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MVST 1B (Fach) / MoDA (Lektion)

MVST 1B - MoDA

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  • Melarsen Trypanosomiasis medication (Chagas, African Sleeping Sickness) Toxic heavy metal side effects
  • Methotrexate Use: inflammatory / autoimmune diseases: RA, sarcoidosis, Crohn's disease, psoriasis MoA: Antifolate antimetabolite; inhibits DHFR and TH2 uptake, leucovorin as adjuvant SE: agranulocytosis (→FBC), lung/liver fibrosis (→lung & liver function tests); once weekly! → hydroxychloroquine (HCQ), sulfasalazine (5-ASA), infliximab, penicillamine, gold
  • Miconazole Use: Fungal infections - skin, oral, intestinal; vaginal candidiasis MoA: Azole antifungal; inhibits ergosterol synthesis SE: local irritation, hpersesitivity → Itraconazol, fluconazole; amphotericin B, nystatin; griseofulvin,
  • Mitomycin C Use: Certain cancers, adjuvant bladder irrigation MoA: Anthracyclie derivative DNA crosslinker; quinone group activated by bioreductive enzymes, reducing environment; alkylating / crosslinking agent at guanosine residues → bleomycin, dactinomycin/-rubicin, daunorubicin/mitoxantrone
  • Mitoxantrone Use: Certain cancers MoA: anthracycline derivative; intercalates in DNA; no free radical production and cardiac toxicity, unlike doxorubicin → doxorubicin; mitomycin, daunomycin, dactinomycin
  • Oseltamivir Use: Influenza: treatment + post-exposure prophylaxis MoA: competitively inhibits neuroaminidase SE: GI upset → zanamivir; amantadine
  • Nevirapine Non-nucleoside reverse transcriptase inhibitor; anti-HIV
  • Penicillins β-lactam antibiotic, inhibit TG/TP bacteriocidal enhanced effectiveness with aminoglycosides (wobbly reading), but not other ribosome inhibitors, i.e. chloramphenicole, tetracyclines, macrolides
  • Polymixin Bacteriocidal antibiotic targeting the cell membrane; selectively toxic for Gram (-)ve bacteria cyclic peptide + tail → insert into outer membrane
  • Pyrimethamine Anti-protozoal drug; inhibits DHFR → Fansidar
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  • Rifampicin Use: Tuberculosis MoA: Antibiotic; inhibits DNA dependent RNA polymerase SE: orange tears & urine; hepatotoxicity → isoniazid + pyridoxine, ethambutol, pyrazinamide; D-cycloserine
  • Saquinavir Use:HIV infection MoA: HIV protease inhibitor 'never tease a protease' →zidovudine, nevirapine, enfuvirtide, raltegravir
  • Streptomycin Use: Tuberculosis in conjunction with other drugs, infective endocarditis (→gentamicin) MoA: Aminoglycoside antibiotic SE: GI upset, oto-, nephrotoxic → gentamicin, amikacin; D-cycloserine; rifampicin, isoniazid, pyrazinamide, ethambutol
  • Sulfadoxine Use: Adjunct to quinine in malaria treatment +  pyrimethamine MoA: Anti-protozoal DHPS inhibitor + pyrimethamine → fansidar→ trimethoprim + sulfamethoxazole = co-trimoxazole
  • Sulfamethoxazole Antibiotic DHPS inhibitor → Co-trimoxazole
  • Suramin Obsolete drug for onchocerciasis
  • Tetracycline Use: Chlamydia, rickettsia, Lyme disease, acne vulgaris, rosacea MoA: Bacteriostatic antibiotics; interact with 16S rRNA of 30S unit of ribosome SE: teratogenic, GI upset →doxycycline
  • Toremifene Use: hormone-dependent breast cancer in post-menopausal women MoA: selective oestrogen receptor modulator SE: nausea, vomiting; oedema; depression, dizziness, fatigue; sweating, hot flushes, vaginal bleeding or discharge; endometrial cancer → tamoxifen  
  • Topotecan Use: Certain cancers MoA: DNA topoisomerase I inhibitor →irinotecan
  • Trastuzumab HER2/neu receptor antibody; breast cancer; herceptin
  • Trifluridine Nucleoside analogue anti-herpes drug "Viroptic"
  • Trimethoprim Use: Uncomplicated urinary tract infections, bronchitis, PCP Spectrum: Gm- bacteria MoA: Antibiotic DHFR inhibitor, antifolate SE: GI disturbance, pruritus, rashes; contraindicated in pregnancy → Co-trimoxazole, nitrofurantoin; amoxicillin, cefadroxil
  • Valinomycin K+ ionophore antibiotic; ion transporter
  • Vancomycin Use: penicillin hypersensitivity or resistance: MRSA, enterococci, C. diff. (oral), endocarditis, surgical prophylaxis MoA: Bacteriocidal glycopeptide antibiotic targetting cell wall synthesis; caps binding-site for new monomers Spectrum: only Gram positives, no good tissue penetration SE: Red person syndrome: administer slowly; nephro-, ototoxicity → teicoplanin
  • Vinblastine Use: Certain cancers MoA: Vinca alkaloid; inhibits mitotic spindle; interacts with tubulin monomers → vincristine; etoposide (TopIso-II), topotecan/irinotecan (TopIso-I)
  • Zanamivir Use: influenza: treatment + post-exposure prophylaxis MoA: neuroaminidase inhibitor SE: GI upset → oseltamivir; amantadine
  • Zidovudine Use: HIV + other drugs → HAART MoA: Azidothymidine [AZT] nucleoside reverse transcriptase inhibitor → nevirapine, saquinavir, enfuvirtide
  • Adalimumab Use: Rheumatoid & psoriatric arthritis, ankylosing spondylitis; inflammatory bowel MoA: Anti-TNF-α antibody SE: reactivation of TB, heart failure →infliximab, etanercept
  • Alemtuzumab Use: relapsing-remitting MS MoA: CD52 antibody on T- and B- cells → rituximab; steroids, interferon-β; baclophen, oxybutynin, pregabalin
  • Azathioprine Use: inflammatory bowel, autoimmune disease, incl rheumatic, solid organ transplant MoA: Cytostatic immunosuppressant; purine analogue (6-mercaptopurine), prodrug for mercaptopurin SE: agranulocytosis, pancreatitis; hypersensitivity, liver impairment; worse w/ enzyme deficiency; safer in pregnancy than →mycophenolate → mycophenolate; ciclosporin/tacrolimus, cyclophosphamide, steroids
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  • Celecoxib Use: Pain & inflammation in ankylosing spondylitis, rheumatoid arthritis, osteoarthritis MoA: NSAID; selective COX-2 inhibitor SE: lower risk of GI complications; dyspnoea, flu-like symptoms →diclofenac*, ibuprofen*; indomethacin; aspirin*; paracetamol*
  • Cimetidine Use: GORD, oesophagitis, gastric & duodenal ulceration, H. pylori (stop 2 weeks before eradication) MoA: H2-receptor antagonist; better than PPI's with clopidogrel SE: diarrhoea, headache, dizziness, malaise →ranitidine; gaviscon; omeprazole, lansoprazole; pirenzepine
  • Clarithromycin Use: Pneumonia with atypical pathogens, H. pylori eradication, Lyme disease Spectrum: similar to penicillins MoA: Macrolide antibiotic, blocking the ribosome exit tunnel SE: GI upset, chlestatic jaundice; P450 inhibitor → warfarin, statin → erythromycin, azithormycin
  • Cromolyn sodium Mast cell stabiliser, asthma
  • Ciclosporin Use:Prevention of rejection in solid organ (liver, kidey, heart) transplants + mycophenolate/cyclophosphamide + steroids MoA: Immunosuppressant; interact with cyclophillin to inhibit calcineurin →mycophenolate mofetil, cyclophosphamide, tacrolimus, prednisolone; azathioprine
  • Dexamethasone Use: Inflammatory and allergic disorders, diagnosis of Cushing's disease (dexamethason suppression test), cerebral oedema (malignancy), rheumatic disease MoA: Corticosteroid: gluco >> mineralo SE: Cushing's syndrome, incl. osteoporosis/-necrosis, diabetes, cataracts, hypertension, psychiatric, Addison's on withdrawal, etc. → hydrocortisone, fludrocortisone, prednisolone
  • Dimenhydrinate H1-receptor antagonist; anti-emetic
  • Ecallantide Use: hereditary Angiooedema (not licensed) MoA: Kallikrein inhibitor
  • Etanercept Use: Moderate-to-severe rheumatoid arthritis ± methorexate MoA: Competitive TNF-a receptor antagonist → sulfasalazine, adalimumab, methotrexate, steroids, gold
  • Fexofenadine Non-drowsy H1-receptor antagonist
  • Ibuprofen* Use: Analgesic for mild to moderate pain: dysmenorrhoea, rheumatic, post-OP, dental, migraine MoA: NSAID; non-selective competitive COX-1/2-inhibitor SE: GI events: bleeding, nausea, vomiting, diarrhoea → misoprostol; asthma Dose: Acute: 300-400mg 3-4 time daily; max 2.4g daily →Diclofenac, aspirin, paracetamol
  • Infliximab Use: Rheumatoid arthritis, ankylosing spondylitis; inflammatory bowel; psoriasis, psoriatic arthritis MoA: Anti-TNF-α antibody SE: reactivation of TB (→ screen before), blood disorders (→warn), hypersensitivit reactions; heart failure, GI upset, injection site reactions → adalimumab, etanercept
  • Ipratropium bromide Use: acute asthma, COPD (maintenance + acute), rhinitis MoA: mACh-receptor antagonist; mast cell stabiliser SE: dry mouth, GI upset, dizziness   → tiotropium
  • Loratadine Use: Allergy, hayfever, uticaria MoA: Non-drowsy H1-receptor antagonist SE: drowsiness, agitatopm. GI upset →fexofenadine, ceterizine
  • Mepyramine 1st generaton drowsy H1-receptor antagonist; not used →cyclizine*, chlorphenamine
  • Metronidazole Use: anaerobic infections; perianal disease incl fistulating Crohn's, H. pylori eradication, C. diff PMC, giardiasis, trichomonal vaginitis, bacterial vaginosis Spectrum: Anaerobes MoA: partial reduction → inhibition of DNA synthesis SE: GI upset, taste disturbance, anorexia →tinidazole
  • Mycophenolate mofetil Use: Prophylaxis of solid organ (liver, heart, kidney) transplant rejection + ciclosporin (=calcieurin inhibitor) + prednisolone (=steroid) MoA: Immmunosuppressant (inihibitor of de novo purine synthesis in T cells) ~ Azathioprine; ciclosporin/tacrolimus, prednisolone; cyclophosphamide
  • Omalizumab Use: prophylaxis of allergic asthma MoA: IgE antibody
  • Omeprazole Use: Gastro-Oesophageal Reflux Disease, heartburn, ulcers (NSAIDs, gastric, duodenal) MoA: Proton pump inhibitor → lansoprazole SE: GI upset, headache, impotence → gaviscon; lansoprazole, ranitidine/cimetidine, misoprostol; pirenzepine
  • Ondansetron Use: Nausea & vomiting; incl. chemo-/radiotherapy-induced, post-OP MoA: Selective 5-HT3-receptor antagonist, centrally acting SE: constipation, headache, flushing, injection-site reactions → cyclizine; domperidone, metoclopramide

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