Germone Shared "Infectious Disease Drugs, Exam 3" - 19 Picmonics

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Infectious Disease Drugs, Exam 3

Acyclovir (Zovirax)
Mechanism
Guanosine Analog
Inhibits Viral Replication
Thymidine Kinase Activation
Indications
Herpes Simplex Virus (HSV)
Varicella Zoster Virus (VZV)
Side Effects (Oral)
Headache
GI Distress
Side Effects (IV)
CNS Toxicity
Nephrotoxicity (Crystalline Nephropathy)
Considerations
Prevents Recurrent Episodes
Slow IV Infusion
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Ganciclovir
Treat CMV for the Immunocompromised
IV only
Granulocytopenia and thrombocytopenia
Teratogenic, handle with CARE. Leads to infertility.
Monitor CBC & Platelets
Report symptoms of infection
Too toxic for other herpes family treatment--CMV only
Beware: cyclovir meds are often confused with ciclovir meds (Valacyclovir versus Valgaciclovir)
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Oseltamavir (Tamiflu)
Also a prophylaxis for the young during outbreaks, etc.
Interacts with LAIV- Live Active Influenza Vaccine
Allergic reactions (rare) include: headache, nosebleed, red eyes, insomnia, cough
Give within 2 days...
Rare: hypersensitivity and neuropsychiatric effects.
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Amphotericin B
Indications
Systemic Mycosis
Fungal Meningitis
Last Resort for Protozoan infections
Mechanism
Polyene
Binds Ergosterol
Forms Membrane Pores
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1 min
Amphotericin B Side Effects & Toxicity
Side Effects
Fever/Chills "Shake and Bake"
Nephrotoxicity
Milder with Liposomes
Hypotension
Anemia
IV Phlebitis
Arrhythmias
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Azoles (Ketoconazole)
"-azole" suffix
Indications
Local and Less Serious Systemic Mycosis
Mechanism
Inhibits Ergosterol Synthesis
Inhibits P450
Side Effects
Liver Dysfunction
Inhibition of Testosterone Synthesis
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Isoniazid (INH)
Mechanism
Interferes with DNA Metabolism
Indications
Tuberculosis (TB)
Side Effects
Optic Neuritis
Nausea and Vomiting
Hepatotoxicity
Peripheral Neuropathy
Considerations
Vitamin B6 Prophylaxis
Monitor AST/ALT
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Rifampin
Most importantly: MANY MANY drug interactions (strong inducer of CYP450)
Contraindicated for Protease Inhibitors
Adverse reactions include hepatotoxicity (AJ FAN US!), pruritis, and flu symptoms.
Avoid alcohol.
Be aware of impending orange body fluids.
Warfarin is dangerous.
Contraindicated with oral contraceptives and delavirdine.
Do not confuse with other Rifs: Rifapentine, Rifabutin.
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Pyrazinamide
Hepatoxicity and rash.
Nongouty Polyarthralgias or precipitation of gouty attack
Photosensitive Dermatitis
Use NSAIDs for non-gout pain.
Hepatotoxicity: AJ, FAN US! (Anorexia, Jaundice, Fatigue, Urine dark, Stool pale
Avoid alcholol
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Ethambutol (Myambutol)
Mechanisms
Inhibits RNA Synthesis
Bacteriostatic
Indications
Tuberculosis (TB)
Side Effects
Optic Neuritis
Red/Green Color Blindness
Gouty Arthritis
Consideration
Monitor Vision Acuity
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Zidovudine-NRTI
2 NRTI's (with 1 PI & 1 Insti/PPI) are the backbone of HIV therapy.
Used as prophylaxis before, during, and after HIV+ labor.
Also treats HBV
May lead to anemia or neutropenia.
Metabolic effects include: hepatotoxicity, pancreatitis, lipoatrophy, or lactic acidosis.
May lead to GI distress (NVD).
Be careful of using with other nephrotoxic or meylosuppressive drugs
You can take it with or without food.
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NNRTIs: Efavirenz
Falling out of favor as HIV treatment (often replaced by INSTIs).
Directly binds and inhibits reverse transcriptase.
Do not use with a history of mental illness.
Do not use if pregnant or lactating.
Watch for rash, Hepatotoxicity, and CNS effects (psychiatric changes, dizziness).
Watch for Stevens Johnson and Lipodystrophy
Effects include toxic epidermal necrolysis and macupapular rash.
High risk for resistance, adherence is vital.
Many drug interactions, more than NRTIs.
NN is for no no
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Protease Inhibitor: Lopinivir
Always boosted with Ritonivir: the strongest PI know, but only used in combinations.
Caution with newborns and cardiac patients.
PIs have many, many drug interactions.
Watch for the development of Diabetes.
Adverse effects include hepatotoxicity and GI distress
Lipohypertrophy is possible.
Sometimes taken with food, sometimes not.
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INSTI: Integrase Strand Transfer Inhibitor
Drug therapy can fail if taken with Ca, Al, Mg, Iron, or Zinc.
Less interactions than others in its class, but still watch for hypersensitivity, increased Cr, and insomnia.
Rare, but watch for muscle breakdown.
Prototype: Raltegravir. Modern therapy line includes 2 NRTIs, 1 PI, & an INSTI.
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Fusion Inhibitor: Enfuvirtide
CCR5 Antagonist
Is considered a salvage therapy due to cost and the need to inject, BID.
Injection site reactions.
Signs and symptoms of pneumonia
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Maraviroc: a CCR5 Antagonist
Caution with strong CYP34A inducers/inhibitors
Is considered salvage therapy: not all HIV strains need CCR5 receptors to bind to CD4 cells.
Monitor closely: falls under black box warning.
Tropism test is used to determine if eligible for therapy.
Monitor for hypersensitvity.
All HIV Therapy: Monitor for Vaccines...ie, HIP T...Hep B, Influenza, Pneumococcal, Tetanus
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Morphine
Mechanism
Opioid Receptor Agonist
Indications
Pain
Myocardial Infarction
Side Effects
Nausea and Vomiting
CNS Depression
Biliary Colic
Constipation
Increased Intracranial Pressure (ICP)
Pupillary Constriction
Hypotension
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Sumatriptan
Mechanism of Action
Short Half-Life
5-HT Agonist
Inhibits Trigeminal Nerve Activation
Induces Vasoconstriction
Indications
Migraine
Cluster Headache
Side Effects
Increased Risk of Serotonin Syndrome
Paresthesias
Coronary Vasospasm
Contraindication
Prinzmetal's Angina
Coronary Artery Disease (CAD)
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Promethazine (Phenergan)
Mechanism
Histamine H1 Receptor Antagonist
Weak Dopamine Antagonist
Indications
Nausea and Vomiting
Motion Sickness
Side Effects
Respiratory Depression
Sedation
Anticholinergic Effects
Extrapyramidal Symptoms
Considerations
Use Large Bore IV
Monitor for Tissue Necrosis
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2 mins

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