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Pharmacology - Final Exam > Antivirals, Disinfectants, Antiseptics, & Sterilants > Flashcards

Antivirals, Disinfectants, Antiseptics, & Sterilants Flashcards

(51 cards)

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1
Q

What is the initial preferred treatment of HIV?

A
  • tenofovir/emtricitabine

- ADD efavirenz, atazanavir/ritonavir, raltegravir, darunavir/ritonavir

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2
Q

What is an adverse effect of tenofovir?

A
  • renal insufficiency

check serum creatinine

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3
Q

What is tenofovir’s place in therapy?

A
  • 1/2 of the backbone of preferred HIV tx
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4
Q

Besides direct HIV tx, when can tenofovir be used?

A
  • used with emtricitabine for pre- + pos-exposure prophylaxis
    (i. e. needle stick & sexual assault)
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5
Q

What are the ADEs of emtricitabine?

A
  • hyperpigmentation of the palms (mimics 2ndary syphillis)

- skin discoloration

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6
Q

What are the ADEs of zidovudine?

A
  • bone marrow suppression
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7
Q

What is a special consideration for lamivudine?

A
  • lower dose for HBV (Hep B) tx, Epivir
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8
Q

What are the combination HIV products?

A
  • emtricitabine + tenofvir (Truvada)
  • e + t + efavirenz (Atripla)
  • e + t + elvitegravir + cobicistat (Stribild)
  • abacavir + lamivudine + dolutegravir (Trimumeq)
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9
Q

How are the combination HIV products dosed?

A
  • 1 tablet PO BID
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10
Q

What is unique about efaviranz’s dosing?

A
  • HS (take @ bedtime) on an empty stomach
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11
Q

What are the ADEs of efaviranz?

A
  • CNS effects which subside after 2-4w
  • rash
  • elevated LFTs
  • teratogenic
  • false (+) cannabinoid test
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12
Q

What viral load is rilpivirine used for?

A
  • NOT high loads (>100,000)
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13
Q

What is rilpivirine’s DI?

A
  • avoid use with PPI (proton pump inhibitor); needs acidic enviornment
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14
Q

What are the ADEs of nevirapine?

A
  • hepatitis, including fatal hepatic necrosis
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15
Q

How is ritonavir dosed?

A
  • booster

- NEVER ALONE

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16
Q

What special considerations must be known with atazanavir?

A
  • separate dosing from antacids/H2 blockers/PPIs

take 12 hrs AFTER omeprazole 20mg qd

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17
Q

What are the ADEs of atazanavir?

A
  • indirect hyperbilirubinemia

- lack of effect on lipids (good! does not cause hyperlipidemia! woohoo!)

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18
Q

What are the special considerations of darunavir?

A
  • caution in sulfa-allergic patients
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19
Q

What are the ADEs of darunavir?

A
  • rash
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20
Q

What is the preferred PI?

A
  • darunavir
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21
Q

What are the special considerations of lopinavir/ritonavir?

Study These Flashcards
A

(Kaletra)

- drug of choice in pregnancy

22
Q

What is the ADE of reltegravir?

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A
  • increased CK (creatine kinase)
23
Q

What are the special considerations for dolutegravir?

24
Q

When must antivirals for HSV and VZV be initiated?

Study These Flashcards
A
  • w/in 48-72h of rash onset
25
What does acyclovir tx?
- HSV1 - HSV2 - VZV
26
What are the special considerations of acyclovir?
- topical therapy limited to oral labial herpes, NOT GENITAL - IV therapy for disseminated zoster - manage patient expectations that there is no cure
27
What is valacyclovir's MOA?
- prodrug of acyclovir
28
T/F: HSV and VZV treatments are virucidal.
- false, virustatic
29
T/F CMV treatments are virustatic.
- true
30
What are the treatments for CMV?
- ganciclovir - valganciclovir - foscarnet - cidofovir
31
What is the ADE of ganciclovir?
- black box warning: bone marrow toxicity
32
What are the special considerations of ganciclovir?
- causes nephrotoxicity so hydrate aggressively - monitor renal fxn, adjust accordingly - avoid direct contact with skin
33
What is the drug of choice for tx and prevention of CMV retinitis?
- valganciclovir
34
How is valganciclovir delivered?
- PO
35
T/F: Valacyclovir treats CMV.
- False, valganciclovir | BE AWARE OF LOOK-ALIKE/SOUND-ALIKE NAMES
36
What are the ADE of foscarnet?
- HIGHLY NEPHROTOXIC!!
37
What are the PO antivirals for HBV?
- adefovir - *lamivudine (also for HIV) - *entecavir - telbivudine - tenofovir (also for HIV)
38
What is the subQ antiviral for HBV?
- interferon alfa
39
What are the special considerations of tenofovir when used for HBV?
- works against lamivudine and entecavir resistant isolates - does not work against adefovir resistant isolates - significantly higher rate of response than adevfovir
40
What are the ADEs of entecavir?
- dizziness | - fatigue
41
What are the special considerations for lamivudine (Epivir HBV)?
- resistance is common | - lower dose than for HIV
42
What are the ADEs of interfereon?
- flu-like sx that improve as tx continues | H/A, myalgias, arthralgias, fatigue, malaise, fever, chills
43
What are the CIs of interferon?
- hepatic decompensation - autoimmune dz - hx of arrhythmia - pregnancy
44
What type of tx is the standard of care for HCV?
- combo therapy
45
What are the treatment options for HCV?
- sofosbuvir - ledipasvir/sofosbuvir - simeprevir - ombitasvir/paritaprevir/ritonavir & dasabuvir (Viekira Pak) - ribavirin
46
What is the Viekira Pak approved for treating?
- genotype 1 HCV
47
What is the best method of routine prevention of the flu?
- inactivated influenza vaccine
48
What are the antivirals for influenza?
- amantadine - rimantadine - oseltamivir - zanamivir
49
What are the ADEs of amantadine and rimantadine?
- CNS toxicity, increased risk in eldery | rimantadine less than amantadine
50
What are the special considerations of amantadine?
- no longer recommended for influenza prophylaxis | - used to tx Parkinson and drug-induced EPS
51
What may happen with disinfectants and antiseptics?
- contaminated with spores or bacteria that transmit infection

Pharmacology - Final Exam (4 decks)

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