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NAPLEX 2021 (select RxPrep&PNN) > Infectious Disease 3: Antifungals & Antivirals > Flashcards

Infectious Disease 3: Antifungals & Antivirals Flashcards

1
Q

MOA amphotericin B

A

Binds ergosterol altering cells membrane permeability causing cell death

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2
Q

Boxed warning for amphotericin B

A

conventional amphoB dosing is much lower than the lipid formulations. Overdose causes cardiopulmonary arrest

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3
Q

Amphotericin B

SE and notes

A

Infusion related reactions: fevers, chills, HA, malaise, rigors

Decreased K, Mg

Nephrotoxicity

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4
Q

amphotericin B diluent and filter

A

D5W only, filter for lipid formulations

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5
Q

premediation for amphotericin B

A

required for conventional

optional for lipid

use APAP/NSAID and diphenhydramine +/- meperidine

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6
Q

use of flucytosine

A

combination with AmphoB for invasive Crytooccal and Candida infection

SE myelosuppression

Never monotherapy

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7
Q

MOA azole

A

decrease ergosterol synthesis

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8
Q

Azole class effects

A

increase LFT

QTc prolongation

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9
Q

fluconazole (Diflucan)

dosing

A

vaginal candidiasis: 150 mg PO x1

PO/IV

IV:PO = 1:1

requires renal adjustment

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10
Q

intraconazole

BW

A

Can worsen or casue heart failure

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11
Q

ketoconazole

warning

A

hepatotoxicity that leads to transplant

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12
Q

voriconazole

SE

A

visual changes

phototoxicity

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13
Q

Which azoles can cross the BBB to treat fungal meningitis?

A

fluconazole

voriconazole

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14
Q

Which azole is taken on an empty stomach?

A

Vfend

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15
Q

Which azole is taken with food?

A

posaconazole (Noxafil)

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16
Q

Which azole causes QT shortening?

A

isavuconazonium sulfate (Cresemba)

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17
Q

Which azoles use SBECD as a vehicle and can accumlate?

A

voriconazole

posaconazole

18
Q

MOA echinocandins

A

inhibits synthesis of beta 1,3-D-glucan

19
Q

echinocandins agents (brand)

A

caspofungin (Cancidas)

micafungin (Mycamine)

anidulafungin (Eraxis)

20
Q

echinocandin SE and dosing frequency

A

histamine-mediated symptoms

Given once daily, no renal dose adjustment

21
Q

Griseofulvin

indication, CI, SE, administration

A

indicated for fungal infections of the skin, hair, and nails

CI pregnancy

SE photosensitivity, increase LFT

Take with a fatty meal or with food or milk

22
Q

terbinafine (Lamisil AT)

formulation, warning, SE

A

topical form

warning: hepatotoxicity

SE: HA, increased LFT

23
Q

treatment for candida albicans (thrush)

A

mild:

nystatin; suspension or tablet

clotrimazole; troche/lozenges

moderate or HIV+: fluconazole

24
Q

treatment for candida albicans (esophageal infection)

A

fluconazole

25
Q

treatment for candida krusei and glabrata

A

echinocandin

26
Q

treatment for aspergillus

A

voriconazole

27
Q

treatment for crytococcus neoformans meningitis

A

amphotericin B + flucytosine

28
Q

treatment for dermatophytes

A

terbinafine

intraconazole

29
Q

treatment for influenza

A

neuraminidase inhibitors

oseltamivir (Tamiflu)

zanamivir (Relenza diskhaler)

peramivir (Rapivab)

endonuclease inhibitors

baloxavir marboxil (Xofluza)

30
Q

oseltamivir (Tamiflu)

T/Px dosing, warning

A

Tx >12 yo : 75 mg BID x 5 days

Px >12 yo: 75 mg daily x 10 days

warning: neuropsychiatric events

31
Q

zanamivir (Relenza diskhaler)

formulation, warning

A

inhaler

warning: bronchospasm

32
Q

baloxavir marboxil (Xofluza) dosing frequency

A

1 time dose

33
Q

weight used for acyclovir dose

A

IBW

34
Q

Treatment for herpes viruses (including genital herpes)

A

acyclovir (Zovirax)

valacyclovir (Valtrex)

35
Q

Warning for Zovirax and Valtrex

A

caution in patients with renal impairment, the elderly and those receiving nephrotoxic agents

36
Q

Topical treatments (dosing frequency) for cold sores

A

docosanol (Abreva)

acyclovir (Zovirax)

apply 5 x daily

37
Q

Treatment for invasive HSV infections

A

acyclovir IV

38
Q

Treatment for herpes Zoster (Shingles)

A

acyclovir (Zovirax) for 7 days

valacyclovir (Valtrex) for 7 days

39
Q

Treatment for cytomegalovirus

A

ganciclovirr (Cytovene)

valganciclovir (Valcyte)

foscarnet (Foscavir)

40
Q

ganciclovirr (Cytovene) and valganciclovir (Valcyte)

BW, notes

A

myelosuppression

refrigerate suspension

41
Q

foscarnet (Foscavir)

indication and BW

A

CMV retinitis; resistant HSV

BW: renal impairment

NAPLEX 2021 (select RxPrep&PNN) (5 decks)

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