Chamberlain NR 566 QUIZ,STUDY GUIDE
How do you treat tinea capitis? - ANSWER Antifungal
What specific drug is used to treat aspergillosis? - ANSWER Caspofungin
Which anthelmintic drugs carry the risk for hypotension with patients on
antihypertensives? - ANSWER ivermectin and moxidectin
Which anthelmintic drugs can cause bone marrow suppression and liver
impairment? - ANSWER Mebendazole and Abendazole
Which anthelmintic drug is generally safe to give without obtaining baseline data? -
ANSWER Pyrantel
Which anthelmintic drug is safe for use in pregnancy? - ANSWER Praziquantel
and Moxidectin
HIV Medication: What are the risks associated with Didanosine (NRTI)? - ANSWER
lactic acidosis, severe hepatomegaly with steatosis, severe pancreatitis,
hepatotoxicity, non-cirrhotic portal hypertension, immune reconstitution syndrome,
Redistribution of adipose tissue, peripheral neuropathy, retinal disorders, and/or
optic neuritis, headache, nausea, vomiting, and rash.
HIV Medication: What are the risks associated with Saquinavir (aka Invirase) a
Protease Inhibitor? - ANSWER Dangerous drug interactions (danger with ritonavir),
hepatotoxicity, pancreatitis, severe hypersensitivity reactions, PR interval
prolongation, hyperlipidemia, diabetes (exacerbation and new onset), immune
reconstitution, syndrome, redistribution of adipose tissue, renewed bleeding in
patients with hemophilia, exacerbation of comorbid hepatic disease, hyperlipidemia,
nausea, vomiting, abdominal pain, diarrhea, and fatigue
P-R Interval impacts the use of which HIV drugs? - ANSWER Protease Inhibitors
can decrease the speed of cardiac conduction.
The most common effect is a prolongation of the PR interval.
May lead to blocking of the bundle branches
B-Blockers can worsen this effect
,How do you measure success with antiretroviral therapy for HIV? - ANSWER A
decrease in plasma HIV RNA.
With ART, plasma HIV RNA should decline to 10% of baseline within 2 to 8 weeks.
After 16 to 20 weeks of treatment, plasma HIV RNA should reach its minimum.
Ideally, the minimum will be undetectable with sensitive assays.
What does an increase in CD4 T cells indicate? - ANSWER CD4 T-Cell Counts:
As viral load decreases, CD4 T-cell counts may rise, indicating some restoration of
immune function.
When do we use foscarnet in HIV+ patients? - ANSWER Foscarnet has two
approved indications:
(1) CMV (cytomegalovirus) retinitis in patients with AIDS
(CMV retinitis resistant to ganciclovir may respond to foscarnet)
(2) acyclovir-resistant mucocutaneous HSV and VZV infection in the
immunocompromised host.
What patient education is needed when you prescribe Metronidazole? - ANSWER
No ETOH, A disulfiram-like reaction can occur
Black box warning: increased carcinogenic risk; avoid any unnecessary use
Some providers advise avoiding breastfeeding for 12 to 24 hours
What are the adverse effects of abacavir? - ANSWER Lactic acidosis and
hepatomegaly with steatosis.
Hypersensitivity reactions develop during the first 6 weeks of treatment and can
cause multi-organ failure and anaphylaxis.
Symptoms can include fever, rash, myalgia, arthralgia, and GI disturbances.
Initial hypersensitivities can manifest as respiratory symptoms.
People who test genetically positive for HLA-B*5701 should not take Abacavir
Association between myocardial infarction and
10% of patients experience fatigue and headaches.
What are the long-term monitoring needs of antifungal use? - ANSWER Liver
function Test (AST, ALT, alkaline phosphatase, and bilirubin)
Which antifungals should I prescribe to immunocompromised patients? - ANSWER
ORAL CANDIDIASIS:
, fluconazole or ketoconazole
INVASIVE FUNGAL INFECTIONS:
(candidiasis and Aspergillosis)
Posaconazole
Cannot give amphotericin B to immunocompromised patients.
Systemic mycoses are fungal infections affecting internal organs. How do you treat
fungal systemic infections? - ANSWER Treating systemic mycoses can be difficult.
These infections often resist treatment, requiring prolonged therapy and increasing
the chances of toxicity.
Aspergillosis: voriconazole
Candidiasis: amphotericin B or fluconazole plus or minus flucytosine
Histoplasmosis: amphotericin B or itraconazole
What does the patient need to know about combining Ketoconazole and
Omeprazole? - ANSWER Combining these medications may interfere with the
absorption of ketoconazole and reduce its effectiveness.
Decrease the absorption of ketoconazole
Enterobius vermicularis: What is it and who would you expect to have it? -
ANSWER Pinworm infestation (Nematode) in the ileum and large intestine
Perianal itching is a symptom (otherwise asymptomatic)
The mode of transmission, once on hands, will spread to everything person touches
Pinworms. All members of the household should be treated at the same time.
Handwashing is important. Perianal itching is the cause of transmission.
Medications: albendazole, mebendazole, and pyrantel pamoate
The Most common nematode infection in the USA
Primarily in children (spreads through schools and daycares),
Important information associated with Voriconazole. - ANSWER Treats serious
fungal or yeast infections
It slows the growth of infections and can interact with many drugs.
It should not be combined with drugs that are powerful P450 inducers, including
phenobarbital, because they can reduce the levels of voriconazole
Community-Acquired Pneumonia: Pathogens for the General Population. -
ANSWER · Streptococcus Pneumoniae (gram-positive)
How do you treat tinea capitis? - ANSWER Antifungal
What specific drug is used to treat aspergillosis? - ANSWER Caspofungin
Which anthelmintic drugs carry the risk for hypotension with patients on
antihypertensives? - ANSWER ivermectin and moxidectin
Which anthelmintic drugs can cause bone marrow suppression and liver
impairment? - ANSWER Mebendazole and Abendazole
Which anthelmintic drug is generally safe to give without obtaining baseline data? -
ANSWER Pyrantel
Which anthelmintic drug is safe for use in pregnancy? - ANSWER Praziquantel
and Moxidectin
HIV Medication: What are the risks associated with Didanosine (NRTI)? - ANSWER
lactic acidosis, severe hepatomegaly with steatosis, severe pancreatitis,
hepatotoxicity, non-cirrhotic portal hypertension, immune reconstitution syndrome,
Redistribution of adipose tissue, peripheral neuropathy, retinal disorders, and/or
optic neuritis, headache, nausea, vomiting, and rash.
HIV Medication: What are the risks associated with Saquinavir (aka Invirase) a
Protease Inhibitor? - ANSWER Dangerous drug interactions (danger with ritonavir),
hepatotoxicity, pancreatitis, severe hypersensitivity reactions, PR interval
prolongation, hyperlipidemia, diabetes (exacerbation and new onset), immune
reconstitution, syndrome, redistribution of adipose tissue, renewed bleeding in
patients with hemophilia, exacerbation of comorbid hepatic disease, hyperlipidemia,
nausea, vomiting, abdominal pain, diarrhea, and fatigue
P-R Interval impacts the use of which HIV drugs? - ANSWER Protease Inhibitors
can decrease the speed of cardiac conduction.
The most common effect is a prolongation of the PR interval.
May lead to blocking of the bundle branches
B-Blockers can worsen this effect
,How do you measure success with antiretroviral therapy for HIV? - ANSWER A
decrease in plasma HIV RNA.
With ART, plasma HIV RNA should decline to 10% of baseline within 2 to 8 weeks.
After 16 to 20 weeks of treatment, plasma HIV RNA should reach its minimum.
Ideally, the minimum will be undetectable with sensitive assays.
What does an increase in CD4 T cells indicate? - ANSWER CD4 T-Cell Counts:
As viral load decreases, CD4 T-cell counts may rise, indicating some restoration of
immune function.
When do we use foscarnet in HIV+ patients? - ANSWER Foscarnet has two
approved indications:
(1) CMV (cytomegalovirus) retinitis in patients with AIDS
(CMV retinitis resistant to ganciclovir may respond to foscarnet)
(2) acyclovir-resistant mucocutaneous HSV and VZV infection in the
immunocompromised host.
What patient education is needed when you prescribe Metronidazole? - ANSWER
No ETOH, A disulfiram-like reaction can occur
Black box warning: increased carcinogenic risk; avoid any unnecessary use
Some providers advise avoiding breastfeeding for 12 to 24 hours
What are the adverse effects of abacavir? - ANSWER Lactic acidosis and
hepatomegaly with steatosis.
Hypersensitivity reactions develop during the first 6 weeks of treatment and can
cause multi-organ failure and anaphylaxis.
Symptoms can include fever, rash, myalgia, arthralgia, and GI disturbances.
Initial hypersensitivities can manifest as respiratory symptoms.
People who test genetically positive for HLA-B*5701 should not take Abacavir
Association between myocardial infarction and
10% of patients experience fatigue and headaches.
What are the long-term monitoring needs of antifungal use? - ANSWER Liver
function Test (AST, ALT, alkaline phosphatase, and bilirubin)
Which antifungals should I prescribe to immunocompromised patients? - ANSWER
ORAL CANDIDIASIS:
, fluconazole or ketoconazole
INVASIVE FUNGAL INFECTIONS:
(candidiasis and Aspergillosis)
Posaconazole
Cannot give amphotericin B to immunocompromised patients.
Systemic mycoses are fungal infections affecting internal organs. How do you treat
fungal systemic infections? - ANSWER Treating systemic mycoses can be difficult.
These infections often resist treatment, requiring prolonged therapy and increasing
the chances of toxicity.
Aspergillosis: voriconazole
Candidiasis: amphotericin B or fluconazole plus or minus flucytosine
Histoplasmosis: amphotericin B or itraconazole
What does the patient need to know about combining Ketoconazole and
Omeprazole? - ANSWER Combining these medications may interfere with the
absorption of ketoconazole and reduce its effectiveness.
Decrease the absorption of ketoconazole
Enterobius vermicularis: What is it and who would you expect to have it? -
ANSWER Pinworm infestation (Nematode) in the ileum and large intestine
Perianal itching is a symptom (otherwise asymptomatic)
The mode of transmission, once on hands, will spread to everything person touches
Pinworms. All members of the household should be treated at the same time.
Handwashing is important. Perianal itching is the cause of transmission.
Medications: albendazole, mebendazole, and pyrantel pamoate
The Most common nematode infection in the USA
Primarily in children (spreads through schools and daycares),
Important information associated with Voriconazole. - ANSWER Treats serious
fungal or yeast infections
It slows the growth of infections and can interact with many drugs.
It should not be combined with drugs that are powerful P450 inducers, including
phenobarbital, because they can reduce the levels of voriconazole
Community-Acquired Pneumonia: Pathogens for the General Population. -
ANSWER · Streptococcus Pneumoniae (gram-positive)
