Phar 352 - Viral Infections

Front 1

What are the goals of therapy for Varicella infections?(4)

Back 1

1) Accelerate healing of skin lesions

2) Prevent complications (e.g. Pneumonia, Encephalitis)

3) Prevent Mortality

4) Minimize/prevent adverse reactions from medications

Front 2

Which patients should receive drug therapy for Varicella infections? (4)

Back 2

1) >12 years old

2) Patients with chronic cutaneous or pulmonary disorders

3) Receiving Corticosterioids

4) Immunocompromised patients

Front 3

"The routine use of antibiotics for healthy children is recommended" True or False?

Back 3

FALSE

Front 4

Which patients should receive the Varicella vaccine?

Back 4

1) Healthy Children (12months - 12 years of age)[Two doses i) 12months ii)4-6 years]

2) Adults and Adolescents >13 years of age

[Two doses i) given 6 weeks apart]

Front 5

"The Varicella vaccine is not recommended in pregnant patients" True or False?

Back 5

TRUE

Front 6

When would you initiate drug therapy for Varicella infections in healthy patients?

Back 6

Initiate therapy within 24 hours of rash onset

Front 7

When would you initiate drug therapy for Varicella infections in Immunocompromised patients?

Back 7

Initiate ASAP even if 24 hours have elapsed since the rash began

Front 8

"It is unclear if Acyclovir can reduce the risk of complications" True or False?

Back 8

TRUE

Front 9

"It is confirmed that Famciclovir and Valacyclovir are as effective as Acyclovir"True or False?

Back 9

FALSE

Front 10

What is the drug therapy recommendation for healthy patient Varicella infections?

Back 10

1) Acyclovir (800mg PO QID x 5days)

2) Famciclovir (500mg PO TID x 5days)

3) Valacyclovir (1000mg PO TID x 5days)

Front 11

What is the drug therapy recommendation for immunocompromised patient Varicella infections?

Back 11

1) Acyclovir (800mg PO QID x 7-10days)

2) Famciclovir (500mg PO TID x 7-10days)

3) Valacyclovir (1000mg PO TID x 7-10days)

Front 12

What is the drug therapy recommendation for Severe Varicella infectons?

Back 12

Acyclovir (10mg/kg IV q8h x 7-10days)

Front 13

What are the efficacy monitoring parameters for Varicella drug therapies?

Back 13

1) Number of vesicles should be reduced

2) Symptoms: Temp, Pain, Arthralgias

Front 14

What are the safety monitoring parameters for Varicella drug therapies?

Back 14

1) Nausea & Vomitting

2) Somnolence

3) SCr, Urea, Urine Output

Front 15

Why do patients who take Acyclovir need to drink lots of fluids?

Back 15

To avoid the risk of precipiation in renal tubules and urethra. (which is why we monitor SCr to determine renal function)

Front 16

What are the goals of therapy for Shingles infections?(4)

Back 16

1) Stop viral replication

2) Accelerate healing of skin lesions

3) Relieve Acute Neuritis

4) Prevent postherapeutic neuralgia

Front 17

Which patients should receive drug therapy for Shingles infections? (3)

Back 17

1) Patients >50 years old

2) Ocular Zoster patients [treat even If rash has been present for up to 7days AND refer to Ophthalmologist]

3) Any patient with severe pain and extensive disease

Front 18

"There is no real evidence for treating shingle patients <50 years old" True or False?

Back 18

TRUE

Front 19

Which patients should receive the Shingles vaccine? (1)

Back 19

Healthy adults >60 years old

Front 20

"The shingles vaccine is not publically funded and so costs $150-$195" True or False?

Back 20

TRUE

Front 21

When would you intitate drug therapy for Shingles infections?

Back 21

Initiate within 72 hours of rash onset

Front 22

"Topical anti-virals are as effective as oral therapies" True or False?

Back 22

FALSE

Front 23

What is the drug therapy recommendation for healthy patient Shingle infections?

Back 23

1) Acyclovir (800mg PO x5/day x 7days)

2) Famciclovir (500mg PO TID x 7days)

3) Valacyclovir (1000mg PO TID x 7days)

Front 24

What is the drug therapy recommendation for immunocompromised patient Shingle infections?

Back 24

1) Acyclovir (800mg PO x5/day x 7-10days)

2) Famciclovir (500mg PO TID x 7-10days)

3) Valacyclovir (1000mg PO TID x 7-10days)

Front 25

What is the drug therapy recommendation for Severe Shingles infectons?

Back 25

Acyclovir (10mg/kg IV q8h x 7-10days)

Front 26

What are the efficacy monitoring parameters for Shingles drug therapies?

Back 26

[Same as Varicella]

1) Number of vesicles should be reduced

2) Symptoms: Temp, Pain, Arthralgias

Front 27

What are the safety monitoring parameters for Shingles drug therapies?

Back 27

[Same as Varicella]

1) Nausea & Vomitting

2) Somnolence

3) SCr, Urea, Urine Output

Front 28

What are the goals of therapy for Influenza infections?(5)

Back 28

1) Decrease mortalitiy

2) Prevent Influenza illness from occuring

3) Prevent Complications (e.g. pneumonia, exacerbation of cardiac/respiratory disease)

4) Decrease Influenza related hospitalizations

5) Minimize adverse events from medications

Front 29

What are non pharmacological methods for Influenza treatment? (4)

Back 29

1) Wash hands often

2) Use hand sanitizer if water and soap are not available

3) Cough/Sneeze into tissue

4) Stay at home if flu symptoms are present

Front 30

Which patients should receive the Influenza vaccine?

Back 30

Everyone should receive it annually in

October --> November

Front 31

Which drugs should be used for Influenza prophylaxis?

Back 31

1) Amantadine: effective against influenza A

2) Oseltamavir: effective against influenza A & B

Front 32

"Amantadine is no longer indicated for prophylaxis of Influenza" True or False?

Back 32

TRUE

Front 33

What is the major side effect of Oseltamivir?

Back 33

Suicidal Thoughts

Front 34

What is the role of Analgesics/Antipyretics in Influenza treatment?

Back 34

For relief of fever, headache and myalgias

Front 35

What is the role of Antiviral agents in Influenza treatment?

Back 35

Used if its confirmed via lab tests that it is viral.

Front 36

When should Neuraminidase Inhibitors be used in Infulenza?

Back 36

Initiate within 48hrs of symptoms

Front 37

"Oseltamivir is restricted to patients in whom Zanamavir is not an option" True or False?

Back 37

False, it is the other way around

Front 38

Is treatment necessary for mild symptoms of Influenza for Children?

Back 38

No treatment is necessary

Front 39

"Zanamivir is given inhaled for patients unable to take oral medications" True or False

Back 39

TRUE

Front 40

What are the common side effects of Zanamivir ?

Back 40

Bronchospasm and CNS effects

Front 41

What is the drug therapy recommendation for Adults and Children>40kg with Influenza?

Back 41

Oseltamivir: 75mg PO BID x 5days

Front 42

What is the drug therapy recommendation for Children>12 months old with Influenza?

Back 42

Oseltamivir:

[23-40kg] 60mg PO BID x 5days

[15-23kg] 45mg PO BID x 5days

[<15kg] 30mg PO BID x5days

Front 43

What is the drug therapy recommendation for Children 6-12months old with Influenza?

Back 43

Oseltamivir: 25mg PO BID x 5days

Front 44

What is the drug therapy recommendation for Children 3-6months old with Influenza?

Back 44

Oseltamivir: 20mg PO BID x 5days

Front 45

What is the drug therapy recommendation for Children 0-3months old with Influenza?

Back 45

Oseltamivir: 12mg PO BID x 5days

Front 46

What is the dose recommendation for Zanamivir?

Back 46

10mg inh BID x5days

Front 47

What are the efficacy monitoring parameters for Influenza drug therapies?

Back 47

1) Temp, Malaise, Symptoms

Front 48

What are the safety monitoting parameters for Influenza drug therapies?

Back 48

1) CNS (Seizures, Changes in mood)

2) Rash

3) Renal Function: SCr, Urea, Baseline