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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
Q

interesting little thing about famciclovir

A

conc increases proportional to drug given -> linear kinetics

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26
Q

how is famciclovir excreted

A

urine -> tubular secretion -> glomerular filtration

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27
Q

DDI with famciclovir and what does it do?

A

probenecid, dec renal clearance, inc serum conc = bad

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28
Q

famciclovir dose in oral herpes

A

1.5g single dose

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29
Q

famciclovir dose for genital herpes, primary

A

250 mg po tid x 7-10 days

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30
Q

famciclovir dose for recurrent genital herpes infection (2)

A
  • 125 mg po bid x 5 days
  • 1g po bid x 1 day
31
Q

famciclovir dose for suppression of genital herpes

A

250 mg po bid

32
Q

dose of acyclovir for varicella

A

800mg po q4h for 5-7 days

33
Q

dose of acyclovir for zoster

A

800 mg po q4h for 7-10 days

34
Q

dose of acyclovir for severe disseminated disease or VZV encephalitis *

A

10mg/lg IV q8hr for 14-21 days (use adjBW)

35
Q

Valacyclovir dose for varicella

A

1g po q8h for 5-7 days and until lesions have crusted

36
Q

valacyclovir dose for zoster

A

1g po q8h for 7 days (pref over PO acyclovir)

37
Q

valacyclovir dose for disseminated zoster (3 things here)

A
  • initial treatment with IV acyclovir
  • treat for 10-14 days
  • can transition to valacyclovir once improved
38
Q

dose of famciclovir for varicella

A

there is none dumbass thats shingles only

39
Q

famciclovir dose for zoster

A

500mg po tid for 7 days

40
Q

CMV can cause serious infections most commonly where

A

in the eyes

41
Q

DDI w/ ganciclovir: class of drug and problem caused

A

cytotoxic drugs, risk of BM suppression, probenecid

42
Q

most notable AE for ganciclovir

A

bone marrow suppression

43
Q

what should you monitor if suspected BM suppression on ganciclovir? when should you stop the drug?

A

CBC w/ differential. stop if ANC <500 OR platelet <25,000

44
Q

Ganciclovir dose for CMV retinitis induction

A

5mg/kg IV q12h for 14-21 days

45
Q

Should counsel patient to take with food.
A. Valacyclovir
B. Acyclovir
C. Valganciclovir
D. Famciclovir

46
Q

Valganciclovir dose for CMV retinitis induction

A

900 mg bid for 21 days

47
Q

valganciclovir dose for CMV retinitis maintenance

A

900mg po qd (usually the drug we use for maintenance*)

48
Q

IV formulation contains hydroxypropyl betadex.
A. Valacyclovir
B. Letermovir
C. Foscarnet
D. Valganciclovir

49
Q

Dont use often bc there is a ton of DDI
A. Valacyclovir
B. Letermovir
C. Foscarnet
D. Valganciclovir

50
Q

Bone sequesters
A. Valacyclovir
B. Letermovir
C. Foscarnet
D. Valganciclovir

51
Q

not a prodrug
A. Valacyclovir
B. Penciclovir
C. Foscarnet
D. Valganciclovir

52
Q

big dose limiting AE for foscarnet

A

nephrotoxicity no way

53
Q

Foscarnet CMV retinitis induction dose

A

60 mg/kg IV q8h or 90 mg/kg q12h for 14-21 days

54
Q

Foscarnet CMV retinitis maintenance dose

A

90-120 mg/kg IV q24h

55
Q

inhalation
A. Zanamivir
B. Oseltamivir
C. Peramivir

56
Q

can be in capsules
A. Zanamivir
B. Oseltamivir
C. Peramivir

57
Q

IV only
A. Zanamivir
B. Oseltamivir
C. Peramivir

58
Q

when not to give live vaccine if pt taking oseltamivir

A

do NOT administer within 2 weeks before or 48 hours after admin of tamiflu

59
Q

no significant DDI
A. Zanamivir
B. Oseltamivir
C. Peramivir

60
Q

bronchospasm, cant use in asthma or COPD
A. Zanamivir
B. Oseltamivir
C. Peramivir

61
Q

tx of pts >7 years of age who have been symptomatic for no more than 2 days
A. Zanamivir
B. Oseltamivir
C. Peramivir

62
Q

AEs of diarrhea, serious hypersensitivity reactions
A. Zanamivir
B. Oseltamivir
C. Peramivir

63
Q

indicated in pts 18 or older
A. Zanamivir
B. Oseltamivir
C. Peramivir

64
Q

dose of peramivir for flu

A

600mg IV infusion over 15 min SINGLE DOSE

65
Q

Baloxavir MOA

A

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
Q

Baloxavir is a prodrug converted to active drug by _______

A

hydrolysis

67
Q

what should you avoid with baloxavir?

A

dairy / calcium stuff

68
Q

baloxavir doses for flu (2)

A

40 kg to < 80 kg - 40 mg PO single dose
>80 kg - 80 mg PO single dose

69
Q

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

70
Q

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

71
Q

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

72
Q

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

73
Q

Famciclovir has activity against which of the following? (select all that apply)
A. HSV 1/2
B. VZV
C. CMV
D. EBV

74
Q

Foscarnet has activity against which of the following? (select all that apply)
A. HSV 1/2
B. VZV
C. CMV
D. EBV

PHRM 865 (32 decks)

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