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APRN A. Pharm- Test 1 > Week 3- Other antimicrobials/ TB Treatment Goals > Flashcards

Week 3- Other antimicrobials/ TB Treatment Goals Flashcards

1
Q

what drug class is acyclovir, famciclovir and valacyclovir

A

Nucleoside Analogue

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2
Q

How does acyclovir, famciclovir and valacyclovir work?

A

interferes with DNA synthesis and inhibiting viral replication

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3
Q

what are acyclovir, famciclovir and valacyclovir commonly used for

A

HSV 1 & 2, Varicella- Zoster, EBV

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4
Q

what does acyclovir, famciclovir and valacyclovir target to do

A

Increases rate of healing, not prevent recurrences

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5
Q

common side effects of acyclovir and valacyclovir

A

Headache, skin rash, nausea, vomiting, diarrhea

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6
Q

common side effects of famiciclovir?

A

Headache, dizziness, somnolence, paresthesias

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7
Q

adverse reaction of acyclovir

A

Renal failure, acute tubular necrosis, neurologic effects

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8
Q

adverse effects of all herpes meds

A

renal failure

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9
Q

adverse effects of valacyclovir

A

Renal failure, TTP/HUS in immunocompromised patients

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10
Q

what drug class is Nirmatrelvir / Ritonavir (Paxlovid)

A

Antiviral- for mild/mod COVID

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11
Q

how does Nirmatrelvir / Ritonavir (Paxlovid) work

A

Nirm: viral protease inhibitor that halts viral replication

Riton: hibits CYP3A-mediated metabolism to increase Nirm

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12
Q

is Paxlovid or Remdesivir 1st line

A

Paxlovid- PO, easier for outpatient use

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13
Q

common side effects of Paxlovid

A

Decrease sense of taste/smell, diarrhea, myalgia

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14
Q

adverse reactions of Paxlovid

A

Strong CYP3A inhibitor- many drug inx, ^ effect of opioid, v effect of oral BC, hold statins

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15
Q

adverse reaction of remdesivir

A

Interacts w/ chloroquine, warfarin, watch for kidney/liver injury

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16
Q

what drug class is oseltamivir and zanamivir

A

antiviral- prophylaxis and treatment of flu a and b

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17
Q

how do oseltamivir and zanamivir work?

A

Neuraminidase inhibitor- prevents release of virus

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18
Q

what is zanamivir’s route?

A

inhaled treatment

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19
Q

side effects of oseltamivir

A

nausea/vomitting

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20
Q

side effects of zanamivir

A

bronchitis, cough, shortness of breath

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21
Q

adverse reaction of zanamivir

A

r/o severe bronchospasm for asthmatics

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22
Q

what drug class is itraconazole, fluconazole, ketaconazole and voriconazole

A

Antifungal- triazole

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23
Q

are itraconazole, fluconazole, ketaconazole and voriconazole fungistatic or cidal?

A

static at low concentrations, cidal at high concentrations

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24
Q

how do itraconazole, fluconazole, ketaconazole and voriconazole work?

A

Reduce ergosterol production by enzyme inhibition (CYP 450)

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25
Q

what is fluconazole used for?

A

Vaginal candidiasis oral candidiasis

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26
Q

what are side effects of fluconazole?

A

GI s/s, exfoliative skin disorder, QT prolongation

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27
Q

adverse effects of fluconazole

A

Hepatotoxicity, interactions w/ warfarin & rifampin

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28
Q

what is itraconazole used for?

A

Onychomycosis, histoplasmosis, blasto

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29
Q

side effects of itraconazole

A

HEART FAILURE, GI s/s, exfoliative skin disorder, QT prolongation

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30
Q

adverse effects of itraconazole

A

Hepatotoxicity, teratogenic, many drug interactions

31
Q

what is ketoconazole used for

A

also topical agent, but used for Vulvovag candidiasis, fungal PNA,

32
Q

side effects of ketoconazole

A

GI s/s, exfoliative skin disorder, QT prolongation

33
Q

adverse effect of ketoconazole

A

hepatoxicity

34
Q

what is voriconazole used for?

A

Invasive aspergillosis, deep candida infection

35
Q

side effects of voriconazole

A

Visual disturbance, GI s/s, exfoliative skin disorder, QT prolongation

36
Q

adverse effects of voriconizole

A

Hepatotoxicity, teratogenic

37
Q

what class is terbinafine

A

Antifungal- Allylamines

38
Q

how does terbinafine work?

A

Reduces ergosterol production by inhibition of squalene epoxide

39
Q

what is terbinafine used for

A

Onychomycosis, fungal infection of scalp, body, feet, groin

40
Q

side effects of terbinafine

A

GI, loss/change of taste

41
Q

adverse effects of terbinafine

A

Hepatotoxicity, no drinking alc, caffeine

42
Q

what drug class is albendazole and mebendazole

A

Anthelmintic- benzimidazole

43
Q

how do mebendazole and albendazole work?

A

Bind to beta tubulin causing inhibition of polymerization

44
Q

what does albendazole clinically treat

A

Whipworm, roundworm, hookworm, giardiasis,

45
Q

what are some side effects and considerations with albendazole?

A

negative pregnancy test, W/ high fat meal, neutropenia,

46
Q

adverse effects of albendazole

A

Teratogenic, bone marrow suppression, hepatitis

47
Q

what does mebendazole treat

A

Whipworm, roundworm, hookworm

48
Q

what are side effects/adverse effects of mebendazole

A

Bone marrow suppression, hepatitis, teratogenic, take with high fat meals

49
Q

what class is ivermectin

A

Anthelmintic, semisynthetic

50
Q

how does ivermectin work?

A

Binds selectively to glutamate-gated chloride ions, paralysis & death

51
Q

what does ivermectin treat?

A

Roundworm,scabies, threadworm

52
Q

side effects of ivermectin

A

Lightheaded, skin rash

53
Q

adverse reaction to ivermectin

A

Teratogenic, Mazzotti reaction

54
Q

what is pyrantel pamoate

A

Anthelmintic- Depolarizing NM blocking agent

55
Q

how does pyrantel work?

A

Spastic paralysis of worm, inhibits cholinesterase

56
Q

what does pyrantel treat?

A

OTC, Pinworm, whipworm, hookworm

57
Q

What drug class is metronidazole?

A

Nitroimidazole

58
Q

how does metronidazole work?

A

Disrupts DNA and protein synthesis

59
Q

what does metronidazole treat?

A

BV, C. Diff, Giardia, Trichomoniasis (bacterial and parasitic ifxns)

60
Q

side effects of metronidazole

A

Seizures, r/o hepatic dysfunction, anorexia, nausea, abd pain, dry mouth, metallic taste

61
Q

adverse reactions of metronidazole

A

Severe N/V if alcohol consumed while on medication , blood dyscrasias, dont take with disulfiram or you’ll go insane

62
Q

Class of tindazole

A

antiprotozoal (also antibacterial properties

63
Q

how does tinidazole work?

A

Disrupts DNA and protein synthesis

64
Q

what does tinidazole treat?

A

Intestinal amebiasis, giardia, trichomoniasis

65
Q

side effects of tinidazole

A

anorexia, nausea, abd pain, dry mouth, metallic taste

66
Q

considerations with tinidazole

A

Monitor INR, no drinking

67
Q

goals of TB treatment

A
  1. To reduce the bacillary population rapidly, decrease severity of the disease, prevent death, and halting transmission of M. tuberculosis
  2. Prevent relapse after therapy
  3. Prevent drug resistance
68
Q

INH:

A

isoniazid

69
Q

RIF:

A

rifampin

70
Q

PZA:

A

pyrazinamide (vitamin B6)

71
Q

EMB

A

ethambutol

72
Q

preferred drug combination for treatment of TB

A

INH, RIF, PZA, EMB for 2 months

INH & RIF for 4 months (7 d/wk doses)

73
Q

alternate drug combo for TB

A

INH, RIF, PZA, EMB for two months (5 d/wk) for 8 weeks

INH & RIF 5 d/wk for 18 weeks

APRN A. Pharm- Test 1 (5 decks)

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