CHEMOTHERAPY MNEMONICS AND IMPORTANT STUFF TO REMEMBER
THIS INCLUDES :
CHAPTER 1 = CELL WALL SYNTHESIS INHIBITORS AND BETA LACTAM DRUGS
CHAPTER 2=PROTEIN SYNTHESIS INHIBITORS
CHAPTER 3= AMINOGLYCOSIDES
CHAPTER 4 =SULFONAMIDES, TRIMETHOPRIM AND FLOUROQUINOLONES
CHAPTER 5 =ANTIMYOBACTERIAL
CHAPTER 6 =ANTIFUNGAL AGENTS
CHAP 7 = ANTI VIRALS
CHAPTER 8= MISCELLANEOUS ANTIMICROBIALS AND URINARY ANTISEPTICS
CHAPTER 1 = CELL WALL SYNTHESIS INHIBITORS AND
BETA LACTAM DRUGS
PENICILLINS
.VERY NARROW SPECTRUM (MNO)
Methicillin
Nafcillin
Oxacillin
.WIDER SPECTRUM (PAAT)
PIPERACILIN
AMOXICILLIN
AMPICILLIN
TICARACILLIN
.MOST ARE GIVEN ORALLY EXCEPT
PENCILLIN G( syphilis.n form of benzathine penicline ...i/m)
Ampicillin
Piperacillin
Ticarcillin
.Excretion (N.B AEiOU)
NAFCILLIN ...... BILE
AMPICILLIN.... ENTEROHEPATIC RECYCLING
OTHERS....URINE ( DEC BY PROBENECID)
.MOA (PAT)
BIND PBPS
ACTIVATE AUTOLYTIC ENZYMES
TRANSPEPTIDATION INHIBITED
.AMPICILLIN and AMOXICILLIN SPECTRUM
(HEELPSS)
H.INFLUENZA ENTEROCOCCI
E.COLI
LISTERIA MONOCYTOGENES
PROTEUS MIRABLIS
SALMONELLA
SHIGELLA
.JARISCH HERXEIMER REACTION OCCURS IF THERE IS TOXICITY OF PENCILLIN G IN T/M OF SYPHILLIS
CEPHALOSPORINS IMPORTANT STUFF
ENTRY INTO CNS
1ST ...NOT ENTER
2ND ....NOT ENTER EXCEPT CEFUROXIME
3RD... MOST ENTER EXCEPT CEFOPERAZONE ....therefore used to treat meningitis
4TH...ENTER CNS
COVERAGE
1ST... GRAM + AND PEcK
2nd.....GRAM -VE AND HEN PEcK
3rd...serious gram-ve (including gonnorhea sepsis and meningitis)
4th.... gram +ve (like 1st) and gram -ve (like 3rd) but broader spectrum
HEN = H.influenza, Enterobacter, nisseria
PEcK= PROTEUS MIRABLIS, E COLI, KLEBSIELLA PNEUMONIAE
.ALL ARE EXCRETED BY KIDNEYS EXCEPT
CEFOPERAZONE CEFTRIAXONE
(both exc via bile)
.LAME BACTERIA NOT TREATED BY CEPHALOSPORINS
LISTERIA
ATYPICALS (MYCOPLASMA AND CHLAMYDIA ETC.)
MRSA (but treated by cetraoline)**
Enterococci
.Least toxic...Cephalozin
OTHER CELL WALL SYNTHESIS INHIBITORS
.MD
MYOPATHY CAUSED BY DAPTOMYCIN SO CPK LEVELS MUST BE MONITORED
.REDMAN SYNDROME ASSOCIATED WITH VANCOMYCIN IF GIVEN RAPIDLY INTRAVENOUSLY
.AZTREONAM HAVE NO CROSS ALLERGINICITY WOTH PENCILLINS SO, Can be given to ppl allergic to pencillin
.Imipenem is always given with cilastatin (an inhibitor of renal dehydropeptidase I) to decrease inactivation of the drug in the renal tubules
.Van k behry driver ny bukhaar mey aik red man k gurdey mey takkar maari
*adverse effects of Vancomycin* Van→Vancomycin
Behray→Ototoxicity
Bukhar→Fever
Red Man→Red man syndrome due to histamine release
Gurdey→Nephrotoxicity
CHAPTER 2=PROTEIN SYNTHESIS INHIBITORS
.NAMES:
(CT-TCS-ML)
CHLORAMPHENICIL
TETRACYCLINES
TELITHROMYCIN
CLINDAMYCIN
STREPTOGRAMINS
MACROLIDES
LINEZOLID
.ALL ACT ON 50 S RIBOSOME EXCEPT TETRACYCLINES (30S)
.CHLORAMPHENICOL TOXICITY CAUSES GRAY BABY SYNDROME THAT OCCURS DUE TO BONE MARROW SUPRESSION
.DOXYCYCLINE ELIMINATED VIA FEACES
.TIGECYCLINE ELIMINATED VIA BILE
OTHER TETRACYCLINES VIA URINE
.Teteracyclines toxocity (RVP-BEL)
RENAL TOXICITY
VESTIBULAR TOXICITY
PHOTOSENSTIVITY
BONY STR AND TEETH
ENTERIC SYS (GI DISTURBANCES)
LIVER TOXICITY
CHAPTER 3= AMINOGLYCOSIDES
-NOT GIVEN ORALLY BECAUSE:
LESS ORAL BIOAVAILABILITY
CAUSE IBS
-GIVEN IN SINGLE LARGE DOSE BECAUSE:
LESS TOXIC THAN MULTIPLE SMALL DOSES
NO NEED TO MONITOR LEVELS (very imp)
-MOA (TIMP) binds 30s INHIBIT TRANSLOCATION
BLOCK INITIATION COMPLEX FORMATION
MISREADING OF MRNA
DISRUPT POLYSOMAL STRUCTURE
ToXICITY (SONN)
SKIN REACTIONS
OTOTOXICITY
NEPHROTOXICITY
NEUROMUSCULAR BLOCKADE
CONTRAINDICATED (RMP)
RENAL INSUFFICIENCY
MYASTHENIA GRAVIS
PREGNANCY
DRUG INTERACTIONS
B-Lactams=potentiation
Curare=prolonged effect
Bacteriostatic=less efficacy
Nephro and oto toxic drugs= increased toxicity
USES TC TOBRA TO TREAT CYSTIC FIBROSIS
NO NEOMYCIN TO TREAT INFECTIONS NOT TREATED BY OTHER AMINOGLYCOSIDES
SPECTINOMYCIN BACK UP DRUG TO TREAT GONNORHEA IN PTS ALLERGIC TO BETA LACTAMS (Ceftriaxone and cefixime)
CHAPTER 4 =SULFONAMIDES, TRIMETHOPRIM AND FLOUROQUINOLONES
MOA
SLOFONAMIDES (has S)
Inhibit dihydropteroate Synthetase
Trimethoprim (Has R)
Inhibit DHFR
USES OF SULFONAMIDES (RONU-BUT)
RHEUMATOID ARTHRITIS
OCULAR INFECTIONS
GRAM NEGATIVE ORGANISMS
ULCERATIVE COLLITIS
BURNS (Silver Sulfadiazine)
UTIs
Toxoplasmosis
.Sulfonamides Always given in tripple sulfa form as it may ppt in acidic urine leading to crystalluria and hematuria
(S=stones)
.TMP-SMZ Is drug of choice for Nocardiosis
.TOXICITY
SULFONAMIDES=APLASTIC ANEMIA
TRIMETHOPRIM=MEGALOBLASTIC ANEMIA
Classification OF FLOUROQUINOLONES
1st...UTIs
2nd... GRAM -VE (MORE) AND G +VE
3RD....GRAM +VE (MORE) AND G -VE
4TH...GEMI AND MOXIFLOXACIN... BROADEST SPECTRUM
USES (RUGSS)
RTIs
UTIs
GIT infections
Skin infections
Soft tissue infections
CONTRAINDICATED(CP) Children pregnancy
Ppl with prolonged QTc interval
Ppl on drugs that prolong QTc interval
CHAPTER 5 =ANTIMYOBACTERIAL DRUGS
CHEMOTHERAPY COMPLIACTED BY
-LESS KNOWLEDGE
-RESISTANCE DEVELOPMENT
-LONG TREATMENT
-PATIENT COMPLIANCE
-INTRACELLULAR POSITION OF MYOBACTERIUM
.Tuberculosis: treatment If you forget your TBdrugs, you'll die and might need a PRIEST":
Pyrazinamide
Rifampin
Isoniazid (INH)
Ethambutol
STreptomycin
ISONIAZID RESISTANCE
-DELETION OF KAT-G GENE THAT PRODUCES CATALASE PEROXIDASE REQUIRED TO ACTIVATE IDONIAZID PRODRIG FORM
ISONIAZID CAUSES SLE IN FAST ACETYLATORS
AND FAST ACETYLATORS (T 1/2=60-90MIN) REQUIRE MORE DOSE THAN SLOW ACETYLATORS (T 1/2 = 3-4H)
TOXICITY OF RIFAMPIN
R=RASHES
I=IMPAIR ANTIBODY RESPONSES
F=FLU LIKE SYNDROME
A=ANEMIA
M= -
P=PROTEINURIA (LIGHT CHAIN)
I=INDUCE LIVER ENZ MET AND LEAD TO LIVER DYSFUNCTION
N=NEPHRITIS
.RIFAMIXIN TREATS TRAVELLER'S DIARRHEA
.ORANGE COLOURED PIGMENTS IN FEACES WITH RIFAMPIN USE
.PYRAZINAMIDE CONTRAINDICATED IN P=pregnancy
.Capreomycin (hearing loss)
Cycloserine (neurotoxic)
.DRUGS FOR LEPROSY (CARD)
Clofazimine
Acedapsone
Rifampin
Dapsone
CHAPTER 6 =ANTIFUNGAL
AGENTS
.AMPHOTERICIN-B DRUG OF CHOICE
(ACC-HMS)
ASPERGILLUS
CANDIDA
CRYPTOCOCCUS
HISTOPLASMA
MUCOR
SPOROTHRIX
.AMPHOTERICIN B IS NORMALLY GIVEN I/V BUT IN FUNGAL MENINGITIS IT IS GIVEN INTRA THECALLY (S/E INCLUDE SEIZURES AND NEUROLOGIC DAMAGE)
.FLUCYTOSINE IS GIVEN ALONG WITH AMPHOTERICIN-B TO TREAT CANDIDIASIS AND CRYPTOCOCCAL INFECTIONS (CC)
.FLUCYTOSINE SIDE EFFECTS (LAB) LIVER DYSFUNCTION
ALOPECIA
BONE MARROW SUPPRESSION
.THe oral BIOAVAILABILITY OF AZOLES IS
INCREASED BY GASTRIC ACIDITY AND FOOD
DECREASED BY ANTACIDS
.FLUCONAZOLE IS THE ONLY AZOLE THAT CAN PENETRATE CNS .. IT ENTERS CSF AND TREATS MENINGEAL INFECTIONS
.V FOR VORICONAZOLE.....SO IT CAUSES VISUAL DISTURBANCES
.HALF LIVES OF EICOSANOIDS
REMEMBER AMC
ANIDULA>MICA>CASPOFUNGIN
.PULSE DOSING WITH ITRACONAZOLE BECAUSE:
-LESS SIDE EFFECTS(NO PERSISTANCE IN NAILS)
-CHEAPER
.DRUGS FOR SUPERFICIAL FUNGAL INFECTIONS (NMC)
NYSTATIN
MICONAZOLE
CLOTRIMAZOLE
CHAP 7 = ANTI VIRALS
.Anti herpes
ABCD
ACYCLOVIR
BOTH FORMS (ORAL AND I/V)
CAUSE CHAIN TERMINATION
INHIBIT DNA POLYMERASE
.DOCOSANOL BLOCKS THE DOOR
INHIBITS FUSION B/W HSV ENVELOP AND HOST CELL MEMBRANE , PREVENTING VIRAL ENTRY AND REPLICATION
.Gancyclovir is used to treat CMV infections
Ocular implant in CMV RETINITIS
.ACYCLOVIR AND GANCYCLOVIR REQUIRES THYMIDINE KINASE FOR ACTIVITY BUT CIDOFOVIR DOESN'T
SO ACTIVE AGAINST TK- STRAINS
.Anti hiv
HAART THERAPY USES (RIC)
VIRAL RNA DECREASED
OPPORTUNISTIC INFECTIONS DECREASED
REVERSAL/SLOWING OF CD4 CELLS DECLINE
.Major s/e
Zidovudine ..... hematotoxicity
Ddi....pancreatitis
Ddc...peripheral neuropathy
Stavudine...peripheral neuropathy
Lamivudine...LEAST toxic
.Ritonavir paves the road to allow low dose usage of other PIs as it inhibits CYP3A mediated metabolism of other PIs
Brrrrr
Bitter taste with retonavir
.Effect of PIs on metabolism ... syndrome includes
-hyperglycemia and insulin resistance
-hyperlipidemia and altered fat dist (buffalo hump) truncal obesity
Gynaecomastia
Facial n trunca lipodystrophy
[Remember inc fat n cho generally]
.Drugs in hepatitis
Hep B is suppressive (BERATE)
HEP C IS ERADICATIVE (COMPLETE)
INTERFERONS PRESENT FOR
-HEP B C D (Antiviral)
-Kaposis sarcoma , CML , multiple myeloma , renal carcinoma ( antitumor) .Multiple sclerosis (immuno regulatory)
CHAPTER 8= MISCELLANEOUS ANTIMICROBIALS
AND URINARY ANTISEPTICS
.TOXIC EFFECTS OF MTERO AND TINIDAZOLE (Hard Game of LUDO)
HEADACHE
GI IRRITATION
LEUKOPENIA
URINE (DARK COLORED)
DIZZINESS AND ATAXIA
OPPORTUNISTIC FUNGAL INFECTIONS
.URINARY ANTISEPTICS (NMN)
NNITROFURANTOIN
METHENAMINE
NALIDIXIC ACID
NITROFURANTOIN SOMETIMES ANTAGONIZE NALIDOXIC ACID
JAZZAKALLAH UL KHAIR :) DO REMEMBER ME IN YOUR PRAYERS REGARDS AHMAD HASSAN (BATCH 39 RMC) RIFAO