pharm 2 exam 4 (without HIV ad cancer info) Flashcards
Tuberculosis treatment challenges
- Adherence
- Drug resistance (have to use 2 or more antibiotics)
- Toxicities
- Cost
- Grows slowly
Isoniazid
Antituberculosis med
Pyrazinamide
Antituberculosis med
Ethambutol
Antituberculosis med
Rifampin
Antituberculosis med
Tuberculosis high yield concepts
- 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
Amphotericin B
Antifungal med
Ketocanazole
Antifungal med
Fluconazole
Antifungal med
Miconazole
Antifungal med
Amphotericin B mechanism of action
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
Azoles mechanism of action
Interfere with the production of ergosterol, an essential component of fungal cellular membranes. Without a sturdy cellular membrane, fungi die
Amphotericin B problems
- Infusion reaction (fever, chills, rigors, HA)
- Phlebitis
- Nephrotoxicity
- Hypokalemia
- Anemia
Azoles problems
- Better tolerated than amphotericin B
- Hepatotoxicity
- Numerous CYP interactions
Acyclovir
Herpes simplex virus med
Valacyclovir
Herpes simplex virus med
Absorption rate for Acyclovir and Valacyclovir
- Acyclovir: 20% PO absorption (take 3-5 times/day)
- Valacyclovir: 50% PO absorption (1-2 times a day)
Herpes simplex virus med themes
- Very well tolerated
- Headache
- Nausea/vomiting
- Phlebitis (IV acyclovir)
Herpes simplex virus rare side effects
- Crystal urea (kidneys) (drink lots of water)
- Altered mental status
Scenarios with Herpes
- 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