Shared Flashcard Set

Details

integ. drugs
drugs for test 1
35
Other
Professional
03/23/2011

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Term
bacitracin
Definition
Topical, Inhibits cell wall synthesis (peptidoglycan)
Term
Chloramphenicol
Definition
Topical, 50S inhibitor
Term
Gentamycin
Definition
Topical, aminoglycoside, 30S inhibitor
Term
Metronidazole
Definition
Topical, produces reactive intermediate that damages DNA and other sensitive molecules
Term
Mupirocin
Definition
Topical, Binds & inhibits tRNA-synthetase for leucine
Term
Neomycin
Definition
Topical, aminoglycoside, 30S inhibitor
Term
Polymixin B
Definition
Topical, Cationic detergent, interacts as surfactant with negatively charged membrane phospholipids
Term
Povidone
Definition
Topical, Iodine (Betadyne ointment) – topical antiseptic / antibacterial
Term
Mafenide
Definition
Topical, – α-amino-p-toluene-sulfonamide; acts on large variety of Gneg and Gpos bacteria (commonly used in therapy of burns)
Term
Silver Sulfadiazine (Silvadene cream)
Definition
Topical, both silver and sulfa component are active against bacteria and fungi (often used in therapy of burns)
Term
Griseofulvin (general info)
Definition
Anti-fungal, Prevents mitosis by interfering with microtubule system,
NOT USED SYSTEMICALLY
Issues with dosing, efficacy, adverse effects, and drug interactions have made this drug rarely used anymore.
Term
Terbinafine
Definition
Anti-fungal, Inhibits conversion of squalene to lanosterol by squalene epoxidase
Topical or PO, 99% protein bound but losses 40% from first-pass metabolism
Hepatotoxicity is a major concern
Rifampin decreases plasma concentration via effect on P450
Cimetidine increases plasma concentration via effect on P450
Term
Azole drugs
Definition
This class can inhibit gonadal and thyroid steroid synthesis in humans (testosterone, cortisol) Triazoles do this less than imidazoles
Fluconazole and itraconazole used most often in derm
Inhibit conversion of lanosterol to ergosterol
Voriconazole and Posaconazole- used less, have stronger and broader activity
Azoles inhibit P450, (Posaconazole is an exception, no inhibiton)
Adverse effects: Hepatotoxicity, QT prolongation (ketoconazole,Voriconazole, & Itraconazole), visual disturbances, NO USE IN PREGNANCY
Term
Azole drugs
Definition
This class can inhibit gonadal and thyroid steroid synthesis in humans (testosterone, cortisol) Triazoles do this less than imidazoles
Fluconazole and itraconazole used most often in derm
Inhibit conversion of lanosterol to ergosterol
Voriconazole and Posaconazole- used less, have stronger and broader activity
Azoles inhibit P450, (Posaconazole is an exception, no inhibiton)
Adverse effects: Hepatotoxicity, QT prolongation (ketoconazole,Voriconazole, & Itraconazole), visual disturbances, NO USE IN PREGNANCY
Term
2nd generation H1 antagonist
Definition
Loratadine (Claritin), Cetirizine (Zyrtec), Desloratadine (clarinex), Fexofenadine (Allegra)
Do not penetrate CNS, non-sedating, metabolized by CYP3A4 & 2D6
Interacts with: imidazole, antifungals, & macrolide antibiotics
Term
H2 antagonists
Definition
Cimetidine (Tagamet), Ranitidine (Zantac), Famotidine (Pepcid), Nizatidine (Axid)
Cimetidine has many interactions
Possible immunomodulating properties
Term
Leukotriene Receptor Antagonists
Definition
MOA: block the cyc-LT1 receptor to reduce inflammation and itching (also asthma)
Zafirlukast (Accolate), Montelukast (singulair)
Term
Corticosteroids
Definition
Prednisone, Methylprednisolone (Medrol)
Doses should be tapered not stopped abruptly
Term
Doxepin
Definition
Tricyclic antidepressant with potent H1 and H2 histamine blockade
Used in chronic urticaria
Has anticholinergic effects and can cause dry mouth and constipation
Term
Epinephrine
Definition
Angioedema with signs of facial or respiratory involvement, Anaphylaxis
.2ml to 1ml SC or IM
Term
Tetracycline, Minocycline, Doxycycline
Definition
PO, 30S inhibitors
Term
Erythromycin, Clarithromycin (Macrolides)
Definition
PO, 50S inhibitors
Term
Clindamycin (a lincosamide)
Definition
PO, 50S inhibitor and its more active than tetracyclines -50S inhibitor
Term
Penicillin
Definition
Inhibits synthesis of cell wall
Term
Ampicillin, Amoxacillin, Cephalosporins
Definition
PO, Cell wall inhibition
Term
Ciprofloxacin (a quinolone)
Definition
PO, Inhibits topoisomerases to interrupt DNA functions
Term
Sulfamethoxazole, trimethoprim (Bactrim)
Definition
PO, Antifolate
Term
Metronidazole
Definition
PO, Reactive intermediate that damages DNA/ enzymes
Term
Griseofulvin (Onychomycosis treatment)
Grifulvin & Gris-peg
Definition
First oral agent approved for onychomycosis,
Adverse drug reactions and low cure rate
Grifulvin-microsized, need to take with fatty meal for absorption
Gris-peg- ultramicrosize, increased absorption
Dose- Onychomycosis 500mg QD or BID 6-18 months, Tinea Pedis 500 mg QD 6-12 weeks, Tinea capitis 330 mg QD 4-6 weeks, Tinea Cruris/Manuum 500 QD 2-4 weeks
Check ALT, AST, and CBC and repeat at 6 weeks
ADR's- skin rash, GI, photosensitivity, & TEN
DI's- Salicylates, anticoags, Oral contraceptives, & cyclosporin, also can cross react w/ penicillin,
Phenobarbitol decreases serum concentration
Term
Ketoconazole (Nizoral)
Definition
Not effective for onychomycosis & has DI's and hepatotoxicity, Shampoo form works for treating tinea capitice,
Term
Fluconazole (Diflucan)
Definition
Inhibits lanosterol conversion to ergosterol
Good nailbed penetration, can be detected up to 6 months after D/C, But it lacks indication
Dose: Onychomyosis 150mg Q week for 3-12 months w/ re-evaluation at 3 months, Tinea Pedis 150 mg Q week for a month, 50 mg QD 4-6 weeks, Tinea Cruris 150 mg Q week 2-4 weeks, Tinea Veriscolor 300 mg once
Monitor AST, ALT, CBC monthly
Decreased effects of oral contraceptives, increased effects of warfarin, cyclosporine, theophylline, phenytoin, sulfonylureas
Term
Itraconazole (sporanox)
Definition
FDA approved for Onychomycosis, better for candida infections
good abosption by the nail bed, detectable for 6 months after D/C
Dose: Toenails 200 mg QD for 12 weeks, Fingernails 200 mg BID for 7 days with 3 weeks seperation for 2 months, Tinea Capitis 100 mg QD for 4-6 weeks, Tinea Cruris 100 mg QD 2 weeks, Tinea Manuum 200mg QD 7 days, Tinea Veriscolor 200 mg QD 5 days
Monitor AST, ALT, and CBC, Lots of DI's
ADR's- headaches, dizziness, GI, rash
Hepatotoxicity and Black box warning for CHF
Doesn't absorb well with H2 and PPI inhibitors and antacids, but carbination improves absorption
Expensive drug
Term
Terbinafine (lamisil)
Definition
Most effective drug choice,pregnancy category B
Dose: Fingernails 250 QD for 6 weeks, Toenails 250 QD for 12 weeks, Tinea Pedis 250 mg QD for 2 weeks, Tinea capitis 250 mg QD for 4-6 weeks, Tinea Cruris/Manuum 250 mg QD for 2-4 weeks
Monitor AST, ALT, & CBC levels
ADR's GI, rash, taste disturbance, & hepatotoxicity
DI's: tri-cyclic antidepressants, vinlafaxine, cyclosporin
Term
Clotriamazole and Betamethasone
Definition
Topical steroid, antifungal combonation for Tinea Cruris
Term
Nystatin and Triamcinolone
Definition
Topical steroid, antifungal combonation for Tinea Cruris
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