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PHRM 865 > E4 clin pharm (non-HIV) > Flashcards

E4 clin pharm (non-HIV) Flashcards

1
Q

HSV1
A. oral mucosa
B. genital mucosa

A

oral

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2
Q

HSV2
A. oral mucosa
B. genital mucosa

A

B

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3
Q

Cold sore
A. HSV1
B. HSV2

A

A

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4
Q

2 ways to diagnose HSV1/2

A

swab or PCR

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5
Q

how is HSV2 transferred?

A

infected secretions

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6
Q

T or F:
HSV encephalitis is mostly caused by HSV2 but can still be caused by HSV1

A

false, other way around HSV1 90% of cases

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7
Q

3 most common symptoms of HSV encephalitis

A

fever
confusion
abnormal behavior

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8
Q

how do you diagnose HSV encephalitis?

A

lumbar puncture and PCR testing

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9
Q

T or F: acyclovir is removed by hemodialysis

A

true

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10
Q

other than renally, when is another time we dose adjust acyclovir? what weight would we use?

A

obesity, use AdjBW

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11
Q

Notable side effect of oral acyclovir

A

headache

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12
Q

incredibly super duper notable side effect of IV formulation acyclovir

A

nephrotoxicity**

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13
Q

what does nephrotoxicity look like?

A

lethargy, confusino, agitation, disorientation, hallucination, seizure and coma. damn

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14
Q

Dose + duration of acyclovir, genital HSV, primary infection (1)

A

400 mg po TID x 7-10 days (higher dose first)
ignoring the other one cause she said no pts do it 5x a day

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15
Q

Dosing for acyclovir genital HSV, recurrent infection (2 options)

A
  • 800mg po TID x 2 days
  • 800mg po BID x 5 days
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16
Q

classification of suppression for genital/oral HSV -> how many infections a year?

A

more than 10

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17
Q

acyclovir dose for genital HSV suppression

A

400 mg po bid

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18
Q

acyclovir dose for oral HSV

A

400 mg po TID x 5-10 ds

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19
Q

acyclovir dose for HSV encephalitis **

A

10mg/kg IV q8h for 14-21 days (use AdjBW)

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20
Q

what does the conversion of valacyclovir to acyclovir do

A

increase bioavailability of acyclovir

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21
Q

Valacyclovir dose for oral herpes

A

2g q12h for 1 day

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22
Q

valacyclovir dose for genital herpes, primary

A

1g po bid x 7-10 days

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23
Q

valacyclovir dose for recurrent genital herpes (2 options)

A
  • 500mg po bid x 3 days
  • 1 g po qd x 5 days
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24
Q

valacyclovir dose for genital herpes, suppression (2)

A
  • 500-1000mg po qd IF IMMUNOCOMPETENT
  • 500 mg po bid in HIV pts
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25
interesting little thing about famciclovir
conc increases proportional to drug given -> linear kinetics
26
how is famciclovir excreted
urine -> tubular secretion -> glomerular filtration
27
DDI with famciclovir and what does it do?
probenecid, dec renal clearance, inc serum conc = bad
28
famciclovir dose in oral herpes
1.5g single dose
29
famciclovir dose for genital herpes, primary
250 mg po tid x 7-10 days
30
famciclovir dose for recurrent genital herpes infection (2)
- 125 mg po bid x 5 days - 1g po bid x 1 day
31
famciclovir dose for suppression of genital herpes
250 mg po bid
32
dose of acyclovir for varicella
800mg po q4h for 5-7 days
33
dose of acyclovir for zoster
800 mg po q4h for 7-10 days
34
dose of acyclovir for severe disseminated disease or VZV encephalitis *
10mg/lg IV q8hr for 14-21 days (use adjBW)
35
Valacyclovir dose for varicella
1g po q8h for 5-7 days and until lesions have crusted
36
valacyclovir dose for zoster
1g po q8h for 7 days (pref over PO acyclovir)
37
valacyclovir dose for disseminated zoster (3 things here)
- initial treatment with IV acyclovir - treat for 10-14 days - can transition to valacyclovir once improved
38
dose of famciclovir for varicella
there is none dumbass thats shingles only
39
famciclovir dose for zoster
500mg po tid for 7 days
40
CMV can cause serious infections most commonly where
in the eyes
41
DDI w/ ganciclovir: class of drug and problem caused
cytotoxic drugs, risk of BM suppression, probenecid
42
most notable AE for ganciclovir
bone marrow suppression
43
what should you monitor if suspected BM suppression on ganciclovir? when should you stop the drug?
CBC w/ differential. stop if ANC <500 OR platelet <25,000
44
Ganciclovir dose for CMV retinitis induction
5mg/kg IV q12h for 14-21 days
45
Should counsel patient to take with food. A. Valacyclovir B. Acyclovir C. Valganciclovir D. Famciclovir
C
46
Valganciclovir dose for CMV retinitis induction
900 mg bid for 21 days
47
valganciclovir dose for CMV retinitis maintenance
900mg po qd (usually the drug we use for maintenance*)
48
IV formulation contains hydroxypropyl betadex. A. Valacyclovir B. Letermovir C. Foscarnet D. Valganciclovir
B
49
Dont use often bc there is a ton of DDI A. Valacyclovir B. Letermovir C. Foscarnet D. Valganciclovir
B
50
Bone sequesters A. Valacyclovir B. Letermovir C. Foscarnet D. Valganciclovir
C
51
not a prodrug A. Valacyclovir B. Penciclovir C. Foscarnet D. Valganciclovir
C
52
big dose limiting AE for foscarnet
nephrotoxicity no way
53
Foscarnet CMV retinitis induction dose
60 mg/kg IV q8h or 90 mg/kg q12h for 14-21 days
54
Foscarnet CMV retinitis maintenance dose
90-120 mg/kg IV q24h
55
inhalation A. Zanamivir B. Oseltamivir C. Peramivir
A
56
can be in capsules A. Zanamivir B. Oseltamivir C. Peramivir
B
57
IV only A. Zanamivir B. Oseltamivir C. Peramivir
C
58
when not to give live vaccine if pt taking oseltamivir
do NOT administer within 2 weeks before or 48 hours after admin of tamiflu
59
no significant DDI A. Zanamivir B. Oseltamivir C. Peramivir
A
60
bronchospasm, cant use in asthma or COPD A. Zanamivir B. Oseltamivir C. Peramivir
A
61
tx of pts >7 years of age who have been symptomatic for no more than 2 days A. Zanamivir B. Oseltamivir C. Peramivir
A
62
AEs of diarrhea, serious hypersensitivity reactions A. Zanamivir B. Oseltamivir C. Peramivir
C
63
indicated in pts 18 or older A. Zanamivir B. Oseltamivir C. Peramivir
C
64
dose of peramivir for flu
600mg IV infusion over 15 min SINGLE DOSE
65
Baloxavir MOA
inhibits polymerase acidic (PA) endonuclease (influenza specific enzyme in the viral DNA polymerase complex required for viral gene transcription) -> inhibition of mRNA synthesis and viral replication
66
Baloxavir is a prodrug converted to active drug by _______
hydrolysis
67
what should you avoid with baloxavir?
dairy / calcium stuff
68
baloxavir doses for flu (2)
40 kg to < 80 kg - 40 mg PO single dose >80 kg - 80 mg PO single dose
69
Acyclovir is the drug of choice against which of the following? (select all that apply) A. HSV 1/2 B. VZV C. CMV D. EBV
A B
70
Valacyclovir is the drug of choice against which of the following? (select all that apply) A. HSV 1/2 B. VZV C. CMV D. EBV
A B
71
Ganciclovir is the drug of choice against which of the following? (select all that apply) A. HSV 1/2 B. VZV C. CMV D. EBV
C
72
Valganciclovir is the drug of choice against which of the following? (select all that apply) A. HSV 1/2 B. VZV C. CMV D. EBV
C
73
Famciclovir has activity against which of the following? (select all that apply) A. HSV 1/2 B. VZV C. CMV D. EBV
A B
74
Foscarnet has activity against which of the following? (select all that apply) A. HSV 1/2 B. VZV C. CMV D. EBV
all

PHRM 865 (40 decks)

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