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Pharm Exam 3 > Viruses, Fungi, Parasites > Flashcards

Viruses, Fungi, Parasites Flashcards

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1
Q

What are herpesviruses

A

Herpes simplex virus are fever blisters or cold sores on lips, mouth, face.
Genital herpes

There’s also cytomegalovirus which manifests as cytomegalovirus retinitis and patient may have blurry vision

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2
Q

What is the prototype for a herpesvirus drug?

A

Acyclovir

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3
Q

MOA for acyclovir

A

Interrupts viral DNA replication

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4
Q

Uses for acyclovir

A

Herpes simplex virus

Genital herpes

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5
Q

How does acyclovir help a patient with genital herpes?

A

Decreases duration and pain

It helps with viral shedding which means it decreases the risk of transmission

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6
Q

Nursing considerations for acyclovir

A

Apply topical with gloved hand

IV form but it associates with encephalopathy

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7
Q

What is the antiviral for CMV

A

Ganciclovir

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8
Q

MOA for ganciclovir

A

Inhibits viral DNA synthesis

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9
Q

Uses for ganciclovir

A

Cytomegalovirus (CMV) retinitis

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10
Q

Nursing considerations for ganciclovir

A

Use cautiously with patients who have renal impairment

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11
Q

Adverse effects of ganciclovir

A

2 BBW

  • Granulocytopenia (neutropenia),
    Thrombocytopenia
  • Maintain contraceptive precautions during and 90 days after therapy because it can cause birth defects
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12
Q

What is the oral formulation for ganciclovir

A

Valganciclovir

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13
Q

Nursing considerations for valganciclovir

A

Same BBW as ganciclovir

Take with high fat meal to increase absorption

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14
Q

What is respiratory syncytial virus (RSV)?

A

Respiratory illness that is more severe in babies causing cyanosis

Adults and healthy children can carry the disease with just common cold symptoms

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15
Q

What is the prototype drug for RSV

A

Ribavirin

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16
Q

MOA for ribavirin

A

Interferes with DNA and RNA replication

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17
Q

Uses for ribavirin

A

RSV in children

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18
Q

Nursing considerations for ribavirin

A

Given via inhalation

Monitor for signs of respiratory distress such as nasal flaring

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19
Q

Adverse effects of ribavirin

A

BBW for severe teratogenic effects

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20
Q

Antiviral to treat influenza?

A

Oseltamivir phosphate

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21
Q

MOA for oseltamivir phosphate?

A

Does not allow new viruses to escape cell

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22
Q

Uses for oseltamivir phosphate

A

Influenza in patients over 1 year old

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23
Q

Nursing considerations for oseltamivir phosphate

A

May take prophylactically

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24
Q

Adverse effects of oseltamivir phosphate

A

Some side effects are similar to flu symptoms

Take with food to decrease GI upset

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25
What is the result of hepatitis?
Severe liver damage if not properly treated Hep C can lead to cirrhosis, liver cancer, liver failure
26
How do you get Hep A?
Fecal- oral route, or close contact with infected person
27
How do you get Hep B?
Contaminated blood, other bodily fluids
28
Prototype for hepatitis
Lamivudine
29
MOA for lamivudine
Incorporates into the viral DNA and terminates it
30
Uses for lamivudine?
Chronic Hep B HIV (off- label)
31
Adverse effects of lamivudine
*Can cause pancreatitis which presents as severe upper abdominal pain Hepatomegaly with steatosis which is basically an enlarged or fatty liver. *BBW Lactic acidosis which presents as musculoskeletal pain (think pain after a workout)
32
What is human immunodeficiency virus (HIV)
Retrovirus Binds to, and eventually destroys CD4+ cells (ex T lymphocytes) CD4+ cells normally help regulate immune function Can progress to acquired human immunodeficiency syndrome (AIDS)
33
What is the initial phase of HIV
Presents with flu like symptoms, lasting several weeks
34
What is the immune response of HIV
Decrease in viral reproduction Asymptomatic, but infectious
35
What is the immune system damaged phase in HIV
Increased viral production
36
Illness progresses to aids phase in HIV
Once viral load reaches high levels Serious opportunistic infections
37
What is pre exposure prophylaxis (PrEP)
A way for people who do not have HIV, but are at very high risk of getting HIV to prevent HIV infection by taking a pill every day And that pill is Truvada (tenofovir and emtricitabine)
38
How does PrEP work?
When taken daily, lowers risk of HIV infection: From sex by about 99% From injections by about 74% If not taken consistently, not as effective
39
What are the antivirals for HIV
Nucleoside reverse transcriptase inhibitors (NRTIs) Nonnucleoside reverse transcriptase inhibitors (NNRTIs)
40
Prototype for NRTIs?
Zidovudine
41
MOA for Zidovudine
Incorporates into viral DNA and terminates
42
Uses for Zidovudine
Prevents HIV transmission from mother to fetus
43
Adverse effects of Zidovudine
BBW Granulocytopenia, pancytopenia **Lactic acidosis**, hepatomegaly
44
Prototype for NNRTIs?
Efavirenz
45
MOA for Efavirenz
Similar to NRTI Has synergy
46
Uses for Efavirenz
HIV
47
Adverse effects of Efavirenz
Not for patients with hepatic impairment **Stevens-Johnson syndrome** CNS effects Take at night
48
Prototype of the polyenes
Amphotericin B deoxycholate
49
MOA for amphotericin B deoxycholate
Disrupts the membrane of fungal cells and stops reproduction
50
Uses for amphotericin B deoxycholate
BBW: reserved for potentially fatal infections
51
Adverse effects of amphotericin B deoxycholate
Renal impairment common Keep hydrated with IV sodium chloride Organ failure, cardiac arrest, respiratory arrest Premeditate Separate IV line (have its own IV line) and it should use an inline filter when administered
52
What’s special about the lipid formulation of amphotericin B deoxycholate
Less terrible Less nephrotoxic Do not use inline filter!
53
Prototype for the anti fungal Azoles
Fluconazole Usually ends in -conazole
54
MOA for fluconazole
Disrupts membrane permeability
55
Uses for fluconazole
Drug of choice for candida infections
56
Adverse effects for fluconazole
Half dose if poor renal failure Hepatotoxicity Enzyme inhibitor Watch for drug interactions
57
What’s an enzyme inhibitor?
Enzyme inhibitor = decreased drug metabolism= increased effects of some drugs= increased risk of toxicity
58
Prototype for pyrimidine analog?
Flucytosine
59
MOA for Flucytosine
Affects cell membrane, resulting in cell death
60
Uses for Flucytosine
Adjunct with AMP B for candida and cryptococcus
61
Adverse effects of Flucytosine
BBW: caution in renal impairment Hepatotoxicity and bone marrow toxicity But those things are dose dependent.. so.. Monitor labs closely to adjust dose
62
Prototype for amebicides
Metronidazole
63
MOA for Metronidazole
Diffuses across cell membrane, resulting in cell death
64
Uses for Metronidazole as an anti parasitic
Intestinal amebiasis Trichomoniasis
65
Adverse effects of Metronidazole
Metallic taste, dark urine **Avoid alcohol during treatment and 3 days after** If taken with alcohol, can cause disulfiram reaction which presents as tachycardia, nausea, flushing, vomiting
66
Nursing considerations for anti parasitic Metronidazole
Assess stools for less diarrhea
67
Prototype for the antimalarials
Chloroquine phosphate Usually ends with -quine
68
MOA for Chloroquine phosphate
Interferes with parasite DNA, RNA, and metabolism
69
Uses for Chloroquine phosphate
Treatment and **prophylaxis** of malaria
70
Nursing considerations for Chloroquine phosphate
Visual disturbances Electrocardiogram changes Take weekly (same day) for ppx; and daily for treatment
71
Prototype for anthelmintics
Mebendazole
72
MOA for Mebendazole
Blocks glucose uptake
73
Uses for Mebendazole
Worms (pinwork, hookworm, roundworm, whipworm)
74
Nursing considerations for Mebendazole
Chew/crush and swallow Teratogenic
75
What is the main pinworm?
Enterobius vermicularis
76
What are the symptoms of Enterobius vermicularis
Perianal itching
77
What should you do if infected with Enterobius vermicularis
Disinfect toilets after use Clean clothes, sheets, towels daily Treat family members.. very contagious Wash hands
78
Prototype for scabicides and pediculicides
Permethrin
79
MOA for permethrin
Stops influx of sodium, thus paralyzes and kills the parasites
80
Uses for permethrin
Lice and scabies
81
How do you apply permethrin to kill lice
Wash hair, apply cream, let it sit for 10 minutes, rinse with water, use lice comb Repeat in 1 week if still present but this time keep drug on hair overnight
82
How to use permethrin for scabies
Apply head to toe and leave on for 8 to 14 hours
83
What are the main parasitic infections
Amebiasis Malaria Helminthiasis (worms) Pediculosis (lice) Scabies

Pharm Exam 3 (6 decks)

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