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NAPLEx > antifungals and antivirals III > Flashcards

antifungals and antivirals III Flashcards

1
Q

conventional formulation of amphotericin B deoxycholate

A

0.1-1.5 mg/kg /day

SE infusion-related fever, chills, headache, malaise, rigors

prepare in D5W only

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2
Q

Lipid formulation
Amphotericin B Lipid complex

A

Abelcet
injection
5mg/kg/day

prepare in D5W only

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3
Q

lipid formulation
liposomal amphotericin B

A

AmBisome
injection
3-6mg/kg/day

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4
Q

amphotericin facts

A

decrease K and Mg
nephrotoxic

can give NS bolus to decrease nephrotoxicity and meperidine to decrease duration of severe rigors

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5
Q

flucytosine

A

ancobon

resistance common so use with amphotericin B
- flucytosine (in fungal cell covered to fluorouracil)

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6
Q

fluconazole class info

A

decrease ergosterol synthesis and cell membrane formation
cyp3A4 inhibitor
- increase LFTs
- QT prolongation except isavuconazonium
- many DDI

all azole IV to PO 1:1

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7
Q

fluconazole

A

Diflucan PO/IV 1:1

only azole that requires renal dose adjustment
- azole

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8
Q

itraconazole

A

Sporanox, Tolsura
can cause heart failure
Sporanox brand requires acidic gut
- azole

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9
Q

ketoconazole topical

A

Nizoral A-D, Extina, Ketozole, Xolegel

Nizoral A-D is OTC

hepatotoxic
QT prolongation
for these reasons avoid PO (requires acidic gut), last resort
- azole

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10
Q

Voriconazole

A

Vfend, Vfend IV
can cause visual changes and phototoxicity
avoid sunlight and take on empty stomach (1hr gap)

SBECD Vehicle
- azole

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11
Q

Posaconazole

A

Noxafil- delayed-release tablets, suspension, and injection
with food

tablet dose does not equal the suspension dose due to different bioavailability
SBECD vehicle
-azole

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12
Q

Isavuconazonium sulfate

A

Cresemba
QT shortening not prolonging
requires filter
prodrug of isavuconazole
- azole

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13
Q

Caspofungin

A

Cancidas
- echinocandins

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14
Q

Micafungin

A

Mycamine
light protect during admin
-echinocandins

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15
Q

Anidulafungin

A

Eraxis
echinocandins

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16
Q

echinocandins

A

only injectables
once daily and no renal dose adjustments
inhibit synthesis of beta-D-glucan an essential part of the fungal cell wall

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17
Q

Nystatin

A

suspension, tablet
typical forms (Nyamyc, Nystop)
suspension, swish in the mouth retain for as long as possible, several min before swallowing

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18
Q

Griseofulvin

A

indicated for skin, hair, and nails fungal infection
take with fatty meal or food/milk
can increase metabolism of hormonal contraceptives

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19
Q

Terbinafine

A

Lamisil AT
(Rx, OTC)
hepatotoxic
SJS/TEN/DRESS

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20
Q

Clotrimazole

A

10mg troche /lozenge
topical and vaginal brands
monitor LFTs

21
Q

Miconazole

A

buccal tablets Oravig

22
Q

Candida albicans
oropharyngeal infection (thrush)

A

mild: topical- clotrimazole, miconazole
moderate-severe or HIV +: fluconazole
alternative: nystatin

23
Q

Candida albicans
Esophageal infection

A

fluconazole
alternative: echinocandin

24
Q

Candida krusei and glabrata
all candida species bloodstream infections

A

Echinocandin
alternative: Amphotericin B, high dose fluconazole (susceptible isolates only)

25
Q

Aspergillus
invasive

A

Voriconazole
alternative: Amphotericin B, Isavuconazonium

26
Q

Cryptococcus neoformans
meningitis

A

Amphotericin B + flucytosine (5-FC)
alternative: High-dose fluconazole + flucytonsine (5-FC)

27
Q

Dermatophytes
nail bed infections

A

terbinafine or itraconazole
alternate: Fluconazole

28
Q

neuraminidase inhibitors

A

reduce the amount of virus in the body by inhibiting the enzyme which enables the release of new viral particles from infected cells

29
Q

endonuclease inhibitors

A

post-exposure prevention, within 48 hours of exposure

30
Q

Oseltamivir

A

tamiflu
75mg BIDx 5 days
capsule and suspension
warning neuropsych event
SJS/TEN
renal adjust after CrCl<60
store reconstituted suspension at room temp for 10 days or fridge for 17 days
- neuraminidase inhibitor

31
Q

Zanamivir

A

Relenza Diskhaler
bronchospasms (do not use on asthma, COPD, or breathing issue pt)
- neuraminidase inhibitor

32
Q

Peramivir

A

Rapivab
injection
renal adjust after CrCl<50
- neuraminidase inhibitor

33
Q

Baloxavir marboxil

A

Xofluza
single-dose, withing 48 hr of exposure
- endonuclease inhibitor

34
Q

Acyclovir

A

Zovirax, Sitavig
nephrotoxic
avoid in renal impairment
dosing based on IBW even in obese pts

35
Q

Valacyclovir

A

Valtrex
prodrug of acyclovir

36
Q

Famciclovir

A

prodrug of penciclovir

37
Q

topical Herpes Labialis
Docosanol

A

Abreva
OTC
apply 5x daily of first sign of outbreak

38
Q

topical Herpes Labialis
Acyclovir cream

A

Zovirax- Rx
Apply 5x daily for 5 days

39
Q

topical Herpes Labialis
acyclovir buccal

A

sitavig- rx
apply 50mg tab as a sing dose to upper gum region

40
Q

topical Herpes Labialis
penciclovir
cream

A

denavir- rx
apply every 2hr during waking hours for 4 days

41
Q

systemic oral tx of herpes labialis
acyclovir

A

initial tx for 7-10 days: 200mg 5x daily or 400mg TID
recurrence: 400mg TID x 5-10 days
chronic suppression: 400mg BID

42
Q

systemic oral tx of herpes labialis
Valacyclovir

A

initial tx for 7-10 days: 1g BID
recurrence: 2g BIDx 1 day
chronic suppression: 500,g or 1g daily

43
Q

systemic oral tx of herpes labialis
famciclovir

A

initial tx for 7-10 days: 250mg 3x daily or 500mg BID
recurrence: 1.5 g x 1 dose
chronic suppression:

44
Q

shingles

A

herpes zoster
Zovirax 800mg 5x daily for 7 days
Valtrex 1g TID for 7 days
famciclovir 500mg TID for 7 days

45
Q

Ganciclovir

A

injection

Zirgan- ophtalmic gel
myelosuppression

46
Q

Valganciclovir

A

Valcyte
tablet and solution
prodrug of ganciclovir better bioavailability
solution: refrigerate, discard after 49 days

47
Q

Cidofovir

A

injection
CMV retinitis in HIV pts only
nephrotoxic, contra in SCr >1.5

48
Q

Foscarnet

A

Foscavir
injection, CMV retinits ressitant HSV
boxed warning, renal impairment

49
Q

nail bed infection first line

A

terbinafine, intraconazole, fluconazole

NAPLEx (75 decks)

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