Pharm Exam 2:3

Question 1

Antifungal: polyenes

Answer 1

Amphotericin B

Question 2

Amphotericin B uses and effects

Answer 2

Severe fungal/systematic infections (cryptococal menigitis, candida)

Adverse effects: mostly gi and allergic symptoms like
Flushing, fever, chills, dyspnea, tachycardia, headache, bone marrow supression (anemia), abdominal pain, diarrhea
High doses: nephrotoxicity, electrolytes imbalance

Question 3

Amphotericin B (Antifungal polyenes) considerations
Ex: Before giving amphotericin b, we should administer —— because it can cause ——
What to monitor

Answer 3

Give Iv slowly up to 4hr
Premedication: antihistamine, costicosteroids to minimize fever, chills
Fluid or IV bolus with administration

Monitor electrolytes, renal function

Question 4

Nystatin
Type of med
Methods of administration (5)

Answer 4

Also an antifungal: polyene medication
Methods of administration
Oral, topical, cream, ointment, suspension

Question 5

Side effects of nystatin: which is a type of — med

Answer 5

Nystatin: antifungal: antipolyene
Skin irritation, steven jhonson syndrome

Pt education: swish in mouth, then either spit or swallow as prescribed, careful with alcohol

Question 6

Ketoconazole
Which type med
Uses

Answer 6

Antifungal: azole
Cutaneous infection (candida, yeast infection, tinea infections), histoplasmosis (bird or bat drooping), disaeminated coccidioimycosis (fungus from desert soil)

Question 7

Ketoconazole adverse reactions

Answer 7

An antifungal medication
Topicals: burning, itching, redness, localized hypersensitivity

When given IV: liver toxicity, GI symptms, QT prolongation
Makes sense that topical doesn’t cause gi issues because its not taken oral, it doesn’t go through the GI system (from oral to anus), but IV does affect gi system

Question 8

Why is it better to give ketonazole than amphotericin B

Answer 8

Ketonazole is less toxic than amphotericin B

Question 9

Not all azole are antifungal
They can also be antiprotozoal/antibiotic

Metronidazole is an ex
What is it? Uses?

Answer 9

1. Candidadis
2. histoplasmosis(a fungal infection caused by histoplasma cryspsulatum)
3. cryptococcal meningitis(caused by a fungus named cryptococcus)
4. C diff infection (mild though, its not the best med)

Avoid alcohol when on antibiotics

Question 10

Adverse affects of metronidazole

Answer 10

Gi effects, CNS symptoms, seizures, peripheral neuropathy
Darkening of urine
disulfiram reaction (psychosis))

Question 11

When should you avoid metronidazole (antiprotozoa)

Answer 11

Seizure disorder
History of blood dyscarias
Allergic reaction
Renal failure
Heart failure
Active CNS disease
Severe blood disorder
1st trimester of pregnancy
Carcinogenic in mice

Question 12

Acyclovir
Class and uses

Answer 12

Acyclovir is an herpes antiviral drug
Uses. Herpes simplex, herpes zoster (shingles), genital herpes, varicella zoster (chicken pox)

Question 13

Acyclovir side effectes based on topical, oral, IV

Answer 13

Acyclovir effects
Topical: burning, itching at application site
Oral: nausea, vomiting, headache, veritgo
IV: thrombophlebitis, renal toxicity, thrombocytopenia (low platelet count, sinilar to gentamicin)

Question 14

Contraindications for acyclivir (2)

Answer 14

Allergic
Milk protein hyperintensitivity

Question 15

Isoniazid
Type med
Uses

Answer 15

Antimycrobactrial drug
Uses: antitubercular, active and latent tuberculosis
Latent means germs are in body but they are sleeping

Question 16

Adverse reactions isoniazid (INH)

Answer 16

Gi distress, peripheral neuropathy, seizure, psychotic behavior, blood dyscarias, hepatoxicity, electrolyte imbalances
So not a very safe med

Question 17

Isoniazid (INH): caution, contraindications, considerations

Answer 17

Caution in someone who is over 50 and has alcoholism, liver disease, HIV, seizure fisorder
Think that chronic alcoholism does cause liver problems

Considerations: observe for liver damage (jaundice, abdominal pain, ununsual fatigue)
Monitor liver enzymes
Administer B6 to prevent peripheral neuropathy
Contraindications: allergy to it, hx of liver damage from it

Question 18

Rifampin
Class and uses

Answer 18

Antimycrobial drugs
Rifampin: uses for TB, leprosy, meningitis, legionella

Question 19

Adverse reactions rifampin

Answer 19

Liver toxicity
Urine, saliva, tears, sweat turns red-orange
Gi symptoms
Flushing, rash, itch

Considerations: monitor liver enzymes
Monitor for drug reactions with eosinophilia (high eo) and systematic symptoms
May affect oral birth control

Contraindications: allergy

Question 20

Nitrofurantoin

Answer 20

Treat and prevent UTI
Effects against gram + - bacteria especially ecoli