Antitubercular, Antifungal, and Non-HIV Antiviral Pharmacology

Comprehensive vocabulary flashcards covering antitubercular therapies, antifungal drug classes, and non-HIV antiviral medications based on the lecture notes.

Mycobacterium tuberculosis

An acid-fast bacillus transmitted via airborne droplets released through coughing, sneezing, and speaking that causes tuberculosis primarily in the lungs.

Latent tuberculosis infection

A condition in which a person harbors Mycobacterium tuberculosis without showing symptoms of active disease; the individual cannot infect others but remains at risk of developing active TB later in life.

Active tuberculosis symptoms

Clinical manifestations of active TB infection, which include anorexia, cough with blood-tinged sputum, chest pain, fever, night sweats, weight loss, and positive acid-fast bacilli in the sputum.

Direct Observation Therapy (DOT)

A patient-management strategy used in antitubercular therapy where a healthcare worker directly supervises the patient swallowing each dose of medication to ensure compliance and prevent drug resistance.

First-line antitubercular drugs

The primary group of medications used to treat tuberculosis—consisting of rifampin, isoniazid (INH), pyrazinamide, and ethambutol—which are considered more effective and less toxic than second-line agents.

Multidrug-Resistant Tuberculosis (MDR-TB) drugs

Second-line agents—including aminosalicylate, capreomycin, cycloserine, ethionamide, streptomycin, aminoglycosides (kanamycin, amikacin), and fluoroquinolones—used in combination when M. tuberculosis develops resistance to primary medications.

Initial phase of antitubercular therapy

The first phase of tuberculosis treatment, which lasts for $2\,\text{months}$ and utilizes a multidrug combination to rapidly reduce the bacterial burden.

Continuation phase of antitubercular therapy

The second phase of tuberculosis treatment, typically lasting $4\,\text{to}\,7\,\text{months}$, to eradicate remaining bacilli and prevent disease relapse.

Rifampin

The preferred first-line antitubercular agent from the rifamycin class; notable side effects include orange discoloration of body fluids (which may permanently stain soft contact lenses), thrombocytopenia, and GI intolerance.

Isoniazid (INH)

A first-line antitubercular agent that inhibits tubercle cell wall synthesis and blocks pyridoxine; adverse reactions include hepatotoxicity, peripheral neuropathy, hyperglycemia, hyperkalemia, hypophosphatemia, and hypocalcemia.

Pyridoxine

Vitamin $B_6$, co-prescribed with isoniazid (INH) to prevent vitamin deficiency and minimize drug-induced peripheral neuropathy.

Pyrazinamide

A first-line antitubercular drug requiring routine monitoring of liver function tests and serum uric acid due to risks of hepatotoxicity, arthralgia, myalgia, and thrombocytopenia.

Ethambutol

A first-line antitubercular drug that can cause optic nerve damage resulting in blurred vision or altered color vision; should be taken as a single daily dose with meals to reduce GI disturbance.

Amphotericin B

A highly toxic polyene antifungal administered IV that serves as the drug of choice for severe, life-threatening systemic fungal infections; binds fungal cell membranes to form pores that leak potassium, carrying risks of nephrotoxicity, hypokalemia, hypomagnesemia, and bone marrow toxicity.

Nystatin

A polyene antifungal administered orally or topically to treat Candida infections; commonly used as an oral suspension swished in the mouth for several minutes to manage oral thrush.

Azole antifungals

A major class of antifungal agents (e.g., ketoconazole, fluconazole, posaconazole, voriconazole) that inhibit cytochrome P450 (CYP450) in fungal cells to disrupt the synthesis of ergosterol.

Flucytosine

An orally absorbed antimetabolite antifungal that selectively enters fungal cells and converts into fluorouracil to disrupt fungal DNA and RNA synthesis; commonly combined with amphotericin B.

Echinocandins

The newest class of IV antifungals (anidulafungin, caspofungin, micafungin) that inhibit fungal cell wall biosynthesis; potential adverse effects include phlebitis, elevated AST/ALT, and histamine-mediated reactions from rapid infusion.

Virus

An obligate intracellular organism that depends on a living host cell to survive and replicate by inserting its genetic material into host cells and utilizing host machinery.

Neuraminidase inhibitors

A class of non-HIV antivirals (oseltamivir, zanamivir) active against influenza types A and B that inhibit the viral neuraminidase enzyme to prevent virus release from infected cells, shortening the duration of flu symptoms.

Oseltamivir

An oral neuraminidase inhibitor recommended for influenza types A and B that must be initiated within $48\,\text{hours}$ of symptom onset; patients receiving it should be monitored closely for abnormal behavior.

Acyclovir

An antiviral drug used to manage herpes simplex viruses (HSV-1, HSV-2) and varicella-zoster virus (VZV); must be administered intravenously over at least $60\,\text{minutes}$ (never IV push) alongside adequate hydration to protect renal function.

Ganciclovir

The first approved antiviral medication indicated for cytomegalovirus (CMV) retinitis in patients with AIDS; associated with significant hematologic toxicity and bone marrow suppression.

Cidofovir

An antiviral agent that suppresses viral replication by inhibiting DNA polymerase; used in combination therapy to manage CMV retinitis in immunocompromised patients.

Hepatitis B virus (HBV)

A vaccine-preventable liver infection that can become chronic; managed with long-term nucleoside/nucleotide analogues (lamivudine, adefovir, entecavir, tenofovir) and peginterferon alfa-2a, though no curative treatment exists.

Hepatitis C virus (HCV)

A bloodborne viral infection of the liver with no current vaccine that can cause chronic hepatitis leading to cirrhosis and liver cancer; treated using combinations of NS5A inhibitors (ledipasvir), polymerase inhibitors (sofosbuvir), and peginterferon alfa-2a.

Peginterferon alfa-2a

An antiviral agent used in chronic viral hepatitis; adverse effects include depression, fatigue, flulike symptoms, pancytopenia, alopecia, thyroid dysfunction, and ophthalmic complications.

Ribavirin

An antiviral medication used in hepatitis therapy noted for severe teratogenicity and the risk of inducing hemolytic anemia.