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Pharm2 > Exam4 > Flashcards

Exam4 Flashcards

1
Q

treatment challenges pertaining to tuberculosis

A
  • adherence (hard for pts. to take antibiotics for 6mo-2yrs)
  • drug resistance
  • toxicities (hepatotoxicity*)
  • cost (wallet toxicity)
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2
Q

isoniazid

A

antituberculosis med

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3
Q

pyrazinamide

A

antituberculosis med

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4
Q

ethambutol

A

antituberculosis med

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5
Q

rifampin

A

antituberculosis med

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6
Q

tuberculosis usually requires multiple antibiotics for ___________

A

6 months to 2 years

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7
Q

isoniazid can cause ________

A

(TB med)

peripheral neuropathy

give: pyridoxine (vitamin B6)

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8
Q

which group of meds can have numerous CYP interactions?

A

antituberculosis meds

  • isoniazid
  • pyrazinamide
  • ethambutol
  • rifampin
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9
Q

rifampin causes ________ secretions

A

(TB med)

red-orange

(urine, saliva, sweat, tears)

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10
Q

ethambutol causes _______

A

(TB med)

red-green color blindness

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11
Q

amphotericin B

A

antifungal

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12
Q

-azoles

A

antifungal

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13
Q

amphotericin B mechanism of action

A

(antifungal)

  • BIND to a substance on fungal membranes called ergosterol
  • this causes the membrane to become more permeable, allowing important cations like POTASSIUM to leak out

-amphotericin B also binds to the cholesterol on our cell membranes, causing damage and toxicity

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14
Q

azoles mechanism of action

A

(antifungal)

  • interfere with the PRODUCTION of ergosterol, an important component of fungal cellular membrane
  • without a sturdy cellular membrane, fungi die
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15
Q

problems with amphotericin B

A

(antifungal)

  • infusion rxns (fever, chills, rigors, headache)
  • phlebitis (rotate IV sites! pump slowly– 2-4hrs)
  • nephrotoxicity
  • hypokalemia
  • anemia
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16
Q

when someone is taking amphotericin B and experiences RIGORS, what should you administer?

A

dantrolene

rigors= really strong shaking of the body

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17
Q

problems with azoles

A

(antifungal)

  • better tolerated than amphotericin B
  • hepatotoxicity
  • numerous CYP interactions
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18
Q

antifungal high yield concepts

A
  • amphotericin B is sometimes toxic to our own cells, causing an infusion rxn
  • amphotericin B is reserved for severe, systemic fungal infections
  • amphotericin B is nephrotoxic
  • azoles are hepatotoxic
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19
Q

HSV (herpes simplex virus)

A
  • vesicular lesion (crusts)
  • lies dormant in nerves
  • HSV1- mouth, faces, eyes and CNS
  • HSV2- genitalia
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20
Q

HSV meds

A
  • acyclovir

- valacyclovir

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21
Q

adverse effects of HSV meds

A
  • very well tolerated
  • headache
  • N/V
  • phlebitis
22
Q

rare side effects of HSV meds

A
  • crystal urea (kidneys)

- altered mental status

23
Q

influenza vaccines

A
  • protection begins in 1-2 weeks
  • lasts ~6months (4months for older people)
  • THEY DO NOT CAUSE THE FLU
24
Q

influenza med to know

A

oseltamivir

25
Q

oseltamivir mechanism

A

-blocks neuraminidase to release viral cells (inactivates it)

26
Q

adverse effects of influenza med (oseltamivir)

A
  • extremely well tolerated
  • N/V

rare side effects:
-neuropsychiatric episodes

27
Q

benefits of oseltamivir

A
  • must take within 48 hrs (symptoms)
  • decreases DURATION of symptoms
  • effective at preventing influenza) but not a substitute for vaccination
28
Q

major groups of rheumatoid arthritis

A
  • NSAIDs (decrease inflammation)
  • glucocorticoids (change WBC to become less active)
  • DMARDs (disease-modifying anti-rheumatic drugs) = slow down the disease
29
Q

methotrexate

A

DMARDs

for RA (rheumatoid arthritis)

30
Q

hydroxychloroquine

A

DMARDs

for RA

31
Q

TNF blockers

A

DMARDs

for RA

32
Q

adverse effects of methotrexate

A

(DMARDs) (for RA)

  • N/D
  • GI ulceration
  • decreased bone marrow
  • pneumonitis
  • hepatotoxicity
  • renal failure
  • infection
  • severe rash (Stevens-Johnson syndrome)
33
Q

mechanism of action of methotrexate

A
  • blocks DHRF (dihydrofolate reductase)
  • ->can’t make DNA
  • ->turns of inflammatory response
  • ->slows down bone crunching
34
Q

hydroxychloroquine info

A
  • for mild RA (less toxic, less effective)
  • usually combined with methotrexate
  • take with food
  • **risk of retinal damage
35
Q

infliximab

A

TNF blockers

DMARDs) (used for RA

36
Q

adalimunab

A

TNF blockers

DMARDs) (used for RA

37
Q

etanercept

A

TNF blockers

DMARDs) (used for RA

38
Q

common adverse effects of TNF blockers

A

(infliximab, adalimunab, etanercept)
(DMARDs) (used for RA)

  • injection-site reactions (~40%)
  • increase risk for infections (pneumonia, TB)
39
Q

rare adverse effects of TNF blockers

A

(infliximab, adalimunab, etanercept)
(DMARDs) (used for RA)

  • severe allergic rxns
  • heart failure
  • hepatotoxicity
  • cancer (lymphoma)
40
Q

allopurinol

A

Gout meds

41
Q

colcichine

A

Gout meds

42
Q

allopurinol info

A
  • gout prevention and treatment
  • full effect in 1-2 months
  • goal is uric acid < 6mg/dL
  • indicated for certain cancers
43
Q

adverse effects of allopurinol

A
  • acute gouty attacks
  • hypersensitivity syndrome (rare)
  • hepatotoxicity (rare)
44
Q

adverse effects of colcichine

A
  • diarrhea (25%)
  • myopathy
  • bone marrow suppression
45
Q

bisphosphonates

A

osteoporosis meds

46
Q

raloxifene

A

osteoporosis meds

47
Q

bisphosphonate meds to know

A

ending in -dronate

alendronate
ibandronate
risedronate

48
Q

adverse effects of bisphosphonate

A

VERY IRRITATING TO THE GI TRACT

  • heartburn
  • abdominal pain
  • diarrhea
  • hypocalcemia
  • osteonecrosis of the jaw
49
Q

client teaching about bisphosphonate

A
  • take in the AM
  • completely empty stomach
  • full glass of water
  • stay upright for 30-60min (prevents reflux in the esophagus)
50
Q

raloxifene info

A

(osteoporosis med)

  • estrogen ANTagonist to the uterus and breasts
  • estrogen Agonist to the bones
  • decrease cancer risk
51
Q

adverse effects of raloxifene

A

(osteoporosis med)

  • hot flashes
  • leg cramping
  • edema, weight gain
52
Q

black box warning for raloxifene

A
  • thromboembolism

- stroke

Pharm2 (7 decks)

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