Week 3- Other antimicrobials/ TB Treatment Goals

Question 1

what drug class is acyclovir, famciclovir and valacyclovir

Answer 1

Nucleoside Analogue

Question 2

How does acyclovir, famciclovir and valacyclovir work?

Answer 2

interferes with DNA synthesis and inhibiting viral replication

Question 3

what are acyclovir, famciclovir and valacyclovir commonly used for

Answer 3

HSV 1 & 2, Varicella- Zoster, EBV

Question 4

what does acyclovir, famciclovir and valacyclovir target to do

Answer 4

Increases rate of healing, not prevent recurrences

Question 5

common side effects of acyclovir and valacyclovir

Answer 5

Headache, skin rash, nausea, vomiting, diarrhea

Question 6

common side effects of famiciclovir?

Answer 6

Headache, dizziness, somnolence, paresthesias

Question 7

adverse reaction of acyclovir

Answer 7

Renal failure, acute tubular necrosis, neurologic effects

Question 8

adverse effects of all herpes meds

Answer 8

renal failure

Question 9

adverse effects of valacyclovir

Answer 9

Renal failure, TTP/HUS in immunocompromised patients

Question 10

what drug class is Nirmatrelvir / Ritonavir (Paxlovid)

Answer 10

Antiviral- for mild/mod COVID

Question 11

how does Nirmatrelvir / Ritonavir (Paxlovid) work

Answer 11

Nirm: viral protease inhibitor that halts viral replication

Riton: hibits CYP3A-mediated metabolism to increase Nirm

Question 12

is Paxlovid or Remdesivir 1st line

Answer 12

Paxlovid- PO, easier for outpatient use

Question 13

common side effects of Paxlovid

Answer 13

Decrease sense of taste/smell, diarrhea, myalgia

Question 14

adverse reactions of Paxlovid

Answer 14

Strong CYP3A inhibitor- many drug inx, ^ effect of opioid, v effect of oral BC, hold statins

Question 15

adverse reaction of remdesivir

Answer 15

Interacts w/ chloroquine, warfarin, watch for kidney/liver injury

Question 16

what drug class is oseltamivir and zanamivir

Answer 16

antiviral- prophylaxis and treatment of flu a and b

Question 17

how do oseltamivir and zanamivir work?

Answer 17

Neuraminidase inhibitor- prevents release of virus

Question 18

what is zanamivir’s route?

Answer 18

inhaled treatment

Question 19

side effects of oseltamivir

Answer 19

nausea/vomitting

Question 20

side effects of zanamivir

Answer 20

bronchitis, cough, shortness of breath

Question 21

adverse reaction of zanamivir

Answer 21

r/o severe bronchospasm for asthmatics

Question 22

what drug class is itraconazole, fluconazole, ketaconazole and voriconazole

Answer 22

Antifungal- triazole

Question 23

are itraconazole, fluconazole, ketaconazole and voriconazole fungistatic or cidal?

Answer 23

static at low concentrations, cidal at high concentrations

Question 24

how do itraconazole, fluconazole, ketaconazole and voriconazole work?

Answer 24

Reduce ergosterol production by enzyme inhibition (CYP 450)

Question 25

what is fluconazole used for?

Answer 25

Vaginal candidiasis oral candidiasis

Question 26

what are side effects of fluconazole?

Answer 26

GI s/s, exfoliative skin disorder, QT prolongation

Question 27

adverse effects of fluconazole

Answer 27

Hepatotoxicity, interactions w/ warfarin & rifampin

Question 28

what is itraconazole used for?

Answer 28

Onychomycosis, histoplasmosis, blasto

Question 29

side effects of itraconazole

Answer 29

HEART FAILURE, GI s/s, exfoliative skin disorder, QT prolongation

Question 30

adverse effects of itraconazole

Answer 30

Hepatotoxicity, teratogenic, many drug interactions

Question 31

what is ketoconazole used for

Answer 31

also topical agent, but used for Vulvovag candidiasis, fungal PNA,

Question 32

side effects of ketoconazole

Answer 32

GI s/s, exfoliative skin disorder, QT prolongation

Question 33

adverse effect of ketoconazole

Answer 33

hepatoxicity

Question 34

what is voriconazole used for?

Answer 34

Invasive aspergillosis, deep candida infection

Question 35

side effects of voriconazole

Answer 35

Visual disturbance, GI s/s, exfoliative skin disorder, QT prolongation

Question 36

adverse effects of voriconizole

Answer 36

Hepatotoxicity, teratogenic

Question 37

what class is terbinafine

Answer 37

Antifungal- Allylamines

Question 38

how does terbinafine work?

Answer 38

Reduces ergosterol production by inhibition of squalene epoxide

Question 39

what is terbinafine used for

Answer 39

Onychomycosis, fungal infection of scalp, body, feet, groin

Question 40

side effects of terbinafine

Answer 40

GI, loss/change of taste

Question 41

adverse effects of terbinafine

Answer 41

Hepatotoxicity, no drinking alc, caffeine

Question 42

what drug class is albendazole and mebendazole

Answer 42

Anthelmintic- benzimidazole

Question 43

how do mebendazole and albendazole work?

Answer 43

Bind to beta tubulin causing inhibition of polymerization

Question 44

what does albendazole clinically treat

Answer 44

Whipworm, roundworm, hookworm, giardiasis,

Question 45

what are some side effects and considerations with albendazole?

Answer 45

negative pregnancy test, W/ high fat meal, neutropenia,

Question 46

adverse effects of albendazole

Answer 46

Teratogenic, bone marrow suppression, hepatitis

Question 47

what does mebendazole treat

Answer 47

Whipworm, roundworm, hookworm

Question 48

what are side effects/adverse effects of mebendazole

Answer 48

Bone marrow suppression, hepatitis, teratogenic, take with high fat meals

Question 49

what class is ivermectin

Answer 49

Anthelmintic, semisynthetic

Question 50

how does ivermectin work?

Answer 50

Binds selectively to glutamate-gated chloride ions, paralysis & death

Question 51

what does ivermectin treat?

Answer 51

Roundworm,scabies, threadworm

Question 52

side effects of ivermectin

Answer 52

Lightheaded, skin rash

Question 53

adverse reaction to ivermectin

Answer 53

Teratogenic, Mazzotti reaction

Question 54

what is pyrantel pamoate

Answer 54

Anthelmintic- Depolarizing NM blocking agent

Question 55

how does pyrantel work?

Answer 55

Spastic paralysis of worm, inhibits cholinesterase

Question 56

what does pyrantel treat?

Answer 56

OTC, Pinworm, whipworm, hookworm

Question 57

What drug class is metronidazole?

Answer 57

Nitroimidazole

Question 58

how does metronidazole work?

Answer 58

Disrupts DNA and protein synthesis

Question 59

what does metronidazole treat?

Answer 59

BV, C. Diff, Giardia, Trichomoniasis (bacterial and parasitic ifxns)

Question 60

side effects of metronidazole

Answer 60

Seizures, r/o hepatic dysfunction, anorexia, nausea, abd pain, dry mouth, metallic taste

Question 61

adverse reactions of metronidazole

Answer 61

Severe N/V if alcohol consumed while on medication , blood dyscrasias, dont take with disulfiram or you'll go insane

Question 62

Class of tindazole

Answer 62

antiprotozoal (also antibacterial properties

Question 63

how does tinidazole work?

Answer 63

Disrupts DNA and protein synthesis

Question 64

what does tinidazole treat?

Answer 64

Intestinal amebiasis, giardia, trichomoniasis

Question 65

side effects of tinidazole

Answer 65

anorexia, nausea, abd pain, dry mouth, metallic taste

Question 66

considerations with tinidazole

Answer 66

Monitor INR, no drinking

Question 67

goals of TB treatment

Answer 67

1. To reduce the bacillary population rapidly, decrease severity of the disease, prevent death, and halting transmission of M. tuberculosis 2. Prevent relapse after therapy 3. Prevent drug resistance

Question 68

INH:

Answer 68

isoniazid

Question 69

RIF:

Answer 69

rifampin

Question 70

PZA:

Answer 70

pyrazinamide (vitamin B6)

Question 71

EMB

Answer 71

ethambutol

Question 72

preferred drug combination for treatment of TB

Answer 72

INH, RIF, PZA, EMB for 2 months INH & RIF for 4 months (7 d/wk doses)

Question 73

alternate drug combo for TB

Answer 73

INH, RIF, PZA, EMB for two months (5 d/wk) for 8 weeks INH & RIF 5 d/wk for 18 weeks