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PHRM 865 > Tieman > Flashcards

Tieman Flashcards

(69 cards)

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1
Q

herpes simplex virus (HS1/HS2) shape

A

large double stranded DNA
enveloped

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2
Q

HSV1 location

A

oral mucosa

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3
Q

HSV2 location

A

genital mucosa

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4
Q

HSV locations in immunocompromised patients

A

eye
skin
visceral organs
CNS

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5
Q

HSV1 establishes in what ganglia

A

trigeminal (sensory) ganglia

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6
Q

diagnosis of HSV1 how

A

PCR test and swab

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7
Q

HSV1 presentation

A

cold sores or ulcers in mouth

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8
Q

HSV2 presentation

A

bumps, blisters, ulcers around genitals or anus

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9
Q

HSV2 esablishes in what ganglia

A

sacral ganglia

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10
Q

diagnosis of HSV2 how

A

PCR and swab

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11
Q

HSV encephalitis usually caused by which HSV

A

HSV1

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12
Q

most adults are seropositive for what

A

HSV1

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13
Q

diagnosis of HSV encephalitis how

A

lumbar puncture and PCR testing

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14
Q

symptoms of HSV encephalitis

A

fever
confusion
personality changes
headache
seizure
focal neurological effects

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15
Q

acyclovir MOA

A

competitive inhibitor of viral DNA polymerase
incorporated into viral DNA causing chain termination

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16
Q

bioavailability of acyclovir

A

poor bioavailability
not affected by food

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17
Q

how is acyclovir eliminated

A

renally, need to dose adjust

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18
Q

adverse effects of acyclovir

A

N/V/D
rash
headache (oral)
nephrotoxicity
neurotoxicity
thrombophlebitis

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19
Q

renal consideration with acyclovir

A

need to renal dose adjust
high risk nephrotox
give IV fluids with

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20
Q

genital HSV treatment primary infection

A

acyclovir 400 mg TID x 7-10 days
acyclovir 200 mg 5x/day x 7-10 days
valacyclovir 1 g BID x 7-10 days
famciclovir 250 mg TID x 7-10 days

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21
Q

genital HSV treatment recurrent infection

A

acyclovir 800 mg BID x 5 days
acyclovir 800 mg TID x 2 days
valacyclovir 500 mg BID x 3 days
valacyclovir 500 mg 1 g daily x 5 days

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22
Q

genital HSV treatment for suppression in immunocompromised

A

valacyclovir 500-1000 mg daily (1 g if >10 epsidoes/year)
acyclovir 400 mg BID
famciclovir 250 mg BID
once daily preferred

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23
Q

genital HSV treatment for suppression in HIV patients

A

valacyclovir 500 BID

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24
Q

oral HSV treatment

A

acyclovir 400 mg TID x 5-10 days
valacyclovir 2 g BID x 1 day
famciclovir 1.5 g single dose

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25
HSV encephalitis treatment
acyclovir 10mg/kg IV q8hr for 14-21 days
26
how is valacyclovir metabolized
rapidly absorbed and converted to acyclovir by intestinal and hepatic metabolism
27
valacyclovir bioavailability
3-5 times greate than acyclovir
28
valacyclovir elimination
renally
29
drug interaction with famciclovir
probenecid taken with will decrease renal clearance and increase serum concentrations
30
famciclovir side effects
well tolerated headache N/V/D acute renal failure
31
how does varicella zoster virus stay in the body
becomes dormant in sensory nerve ganglia as latent infection
32
is varicella zoster contagious
highly contagious spread by direct contact or inhalation if not vaccinated
33
varicella (chickenpox) treatment
acyclovir x 5-7 days valacyclovir 5-7 days
34
zoster (shingles) treatment
acyclovir 7-10 days valacyclovir 7 days famciclovir 7 days
35
what is CMV?
most people have it but its opportunistic so usually immunocompromised people get it
36
ganciclovir use
CMV
37
what is gancicloir
prodrug converted to active form by viral thymidine kinase phosphorylated three times
38
ganciclovir interactions
avoid other cytotoxic drugs with risk of bone marrow suppression, and probenecid
39
adverse effects of ganciclovir
myelosuppression bone marrow supression!! - reversible - increase risk w increase dose - stop drug if ANC < 500 or platelet < 25,000
40
treatment for CMV retinitis
ganciclovir 14-21 days valganciclovir x 21 days foscarnet x 14-21 days
41
valganciclovir pearl
take with food, AUC increased with high fat meal
42
prevention of CMV in transplant patients at high risk
ganciclovir valganciclovir
43
letermovir MOA
inhibits CMV terminase complex by binding pUL56 inhibits CMV replication and prevents CMV infection
44
letermovir adverse effects
N/V/D peripheral edema cough headache
45
letermovir drug interactions
CYP3A4 inhibitor and OATP1B1 not preferred due to the drug interactions!
46
foscarnet adverse effect
nephrotoxicity - major dose limiting side effect give hydration with
47
what to give in CMV retinitis resistance to gamciclovir/valgamciclovir?
foscarnet
48
neuramidase inhibitors
zanamivir oseltamivir peramivir
49
zanamivir dosage forn
DPI
50
peramavir dosage form
IV
51
oseltamivir, zanamivir, peramivir given when
in flu but those who have been symptomatic for 2 days or less
52
neruamidase inhibitor consideatiions
do not give live vaccine within 2 weeks before or 48 hours after oseltamivir administratiion
53
caution with zanamivir in who
those with COPD or reactive airway disease
54
age range for oseltamivir and zanamivir
oseltamivir - > 2 weeks zanamivir > 7 years
55
peramivir indication
acute UNCOMPLICATED flu in pts 18+ who have been symptonatic for no more than 2 days
56
peramivir age
> 18
57
peramivir dosing
600 mg IV infusion over > 15 minutes only single dose
58
baloxavir considerations
avoid co-admin with dairy, metals, antacids avoid with live vaccine
59
baloxavir age
>12
60
amantadine + rimantadine use
not used in clinical practice due to high resistance rates
61
acyclovir spectrum
HSV 1/2 VZV
62
valacyclovir spectrum
HSV1/2 VZV
63
ganciclovir spectrum
HSV1/2 VZV CMV EBV
64
valganciclovir spectrum
HSV 1/2 VZV CMV EBV
65
famciclovir spectrum
HSV 1/2 VZV
66
letermovir spectrum
CMV
67
foscarnet spectrum
HSV 1/2 VZV CMV EBV
68
which flu drug works best for Flu B
zanamivir
69
amantadine and rimantidine spectrum
flu A

PHRM 865 (33 decks)

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