Pharm Exam #3

Front 1

NRTI

ZIDOVUDINE (AZT)

Back 1

PD- inhibits synthesis of DNA by reverse transcriptase --> stopping DNA process= incomplete DNA. Used previously for Hep. B and Epstein-Bar Virus. Absorbed rapidly from GI tract.
AE- profound anemia, depressed bone marrow function, mylosuppression, Peripheral neuropathy, GI, HA, As a class r/f acidosis, hepatomegaly and steatosis. Absolute CI= Hypersen, BF, Lactic Acidosi,. Always look up AE & DI.
CPV- early pregnancy wait till week 14, renal or hepatic disorders, glanciclovir, antacids.
MAX/MIN-give 1hr b/f or 2 hrs a/f meal, don't give with fat meal, divide doses, IM r/f bleeding= Thrombocytopenia.
PT ED- adherence

Front 2

NNRTI

NEVIRAPINE

Back 2

PD-inhibits RT by binding to RT and block RNA to DNA conversion. Administer in escalating doses. Combo drug bc highly resistance when given mono not effective in HIV-2.
AE- hepatoxicity, mc= skin rxns, rash, stevens johnson, fever, HA, GI (P450).
CPV- not for kids or infants, DI w/ PIs & BC.
MAX/MIN- divde doses, give with a fat meal to low AE, never double dose.

Front 3

PI
SQUINAVIR

Back 3

PD-inhibits protease= noninfectious virus, effective in both strains, high 1st pass effect.
AE- severe GI (P450), hypergylcemia, lipodytrophy,increase in Try levels, pancreatitis CV probs such as MI. DI- grapefruit and Rifampin (give b/f rif therapy b/f starting PI).
CPV- younger than 16 yo, heptaic dx, DM, hemophiliacs.
MAX/MIN- give 2 hr a/f 1 hr b/f meal, avoid fatty foods, 3x a day, PI mosts suspectible to resistance. s/s resolve in 3-4 wks, encourage exercise to prevent fat.

Front 4

ENTRY INHIBITORS
ENFIVURTIDE

Back 4

PD- binds to gp41 protein= block HIV from entering cell. Not used as a mono therapy but used as an added therapy. Given only SubQ. Used when pt is already mutli-drug resistant.
AE- 95% of pts will have a rxn at injection site, itchy, red, swollen, rash, nodules, cyts, others will have A/N, HA, insomnia, peripheral neuropahty. No DI have been ID yet?
CPV- hypersen, prego, lactation.
MAX/MIN- comes as a powder, reconst w/ sterile water and assure that it dissolves, must be used in 24 hours, give SubQ 12hr, rotate site.

Front 5

H2 AGONISTS
RANTIDINE ANTACID (ZANTAC)

Back 5

PD- blocks histamine and inhibits all phases of gastric secretion. Used for GERD and ulcers, prevent GI beelding, and heart burn. Inhibits both day and night gastric secretions, and does not effect pepsin secretion.
AE-common= HA, dizziness, N, malasie, constipation, rash, itching, loss of sex desire, and impotence serious but rare= neutropenia, agranulocytosis, thrombocytopenia, anemia, give at least 2 hrs aprt from antacids.
CPV-don't sub or add OTC drug to prescription drugs.

Front 6

PROTON PUMP INHIBITORS
OMPERAZOLE

Back 6

PD- used tx of heartburn and s/s of GERD, tx of ulcers. Inhibits last step of gastric acid secretion= block gastric-acid formation. (P450)
AE- usually well tolerated, common HA and D/C/N/V, abd pain.
CPV-heptaic and renal dx do not get a decreased dose, stay away from spicy/acidic foods, not recommended during BF.

Front 7

MAGNESIUM HYDROXIDE
LAXATIVE

Back 7

PD-salt that works in large and small bowel by attracting and retaining water in the intestinal lumen, thereby increasing pressure w/in the intestine= streches receptors and promotes peristalsis. Used for upset stomach, constipation and ti increase magnesium level.
AE- weakness, fatigue, abd gas, distention, cramps, N/V/D, hypo Kalemia/calemia, hyper mag/phos, arrthymias.
CPV- renal, at least 2 years of age, older adults may get constipation d/t decreased peristalsis, give/drink lots of fluids, dependence.

Front 8

SIMETHICONE
ANTI-FLATULENT

Back 8

PD-defoaming action that alters surface action of gas bubbles. Also used w/ antacids to decrease gas. Not absorbed in GI produces film for intestines.
AE- no known or DIs.
CPV-adm a/f meals and at bed to increase effect.

Front 9

DIFFER B/W ALUMINUM AND MAGNESIUM BASED ANTACIDS IN TERMS OF MAJOR AEs AND CPV

Back 9

Both can be used to balance the constipation and diarrhea. Possible hypermag and hypophos, especially in people w/ renal failure. check for gi blleding, don't take if renal insuffiecny, diet and alcohol intake contribute to s/s.
ALUMINUM: PT: can be used to tx hyperphos in renal failure AE- constipation
MAGNESIUM: PT: Do not use in pt w/ renal failure-mag toxicity, used to tx hypomag.
AE:diarrhea

Front 10

SUCRALFATE

Back 10

Used to tx duodenal ulcers. unlike aluminum hydroxide w/ mag hydroxide, sucralfate does not lower the acidity of gastric juices. Sucralfate is an aluminum salt of sucrose. The basically non-absorbing paste that forms adheres to the ulcer lesions and protects the lesion from acid, pepsin, bile salts,. This allows the ulcer to heal.