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68 Cards in this Set
- Front
- Back
What are the most common strains of the Herpes Virus?
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1.Herpes Simplex Virus
2. Varicella-Zoster Virus 3. Cytomegalovirus (CMV) |
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What are the treament options for the Herpes Virus?
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All nucleioside analogues except foscarnet
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What is the one exception to the nucleoside analogues?
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Foscarnet
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What do the Nuceloside Analogues End -In?
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All end in "LOVIR"
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How are the LOVIRs classified?
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They are prodrugs
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What is the MOA of the FLOVIRs?
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1. Phosphorylated
2. INHIBITION OF VIRAL DNA POLYMERASE PREVENTS THE SYNTHESIS OF VIRAL DNA |
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What are the routes of the FLOVIRs?
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PO, IV, Topical
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What are the adverse effects of the Nucleoside Analogues?
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1. GI
2. Headache 3. Rash 4. Drop in WBC, Drop in Platelet |
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What is the unique adverse effect caused by IV acyclovir?
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Increased Serum Creatinine due to Crystalluria
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How should you administer Acyclovir by IV?
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Over 1 hour and keeping patients hydrated
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Which nucleoside analogues are used to treat CMV?
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1. Ganciclovir
2. Valganciclovir 3. Cidofovir |
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What are the adverse effects of Gancilovir?
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1. Bone marrow suppresion
2. GI |
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What are the adverse effects of Cidovir?
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VERY TOXIC!
1. Bone marrow suppression 2. Nephrotoxicity |
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How should Cidovir be administered?
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Only in Combination with PROBENECID!!!
-helps increase renal clearance |
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What is the MOA of Foscarnet?
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Works on the enzyme DNA polyermase preventing attachment of nucleotide precursors to DNA
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What is the main use of Foscarmet?
What is an alternate use? |
Main: CMV!
Alternate: acyclovir resistant HSV, VZV |
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How is foscarnet administered?
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IV ONLY
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What are the adverse effects of Foscarnet?
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TOXIC PRODRUG!
-Nephrotoxicity -Anemia, seizures, arrhythmias -Electrolyte abnormalities |
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What are the two types of RNA virus?
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Type A and B
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What type of drugs are available for Influenza?
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Vaccines and for Treatment
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Which 2 drugs for influenza have viruses become resistant to?
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1. Amantadine
2. Rimantadine |
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What is the main class of drugs used for influenza?
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Neuraminidase Inhibitors
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Describe the result of inhibiting neuraminidase in influenza A and B
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Prevente the release of new virions
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For neuraminidase to be used as a treament option, when must it be delivered?
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Within 48 hours of onset of symptoms
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How long is the treatment of neuraminidase inhibitors?
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5 days
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What two reasons is neuraminidase inhibitors given?
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Treatment and prevention
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What is the overall effect of administering nueraminidase inhibs?
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Symptoms lessen in 24 hours
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Which neuraminidase inhibitor can be administered as an inhaler?
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Zanamivir
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What are the adverse effects of neuraminidase inhibitors?
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GI: nausea
respiratory tract infections (inhaler) |
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What are the 2 types of fungus?
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Yeast(easier to treat) and Mold
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What are some examples of systemic fungal infections?
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UTIs
-pneumonia -meningitis -fungemia/sepsis Often occur in pts with compromised immune systems |
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What are the most common superficial fungal infections?
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Nail
-skin -mucous membranes |
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What are the Dermatophytes?
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The Tineas
-unguium or onchomycosis (nails) -pedis (athlete's foot) -capitis (ringworm of scalp) -corporis (ringworm of the body) -cruis (jock itch) |
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What fungus is responsible for yeast infections?
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Candida
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List the drug classes used to treat Systemic Fungal infection
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Systemic:
-Amphotericin B -Azoles -Flucytosine -Echindocandins |
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What drugs are used to treat superficial fungal infections?
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Superficial:
-Azoles -Griseofulvin -Nystatin -Allylamines (teribinafine) |
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What is the MOA of Amphitericin B?
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Binds to the ergosterol in the fungal CELL MEMBRANE
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How should amphotericin B be administered?
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IV only in DEXTROSE SOLUTION!! OVER 2-4 hours!!
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How long does Amphotericin take to be excreted in urine?
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Very LONG! 24hours-15 days!!
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What are the side effects of Amphotericin B?
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"Amphoterrible" Bad side effects!
-Fever, chills, vomiting, headache -Nephrotoxicity (keep pt well hydrated) -Electrolyte disturbances |
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Which days of treatment with Amphotericin show the most side effect?
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Days 3-5
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What should you do prior to administering Amphotericin B?
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Pre medicate the patient to deal with the side effects
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What is the MOA of Flucytosine?
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Inhibits fungal DNA synthesis
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What type of drug is Flucytosine converted into?
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Fluorouracil (oncology drug)
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How is Fluctyosine administered?
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Always PO and in combination
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What are some common side effects fo Flucytosine?
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Bone marrow suppression, Hepatotoxicity
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What MOA is used by the Echinocandins?
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Inhibit fungal cell wall sythesis by inhibiting Beta Glucan synthase!
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What suffix is common in the Echinocandins?
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Fungin's
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What are some adverse effects of the Fungin's?
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"Echinocandins"
-Thrombophlebitis -Abnormal liver enzymes*** |
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What is the common suffix for the Azoles?
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Azole! :)
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State the MOA of the Azoles.
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Inhibit synthesis of ergosterol (fungal cell mem component)
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Which Azole is excreted in the urine?
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Fluconazole
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Which Azole is the most absorbed when administered orally?
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Fluconazole
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Which antifungal causes visual disturbances?
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Voriconazole (Azole)
-causes halos or blurry vision |
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What are the adverse effects of Azoles?
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Topical agents cause local irritation
-Hepatotoxicity -Visual disturbances (voriconazole) |
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Do Azoles have any drug interactions?
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YES! Potent inhibitors of CYP450
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Which drugs are active against dermatophytes?
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1. Griseofulvin
2. Terbinafine |
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Which antifungal inhibits the mitosis of dermatophytes?
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Griseofulvin
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How long is the treatment using Griseofulvin?
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6-12 MONTHS
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How should Griseofulvin be administered? What causes a increase in its absorption?
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PO only
-High fat meals cause increase in absorption |
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What are some adverse effects of Griseofulvin?
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GI, hepatitis, photosensitivity
Tetrogenic and carcinogenic in the lab (not for pregnant women!) |
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What is the length of therapy for Terbinafine (Lamisil)
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Nails: 6 weeks
Toenails: 12 weeks |
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Which antifungal suffers the First Pass?
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Terbinafine
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Which 2 antifungals inhibit ergosterol synthesis?
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Terbinafine and Azoles
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What are the adverse effects of Terbinafine?
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GI, rash, dizziness, JOINT AND MUSCLE PAIN, HEPATOTOXICITY, neutropenia
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WHIch drug is limited to the surfaces where it can be in direct contact with the mold?
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Nystatin
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How do you administer Nystatin PO?
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Swish and Swallow!!
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Which drug is used to treat Candida?
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Nystatin
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