| Drug Name |
Category |
Comments |
| Mico nazole |
Anti-Microbial; Anti-Fungal
Imidazole (Topical, Systemic) |
Pharmacokinetics: Topical or IV. Not absorbed
orally. Biliary excretion.x
Adverse Effects: Nausea and vomiting when given IV.
It potentiates warfarin. |
| Clotri mazole |
Anti- Microbial; Anti- Fungal
Imidazole (Topical) |
Topical use only. Not absorbed orally. |
|
| Ampho tericin B |
Anti - Microbial; Anti- Fungal
Polyene |
Attacks ergosterol causing cell lysis. Broad-spectrum. Is not
absorbed orally. Given IV for systemic infections, but doesn't readily
penetrate CNS.
Adverse Effects: "Amphoterrible" fever, chills,
nephrotoxicity, anemia, hepatotoxicity. |
| Nystatin |
Anti- Microbial; Ant- Fungal
Polyene (Topical) |
Topical use only. Drug is not
absorbed orally, and side-effects are too severe for systemic use.
Available OTC for dermal fungal infections, or used orally for
intraluminal GI fungal overgrowth infections. Can also be used for
intestinal amebiasis. |
| Meben dazole |
Anti- Microbial; Anti- Parasitic
Anti- Helmin thitic |
Given PO, but only about 10% is absorbed (poorly absorbed).
It inhibits microtubule synthesis in nematodes.
Indicated for pinworms, hookworms, ascariasis. |
| Pipe razine |
Anti -Microbial; Anti- Parasitic
Anti- Helmin thitic |
Mech: It inhibits acetylcholine in helminths (non-depolarizing
blockade). It thus antagonizes the effects of Pyrantel Pamoate. |
| Prazi quantel |
Anti- Microbial; Anti- Parasitic
Anti- Helmin thitic |
Well -absorbed orally. It increases permeability of
helminthitic cell membrane to calcium, causing
contraction, paralysis, death. Indicated for Schistosomiasis
and other fluke infections. |
| Pyrantel Pamoate |
Anti- Microbial; Anti- Parasitic
Anti- Helmin thitic |
Poorly absorbed orally. Triggers the release of
acetylcholine in helminths, causing depolarizing neuromuscular
blockade, paralysis. Indicated for broad-spectrum treatment of
luminal intestinal infections. Ascariasis, pinworm. |
| Thiaben dazole |
Anti- Microbial; Anti- Parasitic
Anti-Helminthitic |
Well-absorbed orally. It blocks microtubule
synthesis., and may also inhibit fumarate reductase in
the parasite. Indicated for nematode infections. |
| Amodiaquine |
Anti-Microbial; Anti-Parasitic
Anti-Malarial |
Blood schizonticide. |
| Mefloquine |
Anti-Microbial; Anti-Parasitic
Anti-Malarial |
Only PO. Primarily used for prophylaxis and treatment of
Chloroquine-resistant P. Falciparum strains. Adverse Effects:
Can have bad CNS and psychological effects. |
| Primaquine |
Anti-Microbial; Anti-Parasitic
Anti-Malarial |
It is the one and only tissue schizonticide,
required for treatment of P. Ovale and P. Vivax
hypnozoite (dormant) tissue-infections. Adverse Effects:
Hemolytic anemia in persons with G6PD-Deficiency. |
| Pyrime thamine |
Anti-Microbial; Anti-Parasitic
Anti-Malarial |
Inhibits Plasmodium dihydrofolate reductase,
similar to trimepthoprim. Indicated for treatment of Chloroquine-resistant
P. Falciparum. Adverse Effects: Anti-Folate effects,
megaloblastic anemia. |
| Quinidine Gluconate |
Anti-Microbial; Anti-Parasitic
Anti-Malarial |
|
| Chloroquine |
Anti-Microbial; Anti-Parasitic
Anti-Malarial
Anti-Inflammatory; Anti-Arthritis |
Usually PO, also IV, IM. Most popular blood schizonticide. Extensive
tissue binding requires large loading dose. Resistance is common and
occurs by P. Falciparum making phosphoglycoprotein pumps to
pump out the drug. Adverse Effects: generally well-tolerated; long-term
retinopathyy, myopathy, ototoxicity.
Also: Low dose, long-term treatment for RA refractory to treatment
with NSAID's. |
| Fansidar (Pyrime thamine- Sulfad oxine) |
Anti-Microbial; Anti-Parasitic
Anti- Malarial
Anti- Protozoal |
Similar to Co-Trimoxazole, except for parasites. Pyrime thamine:
inhibit dihydrofolate reductase. Sulfadoxine: inhibit dihydropteroate
synthetase.
Slow-acting, and resistance can be a problem. |
| Diloxanide Furoate |
Anti-Microbial; Anti-Parasitic
Anti-Protozoal |
Given orally, Diloxinide is the active drug, released by gut
bacteria. Mild drug used to combat intestinal amebiasis. Well-tolerated. |
| Melarsoprol |
Anti-Microbial; Anti-Parasitic
Anti-Protozoal |
Indicated for the late meningeal stages of Trypanosomiasis (T.
Gambiense). |
| Nifurtimox |
Anti-Microbial; Anti-Parasitic
Anti-Protozoal |
Indicates for Chagas Disease (T. Cruzi) |
| Paromomycin |
Anti-Microbial; Anti-Parasitic
Anti-Protozoal |
Indicated for intestinal amebiasis. |
| Pentamidine |
Anti-Microbial; Anti-Parasitic
Anti-Protozoal |
IM or aerosol; not absorbed orally. Indications:
Trypanosomiasis, first-line therapy for
Pneumocystic Cariini infection in AIDS patients.
Second-line therapy for many other parasitic infections.
Adverse Effects: Histamine degranulation can lead to
life-threatening hypotension. Also can see hypoglycemia or
hyperglycemia, TPP, nephrotoxicity, anemia. |
| Sodium Stibogluconate |
Anti-Microbial; Anti-Parasitic
Anti-Protozoal |
Indicated for Leshmaniasis. |
| Suramin |
Anti-Microbial; Anti-Parasitic
Anti-Protozoal |
Indicated for Tryanosomiasis. |
| Metronidazole |
Anti-Microbial; Anti-Parasitic
Anti-Protozoal
Anti-Bacterial |
Mech: Parasites reduce a nitro group on the drug and form
oxidative intermediates that do oxidative damage. Indicated for
a wide variety of intestinal and tissue parasitic infections:
Trichomoniasis, Giardiasis, Amebiasis, Leshmaniasis. Also
indicated for treating Bacteroides and other
serious anaerobic bacterial infections. |
| Foscarnet |
Anti-Microbial; Anti-Viral |
Indicated for treatment of (1) CMV Retinitis
(administer with Ganciclovir), and (2) Serious HSV or VZV infections
that are resistant to treatment by Acyclovir. Serious Adverse Effect: It
chelates Ca+2 which can lead to life-threatening
hypocalcemia. |
| 3- Deoxy thmidin- 2-ene (d4T)
(Stavudine) |
Anti- Microbial; Anti- Viral
Anti- AIDS; Nucleoside Analog |
|
| Dideoxy cytosine (ddC) |
Anti- Microbial; Anti- Viral
Anti-AIDS; Nucleoside Analog |
|
| Dideoxy inosine (ddI) |
Anti-Microbial; Anti-Viral
Anti- AIDS; Nucleoside Analog |
|
| Lami vudine (3TC) |
Anti- Microbial; Anti- Viral
Anti-AIDS; Nucleoside Analog |
|
| Azido thymidine (AZT)
(Zidovudine) |
Anti-Microbial; Anti-Viral
Anti-AIDS; Nucleoside Analog
Immuno suppressant |
Half-life of 1-3 hrs. Gets into CNS (60%). Mech: It is
phosphorylates to the triphosphate form, which is the active form. Then,
(1) It competitively inhibits HIV Reverse Transcriptase,
and (2) It is a chain-terminator of HIV viral DNA
synthesis. Resistance is common, due mutations in viral Reverse
Transcriptase.
Adverse Effects: May be severe. Bone marrow depression.
Headaches, agitation, insomnia. |
| Indinavir |
Anti-Microbial; Anti-Viral
Anti-AIDS; Protease Inhibitor |
|
| Ritonavir |
Anti-Microbial; Anti-Viral
Anti-AIDS; Protease Inhibitor |
|
| Saquinavir |
Anti-Microbial; Anti-Viral
Anti-AIDS; Protease Inhibitor |
Well tolerated, but low oral bioavilability (5%). |
| Inter feron- alpha (IFN- alpha) |
Anti- Microbial; Anti- Viral
Endo genous Factor |
Enhances host-cell resistance to viral infections, and possibly some
tumors. Adverse effects: fever, malaise, headaches, anemia, GI distress. |
| Acyc lovir |
Anti- Microbial; Anti- Viral
Nucle oside Analog |
Indicated for HSV-1, HSV-2, VZV. Used topically for skin lesions, or
IV for encephalitis or neonatal disease. It is activated by HSV viral
Thymidine Kinase ------> (1) it binds and
inhibits viral DNA polymerase, and (2) it is incorporated into
viral DNA, where it acts as a chain-terminator.
Resistance in HSV is due to mutations in Thymidine Kinase or the DNA
Polymerase.. |
| Ganci clovir |
Anti- Microbial; Anti- Viral
Nucle oside Analog |
Indicated for CMV. Deoxyguanosine analog, it
reversibly inhibits viral DNA polymerase. Works similar
to Acyclovir.
Adverse Effects are bad: Neutropenia (common),
anemia, eosinophila. Also CNS changes (headache, behavioral changes,
seizure, coma), fever, rash, phlebitis, nausea. |
| Ribavirin |
Anti-Microbial; Anti-Viral
Nucle oside Analog |
Aerosol spray. Nucleoside analog blocks the formation of GTP.
Indicated for severe Respiratory Syncitial Virus (RSV)
infections in infants. No serious adverse effects. |
| Vidar abine (Ara-A) |
Anti- Microbial; Anti- Viral
Nucle oside Analog |
Topical or IV. It inhibits DNA synthesis by affecting DNA
polymerase. Indicated for HSV, Varicella-Zoster.
Adverse effects are minimal: nausea, vomiting, possible neurotoxicity. |
| Aman tidine |
Anti-M icrobial; Anti- Viral
Uptake Inhibitor |
It inhibits viral absorption and uptake. Indicated for
Influenza A, Rubella. Used prophylactically after Influenza-A
exposure.Adverse Effects: Insomnia, restlessness, nervousness,
depression. |
| Rinan tidine |
Anti- Microbial; Anti- Viral
Uptake Inhibitor |
Longer half-life than Amantadine, biliary excretion. Perhaps fewer
CNS effects. |
| Taxol |
Chemotherapy
Alkaloid; Paclitaxel |
IV only; biliary excretion. Extensively metabolized by the liver. It
stabilizes the mitotic spindle during metaphase,
causing metaphase arrest.
Indications: head and neck carcinomas, ovarian carcinomas, breast
cancers, lung cancers. Adverse Effects: bone marrow suppression,
peripheral neuropathy. |
| Etoposide (VP-16) |
Chemotherapy
Alkaloid; Podophyllotoxin |
IV only; urinary excretion. It inhibits topoisomerase II
------> cause DNA strand breaks, increase DNA degradation.
Indications: small-cell lung cancer, lymphomas and leukemias,
testicular carcinoma. |
| Teniposide (VM-26) |
Chemotherapy
Alkaloid; Podophyllotoxin |
|
| Vinblastine |
Chemotherapy
Alkaloid; Vinca Alkaloid |
IV only; biliary excretion. Binds to microtubules ------> inhibits
the mitotic spindle, causing metaphase arrest. More
likely to show bone marrow toxicity than Vincristine.
Indications: Testicular carcinoma, breast cancers, lymphomas. |
| Vincristine |
Chemotherapy
Alkaloid; Vinca Alkaloid |
IV only; biliary excretion. Binds to microtubules ------> inhibits
the mitotic spindle, causing metaphase arrest. Less
likely to suppress bone marrow than Vinblastine, but do see
peripheral neuropathy which is dose-limiting.
Indications: Part of the MOPP group of drugs, to fight
Hodgkin's Disease. Also acute leukemias, Non-Hodgkin's
Lymphomas. |
| Glutatione S-Transferases (GST's) |
Chemotherapy; Adjunct |
Experimental. In rats and monkeys, when injected directly into
lymphocytes (inject in vitro and then reimplant in the animal),
it prevents lymphocyte death, helping to alleviate
bone-marrow suppression before it occurs. Hasn't been tried in humans
yet. |
| Granulocyte Colony Stimulating Factor
(G-CSF) |
Chemotherapy; Adjunct |
It is thought to mobilize peripheral hematopoeitic stem
cells. It can be given to combat the bone-marrow suppression
side-effects of chemotherapy drugs. |
| Ondansetron |
Chemotherapy; Adjunct |
Serotonin antagonist can be given to alleviate nausea associated
with chemotherapy. Phenothiazines and other drugs can
also be used. |
| Verapamil |
Chemotherapy; Adjunct |
Ca+2-channel blocker can competitively inhibit
phosphoglycoprotein pumps in tumor cells, thus hopefully
helping to combat this form of resistance. Clinical trials are under
way. |
| Busulfan |
Chemotherapy; Alkylating Agent
Alkylsulfonate |
Alkylsulfonate, pro-drug, oral. Indicated for Chronic
Myelogenous Leukemia.
Adverse Effects: Adrenal Insufficiency, increased skin pigmentation.
Pulmonary fibrosis. |
| Thiotepa |
Chemotherapy; Alkylating Agent
Aziridine |
Aziridine, pro-drug. IV. |
| Trieth ylenema lamine |
Chemo therapy; Alkylating Agent
Aziridine |
Aziridine, pro-drug. IV. |
| Procarbazine |
Chemotherapy; Alkylating Agent
Hydrazine |
Hydrazine. Part of the MOPP group of drugs, to fight
Hodgkin's Disease. Adverse Effects: Has especially high
incidence of secondary malignancies, particularly
leukemias. |
| Chlorambucil |
Chemotherapy; Alkylating Agent
Nitrogen Mustard |
Nitrogen Mustard, Oral. Indicated for lymphomas, CLL. |
| Mechlore thamine |
Chemotherapy; Alkylating Agent
Nitrogen Mustard |
Nitrogen Mustard, IV. Directly toxic. It has the shortest half-life
(a few minutes) and is the least stable of all alkylating agents. Is
often infused directly into artery supplying the tumor, due to its short
half-life. Part of the MOPP group of drugs, to fight Hodgkin's
Disease. |
| Melphalan |
Chemotherapy; Alkylating Agent
Nitrogen Mustard |
Nitrogen Mustard, Oral. Indicated for Multiple Myeloma. |
| Cyclopho sphamide |
Chemotherapy; Alkylating Agent
Nitrogen Mustard
Immuno suppressant |
Pro-drug, oral. It is converted to its active form by
Cytochrome-P450 enzyme.
Broad-spectrum agent Useful at fighting solid tumors,
leukemias, ovarian carcinoma.
Immunosuppresant: Bone marrow transplants (but it does not
prevent GVHD), autoimmune disorders (PRCA, Wegener's Granulomatosis).
Adverse Effect: Hemorrhagic cystitis, higher incidence
of alopecia than other drugs. |
| Carmustine (BCNU) |
Chemotherapy; Alkylating Agent
Nitrosurea |
Nitrosurea, pro-drug. IV. Gets into CNS, thus useful for
treating brain cancers. |
| Lomustine (CCNU) |
Chemotherapy; Alkylating Agent
Nitrosurea |
Nitrosurea, pro-drug. IV. Gets into CNS, thus useful for
treating brain cancers. |
