ANTIVIRAL:            Virus:   Mechanism:                                 +                   -                         Notes:
Acyclovir             HSV-     -->Monophosphate (by viral                 1. Inhibits DNA     -Very poorly absorbed     -Anti-herpes nucleoside
                      1,       enzymes) --> Diphosphate (by               Synthesis           -Multiple times a day.    analog.
                      HSV-2    host kinases) --> Triphosphate '--         2. Chain            -SE: GI and HA            -Topical for local reactivatio
                               > 1. Competetive inhibition of             Termination         (common), renal and       -Oral & IV for initial,
                               DNA polymerase --> inhibition of                               neural (uncommon)         recurrent, suppression
                               DNA synthesis. 2. Incorporation                                -Drug interactions, no
                               into viral DNA --> Chain                                       use with other
                               Termination                                                    nephrotoxics.
Ganciclovir           CMV      Same as Acyclovir                          Same as Acyclovir
CCR5 Inhibitors       HIV      Competitive inhibitor of CCR5, which is                        -Substrate of CYP3A4,     -Entry inhibitor (Fusion)
                               the CD4 coreceptor that HIV binds.                             many drug                 -Used to bridge, not seen
                                                                                              interactions              much anymore.
Zidovudine            HIV      Reverse transcriptase inhibitor                                SE: Lactic acidosis,      Nucleoside (NRTI)
                               Chain terminators                                              Peripheral fat wasting,   Similar to Acyclovir
                                                                                              bone marrow
                                                                                              suppression (oral
                                                                                              ulcers), nausea, facial
                                                                                              lipoatrophy.
Efavirenz             HIV      Direct binding to RT enzyme                                    SE: Rash, increases       Non-nucleoside (NNRTI)
                                                                                              transaminases, CNS
                                                                                              (drowsiness, vivid
                                                                                              dreams)
                                                                                              Can inhibit OR induce
                                                                                              P450, drug
                                                                                              interactions
Integrase Inhibitor   HIV      Affects integration
Lopinavir/Ritonavir   HIV      Protease Inhibitor                         Ritonavir given     SE: GI, body fat          -Huge for drug interactions
                               Bind protease, inhibits photolytic         with Lopinavir to   abnormalities,            -ALL inhibit P450 (but
                               cleavage of viral proteins, so inhibits    inhibit it’s        perioral paresthesias,    metabolized by P450, so
                               activation, cleavage and viral assembly.   metabolism and      taste abnormalities,      prolong own half life)
BONE DRUGS:
ANTIBACTERIAL:
CANCER     DRUGS: Class:
                      Class:
                        Bacteria:       Mechanism:
                                          Mechanism:
                                             Mechanism:                   + +                   --          -                             Notes:
                                                                                                                                            Notes:Notes:
Methotrexate
Estrogen              Antimetabolites Anti-Resorptive
                                             -Competetively               -Dental: decrease -SE: Hypercoagulation,
                                                                                                            -SE: Oral mucositis,                  -Cell Cycle Specific
Penicillin VK,        (interfere
                        Penicillin:with (Decrease
                                          CWSI
                                             inhibits bone
                                                         DHFR             tooth loss,           Poor
                                                                                                   breast
                                                                                                        absorption
                                                                                                            cancer,
                                                                                                            leukopenia,cholestasis
                                                                                                                        withnausea,
                                                                                                                               PO           -Beta-lactam
                                                                                                                                                  -Other
amoxicillin           DNA
                        Gramsynthesis
                              +N        resorption)
                                             (dihydrofolate
                                                1. Inhibit                increase              -Shorter
                                                                                                   (no bilethrombocytopenia,
                                                                                                            half
                                                                                                              flow)
                                                                                                                  life than most bone       -Oral:antimetabolites
                                                                                                                                                    60-75%
(Penicillins)         during
                        Amoxicillin:
                              S phase)       reductase,      cell
                                                     Penacilin    cycle   mandibular     bone   antimicrobials
                                                                                                   -Black  box
                                                                                                            marrowwarningtoxicity,
                                                                                                                               for CVvery   bioavailability,
                                                                                                                                                  block  thymidylate
                                                                                                                                                                4-6
                        Gram +N,             enzyme) binding              density, decrease -Penicillin
                                                                                                   diseasesensitive
                                                                                                               SE:        to UV and         hourssynthase
                                                                                                                                                    to work.(another
                        Gram –N              -Antimetabolite,
                                                     proteins            gingival bleeding. Hypersensitivity
                                                                                                            sunlight (must(mostwear -Kidney       enzyme
                                                                                                                                                      excretion
                                                                                                                                                             in cell
Raloxifene           Selective               mimics
                                        -Anti-Resorptive
                                                     no                                             allow
                                                                                                common,
                                                                                                   -SE:    for  lower
                                                                                                            sunglasses)
                                                                                                              anaphylaxis
                                                                                                         Hypercoagulation,         dry mouth.
                                                                                                                                rare,       -Prophy:
                                                                                                                                                  cycle)
                                                                                                                                          -Approved    1.
                                                                                                                                                        forAmoxicillin
                     estrogen                Tetrahydrofolate
                                        (Decrease     bone
                                                     peptoglycan      but                           dose
                                                                                                   hot    (Boosting)
                                                                                                cross-reactivity
                                                                                                            -Resistance:
                                                                                                        flashes.       with decreasedprevention/treatment
                                                                                                                                            2g PO-Works on S phase.
         Lamivudine receptor HBV resorption) doesn’t
                                           NRTI layer    function    like                       cephalosporins).
                                                                                                            transport,
                                                                                                    Well tolerated side  Other:
                                                                                                                           increased        -Augmentin:
                                                                                                                                          -Hepatic
                                                                                                                                   Resistance    can metabolism
                     modulator          -Binds       leakage
                                             it. estrogen                                       Phlebitis,
                                                                                                    effects export,
                                                                                                              GI, Hematologic,
                                                                                                                       altered affinity
                                                                                                                                   develop  Amoxicillin
                                                                                                                                          -Fecally         + Clavulanic
                                                                                                                                                     excreted
                                                                                                                                              over time
         Ribavirin/Pegylated       HCV receptor,
                                           -Directagonist
                                                     and
                                                     effect cellin                              Electrolyte
                                                                                                    Rapidlyfor  disturbances,
                                                                                                                 DHFR, gene CI: Pregnancy,
                                                                                                               absorbed,                    acid severe
                                                                                                                                          -Ellimination    half-life:
                                                                                                                                                                   Proteins
         interferon                     bone   and lipid
                                           -Effect   death
                                                     on host (liver),
                                                                 factors                        Neurologic, amplification
                                                                                                    very long    Renal.
                                                                                                                 half life of heart DHFR.disease,
                                                                                                                                          32.5 hours.              Eliminated renally
                                        antagonist
                                           -Immune     in  breast
                                                2. Cellsystem
                                                            Lysis: effects                      - Amoxicillin
                                                                                                            -Oral SE:
                                                                                                                    complications
                                                                                                                        GI                -Oral
                                                                                                                                   hemolytic anemia,
Cefazolin
Etoposide             DNA
                        Gramtopological
                              +B        and uterus.
                                             -DNA Osmotic
                                                     topoisomerase             -Succesfull in -SE: Well-SE:  tolerated
                                                                                                                   Secondary leukemia.
                                                                                                                                   insomnia.-IV for
                                                                                                                                                  -Cell
                                                                                                                                                     severe
                                                                                                                                                        Cycleinfection,
                                                                                                                                                                Specific
(1st gen
Calcitonin            inhibitor
                        Gram –N              II resolves
                                        -Anti-Resorptive
                                                     pressuretopological
                                                                   or          treating
                                                                          -Onset:  15-30 monocytic
                                                                                                (otherwise  -Oral
                                                                                                                same
                                                                                                   -SE: Rhinitis,   complications
                                                                                                                      GI as                 PO for
                                                                                                                         upset, itch -Approved    -Natural,
                                                                                                                                                     mild/moderate
                                                                                                                                                              derived
                                                                                                                                                        for treatment
Cephalosporin)                               problems,
                                        (Decrease     boneEtoposide
                                                     activation     of mins.   leukemia, smallPenicillins
                                                                                                  cell         above)                     5 -Penicillin
                                                                                                                                             yearsfrom
                                                                                                                                                    pastplant.
                                                                                                                                                         like
                                                                                                                                                          menopause.
2nd gen                 Gram +N              inhibits
                                        resorption)      it.
                                                     endogenous                lung
                                                                          -Duration: cancer,
                                                                                       8-24     -Resistance:      all 3  ways-    1.        distribution
                                                                                                                                                  -Works
                                                                                                                                          -Subcutaneous,    on G2
Cephalosporins          Gram –B              -Blocks
                                        -Binds           cell cycle in hours
                                                 CT autolysins.
                                                     receptors                 testicular cancer.
                                                                                                Inactivation by Penicillinase, intranasal.  -Renalphase
                                                                                                                                                     excretion
                                             late S phase
                        Cephamycin: on osteoclasts             through
                                                             and                                cephalosporinase or ESBLs,
                        Anaerobes            G2 phase.
                                        kidney                                                  2. Alterations in membrane
Vincristine
Ceftriaxone
Bisphosphonates       Mitotic-blocking
                        Gram +N              -To move,
                                        -Anti-Resorptive                  -Long half life in permeability
                                                                                                   -Poorly-Oral    orcomplications
                                                                                                             absorbed  efflux   (drug -Most -Cell
                                                                                                                            orally                commonCycleused
                                                                                                                                                                Specific
                                                                                                                                                                     for
   rd
(3 gen                alkaloid
                        Gram –B              microtubules
                                        (Decrease     bone                bone (10 years)       can’t   reach   target),
                                                                                                   (empty stomach)         3.                     -Works on M
                                                                                                                                          osteoporosis
Cephalosporin)                               polymerize on one -Improves
                                        resorption)                                             Alterations     in PBP (target
                                                                                                   -SE: Hypocalcemia,                             phasefor
                                                                                                                                          -Approved
4th gen                 Gram +B              endhydroxyapetite,
                                        -Binds    and depolymerize        periodontal           site)
                                                                                                   esophagitis, jaw                       prevention and
cephalosporins          Gram –B              on the
                                        released   byother.               health.                  osteonecrosis, bone/joint treatment.
                                             Vincristine
                                        osteoclasts.          inhibits                             pain, atrial fibrillation.
Carbapenems             Broad                polymerization.
                                        -Interferes    with               -Broad                SE: Hypersensitivity,                       -Beta-lactam
                        spectrum             -Causes pathway.
                                        mevalonate        mitotic arrest. spectrum (Gram Seizures                                           -Last line for resistant
Doxorubicin
Teriparatide          Intercalating
                     Parathyroid             -Slide (increase
                                        -Anabolic     between and -Protects
                                                                          +, Gram -,  against      -Daily   -Generates
                                                                                                           subcutaneous      oxygen               -Cell for
                                                                                                                                          -Approved
                                                                                                                                            organisms.  Cycle   Non-
                                                                                                                                                             treatment
                      antibiotic
                     hormone            bonebind   stacked DNA periodontitis-
                                               formation)                 Anaerobes)                        radicals that lead to of-IV
                                                                                                   -SE: Hypercalcemia,                        highSpecific
                                                                                                                                                onlrisk
                                             bases
                                        -Binds   PTH-1(intercalation),associated
                                                                          -Good        bone        headache,cardiotoxicity
                                                                                                                 leg cramping.            -Peak   30 mins,
                                                                                                                                            -Renally          gone 3
                                                                                                                                                       excreted
                                             -Blockon
                                        reseptors      replication and    loss.
                                                                          Distribution             -Blackbox-Oral   complications
                                                                                                                 warning      for         hours.
Clavulanic acid                              transcription
                                        osteoblasts
                                          Contains      to
                                                        penicillins,      Prevents                 osteosarcoma in rats.
Cyclophosphamid
(beta lactamase       Alkyating agent stimulate
                                             -Converted
                                          binds   andbone     to active destruction
                                                          inhibits             -Wide utility
                                                                                         and in             -Liver produces inactive              -Cell Cycle Non-
einhibitor)                             formation.
                                             form in liver by P450enhances
                                          beta-lactamase                       chemotherapy.                metabolites (implications Specific, but most
 Denosumab           Antibody                -Alkylation
                                        -Monoclonal           produces-Maximum
                                                           antibody            -Minimal
                                                                          spectrum        oral -AE: hypocalcemia,
                                                                                      ofbone                for liver tumor       therapy)
                                                                                                                              severe              effective
                                                                                                                                          -Approved           in G1 and
                                                                                                                                                        for treatment
                     antagonist of      bindsmillions
                                                RANKL.of corsslinksresorption  complications
                                                                          parent   drug                     -SE:
                                                                                                   infection,      Nausea, vomiting,of highSrisk.
                                                                                                                dermatologic                        phase.
 Vancomycin          RANKL
                        Gram +               in DNA,
                                          CWSI    at earlier site         suppression
                                                                          -Works on at 1 -Too      reaction,
                                                                                                       largeboneONJ
                                                                                                               to   marrow
                                                                                                                   affect  Gram –                 -Nitrogenevery 6
                                                                                                                                          -Subcutaneous
                                                                                                                                            -For beta-lactam
                        MRSA                 overwhelming
                                          than   PCN               the month.
                                                                          MRSA                  -Poor oral  suppression,
                                                                                                               absorption sterility, months.      Mustards
                                                                                                                                            resistant,  or persons
                                             repair mechanism. -Not             affected by -SE: Infusion
                                                                          -Bacteriacidal                    acuterelated
                                                                                                                     leukemia.(so give can’t tolerate beta-
                                             -Forces cell to kill renal   -Time                 slow), hypersensitivity,                    lactams.
                                             itself.                      impairement.
                                                                          dependent             hematologic, ototoxicity/                   -2nd line for C. difficile
 Tamoxifen
 Fluoride             Hormonal               -Reduces mitogenic
                                        -Accumulates        in bone            -Prolongs
                                                                          -Rapidly
                                                                          killing    and survival  -Excess-Requires
                                                                                                nephrotoxicit (>1ppm) removal
                                                                                                                           leads to of -Indication:
                                                                                                                                                  -Cell
                                                                                                                                            colitis     Cycle
                                                                                                                                                    (only       Non-
                                                                                                                                                         prevention
                                                                                                                                                            time  taken
                      antagonist             signal transduction incompletely
                                        and teeth.                        -Goodafter surgery for mottling   endogenous
                                                                                                               of enamel, estrogen
                                                                                                                               brown of   by      Specific
                                                                                                                                              dental
                                                                                                                                            PO)       caries.
                                             breasteffect
                                        -Anabolic      tissue. on              breastorally.
                                                                          absorbed
                                                                          distribution cancer in post-
                                                                                                   staining.either natural                -Renally-For  breast
                                                                                                                                                     excreted.
                                                                                                                                            -VISA/VRSA:          cancer,
                                                                                                                                                             resistant.
                                             -Estrogen
                                        trabecular     bone  Receptor -Remineralizes
                                                                               menopausal
                                                                          (but poor CSF)     women -SE:     menopause,
                                                                                                         Nausea,    vomiting,  drugs,
                                                                                                                                  GI   or         used  in