Week 2 - Antivirals, Fungal infections and Athelmintics

Question 1

How to treat tinea capitis?

Answer 1

Topical drugs unlikely to work.
Treat with oral griseofulvin or terbinafine.

Question 2

What drug is used to treat aspergillosis?

Answer 2

Voriconazole

Question 3

Which anthelmintic drugs carry a risk for hypotension in patients on antihypertensives?

Answer 3

Ivermectin and moxidectin

Question 4

Which anthelmintic drugs cause bone marrow suppression and liver impairment?

Answer 4

Albendazole and mebendazole

Question 5

Which anthelmintic drug is generally safe to give without obtaining baseline data?

Answer 5

Pyrantel pamoate

Question 6

Which anthelmitic drugs are safe to use during pregnancy?

Answer 6

Praziquantel & moxidectin

Question 7

What are the risks associated with Didanosine?

Answer 7

• Older adults have a higher risk for developing pancreatitis
• Neuropathy
• Lactic acidosis
• Hepatic steatosis

Question 8

What are the risks associated with Saquinavir?

Answer 8

• 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

Question 9

Which type of HIV drugs impact the patient’s PR interval?

Answer 9

Protease inhibitors

Question 10

How do we measure success with antiretroviral therapy for HIV?

Answer 10

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

Question 11

What does an increase in CD4 T-cell indicate?

Answer 11

• Restoration of immune system function

Question 12

When do we use foscarnet in HIV+ patients?

Answer 12

• When treating ganciclovir-resistant cytomegalovirus in patients with AIDS

Question 13

What patient teaching is needed when prescribing metronidazole?

Answer 13

• Don’t take with alcohol
• Take with plenty of water
• Finish course

Question 14

What are the adverse effects of Abacavir?

Answer 14

• Lactic acidosis
• Hepatomegaly
• Hypersensitivity reactions

Question 15

What labs should be monitored during long term anti fungal use?

Answer 15

Liver function & electrolytes

Question 16

What antifungals should be used with immunocompromised patients?

Answer 16

Acyclovir
- Mucocutaneous herpes

Ganciclovir
- For herpesviruses including CMV in immunocompromised patients

Question 17

How are systemic fungal infections treated?

Answer 17

Can be difficult, required prolonged therapy with drugs that frequently prove toxic.

May include voriconazole, itraconazole, fluconazole, amphotericin B

Question 18

What does a patient who is taking ketoconazole and omeprazole together need to know?

Answer 18

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.

Question 19

What is Enterobius vermicularis, who would you expect to have it, how to treat it?

Answer 19

• 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.