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Pharm Exam 3 > Viruses, Fungi, Parasites > Flashcards

Viruses, Fungi, Parasites Flashcards

1
Q

What are herpesviruses

A

Herpes simplex virus are fever blisters or cold sores on lips, mouth, face.
Genital herpes

There’s also cytomegalovirus which manifests as cytomegalovirus retinitis and patient may have blurry vision

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2
Q

What is the prototype for a herpesvirus drug?

A

Acyclovir

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3
Q

MOA for acyclovir

A

Interrupts viral DNA replication

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4
Q

Uses for acyclovir

A

Herpes simplex virus

Genital herpes

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5
Q

How does acyclovir help a patient with genital herpes?

A

Decreases duration and pain

It helps with viral shedding which means it decreases the risk of transmission

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6
Q

Nursing considerations for acyclovir

A

Apply topical with gloved hand

IV form but it associates with encephalopathy

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7
Q

What is the antiviral for CMV

A

Ganciclovir

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8
Q

MOA for ganciclovir

A

Inhibits viral DNA synthesis

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9
Q

Uses for ganciclovir

A

Cytomegalovirus (CMV) retinitis

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10
Q

Nursing considerations for ganciclovir

A

Use cautiously with patients who have renal impairment

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11
Q

Adverse effects of ganciclovir

A

2 BBW

  • Granulocytopenia (neutropenia),
    Thrombocytopenia
  • Maintain contraceptive precautions during and 90 days after therapy because it can cause birth defects
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12
Q

What is the oral formulation for ganciclovir

A

Valganciclovir

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13
Q

Nursing considerations for valganciclovir

A

Same BBW as ganciclovir

Take with high fat meal to increase absorption

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14
Q

What is respiratory syncytial virus (RSV)?

A

Respiratory illness that is more severe in babies causing cyanosis

Adults and healthy children can carry the disease with just common cold symptoms

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15
Q

What is the prototype drug for RSV

A

Ribavirin

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16
Q

MOA for ribavirin

A

Interferes with DNA and RNA replication

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17
Q

Uses for ribavirin

A

RSV in children

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18
Q

Nursing considerations for ribavirin

A

Given via inhalation

Monitor for signs of respiratory distress such as nasal flaring

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19
Q

Adverse effects of ribavirin

A

BBW for severe teratogenic effects

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20
Q

Antiviral to treat influenza?

A

Oseltamivir phosphate

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21
Q

MOA for oseltamivir phosphate?

A

Does not allow new viruses to escape cell

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22
Q

Uses for oseltamivir phosphate

A

Influenza in patients over 1 year old

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23
Q

Nursing considerations for oseltamivir phosphate

A

May take prophylactically

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24
Q

Adverse effects of oseltamivir phosphate

A

Some side effects are similar to flu symptoms

Take with food to decrease GI upset

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25
Q

What is the result of hepatitis?

A

Severe liver damage if not properly treated

Hep C can lead to cirrhosis, liver cancer, liver failure

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26
Q

How do you get Hep A?

A

Fecal- oral route, or close contact with infected person

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27
Q

How do you get Hep B?

A

Contaminated blood, other bodily fluids

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28
Q

Prototype for hepatitis

A

Lamivudine

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29
Q

MOA for lamivudine

A

Incorporates into the viral DNA and terminates it

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30
Q

Uses for lamivudine?

A

Chronic Hep B

HIV (off- label)

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31
Q

Adverse effects of lamivudine

A

*Can cause pancreatitis which presents as severe upper abdominal pain

Hepatomegaly with steatosis which is basically an enlarged or fatty liver.

*BBW
Lactic acidosis which presents as musculoskeletal pain (think pain after a workout)

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32
Q

What is human immunodeficiency virus (HIV)

A

Retrovirus

Binds to, and eventually destroys CD4+ cells (ex T lymphocytes)

CD4+ cells normally help regulate immune function

Can progress to acquired human immunodeficiency syndrome (AIDS)

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33
Q

What is the initial phase of HIV

A

Presents with flu like symptoms, lasting several weeks

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34
Q

What is the immune response of HIV

A

Decrease in viral reproduction

Asymptomatic, but infectious

35
Q

What is the immune system damaged phase in HIV

A

Increased viral production

36
Q

Illness progresses to aids phase in HIV

A

Once viral load reaches high levels

Serious opportunistic infections

37
Q

What is pre exposure prophylaxis (PrEP)

A

A way for people who do not have HIV, but are at very high risk of getting HIV to prevent HIV infection by taking a pill every day

And that pill is Truvada (tenofovir and emtricitabine)

38
Q

How does PrEP work?

A

When taken daily, lowers risk of HIV infection:
From sex by about 99%
From injections by about 74%

If not taken consistently, not as effective

39
Q

What are the antivirals for HIV

A

Nucleoside reverse transcriptase inhibitors (NRTIs)

Nonnucleoside reverse transcriptase inhibitors (NNRTIs)

40
Q

Prototype for NRTIs?

A

Zidovudine

41
Q

MOA for Zidovudine

A

Incorporates into viral DNA and terminates

42
Q

Uses for Zidovudine

A

Prevents HIV transmission from mother to fetus

43
Q

Adverse effects of Zidovudine

A

BBW

Granulocytopenia, pancytopenia

Lactic acidosis, hepatomegaly

44
Q

Prototype for NNRTIs?

A

Efavirenz

45
Q

MOA for Efavirenz

A

Similar to NRTI

Has synergy

46
Q

Uses for Efavirenz

A

HIV

47
Q

Adverse effects of Efavirenz

A

Not for patients with hepatic impairment

Stevens-Johnson syndrome

CNS effects
Take at night

48
Q

Prototype of the polyenes

A

Amphotericin B deoxycholate

49
Q

MOA for amphotericin B deoxycholate

A

Disrupts the membrane of fungal cells and stops reproduction

50
Q

Uses for amphotericin B deoxycholate

A

BBW: reserved for potentially fatal infections

51
Q

Adverse effects of amphotericin B deoxycholate

A

Renal impairment common
Keep hydrated with IV sodium chloride

Organ failure, cardiac arrest, respiratory arrest
Premeditate

Separate IV line (have its own IV line) and it should use an inline filter when administered

52
Q

What’s special about the lipid formulation of amphotericin B deoxycholate

A

Less terrible

Less nephrotoxic

Do not use inline filter!

53
Q

Prototype for the anti fungal Azoles

A

Fluconazole

Usually ends in -conazole

54
Q

MOA for fluconazole

A

Disrupts membrane permeability

55
Q

Uses for fluconazole

A

Drug of choice for candida infections

56
Q

Adverse effects for fluconazole

A

Half dose if poor renal failure

Hepatotoxicity

Enzyme inhibitor
Watch for drug interactions

57
Q

What’s an enzyme inhibitor?

A

Enzyme inhibitor = decreased drug metabolism= increased effects of some drugs= increased risk of toxicity

58
Q

Prototype for pyrimidine analog?

A

Flucytosine

59
Q

MOA for Flucytosine

A

Affects cell membrane, resulting in cell death

60
Q

Uses for Flucytosine

A

Adjunct with AMP B for candida and cryptococcus

61
Q

Adverse effects of Flucytosine

A

BBW: caution in renal impairment

Hepatotoxicity and bone marrow toxicity

But those things are dose dependent.. so.. Monitor labs closely to adjust dose

62
Q

Prototype for amebicides

A

Metronidazole

63
Q

MOA for Metronidazole

A

Diffuses across cell membrane, resulting in cell death

64
Q

Uses for Metronidazole as an anti parasitic

A

Intestinal amebiasis

Trichomoniasis

65
Q

Adverse effects of Metronidazole

A

Metallic taste, dark urine

Avoid alcohol during treatment and 3 days after

If taken with alcohol, can cause disulfiram reaction which presents as tachycardia, nausea, flushing, vomiting

66
Q

Nursing considerations for anti parasitic Metronidazole

A

Assess stools for less diarrhea

67
Q

Prototype for the antimalarials

A

Chloroquine phosphate

Usually ends with -quine

68
Q

MOA for Chloroquine phosphate

A

Interferes with parasite DNA, RNA, and metabolism

69
Q

Uses for Chloroquine phosphate

A

Treatment and prophylaxis of malaria

70
Q

Nursing considerations for Chloroquine phosphate

A

Visual disturbances

Electrocardiogram changes

Take weekly (same day) for ppx; and daily for treatment

71
Q

Prototype for anthelmintics

A

Mebendazole

72
Q

MOA for Mebendazole

A

Blocks glucose uptake

73
Q

Uses for Mebendazole

A

Worms (pinwork, hookworm, roundworm, whipworm)

74
Q

Nursing considerations for Mebendazole

A

Chew/crush and swallow

Teratogenic

75
Q

What is the main pinworm?

A

Enterobius vermicularis

76
Q

What are the symptoms of Enterobius vermicularis

A

Perianal itching

77
Q

What should you do if infected with Enterobius vermicularis

A

Disinfect toilets after use

Clean clothes, sheets, towels daily

Treat family members.. very contagious

Wash hands

78
Q

Prototype for scabicides and pediculicides

A

Permethrin

79
Q

MOA for permethrin

A

Stops influx of sodium, thus paralyzes and kills the parasites

80
Q

Uses for permethrin

A

Lice and scabies

81
Q

How do you apply permethrin to kill lice

A

Wash hair, apply cream, let it sit for 10 minutes, rinse with water, use lice comb

Repeat in 1 week if still present but this time keep drug on hair overnight

82
Q

How to use permethrin for scabies

A

Apply head to toe and leave on for 8 to 14 hours

83
Q

What are the main parasitic infections

A

Amebiasis

Malaria

Helminthiasis (worms)

Pediculosis (lice)

Scabies

Pharm Exam 3 (6 decks)

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