Karch Pharmacology Chapters 8-14 Prototypes

Anti-Infectives: Culture & Sensitivity

Culture identifies the specific invading organism; sensitivity helps determine which drug is effective.

Anti-Infectives: Superinfection

Overgrowth of resistant pathogens such as bacteria, fungi, or yeast during anti-infective therapy.

Aminoglycosides (Gentamicin)

Bactericidal inhibitor of bacterial ribosomes; major toxicities include nephrotoxicity and ototoxicity.

Carbapenems (Imipenem-cilastatin)

Broad-spectrum bactericidal cell-wall inhibitor associated with renal monitoring and seizure risk.

Cephalosporins (Cefazolin)

Cell-wall synthesis inhibitor; major risks include pseudomembranous colitis (C. diff) and penicillin cross-allergy.

Fluoroquinolones (Ciprofloxacin)

Interferes with DNA enzymes; high-yield risks include tendinitis/tendon rupture, QT prolongation, and impaired mineral absorption.

Penicillins (Penicillin G)

Bactericidal cell-wall constructor; major clinical safety concern is hypersensitivity and anaphylaxis.

Sulfonamides (Trimethoprim-sulfamethoxazole)

Bacteriostatic folic-acid synthesis blocker associated with photosensitivity and kidney effects.

Tetracyclines (Doxycycline)

Protein synthesis inhibitor contraindicated in pregnancy, lactation, and children under 8 years.

Antimycobacterials (Isoniazid)

Used for tuberculosis; first-line memory mnemonic RIPE stands for rifampin, isoniazid, pyrazinamide, ethambutol.

Influenza Antivirals (Oseltamivir)

Inhibits viral neuraminidase; antiviral therapy works best when started as soon as possible after diagnosis.

Anti-herpes Agents (Acyclovir)

Interferes with viral DNA replication; most effective when started early in infection.

NRTIs (Zidovudine)

Nucleoside analogs used in HIV treatment that interfere with the building blocks needed for viral DNA.

Protease Inhibitors (Atazanavir)

Blocks HIV protease to prevent viral maturation; associated with hyperglycemia, hyperlipidemia, and liver effects.

Entry/Fusion Inhibitors (Enfuvirtide)

Interferes with HIV binding/fusion; high-yield indicator is injection-site pain and reactions.

Integrase Strand Transfer Inhibitors (Raltegravir)

Inhibits HIV integrase, an enzyme required for viral replication.

Anti-Hepatitis B Agents (Entecavir)

Inhibits HBV reverse transcriptase; antivirals can affect both liver and kidney status.

Locally Active Antivirals (Acyclovir topical)

Used for local viral infections without significant systemic absorption.

Azole Antifungals (Fluconazole)

Binds to fungal sterols; high-yield for liver toxicity and numerous drug interactions.

Echinocandins (Caspofungin)

Inhibits glucan synthesis leading to fungal cell-wall death; administered via IV.

Systemic Antifungals (Amphotericin B)

Damages fungal cell membranes; major high-yield concern is severe nephrotoxicity.

Topical Antifungals (Nystatin)

Alters fungal cell-membrane permeability and is strongly associated with treating Candida infections.

Antimalarials (Chloroquine)

First-line antimalarial requiring regular vision monitoring and cardiac/QT assessment.

Other Antiprotozoals (Metronidazole)

Inhibits protozoal DNA synthesis (used for amoebas, trichomonas, Giardia); patients must avoid alcohol.

Anthelmintics: Albendazole

Blocks tubule formation to treat tapeworm lesions and cystic disease with bone marrow/renal cautions.

Anthelmintics: Ivermectin

Blocks calcium channels causing paralysis; used for strongyloidiasis and river blindness.

Anthelmintics: Mebendazole

Interferes with glucose use; used primarily for common intestinal roundworms, pinworms, and hookworms.

Anthelmintics: Praziquantel

Increases membrane permeability against schistosomes and flukes; specific chapter dosage question is 3 doses in 1 day.

Anthelmintics: Pyrantel

Neuromuscular polarizing agent causing paralysis; used for pinworms and roundworms.

Alkylating Agents (Cyclophosphamide)

Non-cell-cycle-specific agents causing DNA damage and significant myelosuppression.

Antimetabolites (Methotrexate)

Interferes with metabolites needed for DNA production, producing bone marrow, GI, and organ toxicities.

Antineoplastic Antibiotics (Doxorubicin)

Disrupts DNA links; high-yield side effects include cardiotoxicity and characteristic red/orange urine.

Mitotic Inhibitors (Paclitaxel)

Interferes with cell division (mitosis); causes bone marrow suppression and nerve injury.

Hormone Modulators (Tamoxifen)

Blocks hormone stimulation at receptor sites in hormone-sensitive cancers such as breast cancer.

Protein Tyrosine Kinase Inhibitors (Imatinib)

Targeted therapy acting on specific enzymes needed for protein building in tumor cells.

Proteasome Inhibitors (Bortezomib)

Blocks proteasome-related processes in tumor cells; requires monitoring for QT prolongation and GI effects.