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Infectious Disease Drugs, Exam 3
Inhibits Viral Replication
Thymidine Kinase Activation
Herpes Simplex Virus (HSV)
Varicella Zoster Virus (VZV)
Side Effects (Oral)
Side Effects (IV)
Nephrotoxicity (Crystalline Nephropathy)
Prevents Recurrent Episodes
Slow IV Infusion
Treat CMV for the Immunocompromised
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)
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.
Last Resort for Protozoan infections
Forms Membrane Pores
Amphotericin B Side Effects & Toxicity
Fever/Chills "Shake and Bake"
Milder with Liposomes
Local and Less Serious Systemic Mycosis
Inhibits Ergosterol Synthesis
Inhibition of Testosterone Synthesis
Interferes with DNA Metabolism
Nausea and Vomiting
Vitamin B6 Prophylaxis
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.
Be aware of impending orange body fluids.
Warfarin is dangerous.
Contraindicated with oral contraceptives and delavirdine.
Do not confuse with other Rifs: Rifapentine, Rifabutin.
Hepatoxicity and rash.
Nongouty Polyarthralgias or precipitation of gouty attack
Use NSAIDs for non-gout pain.
Hepatotoxicity: AJ, FAN US! (Anorexia, Jaundice, Fatigue, Urine dark, Stool pale
Inhibits RNA Synthesis
Red/Green Color Blindness
Monitor Vision Acuity
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.
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
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.
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.
Fusion Inhibitor: Enfuvirtide
Is considered a salvage therapy due to cost and the need to inject, BID.
Injection site reactions.
Signs and symptoms of pneumonia
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
Opioid Receptor Agonist
Nausea and Vomiting
Increased Intracranial Pressure (ICP)
Mechanism of Action
Inhibits Trigeminal Nerve Activation
Increased Risk of Serotonin Syndrome
Coronary Artery Disease (CAD)
Histamine H1 Receptor Antagonist
Weak Dopamine Antagonist
Nausea and Vomiting
Use Large Bore IV
Monitor for Tissue Necrosis
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