PHARMACOLOGY REVIEW. No antiviral drugs Know both mechanisms and clinical uses Good Review Sources: First Aid, Hi-Yield Pharm, Katzung Review (drug list for Boards) Good texts: Lippincott’s, Big Katzung, Co-ops. PHARMACOKINETICS. KEY EQUATIONS.
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Know both mechanisms and clinical uses
Good Review Sources: First Aid, Hi-Yield Pharm, Katzung Review (drug list for Boards)
Good texts: Lippincott’s, Big Katzung, Co-ops
VD = dose/concentration @ time 0 = Dose x F / AUC
Clearance = KE x VD = 0.7 x VD/T1/2
Clearance ratio = CL (drug)/CL (creatinine)
Css = Q/CL Loading dose = Css x VD
Ct = Css (1 – e–Ket) Dosing rate Q = CL x Css
COMMON MECHANISM: Cell Wall (PBP)
RESISTANCE: Lactamase, PBP
USES: Varies by class (next few slides)
TOXICITY: Allergic reactions (give Epi)
INTERACTS: Probenecid & Aminoglycoside (pen)
Memorize only if you have time
KETOCONAZOLE: Broad Spectrum, Gynecomastia, Inhib w/ Ca, gastric pH; p450)
ITRACONAZOLE: Broad spectrum (blasto, aspergillus), no gynecomastia, Inhib w/ Ca & gastric pH
FLUCONAZOLE: Enters CSF, no gynecomastia, Inhib w/ Ca , but NOT gastric pH
(Keto is an imidazole; itra & flu are triazoles)
H-2 Blockers, antacids increase gastric pHANTIFUNGAL: AZOLES
FLUCYTOSINE: Cryptocox & Candida, CSF. Liver, heme tox, Use with amphotericin.
GRISEOFULVIN: Inhibits MT polymerization to block mitosis. Binds tightly to diseased keratin. Dermatophytes. Minimal toxicity.
Malaria: Travel hx, shivering, headache, fever x 2-3 days
Ameoba: Dysentery w. eosinophilia
Onchocercosis: River blindness. Scaly skin & eye lesions
Giardia: Camping. Abd pain, wt loss, diarrhea
Show the last page of Dr. Le Breton’s handoutfor cancer drug mechanisms