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
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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 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
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7
Q

Amphotericin B

A

Antifungal med

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8
Q

Ketocanazole

A

Antifungal med

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9
Q

Fluconazole

A

Antifungal med

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10
Q

Miconazole

A

Antifungal med

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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

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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

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13
Q

Amphotericin B problems

A
  • Infusion reaction (fever, chills, rigors, HA)
  • Phlebitis
  • Nephrotoxicity
  • Hypokalemia
  • Anemia
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14
Q

Azoles problems

A
  • Better tolerated than amphotericin B
  • Hepatotoxicity
  • Numerous CYP interactions
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15
Q

Acyclovir

A

Herpes simplex virus med

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16
Q

Valacyclovir

A

Herpes simplex virus med

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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)

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18
Q

Herpes simplex virus med themes

A
  • Very well tolerated
  • Headache
  • Nausea/vomiting
  • Phlebitis (IV acyclovir)
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19
Q

Herpes simplex virus rare side effects

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

- Altered mental status

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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
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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
Q

Oseltamivir benefits

A
  • Must take within 48 hours
  • Decreases duration of symptoms (16 hours)
  • Effective at preventing influenza (not a substitute for vaccination)
26
Q

Three major groups of Rheumatoid arthritis meds

A
  • NSAIDs (rapid relief)
  • Glucocorticoids (rapid relief)
  • Disease-modifying anti-rheumatic drugs (DMARDs)
27
Q

Methotrexate

A

Disease-modifying anti-rheumatic drugs (DMARDs) (drug of choice)

28
Q

Hydroxychloroquine

A

Disease-modifying anti-rheumatic drugs (DMARDs)

29
Q

TNF blockers

A

Disease-modifying anti-rheumatic drugs (DMARDs)

30
Q

Methotrexate adverse effects

A
  • Nausea, diarrhea
  • GI ulceration
  • decreased bone marrow
  • pneumonitis
  • Hepatotoxicity
  • Renal failure
  • Infection
  • Severe rash

Take once a week

31
Q

Hydroxychloroquine themes

A
  • MOA unknown
  • usually combined with methotrexate
  • Take with food
  • Risk of retinal damage
  • Less effective but more tolerated
  • regular eye appointment
32
Q

infliximab

A

TNF blocker (Disease-modifying anti-rheumatic drugs (DMARDs)) (IV or SubQ)

33
Q

Adalimumab

A

TNF blocker (Disease-modifying anti-rheumatic drugs (DMARDs)) (IV or SubQ)

34
Q

Etanercept

A

TNF blocker (Disease-modifying anti-rheumatic drugs (DMARDs)) (IV or SubQ)

35
Q

TNF blockers problems

A
  • Injection-site reactions

- Infections

36
Q

TNF blockers rare adverse effects

A
  • Severe allergic reactions
  • heart failure
  • hepatotoxicity
  • cancer
37
Q

Allopurinol

A

Gout medication

38
Q

Colchicine

A

Gout medication

39
Q

Allopurinol themes

A
  • Gout prevent and treatment
  • Full effect in 1-2 months
  • Goal is uric acid < 6 mg/dL
  • Indicated for certain cancers
40
Q

Allopurinol adverse effects

A
  • Acute gouty attack
  • Hypersensitivity syndrome (rare)
  • Hepatotoxicity
41
Q

Colchicine themes

A
  • MOA poorly understood

- Gout prevention and treatment

42
Q

Colchicine adverse effects

A
  • Diarrhea (25%)
  • Myopathy
  • Bone marrow suppresion
43
Q

Alendronate

A

Bisphosphonate (Osteoporosis med)

44
Q

Ibandronate

A

Bisphosphonate (Osteoporosis med)

45
Q

Risedronate

A

Bisphosphonate (Osteoporosis med)

46
Q

Bisphosphonates adverse effects

A
  • heartburn
  • abdominal pain (very irritating to GI tract)
  • Diarrhea
  • Hypocalcemia
  • Osteonecrosis of jaw (ONJ)
47
Q

Bisphosphonates client teaching

A
  • Take in the AM
  • Completely empty stomach
  • Full glass of water
  • Stay upright for 30-60 min.
48
Q

Raloxifene

A

Osteoporosis med

49
Q

Raloxifene themes

A
  • Mimics estrogen (bones)
  • Blocks estrogen (uterus and breasts)
  • decrease cancer risk
50
Q

Raloxifene adverse effects

A
  • Hot flashes
  • Leg cramping
  • Edema, weight gain
51
Q

Raloxifene black box warning

A
  • Thromboembolism

- Stroke