NR-566 Advanced Pharmacology for Care of the Family
NR566 Midterm Exam
What does an increase in CD4 T-cell indicate?
Correct Answer:
Restoration of some immune function
When do use foscarnet in HIV+ patients?
Correct Answer:
Treatment of ganciclovir-resistant cytomegalovirus (CMV) infections in patients with the acquired immunodeficiency syndrome (AIDS).
Metronidazole patient teaching
Correct Answer:
Can cause metallic taste in mouth, avoid alcohol with the medication d/t risk of Disulfiram reaction (n/v/HA)
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Abacavir adverse effects
Correct Answer:
Lactic acidosis, severe hepatomegaly with steatosis, severe hypersensitivity reactions, MI, headache, nausea, vomiting, fatigue, malaise, sleep disorders.
Monitoring needs for long-term antifungal use
Correct Answer:
AST, ALT, alkaline phosphatase, bilirubin
Antifungals to use in immunocompromised patients:
Correct Answer:
Fluconazole or ketoconazole, azole drugs-Posaconazole (Noxafil)
How to treat systemic fungal infections:
Correct Answer:
Amphotericin B & azoles
Amphotericin B
Correct Answer:
Broad-spectrum antifungal, highly toxic, life-threatening infections only, IV only, daily or every other day for 6-8 weeks
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Azoles
Correct Answer:
Broad-spectrum antifungal, inhibit CYP450, IV or PO, Ketoconazole or
Fluconazole (Diflucan), daily for 3 weeks-3 months, black box: rare fatal
hepatic necrosis, can be teratogenic.
Ketoconazole and omeprazole concurrently - what does patient need to know?
Correct Answer:
ketoconazole will decrease the effect of omeprazole oral by reducing stomach acidity
Enterobius vermicularis - what is it and who would you expect to have it?
Correct Answer:
Pinworm: common in children
A patient with HIV contracts herpes simplex virus (HSV), and the prescriber orders acyclovir 400 mg PO twice daily for 10 days. After 7 days of therapy, the patient reports having an increased number of lesions. Which of the following is the best course of action?· Extend this patient's drug therapy to twice daily for 12 months · Order intravenous foscarnet every 8 hours for 2 to 3 weeks · Increase the acyclovir dose to 800 mg PO five times daily · Order intravenous valacyclovir [Valtrex] 1 g PO twice daily for 10 days
Correct Answer:
Order intravenous foscarnet every 8 hours for 2 to 3 weeks
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