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28 Cards in this Set
- Front
- Back
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What patients should you NOT give Varivax or VZV live attenuated vaccines?
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immunosuppressed, pregnant women
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What class of antibiotics will cause a rash in > 80% of pts with mononucleosis with pharyngitis?
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Aminopenicillins: Ampicillin, Amoxicillin
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-ovirs drugs are commonly used for what class of virus?
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herpes
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-avirs drugs are commonly used for what class of virus?
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AIDS/HIV
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-ivirs drugs are commonly used for what class of virus?
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influenza
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What is the required activation site for acyclovir?
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viral specific thymidine kinase, so not toxic. will not interact with human cells
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Is acyclovir effective in treating CMV?
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nope, because CMV doesn't have that viral specific thymidine kinase
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What is acyclovir used to treat?
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VZV, HSV to decease severity and duration
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How is CMV treated and why are the drugs not used a lot?
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Cidofovir, Ganciclovir and valganciclovir, but will interact with human cells so are very toxigenic. adverse side effect include neutropenia and renal toxicity. reserved for very serious cases.
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Why does AST/ALT increase first, then GGT, AlkPhos, and bilirubin increase in that order with an acute virl hepatitis?
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first liver cells are killed, so AST/ALT increases, then as more necrosis and such that are secondary to dead liver cells.
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What are the means of hepatitis infection?
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hAvE you washed your hands? Hep A, E fecal/oral. Hep A from wells, pools, too
Hep B = bad blood borne Hep D = dependent because must be co-infected with B to get D Hep C - cirrhotic hepatitis |
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*How is Interferon-alpha used for hepatitis tx?*
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used in Hep B and C tx and can cause depression, altered mental state, psychosis, and flu-like symptoms.
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What is the mechanism of action for interferon-alpha?
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increase protein kinase R which turns off cellular machinery needed for viral replication
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*Why is HIV tx particularly complex and HIV tx resistance is problematic?*
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HIV therapy uses many med in conjunction and balance, if only partial therapy is achieved for whatever reason (including non-compliance) then HIV tx resistance can occur.
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*What is an NRTI?*
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neuoside and nucleotide reverse transcriptase inhibitors used to treat HIV. they are problemmatic because they incorporate into viral DNA and cause chain termination, but they cause mitochondrial dysfunction in the host -> lactic acidosis, hepatomegaly, pancreatitis, lipodystrophy
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What is tenovovir?
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nucleotide inhibitor
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What is an nNRTI?
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non-nucleoside reverse transcriptase inhibitor that uses allosteric inhibition of reverse transcriptase. memory aid: all have "..vir.." in the middle of the name
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*What are the adverse reaction of nNRTIs?*
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efavirenz - neuropsychiatric effects, teratogenic
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What do delavirdine, efavirenz, and nevirapine have in common?
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they are all nNRTIs used to treat HIV and disrupt, by induction or inhibition, the CYP P450.
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*what are the side effects of protease inhibitors used to treat HIV?*
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lipodystrophy, pancreatitis, hyperlipidemia, insulin resistance, diabetes, nephrolithiasis
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what is a ritonavir boost?
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blocks the metabolism of other protease inhibitors in order to boost the levels of protease inhibitors. do not discontinue this drug unless you adjust the rest of the regiment?
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What is the significance of HAART and rifampin?
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rifampin is a broad spectrum enzyme inducer that will induce 3A4. don't use this unless you want to disrupt HAART even though it is standard treatment for other infections/diseases.
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what is haart?
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Highly Active AntiRetroviral (anti-HIV) Therapy
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what is pep?
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post exposure prphylaxis for HIV exposure
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What are the three types of occupational HIV exposure?
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1. percutaneous
2. mucocutaneous 3. non-intact skin infection based on occupational exposure depends on severity of exposure and severity of infection of the source |
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What viruses can cross the placenta?
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HITCHERS
HIV Toxoplasmosis Cytomegaloviruses Herpes Rubella Syphilis |
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What are neuraminidase inhibitors?
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drugs for preventing influenza viral release (oseltamivir and zanamivir)
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What is significant about when tx need to start for oselantamivir and zanamivir?
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tx must start w/i 48 hours of symptom onset or will not be effective in preventing viral release
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