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Pharm Exam 3 > ch 80 > Flashcards

ch 80 Flashcards

1
Q

drug for Herpes simplex virus (HSV) and Varicella zoster virus (VZV) and CMV (cytomegalovirus)

A

Acyclovir for HSV only treat infections of gum and mouth

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2
Q

herpes face and oropharynx is usually what

A

HSV 2 ALSO HSV1

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3
Q

oral acyclovir can be used for treatment of HSV2 unless they are

A

immune compromised - they need IV acyclovir - because the infection can get severe

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4
Q

herpes labialis treatment

A

no treatment but oral acyclovir can be taken prophylactically to prevent episodes of recurrent episodes

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5
Q

herpes zoster (shingles) treatment in older adults

A

high doses of oral acyclovir - can also help with post herpetic neuralgia in shingles

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6
Q

varicella (chicken pox) in children adolescents and adults

A

oral acyclovir if begun early (within 24 hours of rash onset)

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7
Q

acyclovir in renal

A

renal dosing needed

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8
Q

adverse effects oral acyclovir

A

n/v/d
headache
vertigo

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9
Q

topical acyclovir

A

local burning

stinging

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10
Q

adverse effects IV acyclovir

A

renal failure

patients with preexisting renal disease and dehydration are at increased risk

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11
Q

pt ed acyclovir

A

only decreases symptoms - does not cure

apply topical with a finger cot or rubber glove to avoid transfer to other body sites and other people. some transient local burning or stinking may occur and this is not a reaction

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12
Q

acyclovir and children

A

approved for children as young as 3 months old
Valcyclovir approved for 2 and older
no foscarnet or famciclovir

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13
Q

pregnant and acyclovir

A

no for pregnancy

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14
Q

use of what drug in pregnancy is linked to depositing in tooth enamel and causes abnormal development of tooth enamel

A

foscarnet

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15
Q

breastfeeding and acyclovir

A

no

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16
Q

older adults and acyclovir

A

no contraindications
renal impairment need renal dosing
acyclovir and valacyclovir put them at greater risk for CNS effects

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17
Q

Valacyclovir (Valtrex) is a ______ form of acyclovir

A

prodrug

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18
Q

herpes labialis is a

A

cold sore

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19
Q

herpes simplex genitalis

A

genital herpes

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20
Q

Valacyclovir is approved for

A

1) herpes labialis
2) varicella (chickenpox)
3) herpes zoster (shingles)
4) herpes simplex genitalis (genital herpes)

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21
Q

adverse effect of valacyclovir in immunocompromised

A

thrombotic thrombocytopenic purpura/hemolytic uremic syndrome (TTP/HUS) - can be fatal)

only approved in this population for chronic suppressive therapy for recurrent genital herpes in pt with HIV

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22
Q

______ is a prodrug of penciclovir

A

Famciclovir

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23
Q

famciclovir is used to treat

A

acute herpes zoster and herpes simplex genitalis, can decrease the time to full crusting from 7 days down to 5 days - does not decrease the incidence of postherpetic neuralgia but can decrease from 112 days to 61 days

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24
Q

adverse effects of famciclovir

A

headache and nausea

if higher than rec doses, renal failure

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25
Q

topical drugs for herpes Labialis

A

penciclovir

docosanol

26
Q 
Penciclovir cream (denavir) - how often/how long
how well does it work
single adverse effect
A

applied every 2 hrs when awake for 4 days
only decreased it by a half a day
adverse effect is mild local erythema

27
Q 
Docosanol cream (abreva)
for what?
apply 5 times a day
how well does it work
adverse effect
A

topical for recurrent herpes labialis
apply 5 times a day
decreases from 4.8 days to 4.1 days
no effects

28
Q

Trifluridine (Viroptic)
treats what
side effects
systemic?

A

for topical treatment of ocular infections caused by HSV1 and HSV2
given to treat acute keratoconjunctivitis and recurrent epithelial keratitis
most common side effects localized burning and stinking

minimal systemic absorption

29
Q

Ganciclovir gel
what does it treat
adverse effects

A

acute herpetic keratitis (inflammation and ulceration of the cornea caused by HSV)

adverse effects - blurred vision, eye irritation and red eyes
no systemic affects

30
Q

baseline data for acyclovir

A

liver enzymes

31
Q

baseline data for valacyclovir

A

liver enzymes

32
Q

baseline data for foscarnet

A

electrolytes
24 hr creatinine clearance
ecg

33
Q

monitoring for acyclovir

A

serum creatinine with BUN (if clinically indicated)
CBC
Urinalysis sp. gravity for evidence of dehydration
urine output
liver enzymes

34
Q

monitoring for valacyclovir

A

serum creatinine with BUN (if clinically indicated)
CBC
urinalysis
liver enzymes

35
Q

monitoring for Foscarnet

A 
serum creatinine with BUN (if clinically indicated)
CBC
Electrolytes
calcium
ionized calcium
magnesium
phosphorus
36
Q

which antiviral causes QT

A

Foscarnet

37
Q

adverse reactions for Foscarnet

A 
QT prolongation
hypocalcemia
hyper/hypophosphatemia
hypomagnesemia
hypokalemia
renal injury
anemia 
granulocytopenia
common reactions include
fever
n/v/d
anemia
headache
38
Q

if mom has genital herpes and is in labor, what is given

A

Acyclovir

39
Q

which herpes is not treated for suppression

A

zoster

40
Q

what is used in acyclovir resistant HSV or VZV

A

foscarnet

41
Q

can you use foscarnet in pregnancy

A

no

42
Q

who cannot take Foscarnet

A

heart failure (due to high sodium content of drug)
history of QT
renal impairment
preexisting electrolyte cardiac or neuro abnormalities

43
Q

renal injury risk is increased when taking Foscarnet when taking

A

nephrotoxic drugs such as amphoteracin B
aminoglycosides (Gentamicin)
pentamidine

Prehydrate with IV saline to reduce risk
monitor renal function (creatinine clearance) closely
reduce dose if renal impairment develops

44
Q

symptoms of low calcium

A

paresthesias
perioral tingling

monitor ionized calcium, serum may be normal

45
Q

severe hypocalcemia can result in

A

dysrhythmias
tetany
seizures

46
Q

the risk for hypocalcemia is increased if also taking _____ with Foscarnet

A

Pentamidine

47
Q

flue symptoms begin _____ days after exposure and lasts _____

A

2-4 days

5-6 days

48
Q

flu symptoms

A 
fever
cough
chills
sore throat
headache
myalgia
49
Q

route of transmission flu

A

droplet
enters through mucous membranes
such as mouth nose eyes

replication in resp tract

50
Q

what kinds are available

A

inactivated influenza vaccine (IIV)
recombinant hemagglutinin vaccine (RIV)
Live attenuated influenza vaccine (LAIV)

51
Q

How many flu vaccines

A

one dose per year for ages 2-8 years who have not been vaccinated before require 2 doses given 1 month apart. protection is 1-2 weeks after and immunity lasts about 6 mos or longer

52
Q

inactivated influenza adverse effects

A

soreness at site
myalgia, fever, malaise
Guillain Barre syndrome (paralytic illness)

53
Q

live vaccine side effects (flu

A 
congestion
rhinorrhea
lethargy
headache
sore throat
decreased appetite
54
Q

who cannot get live flu vaccine

A 
pregnant
immune compromised
Guillain Barre
flu vaccine reaction
do not give if have moderate ot severe acute illness when going to give
55
Q

who should get flu vaccine

A 
children younger than 5 esp younger than 2
pregnant
children 18 and younger receiving long term ASA therapy
65 and older
morbidly obese
nursing home or ltac residents
native americans /alaskan natives
immunosuppressed
chronic med conditions
neuro disorders
cerebral palsy
56
Q

best time to give flu vaccine

A

oct nov and as late as april

flu season is nov - march or april

57
Q

tamiflu has to be taken with in the first

A

48 hours of symptoms

earlier the better

within 12 hours reduces by more than 3 days
within 24 hours reduces by 2 days
within 36 hours, reduces by 29 hours
within

58
Q

if someone at home is sick with flu, and someone is high risk

A

use tamiflu prophylactically

59
Q

tamiflu should be discontinued ___ weeks before giving LAIV

A

2

60
Q

After dosing with LAIV wait ____ before starting tamiflu

A

2 weeks

Pharm Exam 3 (19 decks)

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