Staying on Track Quiz 2 Flashcards

Question

sofosbuvir + velpatasvir

Answer 1

Brand: Epclusa Class: NS5B RNA polymerase inhibitor + NS5A inhibitor Indication: Hepatitis C. (1-6) MOA: Velpatasvir inhibits the HCV NS5A protein necessary for viral replication. Sofosbuvir - prodrug converted to its pharmacologically active form (GS-461203), which inhibits NS5B RNA-dependent RNA polymerase, also essential for viral replication, and acts as a chain terminator. BBW: N/A SE: HA, nausea, fatigue

Answer 2

Brand: Harvoni Class: NS5B RNA polymerase inhibitor + NS5A inhibitor Indication: Hepatitis C (1,4,5,6) MOA: Ledipasvir inhibits the HCV NS5A protein necessary for viral replication; sofosbuvir is a prodrug converted to its pharmacologically active form (GS-461203), inhibits NS5B RNA-dependent RNA polymerase, also essential for viral replication, and acts as a chain terminator. BBW: N/A SE: HA, fatigue, asthenia

Answer 3

ombitasvir + paritaprevir + ritonavir + dasabuvir Brand: Viekira Pak Indication: Hepatitis C (1a, 1b) Class: NS5A inhibitor + protease inhibitor + CYP3A4 inhibitor + NS5B RNA polymerase inhibitor MOA: Ombitasvir inhibits HCV NS5A, and interferes with viral RNA replication and virion assembly. Paritaprevir inhibits HCV NS3/4A protease and interferes with HCV coded polyprotein cleavage necessary for viral replication. Dasabuvir inhibits HCV RNA-dependent RNA polymerase (encoded by the NS5B gene) which is also necessary for viral replication. Ritonavir is a CYP3A inhibitor that increases concentrations of paritaprevir. BBW: N/A SE: Skin reactions, pruritis, nausea, insomnia, fatigue

Answer 4

Brand name: Pegasys Class: Interferon Indication: Hep B & C MOA: Interferons interact with cells through high affinity cell surface receptors. Following activation, multiple effects can be detected including induction of gene transcription. Interferons inhibit cellular growth, alter the state of cellular differentiation, interfere with oncogene expression, alter cell surface antigen expression, increase phagocytic activity of macrophages, and augment cytotoxicity of lymphocytes for target cells. BBW: fatal or life-threatening neuropsychiatric, autoimmune, ischemic, and infectious disorders SE: alopecia, dermatitis, injection site inflammation/rxn, pruritus, rash, high TG, weight loss, abdominal pain, N/V/D, loss of appetite, arthralgia, myalgia, dizziness, HA, insomnia, anxiety, dyspnea, fatigue, fever, influenza-like illness, rigor

Answer 5

Brand name: Virazole Class: Antihepaciviral, Nucleoside (Anti-HCV) Indication: Chronic Hep C (in combo w/ peginterferon), RSV MOA: Inhibits replication of RNA and DNA viruses; inhibits influenza virus RNA polymerase activity and inhibits the initiation and elongation of RNA fragments resulting in inhibition of viral protein synthesis BBW: don't use alone for treatment of Hep C; Hemolytic anemia (which could lead to CV complications); Teratogenicity SE: injection site rxn, weight loss, diarrhea, loss of appetite, N/V, neutropenia, asthenia, dizziness, HA, insomnia, fatigue, influenza-like illness

Answer 6

Brand: Lidoderm Class: Local Anesthetic Indication: postherpetic neuralgia MOA: blocks both the initiation and conduction of nerve impulses by decreasing the neuronal membrane's permeability to sodium ions, which results in inhibition of depolarization with resultant blockade of conduction BBW: N/A SE: skin pigmentation, skin edema, bruise, local irritation

Answer 7

Brand: Sublimaze, Actiq, Duragesic Class: Opioid analgesic Indication: Pain MOA: Binds with mu-receptors at sites within the CNS, increases pain threshold, alters pain perception, inhibits ascending pain pathways BBW: Addiction, abuse, and misuse; life-threatening respiratory depression; accidental exposure; neonatal opioid withdrawal syndrome; CYP450 interaction; Exposure to heat increases transdermal absorption SE: bradycardia, chest wall rigidity, edema, central nervous system depression, confusion, dizziness, drowsiness, fatigue, HA, sedation, diaphoresis, dehydration, constipation, N/V, xerostomia, application site erythema, muscle rigidity, weakness, miosis, dyspnea, respiratory depression

Answer 8

Brand: various Class: Analgesic, Opioid Indication: Management of pain MOA: Binds to opioid receptors in the CNS, causing inhibition of ascending pain pathways, altering the perception of and response to pain; produces generalized CNS depression BBW: Astramorph PF, Infumorph, Duramorph: Because of the risk of severe adverse effects when the epidural or intrathecal route of administration is employed, patients must be observed in a fully equipped and staffed environment for at least 24 hours after the initial dose. Infumorph: Infumorph is not recommended for single-dose intravenous (IV), intramuscular (IM), or subcutaneous administration because of the very large amount of morphine in the ampul and the associated risk of overdosage. SE: pruritus, constipation, nausea, vomiting, dizziness, HA, lightheadedness, somnolence, miosis, urinary retention

Answer 9

Brand: Oxycontin, M-Oxy Class: Analgesic, Opioid Indication: Management of pain MOA: Binds to opiate receptors in the CNS, causing inhibition of ascending pain pathways, altering the perception of and response to pain; produces generalized CNS depression BBW: Addiction, abuse, and misuse; life-threatening respiratory depression; accidental ingestion; neonatal opioid withdrawal syndrome; CYP450 3A4 interaction; concentrated oral solution SE: drowsiness, dizziness, pruritus, constipation, N/V

Answer 10

Brand: Dilaudid Class: Analgesic, Opioid Indication: Management of pain MOA: Binds to opioid receptors in the CNS, causing inhibition of ascending pain pathways, altering the perception of and response to pain; causes cough supression by direct central action in the medulla; produces generalized CNS depression BBW: Addiction, abuse, and misuse; life-threatening respiratory depression; accidental ingestion; neonatal opioid withdrawal syndrome SE: constipation, N/V, asthenia, dizziness, HA, somnolence

Answer 11

Brand: Opana, Opana ER Class: Analgesic, Opioid Indication: Management of pain MOA: pure opioid agonist that is relatively selective for the mu receptor BBW: addiction/abuse/misuse, respiratory depression, accidental ingestion, neonatal withdrawal, alcohol interaction SE: drowsiness, dizziness, HA, pruritus, nausea, constipation, vomiting, fever

Answer 12

Brand: Coumadin Class: Vitamin K Antagonist Indication: Ppx & tx of thromboembolic disorders and embolic complications (after Afib, prosthetic valves), adjunct to reduce risk of systemic embolism after MI MOA: Inhibits synthesis of factors II, VII, IX, and X, proteins C & S; inhibits vitamin K epoxide reductase, which leads to vitamin K depletion. BBW: Bleeding risk SE: Bleeding, hemorrhage, alopecia

Answer 13

Brand: Lovenox Class: LMWH Indication: acute coronary syndromes (UA, NSTEMI, STEMI), DVT prophylaxis for abd surgery, immobile patients, & following hip/knee replacement, acute DVT treatment MOA: inhibits thrombin (IIa) and to a larger extent factor Xa BBW: Spinal/epidural hematomas SE: anemia, hemorrhage

Answer 14

Brand: Fragmin Class: LMWH Indication: ABD surgery postop DVT ppx; ACS; VTE in cancer; DVT ppx in hip replacements MOA: inhibits Factor IIa (thrombin) and to a greater extent factor Xa by means of antithrombin BBW: Spinal/epidural hematomas SE: hematomas, injection site pain, thrombocytopenia

Answer 15

Brand: Pradaxa Class: Direct Thrombin Inhibitor Indication: DVT/PE treatment and ppx in pts who have been treated on a parenteral anticoag for 5-10 days, afib, ppx after hip replacement MOA: prodrug; inhibits both free and fibrin bound thrombin. Inhibits coagulation by preventing thrombin mediated effects BBW: premature discontinuation increases risk for thrombotic events; spinal/epidural hematoma SE: GI symptoms, hemorrhage

Answer 16

Brand: Epogen, Procrit Class: Erythropoiesis-Stimulating Agent; CSF Indication: Treatment of anemia in cancer, CKD, zidovudine usage MOA: Induces erythropoiesis by stimulating the division and differentiation of committed erythroid progenitor cells; induces the release of reticulocytes from the bone marrow into the bloodstream, where they mature to erythrocytes. There is a dose response relationship with this effect. This results in an increase in reticulocyte counts followed by a rise in hematocrit and hemoglobin levels. BBW: CKD- increased risk of death, serious adverse CV reactions, stroke Cancer- shortens overall survival and/or increased risk of tumor progression or recurrence Perisurgery- increased risk of DVT SE: HTN, fever, HA, pruritus, rash, N/V, injection site reaction, arthralgia, cough

Answer 17

Brand name: Aranesp Class: Erythropoiesis-Stimulating Agent (ESA); CSF Indication: anemia IN CANCER (nonmyeloid malignancies) & in CKD MOA: Induces erythropoiesis by stimulating the division and differentiation of committed erythroid progenitor cells; induces the release of reticulocytes from the bone marrow into the bloodstream, where they mature to erythrocytes. There is a dose response relationship with this effect. This results in an increase in reticulocyte counts followed by a rise in hematocrit and hemoglobin levels. BBW: CKD- increased risk of death, serious adverse CV reactions, stroke Cancer- shortens overall survival and/or increased risk of tumor progression or recurrence SE: HTN, peripheral edema, edema, abdominal pain, dyspnea, cough

Answer 18

Brand: Arixtra Class: Factor Xa Inhibitor Indication: DVT prophylaxis in hip/knee replacement, treatment of acute pulmonary embolism, treatment of acute DVT MOA: Fondaparinux is a synthetic pentasaccharide that causes an antithrombin III-mediated selective inhibition of factor Xa. Neutralization of factor Xa interrupts the blood coagulation cascade and inhibits thrombin formation and thrombus development. BBW: Spinal/epidural hematomas SE: Anemia

Answer 19

Brand: Neupogen Class: Hematopoietic Agent; CSF Indication: febrile neutropenia ppx in myelosuppressive chemo recipients with nonmyeloid malignancies; AML following induction or consolidation chemo; neutropenia with BMT; Hematopoietic radiation injury syndrome; Peripheral blood progenitor cell collection and therapy; Severe chronic neutropenia MOA: stimulate the production, maturation, and activation of neutrophils to increase both their migration and cytotoxicity. BBW: N/A SE: chest pain, fatigue, dizziness, pain, increased lactate dehydrogenase, increased uric acid, skin rash, splenomegaly, thrombocytopenia, petechiae, increased ALP, fever, ostealgia in lower back, epistaxis, cough, dyspnea, fever

Answer 20

``` Brand: Granix Class: Hematopoieic Agent; CSF Indications: neutropenia MOA: increases neutrophil counts and activity by binding to G-CSF receptors and stimulating differentiation commitment and some end-cell functional activation BBW: n/a SE: leukocytosis and bone pain ```

Answer 21

Brand: Neulasta Class: Hematopoietic Agent; CSF Indication: hematopoeic radiation injury; To decrease the incidence of infection, by stimulation of granulocyte production, in patients with nonmyeloid malignancies receiving myelosuppressive chemo associated with a significant risk of febrile neutropenia MOA: Stimulates the production, maturation, and activation of neutrophils, pegfilgrastim activates neutrophils to increase both their migration and cytotoxicity. Pegfilgrastim has a prolonged duration of effect relative to filgrastim and a reduced renal clearance BBW: N/A SE: ostealgia, limb pain

Answer 22

Brand: Ferrlecit Class: Iron Salt Indication: iron deficiency anemia MOA: Supplies a source of elemental iron necessary to the function of hemoglobin, myoglobin and specific enzyme systems; allows transport of oxygen via hemoglobin BBW: N/A SE: Hypotension, HTN, tachycardia, HA, dizziness, N/V/D, abnormal erythrocytes, injection site reaction, cramps, dyspnea

Answer 23

Brand: Feraheme Class: Iron Salt Indication: iron-deficiency anemia in adults with CKD MOA: releases iron within vesicles in the macrophages of the liver, spleen, and bone marrow where it then enters into either the intracellular storage iron pool, or is transferred to plasma transferrin and is incorporated into hemoglobin by erythroid precursor cells BBW: Fatal and serious hypersensitivity reactions SE: diarrhea, nausea, dizziness, constipation, peripheral edema