidoFOvir, tenoFOvir [NRTI nucleotide, not -side], phosphate+something analog)
  45. abacavir
    • ABC
    • NRTI
    • nucleoside lacking 3'OH phosphoryalted to nucleotide inhibits reverse transcriptase. HIV therapy 2 NRTIs plus 1 integrase inhibitor
    • type IV hypersensitivity (HLA-B*5701 only->contraindicated), bone marrow suppression (give G-CSF and EPO), peripheral neuropathy, lactic acidosis
    • know your HL ABC's (HLA-B*5701, ABC)
    • NRTILMNOP (NRTI, alphabet soup of these things, Lactic acidosis, Marrow suppression, Neuropathy...Oh--Peripheral)
  46. didanosine
    • ddl
    • NRTI
    • nucleoside lacking 3'OH phosphoryalted to nucleotide inhibits reverse transcriptase. HIV therapy 2 NRTIs plus 1 integrase inhibitor
    • pancreatitis, bone marrow suppression (give G-CSF and EPO), peripheral neuropathy, lactic acidosis
    • duodanosine (pancreatitis)
    • NRTILMNOP (NRTI, alphabet soup of these things, Lactic acidosis, Marrow suppression, Neuropathy...Oh--Peripheral)
  47. emtricitabine
    • FTC
    • NRTI
    • nucleoside lacking 3'OH phosphoryalted to nucleotide inhibits reverse transcriptase. HIV therapy 2 NRTIs plus 1 integrase inhibitor
    • bone marrow suppression (give G-CSF and EPO), peripheral neuropathy, lactic acidosis
    • NRTILMNOP (NRTI, alphabet soup of these things, Lactic acidosis, Marrow suppression, Neuropathy...Oh--Peripheral)
  48. lamivudine
    • 3TC
    • NRTI
    • nucleoside lacking 3'OH phosphoryalted to nucleotide inhibits reverse transcriptase. HIV therapy 2 NRTIs plus 1 integrase inhibitor
    • bone marrow suppression (give G-CSF and EPO), peripheral neuropathy, lactic acidosis
    • haVE YOU DINEd with my nuclear family (-vudine, nucleoside)
    • NRTILMNOP (NRTI, alphabet soup of these things, Lactic acidosis, Marrow suppression, Neuropathy...Oh--Peripheral)
  49. stavudine
    • d4T
    • NRTI
    • nucleoside lacking 3'OH phosphoryalted to nucleotide inhibits reverse transcriptase. HIV therapy 2 NRTIs plus 1 integrase inhibitor
    • bone marrow suppression (give G-CSF and EPO), peripheral neuropathy, lactic acidosis
    • haVE YOU DINEd with my nuclear family (-vudine, nucleoside)
    • NRTILMNOP (NRTI, alphabet soup of these things, Lactic acidosis, Marrow suppression, Neuropathy...Oh--Peripheral)
  50. tenofovir
    • TDF
    • NRTI
    • nucleotidedoes not need phosphorylation to inhibit reverse transcriptase. HIV
    • bone marrow suppression (give G-CSF and EPO), peripheral neuropathy, NO lactic acidosis
    • faux pho (FOscarnet, cidoFOvir, tenoFOvir [NRTI nucleotide, not -side], phosphate+something analog)
  51. zidovudine
    • ZDV (formerly AZT)
    • NRTI
    • nucleoside lacking 3'OH phosphoryalted to nucleotide inhibits reverse transcriptase. HIV prevention and during pregnancy to reduce fetal transmission and therapy 2 NRTIs plus 1 integrase inhibitor
    • anemia, bone marrow suppression (give G-CSF and EPO), peripheral neuropathy, lactic acidosis
    • haVE YOU DINEd with my nuclear family (-vudine, nucleoside)
    • NRTILMNOP (NRTI, alphabet soup of these things, Lactic acidosis, Marrow suppression, Neuropathy...Oh--Peripheral)
  52. delaviridine
    • NNRTI
    • inhibit reverse transcriptase
    • not a nucleotide analog
    • rash, hepatotoxicity, contrainidicated in pregnancy (navirapine is not)
    • never delay e favir to your non-nuclear family (nevirapine, delaviridine, efavirenz, NNRTI)
  53. efavirenz
    • NNRTI
    • inhibit reverse transcriptase
    • not a nucleotide analog
    • rash, hepatotoxicity, vivid dreams, CNS symptoms, contrainidcated in pregnancy (navirapine is not)
    • never delay e favir to your non-nuclear family (nevirapine, delaviridine, efavirenz, NNRTI)
  54. nevirapine
    • NNRTI
    • inhibit reverse transcriptase
    • not a nucleotide analog
    • rash, hepatotoxicity, NOT contraindicated in pregnancy
    • never delay e favir to your non-nuclear family (nevirapine, delaviridine, efavirenz, NNRTI)
  55. protease inhibitors
    • atazanavir, darunavir, fosamprenavir, indinavir, lopinavir, ritonavir, saquinavir
    • stop protyolytic processing by HIV-1 protease (pol gene) to reduce functional proteins
    • hyperglycemia, GI intolerance (nausea, diarrhea), Cushing-like lipodystrophy
    • never tease indie kids about being fat and eating sugar because it hurts to the core (-navirs, protease, nephropathy/hematuria with indinavir, hyperglycemia, lipodystrophy, Gi intolerance)
  56. atazanavir (class/special?)
    protease inhibitor
  57. darunavir (class/special?)
    protease inhibitor
  58. fosamprenavir (class/special?)
    protease inhibitor
  59. indinavir (class/special?)
    • protease inhibitor
    • nephropathy with hematuria
    • never tease indie kids about being fat and eating sugar because it hurts to the core (-navirs, protease, nephropathy/hematuria with indinavir, hyperglycemia, lipodystrophy, Gi intolerance)
  60. lopinavir (class/special?)
    protease inhibitor
  61. ritonavir (class/special?)
    • protease inhibitor
    • P-450 inhibitor
    • tones down P-450 (riTONavir, P-450 inhibitor)
  62. saquinavir (class/special?)
    protease inhibitor
  63. integrase ihibitors
    • raltegravir, elvitegravir, dolutegravir
    • inhibit HIV integrase to prevent integration of genome into chromosome
    • increase creatine kinase (muscle inflammation indicator)
    • -tegra = inTEGRAse
  64. raltegravir (class)
    integrase inhibitor
  65. dolutegravir (class)
    integrase inhibitor
  66. elvitegravir (class)
    integrase inhibitor
  67. enfuviritide
    • bind gp41 on HIV preventing entry
    • skin reaction at injection site
    • stop FURTIVE ENtry (stop entry, injection site rash[not furtive that's for sure], enfuviritide)
  68. maraviroc
    • bind CCR-5 on T cell inhibiting gp120 interaction to prevent binding (and thereby entry) of HIV
    • bounce off like a mirror (no binding, maravoc)
  69. interferon alpha
    • used in chronic hep B and C, kaposi sarcoma, hairy cell leukemia, condyloma acuminatum, renal cell carcinoma, malignant melanoma
    • flu-like, depression, neutropenia, myopathy
    • pass interference makes me sick and depressed and it's always little white skinny guys (interferons, flu-like, depression, neutropenia, myopathy)
  70. infterferon beta
    • multiple sclerosis (interesting because totally unrelated to systemic sclerosis [scleroderma], which is caused by INF beta
    • flu-like, depression, neutropenia, myopathy
    • pass interference makes me sick and depressed and it's always little white skinny guys (interferons, flu-like, depression, neutropenia, myopathy)
  71. interferon gamma
    • chronic granulomatous disease (immune deficient NADPH->risk catalase+ infections)
    • chronic grammalomatous disease
    • flu-like, depression, neutropenia, myopathy
    • pass interference makes me sick and depressed and it's always little white skinny guys (interferons, flu-like, depression, neutropenia, myopathy)
  72. ribavirin
    • competitive inhibition of inosine monophosphate dehydrogenase reduces guanine synthesis. Chronic HCV and RSV (plavizumab preferred in children)
    • hemolyitic anemia and severe teratogen
    • ripAvirin (ribavirin, hemolytic anemia, amnion)
  73. plavizumab
    monoclonal antibody against RSV F protein. RSV prophylaxis in children
  74. sofosbuvir
    • inhibits RNA-depenent RNA polymerase (chain termination). HCV used with ribavirin (never monotherapy) +/-peginterferon alfa
    • fatigue, headache, nausea
  75. simeprevir
    • HCV protease inhibitor. Chronic HCV with ledipasvir (never monotherapy)
    • photosensitivity, rash
    • ladies C (see) me with a sun rash (ledipasvir, hep C/simeprevir, photosensitivity, rash)
  76. ledipasvir
    • inhibits NS5A of HCV (possible transcription factor). Used in chronic HCV with simeprevir
    • ladies C (see) me with a sun rash (ledipasvir, hep C/simeprevir, photosensitivity, rash [side effects are due to simeprevir so they follow see me])
Author
countchocula58
ID
318287
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The Pharm of Old McDonald 2
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