Week 2 - Antivirals, Fungal infections and Athelmintics Flashcards
How to treat tinea capitis?
Topical drugs unlikely to work.
Treat with oral griseofulvin or terbinafine.
What drug is used to treat aspergillosis?
Voriconazole
Which anthelmintic drugs carry a risk for hypotension in patients on antihypertensives?
Ivermectin and moxidectin
Which anthelmintic drugs cause bone marrow suppression and liver impairment?
Albendazole and mebendazole
Which anthelmintic drug is generally safe to give without obtaining baseline data?
Pyrantel pamoate
Which anthelmitic drugs are safe to use during pregnancy?
Praziquantel & moxidectin
What are the risks associated with Didanosine?
- Older adults have a higher risk for developing pancreatitis
- Neuropathy
- Lactic acidosis
- Hepatic steatosis
What are the risks associated with Saquinavir?
- Dangerous drug interactions
- PR prolongation
- QT prolongation
- DM (new onset or exacerbation)
- Immune reconstitution syndrome
- Redistribution of adipose tissue
- Bleeding in hemophilia patients
- Exacerbation of current hepatic disesase
- Hyperlipidemia
- n/v
- abdo pain
- diarrhea
fatigue
Which type of HIV drugs impact the patient’s PR interval?
Protease inhibitors
How do we measure success with antiretroviral therapy for HIV?
Reduction in plasma HIV RNA
- When therapy is started there should be at 10% decline from baseline within 2-8 weeks
- After 16-20 weeks plasma RNA should reach its minimum, ideally undetectable with sensitive assays
What does an increase in CD4 T-cell indicate?
- Restoration of immune system function
When do we use foscarnet in HIV+ patients?
- When treating ganciclovir-resistant cytomegalovirus in patients with AIDS
What patient teaching is needed when prescribing metronidazole?
- Don’t take with alcohol
- Take with plenty of water
- Finish course
What are the adverse effects of Abacavir?
- Lactic acidosis
- Hepatomegaly
- Hypersensitivity reactions
What labs should be monitored during long term anti fungal use?
Liver function & electrolytes
What antifungals should be used with immunocompromised patients?
Acyclovir
- Mucocutaneous herpes
Ganciclovir
- For herpesviruses including CMV in immunocompromised patients
How are systemic fungal infections treated?
Can be difficult, required prolonged therapy with drugs that frequently prove toxic.
May include voriconazole, itraconazole, fluconazole, amphotericin B
What does a patient who is taking ketoconazole and omeprazole together need to know?
The use of omeprazole can decrease the absorption of ketoconazole. Dosages should be separated - ketoconazole should be taken 1 hour before or 2 hours after a PPI, H2RA, and antacids.
What is Enterobius vermicularis, who would you expect to have it, how to treat it?
- Pinworm infestation of the ileum and large intestine
- School age children, institutionalized individuals, household members of affected individual are most at risk.
- Found in the US
- Treated with albendazole, mebendazole, and pyrantel pamoate.
