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Pharmacology for Advanced Practice Nurses > Week 3 Pearls > Flashcards

Week 3 Pearls Flashcards

1
Q

Anitvirals must either block

A

entry into the cells or be active inside the host cells

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2
Q

Steps of viral replication

A
  1. adsorption
  2. uncoating of the viral nucleic acid
  3. synthesis of early, regulatory proteins
  4. synthesis of RNA or DNA
  5. Synthesis of structural proteins
  6. Assembly of viral particles
  7. Release from the cell
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3
Q

Most antivirals work on step

A
  1. synthesis of RNA or DNA
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4
Q

Antivirals: Nucleoside Analogues examples

A

Acyclovir and Valacyclovir
Famciclovir
Ganciclovir

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5
Q

Benefit of valacyclovir

A

less doses required

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6
Q

Antivirals: Nucleoside Analogues pharmacodynamis

A

Antiviral drugs must either block entry into the cells or be active inside host cells to be effective.

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7
Q

Acyclovir: active against

A

herpes simplex viruses 1 and 2 (HSV-1 and HSV-2); varicella-zoster virus (VZV); Epstein-Barr virus (EBV), cytomegalovirus (CMV), and herpes virus 6

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8
Q

Valacyclovir is converted

A

into acyclovir after oral administration and is active against the same virus

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9
Q

Famciclovir: active against

A

HSV-1 and HSV-2, HSV-1 and HSV-2, VZV, EBV, and hepatitis B virus

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10
Q

Ganciclovir active against

A

CMV

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11
Q

ADR Acyclovir/valacyclovir

A

few ADRs when given orally

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12
Q

Valacyclovir ADR:

A

may cause thrombocytopenia purpura, hemolytic uremic syndrome in immunocompromised patients

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13
Q

Famciclovir ADR

A

headach

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14
Q

Granciclovir ADR

A

granulocytopenia, anemia, and thrombocytopenia

may be carcinogenic**

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15
Q

Nucleoside drug interactions

A

few

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16
Q

Clincial use and dosing for Antivirals Nucleoside

A 
Herpes simplex: genital herpes, both initial outbreak and suppression therapy 
Herpes zoster (shingles): start therapy within 3 days of outbreak

Varicella (chickenpox): start within 24 hours of outbreak
Gingivostomatitis in children
Bell’s palsy

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17
Q

When do you start antivirals with Herpes zoster

A

within three days of the outbreak. Same with simplex

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18
Q

Rational drug selection for antivirals nucleoside

A

cost and convenience

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19
Q

acyclovir is taken

A

5 times a day but is inexpensive.

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20
Q

Antivirals: Nucleoside Analogues

Monitoring

A

Rash for resolution
Temperature
Blood urea nitrogen and creatinine in high-risk patients

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21
Q

Antivirals: Nucleoside Analogues

Patient education

A

**Drug started at earliest sign of infection
Good hydration
Symptoms of renal failure, encephalopathic changes, blood dyscrasias

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22
Q

Antiviral guidelines for treatment for Hep C

A

Joint guidelines for treatment by American Association for the Study of Liver Diseases (AASLD) and the Infectious Diseases Society of America (ISDA)

23
Q

Treatment of Hep C (HCV) infection based on

A

the genotype and stage of the disease

24
Q

Antivirals for Hepatitis C Pharmacodynamics

A

most of HCV antivirals formatted as a fixed-dose combination of two antivirals

25
Q

Antivirals for Hepatitis C Pharmacokinetics

A

administered orally and widely distributed

26
Q

Antivirals for Hepatitis C Contraindications

A

Black Box warning regarding HBV reactivation and to test before starting HCV treatment

27
Q

Anivirals for Hep C ADR

A

headache, fatigue, and nausea are the most frequent ADRs for all

28
Q

Antivirals for Hep C Drug interactions

A

co-administration of ledipasvir and sofosbuvir (Harvoni) and amiodarone may cause serious symptomatic bradycardia

Multiple drug interactions

29
Q

What should you really know about antivirals for Hep C

A

you will be seen by a specialist and they are given based on genotype and stage of the disease

30
Q

Antivirals for Hepatitis C

Clinical use and dosing

A

dependent on the genotype of the HCV virus, renal and hepatic function

31
Q

Antivirals for Hepatitis C

Monitoring

A

bilirubin, liver enzymes, and serum creatinine levels

32
Q

Antivirals for Hepatitis C

Patient education

A

taking medication daily, ADRs, drug interactions

33
Q

Antivirals for influenza names

A

Oseltamivir (Tamiflu), peramivir (Rapivab), zanamivir (Relenza) are used to treat influenza A and B.

34
Q

Anitvirals for influenza Pharmacodynamics

A

Sensitivity varies by year.

Resistance to amantadine and rimantadine is common, so these drugs are no longer recommended for influenza.

35
Q

Oseltamivir is

A

is well absorbed after oral administration.

36
Q

Zanamivir is

A

inhaled; 4% to 17% is absorbed

37
Q

Peramivir is administered

A

IV

38
Q

What will change the evfectiveness of oseltamivir

A

variences of viruses annually

39
Q

Osetamir and Zanamivir ADR

A

Ostemivir - GI upset

Zanamivir - brhonchitis and SOB

40
Q

Oseltamivir, zanamivir: approved for

A

the prophylaxis and treatment of influenza type A and B

41
Q

Peramivir is approved

A

Peramivir is approved

42
Q

Antivirals for Influenza Monitoring

A

Monitoring
Renal function in older and debilitated patients
Older patients: evaluate for confusion, hallucinations, and cognitive impairment

43
Q

Anitvirals for Influenza Patient Education

A

Patient education
Taking full course of therapy
ADRs
Annual influenza vaccination

44
Q

Where do you refer for prescribing guidelines for antivirals

A

CDC

45
Q

Systemic Azoles and Other Antifungals

Polyene macrolides:

A

amphotericin B and nystatin

46
Q

Systemic Azoles and Other Antifungals

Azoles with broad-spectrum activity

A

butoconazole, clotrimazole, ketoconazole, minonazole, terconazole, tioconazole, fluconazole, itraconazole

47
Q

Systemic Azoles and Other Antifungals

Allylamines active against yeast and dermatophytes

A

naftifine, terbinafine

48
Q

Systemic Azoles and Other Antifungals

Nuclear acid synthesis inhibitors

A

flucytosine

Griseofulvin

49
Q

Absorption of itraconazole is enhanced

A

food

50
Q

Absorption of griseofulvin is enhanced by

A

fat

51
Q

Fluconazole is an inhibitor of

A

cytochrome 3A4 (CYP3A4) and CYP2C9.

52
Q

Itraconazole is an inhibitor of

A

3A4 (CYP3A4) and CYP2C9

53
Q

Ketoconazole is an inhibitor of

A

is an inhibitor of CYP3A4.

54
Q

Systemic Azoles and Other Antifungals

ADRs

A

All of the azoles and terbinafine have been associated with hepatotoxicity.

Pharmacology for Advanced Practice Nurses (50 decks)

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