Nursing Pharmacology Antivirals (Karch)
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| What is the prototype drug for Influenza A and respiratory antivirals? | Rimantadine
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| How do influenza A and Resp. virus antivirals work? | Inhibit viral repl. by preventing shedding of protein coat and entry into cell
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| What are influenza A and resp. virus antivirals used for? | prophylaxis and treatment of influenza A virus
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| What are the major contraindications for influenza a/resp. virus antivirals? | prg and lact.: embryotoxic
allergy
renal dysfunction
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| What are the adverse effects of Influ. A/Resp. virus anti virals? | CNS: lightheaded, dizzy, insomnia, depression
Nausea
Orthostatic hypotension
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| What are the drug-drug interactions with influenza A/resp. virus antivirals? | Anticholinergic agents, asprin, acetomenophen, atropine (not Ibuprofin)
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| What is the prototype drug for herpes and cytomegalovirus antivirals? | Acyclovir
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| How do Herpes and Cytomegalovirus antivirals work? | inhibit viral DNA replication by competing with viral substrates to form shorter, non-effective DNA chains
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| What are herpes and cytomegalovirus antivirals used for? | HSV 1 &2
genital HSV
HSV encephilitis
shingles/chicken pox
cream used for cold sores
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| What are the contraindications for herpes and cytomegalovirus antivirals? | preg. & lact
allergy
renal disease
CNS disorders
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| What are the adverse effects of herpes and cytomegalovirus antivirals? | headache
vertigo
tremors
n/v
rash
hair loss
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| What are the drug-drug interactions with herpes and cytomegalovirus antivirals? | Nephrotoxic drugs
Zidovudine
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| What is the prototype drug for nonnucleoside reverse transcriptase inhibitors? (HIV) | Neviparine
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| How do the NNRTI drugs work? | binds to HIV-1 reverse transcriptase and changes the structure of the HIV enzyme
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| What are the NNRTI drugs used for? | HIV patients w/immunological deterioration
used in combination
used for AIDS patients with decreased T cells
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| What are the contraindications for NNRTI drugs? | preg and lact.
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| What are the adverse effects of NNRTI? | Headache
n/v/d
rash
liver dysfunction
chills
fever
dry mouth
constipation
dyspepsia
abdominal pain
muscle aches
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| What is the one common drug-drug interaction to all the HIV drugs? | St. John's Wort
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| What is the CCR5 correcptor antagonist prototype drug? | Maraviroc
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| How do CCR5 correceptor antagonists work? | selectively bind to human chemokine receptor CCR5
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| What are CCR% correcptor antagonist drugs used for? | Combination HIV therapy
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| What are the contraindications for CCR5 Corecceptor antagonist drugs? | hypersensativity to drug components
liver disease
preg and lact
coinfaction with HEP B
Cardiac disease
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| What are the adverse effects of CCR5 correcptor antagonists? | n/v/d
headache, dizziness, fever
musculoskeletal
hepatoxicity
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| What is the prototype drug for Integrase Inhibitor antivirals? | Raltegravir
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| What do Integrase Inhibitor antivirals do? | inhibit activity of virus specific enzyme integrase, prevents formation of HIV-1 provirus
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| What are integrase inhibitor antivirals used to treat? | combination antiretroviral therapy for CCR5 tropical HIV
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| What are the contraindication for integrase inhibitor antivirals? | hypersensativity or allergy
risk for RHABDOMYOLYSIS
myopathy
pregnancy
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| what are the adverse effects of integrase inhibitors? | rhabdomyolysis
myopathy
dizziness, fever, headache
n/v/d
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| What is the prototype for the anti-hepatitis B agents? | Adefovir
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| What are the adverse effects of the anti Hep B agents? | nephrotoxicity
lactic acidosis
elevated liver enzymes
headache
asthma
nausea
SEVERE or FATAL hepatomegaly with steatosis
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| What are the contraindications for anti Hep B agents? | preg and lact
allergy
renal impairment
severe liver disease
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| What are the two drugs for local active antiviral agents? | Ganciclover
Penciclover
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| How do the local antivirals work? | interfere with viral replication
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| What is the prototype drug for the Nucleoside Reverse Transcriptase Inhibitors | Zidovudine
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| What is special about Zidovudine among the HIV antivirals? | Proven safe when used in pregnancy. Used to prevent maternal transmission of HIV
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| How do the nucleoside reverse transcriptase inhibitors work? | Inhibit replication by competing with naturally occuring nucleosides within the cell that the virus would use to build its DNA chain
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| What are the contraindications for Nucleoside RTIs? | caution with:
hepatic dysfunction
renal impairment
bone marrow suppression
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| What are the adverse effects of the nucleoside RTIs? | headache, insomnia, dizziness, fever
rash
n/d
bone marrow suppression
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| What are the drug-drug interactions with nucleoside RTIs? | Cyclosporine
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| What is the prototype drug for Protease Inhibitor anti-virals? | Fosamprenavir
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| How do protease inhibitor antivirals work? | inhibit protease activity, leads to immature, non-infectious viral particles
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| What are protease inhibitor antivirals used for? | combination HIV therapy
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| What are the contraindications for use of protease inhibitors? | pg and lact.
Saquinavir only agent shown to NOT be teratogenic
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| What are the adverse effects of protease inhibitors? | headache, mood changes, fatigue
rash
N/D
Stevens Johnson Syndrome
Redistribution of body fat (buffalo hump)
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| What is the prototype drug for fusion inhibitors? | Enfuvirtide
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| What are the contraindications for fusion inhibitors? | pregnancy
lung disease
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| What are the adverse effects of fusion inhibitors? | insomnia, depression
injection site reaction
n/d
peripheral neuropathy
pneumonia
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| What are the six prototype drugs used for HIV combination treatment? | Enfuvirtide-fusion inhibitor
Fosamprenavir-protease inhibitor
Maraviroc-CCR5 correceptor antagonist
Neviparine-Nonnucleoside Reverse Transcriptase Inhibitor
Zidovudine-Nucleoside Reverse Transcriptase Inhibitor
Raltagravir-Integrase Inhibitor
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| which class of HIV drugs works by competing with naturally occuring nucleosides in the cell to prevent the virus from using it to build it's DNA chain? | Nucleoside Reverse Transcriptase Inhibitors
(prototype: Zidovudine)
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| Which HIV antiviral treatment has rhabdomyolysis as an adverse effect? | Integrase inhibitors
(prototype: raltagravir)
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| Which antiviral has a drug-drug interaction with nephrotoxic drugs? | antiHep B drugs
(prototype: Adefovir)
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| Which antivirals are contraindicated when there is renal impairment? | anti-hep B agents (adefovir)
herpes and cytolomegalovirus (acyclovir)
influenza A and resp. virus (rimantadine)
nucleoside reverse transcriptase inhibitors (zidovudine)
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| Which anvirials are contraindicated when there is liver disease or damage? | nucleoside reverse transcriptase inhibitors (zidovudine)
anti-hep b agents (adefovir)
CCR5 correceptor antagonists (Maraviroc)
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| Which antiviral has severe to fatal hepatamegaly as an adverse effect? | Anti-hep B agents (Adefovir)
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| Carbapenems have a drug-drug interaction with which anti-viral? | Ganciclovir
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| Aminoglycosides have drug-drug interactions with which antiviral? | Acyclovir
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| Which antiviral works by inhibiting viral replication by preventing the shedding of the protein coat of the virus? | Influenza A-resp. virus antivirals
(Rimantadine)
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| Which antiviral has a drug-drug interaction with another antiviral and which one is it? | Herpes/cytomegalovirus antivirals (acyclovir) has a drug-drug interaction with Zidovudine (nucleoside reverse transcriptase inhibitor)
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| What is the most common side effect associated with Maraviroc? | parasthesias and fever
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| What are the most common side affects associated with Rimantadine? | Lightheadedness and dizziness
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| What are the most common side affects associated with fosamprenavir? | Buffalo hump, fat redistribution
(also with tenefovir)
(protease inhibitors!)
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| What are the most common side affects seen with Neviripine? | GI problems: n/v/d, dry mouth, dyspepsia, constipation, abdominal pain
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| Which was the first class of drugs developed to treat HIV? | Nucleoside reverse transcriptase inhibitors such as Zidovudine and didanosine were the first
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| Which antiviral would be best for someone with acute renal impairment? | Nelfinavir-primarily excreted in feces so little kidney involvement
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| Which antiviral is used to treat influenza a and Respiratory virus in children? | Ribivirin
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