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PHARM > Antiinfectives part 2 > Flashcards

Antiinfectives part 2 Flashcards

1
Q

Which medication can be used to treat influenza A and B?

A

Oseltamivir (Tamiflu)

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2
Q

INH is available in what forms?

A

PO and IM

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3
Q

Sx of lactic acidosis and hepatomegaly?

A

nausea, vomiting, abdominal pain, malaise, fatigue, anorexia, and hyperventilation

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4
Q

How often should we monitor serum creatine with Amp B tx?

A

Q2-4 days

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5
Q

Adverse effects of Amphotericin B?

A

infusion rxns*, elevated liver enzymes, nephrotoxicity, delirium, hypotension, HTN, wheezing, hypoxia, hypokalemia, and hematologic effects.

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6
Q

Therapeutic use of INH?

A
  1. Single use for latent TB.

2. Must be used in combination for active TB.

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7
Q

What 2 main labs need to evaluated prior to administration of all HIV meds?

A

CD4 T cell counts and plasma HIV RNA (viral load) assays

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8
Q

MOA of Enfuvirtide?

A

Keep virus from entering the cell

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9
Q

How should Itraconazole be taken?

A

with food or cola beverage to enhance absorption

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10
Q

What is a disadvantage of Azoles?

A

Inhibit cytochrome P450

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11
Q

Common adverse effects of Darunavir?

A

Hyperglycemia/ diabetes, fat redistribution, HLD, reduced bone density, elevation of serum transaminase.

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12
Q

Pre-tx options for mild infusion rxns assoc with Amp B?

A

Diphenhydramine + acetaminophen. ASA (not best option d/t kidney damage)

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13
Q

Precautions with Enfuvirtide?

A

PNA risk factors, low initial CD4 counts, high initial viral load, IV drug use, smoking, hx of lung disease.

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14
Q

How to prevent phlebitis if using peripheral line?

A

change PIV sites often

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15
Q

What is used to treat when a patient has issues with peripheral neuropathy?

A

Pyridoxine (vitamin B6)

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16
Q

T/F. Take drugs that raise gastric pH at least 1hr before Itraconazole or 2 hours after.

A

True

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17
Q

What are the 4 classes of antifungal drugs?

A

Polyene abx, Azoles, Echinocandins, and Pyrimidine analogs.

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18
Q

When does Oseltamivir need to be taken to be effective?

A

Within 48 hours

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19
Q

Precautions with Raltegravir?

A

Pregnancy risk, category C

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20
Q

Adverse effects of Itraconazole?

A

Cardiosuppression, Liver damage, inhibit drug-metabolizing enzymes, *nausea, *vomiting, *diarrhea

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21
Q

How should Darunavir be taken?

A

PO w/ food. Must be boosted w/ Ritonavir.

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22
Q

How can we minimize renal damage during Amp B therapy?

A

infuse 1L of saline on tx days

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23
Q

Common adverse effects for NRTIs?

A

Lactic acidosis with hepatomegaly

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24
Q

Ethambutol is available in what forms?

A

PO (QD, w/ food if GI upset)

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25
Q

What are the 1st line drugs for TB tx?

A

Isoniazid (INH), Rifampin (RIF), Pyrazinamide (PZA), and Ethambutol (EMB)

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26
Q

Common adverse effects of Raltegravir (Isentress)?

A

insomnia and HA

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27
Q

MOA of Acyclovir?

A

Interferes with viral DNA synthesis.

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28
Q

Therapeutic use of Rifampin?

A
  1. Active TB.
  2. Elimination of meningococcal carriers.
  3. Prevention of disease caused by Haemophilus influenzae type B in close contacts.
  4. Synergy with other antimicrobial agents for S. aureus infections.
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29
Q

Rifampin contraindications?

A

patient’s taking protease inhibitors and delavirdine.

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30
Q

Which azole is an alternative to Amp B?

A

Itraconazole (Sporanox)

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31
Q

Therapeutic use of Acyclovir?

A

Recurrent genital herpes infections, mucocutaneous herpes, varicella-zoster.

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32
Q

Therapeutic use of Metronidazole?

A 
o	Intestinal amebiasis
o	Amebic liver abscess
o	Trichomoniasis
o	Bacterial vaginosis
o	IV anaerobic infections.
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33
Q

What class drug is Efavirenz (Sustiva)?

A

NNRTI

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34
Q

What are sx of hepatitis?

A

jaundice, anorexia, malaise, fatigue, nausea

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35
Q

MOA of Itraconazole

A
  1. Inhibits synthesis of ergosterol.

2. Inhibits fungal cytochrome P450.

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36
Q

MOA of Efavirenz?

A

acts within the CD4 cell

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37
Q

Adverse effects of Maraviroc?

A

Cough, dizziness, pyrexia, rash, abdominal pain, MSK symptoms, URI, hepatotoxicity

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38
Q

Abacavir falls under which class of antivirals?

A

NRTIs

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39
Q

Available forms of PZA?

A

PO (QD, empty stomach)

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40
Q

Serious adverse effects of Flagyl?

A

superinfection, seizures, Steven-johnson’s syndrome

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41
Q

Acyclovir precautions?

A

dehydration , renal impairment, taking nephrotoxic drugs

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42
Q

Common adverse effects of Flagyl?

A

dizziness, HA, abd pain, nausea, anorexia, metallic taste

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43
Q

What antiviral class is Enfuvirtide (Fuzeon)?

A

Fusion inhibitor

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44
Q

MOA of Oseltamivir?

A

inhibits viral enzyme neuraminidase

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45
Q

MOA of Abacavir?

A

Will work within the CD4 cell

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46
Q

What are signs of liver dysfunction?

A

anorexia, darkened urine, pale stools, yellow discoloration of eyes or skin.

47
Q

MOA of Ethambutol?

A

Bacteriostatic: weakens but does not fully kill the bacilli. Active against strains that are resistant to isoniazid and rifampin.

48
Q

Therapeutic use of Ethambutol (Myambutol)?

A
  1. Initial treatment of TB and treatment of patients who have received therapy previously.
  2. Tuberculosis
49
Q

Extent of renal damage assoc w/ Amp B is r/t?

A

TOTAL dose administered over full course of tx.

50
Q

Interactions with INH?

A

phenytoin, rifampin, rifabutin, rifapentine or pyrazinamide

51
Q

Metronidazole is available in what?

A

Topical, PO, IV

52
Q

What meds should be avoided while takin Amp B?

A

nephrotoxic drugs and NSAIDs

53
Q

Infusion consideration with Amp B?

A

test dose, check for precipitate, assess for phlebitis, individualized dosing.

54
Q

Caution use of INH with?

A

ETOH abuse, DM, vitamin B6 deficiency, >50

55
Q

Rifampin can reduce effectiveness of what drugs?

A

warfarin, delavirdine (NNRTI), oral contraceptives, most protease inhibitors.

56
Q

Adverse effects of Rifampin?

A

Red discoloration of tears, sweat, saliva, & urine, abdominal pain, diarrhea, flatulence, heartburn, nausea, vomiting, hepatotoxicity, CNS symptoms, rash, blood dyscrasias, acute renal failure

57
Q

Pre-tx options for rigors assoc with Amp B?

A

Meperidine (Demerol), dantrolene (Revonto), hydrocortisone (if needed give slowly)

58
Q

Adverse effects of Enfuvirtide?

A

injection site rxns, PNA, hypersensitivity rxns

59
Q

Drug class of Metronidazole (Flagyl)?

A

Abx, Antiprotozoal

60
Q

Adverse effects of INH?

A

Peripheral neuropathy*, hepatotoxicity, optic neuritis, anemia, psychological disturbances.

61
Q

Contraindications for Oseltamivir?

A

HTN, children <1

62
Q

Rifampin is available in what forms?

A

PO and IV (slow infusion)

63
Q

How is PO Flagyl taken?

A

QD with food if GI upset

64
Q

Darunavir drug interactions?

A

Inhibits cytochrome P450

65
Q

How should Acyclovir be applied topically?

A

with rubber glove

66
Q

How should Efavirenz be taken?

A

PO, empty stomach, same time QD

67
Q

Therapeutic use of Pyrazinamide (PZA)?

A

TB

68
Q

What other baseline labs should be taken for Darunavir?

A

serum transaminase and blood glucose

69
Q

Contraindications for Itraconazole?

A

contraindicated for patients taking pimozide, quinidine, dofetilide, or cisapride

70
Q

MOA of Raltegravir?

A

works outside of the CD4 cell to stop HIV from replicating

71
Q

PZA contraindications?

A

severe liver disease or acute gout

72
Q

What are the injectable drugs used as second line TB drugs?

A

Streptomyces: Capreomycin [Capastat Sulfate]

Aminoglycoside antibiotics: Amikacin [Amikin], kanamycin

73
Q

Name 2 fluoroquinolones used as second line TB drugs?

A

Levofloxacin [Levaquin] and moxifloxacin [Avelox]

74
Q

Residual kidney damage assoc with Amp B is likely to occur at what level?

A

total dose >4g

75
Q

T/F. Heparin can be used in the infusion site to prevent phlebitis associated with Amp B therapy.

A

True

76
Q

Amphotericin B is available in what forms?

A

IV- slow infusion 2-4hrs

Intrathecal??

77
Q

How does PZA cause hyperurecemia?

A

inhibits the excretion of uric acid

78
Q

What are rare side effects of Amp B?

A

rash, seizures, anaphylaxis, dysrhythmias, acute liver failure, nephrogenic diabetes insipidus.

79
Q

What class drug is Raltegravir (Isentress)?

A

INSTIs

80
Q

INH contraindications?

A

acute liver disease or hx of INH hepatotoxicity

81
Q

MOA of Amphotericin B?

A

Binds to ergosterols to make fungal cell more permeable.

82
Q

Precautions with Ethambutol?

A

ETOH abuse

83
Q

When are second line TB drugs used?

A
  1. Resistance to 1st line drugs.
  2. severe pulmonary TB
  3. disseminated (extrapulmonary) infection.
84
Q

PZA precautions?

A

ETOH abuse

85
Q

Precautions with Tamiflu?

A

Lactation

86
Q

What baseline information do we need for Itraconazole?

A

hx of heart disease, liver function test

87
Q

How can nephrotoxicity be reduced with Acyclovir tx?

A

ensure adequate hydration during the infusion and for 2 hours after.

88
Q

How is IV Flagyl administered?

A

Infuse over 60min

89
Q

Precautions with Maraviroc?

A

elevated liver function and cardiovascular disease.

90
Q

Precautions with Metronidazole?

A

hepatic and renal impairment and seizure disorder

91
Q

What additional baseline lab should be assessed before giving Maraviroc?

A

proof that HIV strain is CCR5 tropic

92
Q

Itraconazole is available in what forms?

A

PO, QD

93
Q

Adverse effects of Ethambutol?

A

Hyperuricemia, optic neuritis; allergic rxn, GI upset, confusion.

94
Q

Ethambutol contraindications?

A

optic neuritis (take baseline eye test)

95
Q

What class is Darunavir?

A

Protease inhibitor

96
Q

Rifampin precautions?

A

ETOH abuse, liver disease.

97
Q

Precautions for Itraconazole?

A

Cardiac disease, significant pulmonary disease, liver disease.

98
Q

MOA of Pyrazinamide?

A

Bactericidal to M. tuberculosis

99
Q

What 2 drugs can produce the shortest TB therapy?

A

Isoniazid and Rifapentine

100
Q

MOA of Rifampin?

A

Inhibits synthesis of RNA; bactericidal effect.

101
Q

What antiviral class is Maraviroc (Selzentry)?

A

CCR5 antagonist

102
Q

What are the advantages of Azoles?

A

lower toxicity and can be given orally

103
Q

What are sx of infusion rxns with Amp B?

A

flu like: fever, chills, N, HA

104
Q

Which polyene abx is reserved for life threatening infections?

A

Amphotericin B

105
Q

Adverse effects of Tamiflu?

A

Nausea, vomiting, abdominal pain, CNS symptoms

106
Q

What is cardiosuppression?

A

transient decrease in ventricular ejection fraction

107
Q

Adverse effects of PZA?

A

Hepatotoxicity,
Nongouty polyarthralgias **,
Hyperuricemia, N/V/D, Photosensitivity.

108
Q

Available forms of Acyclovir?

A

PO, buccal, IV, topical

109
Q

Best line to infuse Amp B?

A

using a central vein

110
Q

Adverse effects of Efavirenz?

A

CNS rash and other hypersensitivity rxns, Steven Johnson’s, teratogenicity

111
Q

Adverse effects of Acyclovir?

A

Dizziness, headache, diarrhea, nausea, IV form: phlebitis*, reversible nephrotoxicity also vertigo.

112
Q

Interactions with Metronidazole?

A

alcohol, Cimetidine, phenobarbital, rifampin, phenytoin, lithium, and warfarin

113
Q

How should Enfuvirtide be given?

A

Subcut BID

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