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PHARM > PHARM EXAM 8--STUDY GUIDE Qs > Flashcards

PHARM EXAM 8--STUDY GUIDE Qs Flashcards

1
Q

Humans are exposed to fungi

when they handle

A

contaminated soil

or inhale spores

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2
Q

also occur due to

an overgrowth of a fungus that is normally present in the body.

A

fungal infections

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3
Q

The human body is quite resistant to

A

fungi

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4
Q

Most serious fungal infections occur in

patients with

A

suppressed immune defenses

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5
Q

Previously rare fungal infections occur in

patients with

A

AIDS

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6
Q

Other people who are more susceptible for fungal infections

A

patients receiving prolonged therapy with corticosteroids,

experiencing extensive burns,

receiving antineoplastic agents,

having indwelling vascular catheters, or

having recently
received organ transplants

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7
Q

can affect those with intact

immune systems.

A

community-acquired infections

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8
Q

are those nosocomial infections that occur in

the immunosuppressed patient.

A

opportunistic infections

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9
Q

where do protozoan thrive

A

in areas of poor sanitation

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10
Q

who is more susceptible to protozoan infections?

A

immunosuppressed

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11
Q

which drugs are ineffective to protozoans?

A

drugs used to tx bacterial and fungal infections

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12
Q

is the most common protozoal disease and the second most fatal infectious
disease in the world.

A

malaria

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13
Q

what is malaria caused by?

A

protozoan plasmodium

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14
Q

how is malaria transmitted?

A

by the bite of a female anopheles mosquito

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15
Q

how is malaria treated

A

multidrug therapy

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16
Q

why is multi drug therapy required for tx of malaria?

A

the complicated life cycle of the parasite

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17
Q

Drugs may be administered for prophylaxis, as

therapy for acute attacks, and for prevention of relapses

A

…

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18
Q

what also thrives in unsanitary conditions

A

non-malarial protozoan infections

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19
Q

other

protozoal diseases include

A

amebiasis,

toxoplasmosis,

giardiasis,

cryptosporidiosis,

trichomoniasis,

trypanosomiasis, and

leishmaniasis

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20
Q

Treatment of non-Plasmodium protozoan disease

A

requires a different set of medications from those used for malaria.

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21
Q

are parasitic worms that cause significant disease in certain regions of the
world.

A

helminths

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22
Q

the group of helminths include

A

roundworms
flukes
tapeworms

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23
Q

roundworms

A

nematodes

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24
Q

flukes

A

trematodes

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25
Q

tapeworms

A

cestodes

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26
Q

most helminths enter the body through ?

A

the skin or GI tract

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27
Q

Once inside the human host, Plasmodium multiplies in the liver and transforms into progeny called ____

A

merozites

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28
Q

about 14-25 days after the infection the ___ are released into the blood, infecting and rupturing RBCs and release more ____.

A

merozites

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29
Q

can remain in a latent state in body tissues for extended periods of time, causing relapses months or years after the initial infection.

A

plasmodium

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30
Q

prevention of plasmodium involves administering prophylactic antimalarials when?

A

prior to, during, and for 1 week after visits to infested areas.

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31
Q

Tx of plasmodium involves interrupting ____ and eliminating _____.

A

interrupting the erythrocytic stage

and

eliminating the merozites from RBCs.

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32
Q

what does prevention of relapse of plasmodium mean?

A

attempting to eliminate the latent forms of plasmodium residing in the liver.

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33
Q

causes some degree of kidney damage in 80% of the patients who take it,

A

amphotericin B (Fungizone)

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34
Q

what to closely monitor for if pt is on amphotericin B

A

F/E status

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35
Q

what can Amphotericin B cause?

A

ototoxicity (assess for hearing loss, vertigo, unsteady gait, or tinnitus)

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36
Q

do not give to patients with chronic alcoholism because this drug can be toxic to the liver.

A

ketoconazole (Nizoral)

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37
Q

Assess for what in pts taking ketoconazole (Nizoral) ?

A

Assess for nausea, vomiting, abdominal pain, or diarrhea.

Also monitor for signs and symptoms of hepatotoxicity, such as pruritus, jaundice, dark urine, and skin rash.

38
Q

may affect glycemic control in diabetic patients, so monitor blood-sugar levels carefully in these patients.

A

-azoles

39
Q

Monitor for alcohol use because it increases the risk of side effects, such as nausea and vomiting, and increases blood pressure.

A

ketoconazole

40
Q

Do not use superficial antifungals, such as nystatin (Mycostatin) when?

A

intravaginally during pregnancy to treat infections caused by gardener vaginalis or trichomonad species

or in pts. who are lactating

41
Q

what should you monitor for if pt is taking high doses of superficial anti fungal therapy

A

N/V/D

42
Q

use antiprotozoal drugs with caution in patients with?

A

preexisting cardiovascular dx and those who are lactating

43
Q

test for G6PD deficiency in pts taking which type of drug?

A

antiprotozoal drugs

44
Q

may precipitate anemia in those with G6PD

deficiency and may cause bone-marrow depression

A

Chloroquine (Aralen)

45
Q

obtain a baseline ___ because of the potential cardiac complications associated with some antimalarial drugs

A

ECG

46
Q

what kind of GI effects do you need to monitor for in pts taking antiprotozoal drugs?

A

V/D

abdominal pain

47
Q

oral antimalarials can be given with ___ to reduce GI distress.

A

food

48
Q

non-malarial antiprotozoal drugs are contraindicated in ?

A

alcoholics

49
Q

closely monitor __ & ___ ___ during therapy because serum iodine may increase and cause thyroid enlargement with iodoquinol (yodoxin).

A

vital signs & thyroid function

50
Q

Monitor for signs of CNS toxicity, such as seizures, paresthesia, nausea, and vomiting,
and for allergic responses, such as urticaria and pruritus.

A

non malarial, antiprotozoal drugs

51
Q

cases of

leukopenia, thrombocytopenia, and agranulocytosis have been associated with the use of

A

albendazole (Albenza)

Antihelminthic drug

52
Q

The mechanism of action is to bind to ergosterol in fungal cell
membranes, causing them to become permeable or leaky.

A

amphotericin B

deoxycholate (Fungizone)

53
Q

adverse effects of amphotericin B

deoxycholate (Fungizone)?

A

fever and chills, vomiting, and headache at the beginning of therapy,

which subside as
treatment continues

54
Q

what is common during IV therapy of amphotericin B

deoxycholate (Fungizone)?

A

phlebitis

55
Q

Some degree of
nephrotoxicity is observed in most patients.

Electrolyte imbalances frequently occur.

Cardiac arrest, hypotension, and dysrhythmias are possible.

A

amphotericin B

deoxycholate (Fungizone)

56
Q

The mechanism of action is to interfere with the synthesis of ergosterol

A

fluconazole

Diflucan

57
Q

The
primary use is to penetrate most body membranes to reach fungal infections in the CNS,
bone, eyes, urinary tract, and respiratory tract.

A

fluconazole

Diflucan

58
Q

whats possible with high doses of fluconazole (diflucan)

A

N/V/D

59
Q

what has been reported in patients with immunosuppression while taking fluconazole (diflucan)?

A

stevens-johnson syndrome

60
Q

The mechanism of action is to bind to sterols in the fungal cell
membrane, allowing leakage of intracellular contents.

A

nystatin (Mycostatin,

Nysop)

61
Q

adverse effects of nystatin?

A

minor skin irritation.

if given orally N/V/D

62
Q

The mechanism of action is to concentrate in the food vacuoles of Plasmodium residing
in red blood cells.

A

chloroquine (Aralen).

63
Q

once in the vacuole, chloroquine is believed to prevent the metabolism of ___, which then builds to toxic levels within the parasite.

A

heme

64
Q

adverse effects of chloroquine

A

N/V

@ higher doses: CNS, cardiovascular, and retinal toxicity may be observed

65
Q

what type of drug is chloroquine?

A

antiprotozoal–antimalarial

66
Q

antiprotozoal non malarial agents

A

metronidazole (Fagyl)

67
Q

It is primarily used to treat most forms of amebiasis,

and to treat a number of respiratory, bone, skin, and CNS infections.

A

metronidazole

68
Q

Adverse effects
include relatively frequent cases of anorexia, nausea, diarrhea, dizziness, and headache.

Dryness of the mouth and an unpleasant metallic taste may be experienced. Bone-marrow
suppression is possible, although rare.

A

metronidazole

69
Q

metronidazole can have a ____ effect

A

“disulfiram”

70
Q

antihelminthic drugs:

A

mebendazole (Vermox)

71
Q

The mechanism of
action is to act as a broad-spectrum antihelminthic drug.
It retains high concentrations in
the intestine, where it kills both the adult and larval parasites.

A

mebendazole

72
Q

why is antiviral therapy challenging?

A

viruses mutate rapidly, and the drug becomes ineffective.

73
Q

it is difficult for the drug to find the virus without injuring ____ ____.

A

normal cells.

74
Q

HIV targets what?

A

the CD4 receptor of the T4 helper lymphocyte

75
Q

how does HIV make viral DNA from RNA?

A

reverse transcripase

76
Q

bud from the host cell

A

virions

77
Q

which enzyme enables virion to infect other T4 lymphocytes?

A

protease

78
Q

HIV is called a “retrovirus” because of this reverse synthesis.

A

retrovirus

79
Q

when does the latent phase of HIV occur?

A

when the virus lies dormant

80
Q

what is the current protocol for pts with HIV?

A

to defer tx in asymptomatic adults who have CD4 counts above 350 cells/mcL.

81
Q

when is therapy initiated?

A

when CD4 is under 200 cells/mcL or when symptoms appear

82
Q

therapeutic goals of HIV

A

reduce HIV RNA load in the blood to an undetectable level or less than 50

increase the life span

provide a higher quality of life

decrease the risk of transmission from mother to child

83
Q

5 drug classes for HIV

A

nucleoside/nucleotide reverse transcriptase inhibitor (NRTI, NtRTIs),

nonnucleoside reverse transcriptase inhibitor (NNRTI),

protease inhibitor (PI),

entry inhibitor (fusion inhibitor and CCR5 antagonist), and

integrase inhibitor.

84
Q

tx failure are common with antiretroviral therapy

A

Patients have nontolerance of adverse effects,

they do not adhere to the complex regimen,

resistant strains can emerge, and

genetic variability is a factor

85
Q

Drug companies are responding to make treatment ______.

A

simpler

86
Q

inhibits the viral enzyme protease.

A

lopinavir with ritonavir (Kaletra)

87
Q

The primary use for lopinavir with ritonavir in combination with other antiretrovirals is for

A

HIV infected patients

88
Q

is the preferred drug for initial therapy of HIV infection

A

lopinavir with ritonavir (Kaletra)

89
Q

It is well tolerated, but may lead to nausea, headache, vomiting, dyspepsia, and diarrhea.
Hyperglycemia has been reported.

pancreatitis is a rare, but possible, serious adverse effect.

A

lopinavir with ritonavir (Kaletra)

90
Q

Lipodystrophy syndrome

A

occurs in many patients

receiving long-term therapy of lopinavir with ritonavir (Kaletra)

PHARM (11 decks)

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