-
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)
-
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)
-
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
-
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)
-
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)
-
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)
-
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)
-
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)
-
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)
-
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)
-
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)
-
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)
-
anidulafungin (class)
- echinocandin
- GI upset, flushing
- Asian echidna had too much fun and got sick (flushing, echinocandins, -fungin, GI upset)
-
caspofungin (class)
- echinocandin
- GI upset, flushing
- Asian echidna had too much fun and got sick (flushing, echinocandins, -fungin, GI upset)
-
micafungin (class)
- echinocandin
- GI upset, flushing
- Asian echidna had too much fun and got sick (flushing, echinocandins, -fungin, GI upset)
-
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)
-
pyrimethamine (class/special?)
antiprotozoan for toxoplasmosis
-
suramin (class/special?)
antiprotozoan for trypanosoma brucei
-
melarsoprol (class/special?)
antiprotozoan for trypanosoma brucei
-
nifurtimox (class/special?)
antiprotozoan for trypanosoma cruzi (chagas)
-
sodium stibogluconate (class/special?)
antiprotozoan for leishmaniasis
-
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)
-
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)
-
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)
-
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)
-
artemether (class/special?)
used with lumefantrine for P falciparum
-
lumefantrine (class/special?)
used with artemether for P falcipartum
-
atovaquone (class/special?)
used with proguanil for P falciparum
-
proguanil (class/special?)
used with atovaquone for P falciparum
-
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)
-
artesunate (class/special?)
life-threatening malaria
-
mebendazole (class/special?)
inhibits microtubules. Antihelminthic
-
pyrantel pamoate (class)
antihelminthic
-
ivermectin (class)
antihelminthic
-
diethylcarbamazine (class)
antihelminthic
-
praziquantel (class)
antihelminthic
-
oseltamivir
- inhibit neuraminidase so virus can't leave. Treatment and prevention for influenza A and B
- adios AMIgo (can't leave oseltAMIvir, zanAMIvir)
-
zanamivir
- inhibit neuraminidase so virus can't leave. Treatment and prevention for influenza A and B
- adios AMIgo (can't leave oseltAMIvir, zanAMIvir)
-
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)
-
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)
-
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)
-
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)
-
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)
-
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)
-
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)
-
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)
-
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)
-
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)
-
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)
-
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)
-
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)
-
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)
-
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)
-
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)
-
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)
-
atazanavir (class/special?)
protease inhibitor
-
darunavir (class/special?)
protease inhibitor
-
fosamprenavir (class/special?)
protease inhibitor
-
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)
-
lopinavir (class/special?)
protease inhibitor
-
ritonavir (class/special?)
- protease inhibitor
- P-450 inhibitor
- tones down P-450 (riTONavir, P-450 inhibitor)
-
saquinavir (class/special?)
protease inhibitor
-
integrase ihibitors
- raltegravir, elvitegravir, dolutegravir
- inhibit HIV integrase to prevent integration of genome into chromosome
- increase creatine kinase (muscle inflammation indicator)
- -tegra = inTEGRAse
-
raltegravir (class)
integrase inhibitor
-
dolutegravir (class)
integrase inhibitor
-
elvitegravir (class)
integrase inhibitor
-
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)
-
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)
-
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)
-
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)
-
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)
-
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)
-
plavizumab
monoclonal antibody against RSV F protein. RSV prophylaxis in children
-
sofosbuvir
- inhibits RNA-depenent RNA polymerase (chain termination). HCV used with ribavirin (never monotherapy) +/-peginterferon alfa
- fatigue, headache, nausea
-
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)
-
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])
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