Anti-Infections Part-2 Flashcards
(123 cards)
1
Q
What can identify Latent TB?
A
Positive STS or blood test and Negative X-ray
2
Q
What can identify active TB
A
Positive TST or blood test, Abnormal CXR, Positive Feels Sick
3
Q
Latent TB is treated with how many drugs?
A
1 or 2
4
Q
How many drugs must active TB be treated with?
A
Must include 2 or more drugs
5
Q
What is required if you get a positive skin or blood test for TB?
A
CXR and sputum Culture
6
Q
Multi Drug Resistance TB is resistant to what drugs?
A
Isoniazid and Rifampin
7
Q
Extensively Drug Resistant TB is resistant to what?
A
INh and Rifampin
All fluoroquinolones
at least on injectable second line drug
8
Q
How many phases of Active TB?
A
Two Phases
9
Q
What is the intensive phase of TB tx?
A
First 8 weeks of tx
Most bacilli killed during this phase
4 drugs used
10
Q
What happens n the continuation phase of Active TB?
A
After 8 weeks, at least 2 drugs used
11
Q
If someone has drug sensitive TB what drugs work
A
Rif an INH
12
Q
What is the go to drug for people with TB and HIV?
A
Rifabutin
13
Q
Why not use Rifampin for HIV pt’s?
A
speeds up drugs used for HIV
14
Q
What is DOT?
A
Direct observing therapy
15
Q
How often do you take drugs with intermittent dosing?
A
2-3 times a week
16
Q
Isoniazid MOA?
A
inhibits cell wall formation
17
Q
Use of Isoniazid INH?
A
Single use for latent TB
18
Q
Black Box warning for INH?
A
Hepatotoxicity
19
Q
What do you want to get a baseline screening of with someone on INH?
A
Vision
20
Q
Do not give INH is patient has what? (Hard no)
A
Acute liver disease or hx of hepatotoxicity
21
Q
When should you take INH?
A
1 hour before meals or 2 hours after
22
Q
LFT how often when on INH?
A
Monthly
23
Q
What drug can stop peripheral neuropathy with INH use?
A
Pyridoxine (Vit B6)
24
Q
What is Rifampin used for?
A
Acute TB with other drugs.
25
MOA of Rifampin
Stops synthesis of RNA and is Bactericidal
26
Common adverse effect of Rifampin
Red discoloration of tears an urine
27
Serious SE of Rifampin
Heptotoxic and ARF
28
Hard no for Rifampin?
HIV meds specifically protease inhibitors
29
When do you take Rifampin?
1 hour before meals or 2 hours after
30
What is Pyrazinamide used for?
TB
31
Is Pyrazinaminde Bacteriostatic or Bactericidal?
Bactericidal to M. tuberculosis
32
Serious SE of Pyrazinamide
Gout and of course liver toxic
33
Hard no for Pyrazinamide?
sever liver disease or gout
34
What to eval while on Pyrazinamide?
LFT and uric acid
35
Myambutol is also called what?
Ethambutol
36
Use of Myambutol?
Initial tx of TB and for people that have had TB in past
37
MOA of Myambutol?
impaired cell wall synthesis
38
Serious SE of Myambutol/Ethambutol?
Optic neuritis
39
Hard no for mymnutol?
Optic Neuritis
40
How many classes of Antifungals are there?
4
41
Amphotericin B is used for what?
progressive and fatal fungal infections
42
How in Amphotericin given?
IV only slowly over 2-4 hours
43
MOA of Amphotericin B?
makes cell membrane more permeable
44
black Box warning for Amphotericin B?
Reserve this drug for progressive and life threatening fungus
45
Serious SE of Amphotericin
Nephrotoxicity, CNS, Cardiac Arrest
46
What drugs does everyone get as pretreatment options when given Amphotericin B?
Benadryl and Tylenol
47
What drugs are give for Rigors associated with Amphotericin B?
(Meperidine) Demoral or (Revonto) Dantrolene
48
What drug do you use for rigors associated with amphotericin B when other fail?
Hydrocortisone
49
Will kidney damage occur with Amphotericin B?
Yes extent of damage r/t amount in dose
50
You will ahve ongoing damage to Kidney if dose of Amphotericin total dose is great than what?
4 grams
51
How often do you monitor serum creatinine while patient is on Amphotericin B?
Q 2-4 days
52
Reduce dosage of Amphotericin does if serum creatinine is over wht?
3.5mg/gL
53
Should you give NSAIDS with Amphotericin?
No
54
What should you do on days that client receives Ampotericin dose?
Flush system with 1L bolus
55
What is Itraconazole used for?
Systemic and localized mycoses
56
MOA of Itraconazole?
inhibits synthesis of ergosterol
57
Black Box warning of Itraconazole?
Do not use for treating onychomycosis in patients with ventricular dysfunction like HF
58
Hard No for Itraconazole?
Drugs that mess with CYP34A
59
What should you drink when you take Itrazonazole?
Cola beverage or food
60
Fluconazole is also called what?
Diflucan
61
Diflucan is sued for what?
Yeast infection with 1 pill
62
Is IV and PO dose the same in Diflucan?
Yes
63
Caspofungin is used for what?
Serious diseases hard to reach areas of body
64
Caspofungin is give how?
IV only
65
Acyclovir is used for what?
Recurrent herpes infection and shingles
66
MOA of Acyclovier?
Interferes with viral DNA synthesis and decreases viral shedding
67
Serious SE of Acyclovir?
reversible nephrotoxicity
68
What should you do when giving topical Acyclovir?
Wear a glove due to viral shedding
69
What is major concern with Acyclovir?
Kidney is key
70
Does Acyclovir cure herpes?
No , educate on importance of preventing spread with sexual partners.
71
Who can use Tamiflu?
Adults and kids 1 year and older who have Flu A or B
72
How long should you have sx to use Tmaiflu?
2 days or less
73
Tamiflu is used for what?
Treat and prevent influenza
74
Best way to not get flu?
Flu shot
75
MOA of Tamiflu?
prevents virus from exiting host cell and infecting other cells
76
What labs are used to guide tx of HIV?
CD4 count and Viral Load
77
Do you want CD4 count to be high or low?
Up
78
Do you want high viral load or low viral load in HIV?
Low viral Load
79
What is causes resistance over the course of Tx of HIV?
No adherence to med regimen
80
Abacavir is used for what virus?
HIV
81
MOA of Abacavir?
acts on DNA by incorporating in growing strand of viral DNA
82
Serious SE of Abacavir?
Lactic Acidosis
83
Black Box Warning for Abacavir?
Fatal hypersensitivity in people with HLA-B*5701 mutation.
84
Should you use Abacavir is patient has lactic acidosis?
No
85
Ho long should it take for Abacavir to reach minimal level?
4-5 months for minimal level of viral load
86
Sustiva MOA?
inhibits DNA replication by binding to reverse transcriptase enzyme
87
Can you use Sustiva if prego?
No
88
When should you take sustavia?
empty stomach at bedtime
89
What drug is a protease Inhibitor?
Darunavir
90
Moa of Darunavir
binds to HIV protease preventing cleaving
91
Serious SE of Darunavir?
Diabetes
92
Common SE of Darunavir?
Fat stomach, Hyperlipidemia, Hyperglycemia
93
Can you use Darunavir with Riphafin?
No
94
What drug must you get a booster of if taking Darunavir?
Ritonavir
95
What is the MOA of Isentress?
Stops HIV replication by preventing insertion of HIV DNA
96
HIV fusion inhibitor is what drug?
Enfuvirtide
97
MOA of Enfuvirtide?
does not let HIV into CD4 T-cells
98
Who do you want to be careful with in giving Enfuvirtide?
Respiratory people with problems risk for pneumonia
99
What age patients can use Maraviroc?
16 and older
100
MOA of Maraviroc
Binds with CCR5 to block viral entry
101
If patient forgets to take a dose of Maraviroc what should they do?
Take missed dose ASAP and regular time for future doses
102
What drugs are used for combination Therapy for HIV?
NRTI and ARV
103
What is PrEP?
Drug for people for HIV prophylaxis
104
what makes Prep more effetive?
Taking consistently daily
105
Flyagyl is also called what?
Metronidazole
106
MOA of Flagyl?
Disrupts DNA synthesis in protozoal organisms.
107
Severe SE of Flygyl?
CNS stuff...seizurs aseptic meningitis and SJS
108
How long do you give IV infusion of Metronidazole over if IV?
60 min
109
What do you want to tell patients to avoid using when taking Flygal?
Alcohol due to disufiram reaction
110
What is an Ectoparasiticide?
living thing on the body
111
What is Pediculosos caused by?
Lice
112
What is scabies caused by?
Mites
113
what suffocates lice?
Benzyl alcohol
114
What must you treat with body lice?
Treat the surrounding environment
115
What kills lice that are on the body?
Permethrinin and Malathion
116
What are lice on pubes called?
crabs
117
what are lice on eyelashes called?
Pediculosis ciliaris
118
What is the tx for Scabies?
Permethrin, malathion
119
Malathion can be used in patients at what age?
6 and older
120
What are lice eggs in hair called?
nits
121
When using malathion how should you apply?
put on dry hair, let it dry naturally after 8-12 hours rinse and comb out
122
Permethrin is toxic to what?
mits and lice
123
How do you use Permethrin Nix?
apply to damp hair leave on 10 min rinse with warm water repeat after 1 week if still lice
