Pharm One Final 8 - TB, Herpes, Flu, HIV

Question 1

How do you test for TB

Answer 1

PPD - Sub Derm check 48-72 hours

Quantiferon - blood test

Sputum

Question 2

What causes TB?

What precautions?

Answer 2

Acid-fast bacillus (AFB) Mycobacterium tuberculosis

Droplet transmission
Airborne precautions N95 and negative pressure room

Question 3

Can you treat TB with one drug?

Answer 3

No single drugs treatment not effective and can take 2 years

BEST CHOICE -combination medications 6-9 months,
Minimum of 3 drugs, preferably 4-5 drugs

Question 4

Assessing TB Patient

what to ask?

Answer 4

1. Past history of TB
2. Last PPD and Last CXR
3. Last EYE exam
4. LIVER disease LFTs
   5 KIDNEY function. BUN/Cr
5. Paresthesias (tingling)
6. Hearing changes Cranial Nerve 8

Question 5

When does AFB Sputum test come back NEGATIVE after meds have begun?

Answer 5

Two to three months.

Cannot stop meds tho.

Need to take sputum test 3x

AFB = acid-fast bacillus

Question 6

Adverse effect of INH

Answer 6

Liver toxicity

Question 7

Patient beginning INH and Rifampin treatment for TB

what does the RN instruct?

Answer 7

Do NOT skip doses

Question 8

Name TB drugs

Answer 8

INH -(Isoniazid) take 1 hour before and 2 hours after meals,
NO alcohol,
NO antacids

Only drug that can be used on children with TB

Rifampin - avoid pg - Turns body fluids ORANGE

Ethambutol - avoid pg

Need Vit B6 - to prevent peripheral neuropathy from INH

*TB is leading cause of death in HIV + patients

Question 9

Name herpes antiviral drugs

Answer 9

DRUGS END IN “CLOVIR”

Famiciclovir
Ganciclovir
Penciclovir
Trifluridine
Balacyclovir
Valgancicovir

Interferes with nucleic acid synthesis

Manages HDV 1 and 2 and VZV (Varicella Zoster Virus)

Question 10

Can Herpes antivirals reduce symptoms or prevent?

Answer 10

Controversial

THEY DO NOT CURE.

Question 11

How is INFLUENZA transmited?

Answer 11

Big Droplets - wear a mask
Highly contagious
A,B, and C (cold)

Question 12

Side Effects of INFLUENZA ANTiVIRALS

Answer 12

Nausea
Vertigo
Headache
Insomnia
***Diarrhea

Question 13

Influenza Antivirals
Name
Side Effects

Answer 13

END IN “IVIR”

OSELTAMIVIR. BALOXAVIR. ZANAMIVIR (Tamiflu)
Side effects. Nausea, vertigo, headache, diarrhea*

MUST be taken within 48 hours of onset of symptoms

DOES NOT CURE IT.

Question 14

What is HIV?

Answer 14

HIV is an RNA retro virus it must live in a human cell
It destroys Helper T cells - CD4 lymphocytes
Normal CD4 count is 50-1200 cellMM3

Question 15

How is HIV monitored?

Answer 15

HIV monitoring

Check CD4 count - tells how immune system and drug is working.
Plasma HIV RNA ASSAY (Viral Load) 20-40 copies/ml ideal (takes 24 weeks)
CANNOT stop or it will come back - reactivation of virus
DON’T STOP YOUR MEDS