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ID Quiz 7 - Coggle Diagram
ID Quiz 7
acyclovir (Zovirax)
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rare ADRs: severe hypersensitivity, renal failure, TTP
interactions: phenytoin/forphenytoin/valproic acid (decreased absorption and lower plasma concentration of phenytoin or valproic acid), varicella/zoster vaccine (decreased effectiveness)
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indications: genital herpes simplex, genital HSV suppression, herpes zoster (shingles), varicella (chickenpox)
toxicity: seek medical attention if decreased urination, unusual bruising or bleeding, blistering skin rash, SOB, confusion, lethargy, or seizures
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counseling: complete full course of therapy; ensure adequate hydration; for HSV, initiate treatment ASAP at 1st sign of lesion (tx most effective if initiated within 24 h of onset); for VZV, tx should begin within 24 h of appearance of rash; symptoms should improve in 2-3 d; if they worsen, seek follow-up with HCP; if using for prophylaxis or suppression of infection, this medication should reduce the # of breakouts; maintain adequate hydration during therapy
nitazoxanide (Alinia)
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efficacy: resolution of signs and symptoms of infection, improvement in diarrhea
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counseling: complete full course of therapy; take with food; store suspension at room temperature (expiration = 1 wk)
oseltamivir (Tamiflu)
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rare ADRs: arrhythmias, anaphylaxis, SJS, seizures, delirium
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toxicity: seek care is heart palpitations, SOB, severe rash, swelling, confusion, or anxiety occurs
class: neuraminidase inhibitor, antiviral
counseling: complete full course of therapy; symptoms should improve within 2-3 d; if worsen, seek care; suspension available in 6 mg/mL concentration and packaged with oral syringe calibrated in mL up to total of 10 mL; instructions to patient should be provided on these units of measure (mL); when providing suspension for child < 1 y, use lower calibrated (< 10 mL) oral syringe to ensure accurate dosing; if suspension unavailable, open capsule and compound a 6 mg/mL suspension; take with food to minimize GI irritation; take missed dose ASAP, if next dose within 2 h, skip missed dose
valacyclovir (Valtrex)
common ADRs: malaise, HA, increase LFTs
rare ADRs: severe hypersensitivity, renal failure, TTP
interactions: phenytoin/forphenytoin/valproic acid (decreased absorption and lower plasma concentration of phenytoin or valproic acid), varicella/zoster vaccine (decreased effectiveness),foscarnet (increase change of nephrotoxicity)
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indications: genital herpes simplex, herpes zoster (shingles), varicella, herpes labialis
toxicity: seek medical attention if decreased urination, unusual bruising or bleeding, blistering skin rash, or SOB; monitor CBC, LFTs, and SCr
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counseling: symptoms should improve within 2-3 d; if worsen, seek follow-up with HCP; if using for prophylaxis, this medication should reduce the # of breakouts; maintain adequate hydration during therapy to prevent renal complications
sofosbuvir (Sovaldi)
common ADRs: fatigue, HA, insomnia, chills, pruritus, rash, nausea, anemia
rare ADRs: pancytopenia, depression, suicidality
interactions: P-gp inducers/inhibitors, amiodarone (bradycardia)
efficacy: improvement in S/S of hepatitis C infection; monitor SCr and LFTs; serum HepC viral RNA levels prior and during tx
indications: chronic hepatitis C infection with genotype 1, 2, 3, 4 as part of combo therapy
toxicity: in female patients and female partners of male patients, pregnancy tests should be done prior to and during tx
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counseling: pregnancy warnings (due to ribavirin risk) for female patients and female partners of male patients