pharm 2 exam 4 (without HIV ad cancer info) Flashcards

1
Q

Tuberculosis treatment challenges

A
  • Adherence
  • Drug resistance (have to use 2 or more antibiotics)
  • Toxicities
  • Cost
  • Grows slowly
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Isoniazid

A

Antituberculosis med

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Pyrazinamide

A

Antituberculosis med

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Ethambutol

A

Antituberculosis med

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Rifampin

A

Antituberculosis med

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Tuberculosis high yield concepts

A
  • Usually requires multiple antibiotics for 6 months to 2 years
  • Watch out for hepatotoxicity
  • Numerous CYP interactions
  • Isoniazid can cause peripheral neuropathy (give pyridoxine (Vitamin B6))
  • Rifampin causes red-orange secretions (urine, saliva, sweat, tears)
  • Ethambutol causes red-green color blindness
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Amphotericin B

A

Antifungal med

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Ketocanazole

A

Antifungal med

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Fluconazole

A

Antifungal med

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Miconazole

A

Antifungal med

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Amphotericin B mechanism of action

A

Binds to a substance on fungal membranes called ergosterol (also binds to the cholesterol on our cell membranes and can have toxic effects on us) This causes the membrane to become more permeable, allowing important cations like potassium to leak out

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Azoles mechanism of action

A

Interfere with the production of ergosterol, an essential component of fungal cellular membranes. Without a sturdy cellular membrane, fungi die

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Amphotericin B problems

A
  • Infusion reaction (fever, chills, rigors, HA)
  • Phlebitis
  • Nephrotoxicity
  • Hypokalemia
  • Anemia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Azoles problems

A
  • Better tolerated than amphotericin B
  • Hepatotoxicity
  • Numerous CYP interactions
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Acyclovir

A

Herpes simplex virus med

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Valacyclovir

A

Herpes simplex virus med

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Absorption rate for Acyclovir and Valacyclovir

A
  • Acyclovir: 20% PO absorption (take 3-5 times/day)

- Valacyclovir: 50% PO absorption (1-2 times a day)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Herpes simplex virus med themes

A
  • Very well tolerated
  • Headache
  • Nausea/vomiting
  • Phlebitis (IV acyclovir)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Herpes simplex virus rare side effects

A
  • Crystal urea (kidneys) (drink lots of water)

- Altered mental status

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Scenarios with Herpes

A
  • Pregnant: C-section, the drug, or no action if there is no outbreak
  • Eczema herpeticum: IV
  • Recurrent, painful HSV-2 outbreaks: prophylactic
  • Encephalitis- IV acyclovir
  • Shingles: IV acyclovir or high dose PO
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

HSV med teaching

A
  • The earlier, the better
  • Not a cure; still contagious
  • Drink plenty of fluids
22
Q

Influenza vaccines

A
  • Protections begins in 1-2 weeks
  • Lasts about 6 months (4 if older)
  • They do not cause the flu
23
Q

Oseltamivir

A

Influenza med

24
Q

Oseltamivir adverse effects

A
  • Extremely well tolerated
  • Nausea
  • Vomiting
25
Oseltamivir benefits
- Must take within 48 hours - Decreases duration of symptoms (16 hours) - Effective at preventing influenza (not a substitute for vaccination)
26
Three major groups of Rheumatoid arthritis meds
- NSAIDs (rapid relief) - Glucocorticoids (rapid relief) - Disease-modifying anti-rheumatic drugs (DMARDs)
27
Methotrexate
Disease-modifying anti-rheumatic drugs (DMARDs) (drug of choice)
28
Hydroxychloroquine
Disease-modifying anti-rheumatic drugs (DMARDs)
29
TNF blockers
Disease-modifying anti-rheumatic drugs (DMARDs)
30
Methotrexate adverse effects
- Nausea, diarrhea - GI ulceration - decreased bone marrow - pneumonitis - Hepatotoxicity - Renal failure - Infection - Severe rash Take once a week
31
Hydroxychloroquine themes
- MOA unknown - usually combined with methotrexate - Take with food - Risk of retinal damage - Less effective but more tolerated - regular eye appointment
32
infliximab
TNF blocker (Disease-modifying anti-rheumatic drugs (DMARDs)) (IV or SubQ)
33
Adalimumab
TNF blocker (Disease-modifying anti-rheumatic drugs (DMARDs)) (IV or SubQ)
34
Etanercept
TNF blocker (Disease-modifying anti-rheumatic drugs (DMARDs)) (IV or SubQ)
35
TNF blockers problems
- Injection-site reactions | - Infections
36
TNF blockers rare adverse effects
- Severe allergic reactions - heart failure - hepatotoxicity - cancer
37
Allopurinol
Gout medication
38
Colchicine
Gout medication
39
Allopurinol themes
- Gout prevent and treatment - Full effect in 1-2 months - Goal is uric acid < 6 mg/dL - Indicated for certain cancers
40
Allopurinol adverse effects
- Acute gouty attack - Hypersensitivity syndrome (rare) - Hepatotoxicity
41
Colchicine themes
- MOA poorly understood | - Gout prevention and treatment
42
Colchicine adverse effects
- Diarrhea (25%) - Myopathy - Bone marrow suppresion
43
Alendronate
Bisphosphonate (Osteoporosis med)
44
Ibandronate
Bisphosphonate (Osteoporosis med)
45
Risedronate
Bisphosphonate (Osteoporosis med)
46
Bisphosphonates adverse effects
- heartburn - abdominal pain (very irritating to GI tract) - Diarrhea - Hypocalcemia - Osteonecrosis of jaw (ONJ)
47
Bisphosphonates client teaching
- Take in the AM - Completely empty stomach - Full glass of water - Stay upright for 30-60 min.
48
Raloxifene
Osteoporosis med
49
Raloxifene themes
- Mimics estrogen (bones) - Blocks estrogen (uterus and breasts) - decrease cancer risk
50
Raloxifene adverse effects
- Hot flashes - Leg cramping - Edema, weight gain
51
Raloxifene black box warning
- Thromboembolism | - Stroke