Flashcards in Quiz 2 Reverse Deck (50):
1 - latent in trigeminal ganglia2 - latent in sacral ganglia
Which sites do HSV 1 & 2 prefer?
1. Acyclovir - Zovirax- oral, topical, IV2. Valacyclovir - Valtrex - only oralProdrugs - prevent viral shedding
What are the meds for herpes & how do they work & drug forms?
What is the MCC of severe diarrhea in children?
3 dose regimen to infants 6-32 wksSelf limiting - rehydration
Who gets the rotavirus vaccine & how do you treat when you get it?
RNA Readily inactivated w/ soap, water & disinfectantsMCC of bronchiolitis & PNA in kids <1yr
What type of virus is RSV?
Palivizumab - Synagis Tx - Ribavirin aerosol
What is the vaccine & Tx for RSV?
1. Extracellular - w/in lung cavities2. Inside granulomas3. W/in macrophages
What are the 3 environments TB likes to be in?
What phase do TB drugs target?
8 weeks of 1. Rifampin2. Isoniazid3. Pyrazinamide4. EthambutolFollowed by 16 wks of:1. Rifampin2. Isoniazid
What is typical therapy for TB?
Pregnant ladies - yesKids - don't use Ethambutol <5y/o
Can you use TB therapy in pregnant ladies & kids?
What is the most common side effect of all TB drugs?
For TBinterferes w/ mycolic acid (cell wall)
How does isoniazid work?
Slow - drug levels rise & may cause peripheral neuropathyFast - Make more metabolite & may cause hepatotoxicity
What is the problem w/ slow/fast acetylators & isoniazid?
2C19 & 2D6Careful w/ MAOIs
What drug interactions should you consider with isoniazid?
Rifampin - TB TxBactericidal Used in active TBAlso urine & breast milk
What drugs cause your tears to turn red?
Active TB TxInhibits cell wall synthesisBacteriostatic
How does ethambutol work?
Active TB TxEffects ATP - disrupts plasma membrane & energy metabolism Bactericidal
How does pyrazinamide work?
1. Optic neuritis - dec. acuity, scotoma, color blindness, visual defects 2. Hepatotoxicity3. GI
1. Hyperuricemia2. Hepatotoxicity3. Loss of glycemic control4. GI
Aminoglycoside abxInterrupts formation of proteins Injectable only
How does streptomycin work?
CN VIII1. Nephrotoxicity2. Neurotoxicity3. HOTN4. Ototoxicity - auditory & vestibular
1. Chloroquine For active & prophylactic malaria
What are the 4-aminoquinolones & when are they used?
For active & prophylactic malaria1. Mefloquine Works in blood stage CV changes & seizure inc, CNS
What are the 4-methanoloquinolines & ADRs?
1. Primaquine For active & prophylactic malariaCareful w/ G6PD deficiency
What are the 8-aminoquinolines?
1. Atovaquone/Proguanil (Malarone)For active & prophylactic malariaCareful in AIDS Pts (NNRTIs, PIs)
What are the anti-folates for malaria?
1. Doxycylcine2. Tetracycline3. ClindamycinActs on shizonts - delay death mechanismOnly used in combo therapy
What are the antimicrobials for malaria?
1. Artemether (Coartem)Short 1/2 lifeDO NOT use as monotherapy!For active malaria
What are the artemisinin derivatives?
1. Tinidazole (Tindamax)2. Iodoquinol (Yodoxin)3. Paromomycin 4. Metronidazole (Flagyl)
What drugs would you use for a protozoal infection?
1. C. Diff2. Amebiasis3. Giardiasis4. Trich5. Anaerobic infections DO NOT drink!
What can you treat w/ Metronidazole?
We have Type II immunity
Why are helminth infections worse in kids?
What is the MC infestation throughout the world?
1. Benzimidazoles2. Ivermectin3. Praziquantel4. Pyrantel pamoate
What classes of drugs would you use for a helminth infection?
Type of Benzimidazole for helminth1. Bone marrow suppression2. Inc. liver transaminases3. HA4. Inc. ICP5. Dizziness, vertigo6. Ab pain, N/V
For Helminth - aka Stromectol P-glycoprotein activity can reduce ivermectin levels in CNSRARE - reactions prob due to wormie dying 1. Pruritis, fever, LN tenderness 2. Tachycardia3. Eosinophilia, leukocytes dec., Hgb inc. Get routine blood work!
Major substrate of CYP3A4Aka BiltricideRifampin dec. Praziquantel levels
How is Praziquantel metabolized?
Pyrantel Pamoate aka Pin-XPoor oral absorption GI problemsCareful if hepatic impairment
How do you Tx pinworms?
1. Triazole - Fluconazole2. Imidazole - Ketoconazole
What are the azole antifungals?
1. Kidney & liver function2. Electrolytes3. Vital signs 4 hrs post infusion
What do you need to monitor when using Amphotericin B?
1. Acetaminophen2. CorticosteroidAlso give K supplementation w/ prolonged therapy, load w/ NaCl injection
What do you give with amphotericin B to prevent some of the side effects?
1. Fever & chills2. Tachypnea, stridor3. Nephrotoxicity4. Anemia
ADRs amphotericin B
Micafungin - Mycamine
What are the echinocandins?
1. Nasal corticosteroids2. Singulair3. Ipratropium nasal spray4. Cromolyn nasal spray5. Antihistamines
What are the meds for allergic rhinitis?
Fluticasone nasal - Flonase Need 1-2 wks of therapy until max efect
What are the corticosteroids for allergic rhinitis?
1. Singulair - Montelukast Improves rhinorrhea, sneezing & congestoin
What the the leukotriene modifiers for allergic rhinitis?
1. Cromolyn nasal - NasalCromReduce release of histamine from mast cells Can work w/in 30 min
What are the mast cell stabilizers for allergic rhinitis?
1. Ipratropium nasal - Atrovent Blocks parasympathetic nerve effect - Vidian nerve is postganglionic parasympathetic Can cause xerostomia & taste perversion Tx of rhinorrhea
What are the anticholinergics for allergic rhinitis?
1. Claritin - Loratadine
What are the antihistamines for cold?
Pseudoephedrine - Sudafed 1. CV2. Metabolic3. CNS4. Endocrine
What are the decongestants for cold & ADRs?
1. Dextromethorphan - DelSymDepression of medullary cough center - sigma receptor stimulation 2. Benzonanatate Intractable cough Tx
What are the antitussives for cold?