PHARM 615 EXAM 3 MARYVILLE STUDY GUIDE

. What vitamin will decrease peripheral neuropathy? - Correct Answer The use of pyridoxine or Vitamin B6 can be administered for patients who are on isoniazid therapy for tuberculosis 2. What lab values should be assessed when administering valacyclovir? - Correct Answer Some antiviral drugs that are effective in treating herpes including acyclovir (first discovered and also available in generic form), valacyclovir (also available in generic form), famcyclovir, and pencyclovir. 10% of Valacyclovir is metabolized by the liver, while 90% is metabolized by the kidney. Thus, Blood Urea Nitrogen (BUN) and creatinine levels should be assessed prior to administering Valacyclovir. Food slows down the absorption, but overall, it does not affect the absorption of valcyclovir. Valacyclovir should be taken with a full glass of water and the patient should increase the water intake. 3. When should oseltamivir phosphate be prescribed? - Correct Answer Oseltamivit, marketed under the trade name Tamiflu, is an antiviral medication used to treat influenza A and influenza B and to prevent flu after exposure. The medications taken orally. The CDC recommends use of oseltamivir for people who have complications or are at high risk for complications who percent within 48 hours of the first symptoms infection. 4. For what is rifampin prescribed? - Correct Answer Rifampin is an antibiotic used to treat a number of bacterial infections. This includes tuberculosis, leprosy, and legionella among others. It often is used with other antibiotics. It is also used to prevent haemophilus influenzae type b and meningococcal disease in those who have been exposed, such as people who live in close quarters like soldiers and college students. Before treating someone for a long period of time testing the liver function and blood counts are recommended. It is available by mouth and IV. It is also part of the recommended treatment of active tuberculosis during pregnancy, even though its safety and pregnancy is not known. Rifampin is of the erythromycin group of antibiotics and works. by stopping production of bacterial RNA 5. What are the adverse effects of isoniazid (INH)? - Correct Answer The adverse effects of Isoniazid that is an antibiotic used a first line agent for the prevention and treatment of tuberculosis include; Peripheral neuropathy which is involved in patients taking isoniazid and it occurs in about 2% of patients taking 5 mg/kg/d, and the prevalence is higher for patients taking higher doses, up to about 44% for patients taking 16 mg/kg/d. The symptoms of peripheral neuropathy include symmetrical numbness and tingling in the extremities. The patients who are predisposed to this adverse reaction include people who are malnourished, slow acetylators, pregnant women, older adults, diabetics, and patients with chronic liver disease, including alcoholics. Peripheral neuropathy with the use of isonazid can be prevented with the use of Pyridoxine (Vitamin B6) and is recommended for patients in the at-risk groups. The recommended prophylactic doses range from 10 to 50 mg daily, while the treatment of established neuropathy requires 50 to 200 mg daily. Other adverse effects include; elevated serum transaminases (AST/ALT; liver enzymes) observed in 10% to 20% of patients taking isoniazid occurring usually in the first 3 months of therapy that is asymptomatic, and will return to normal with continued isoniazid therapy. However, in a small portion of patients (0.4%), this condition may progress to hepatic failure or necrosis, and progressive liver damage that increases with age and the risk is increased by concurrent alcohol use, and increased 4-fold with concurrent rifampin administration. In addition, some adverse reactions associated with isoniazid include blood dyscrasias, metabolic acidosis, drug fever, and gynecomastia. 6. When is prophylactic oseltamivir recommended? - Correct Answer The use of oseltamivir (Tamiflu) for prohylaxis is recommended for patients identified with influenza and are hospitalized, have severe disease, or are at risk of developing complications. 7. When prescribing ketoconazole, how should it be administered? - Correct Answer Ketoconazole which is administered orally, 200-400 mg once daily for 3-5 days in adults with vaginal candidiasis with a 1g maximum daily dose, and continued for 1 - 2 weeks. It should also be administered for 1 - 8 weeks for dermatophytic infections and mycoses of hair and scalp, 3 months - 1 year for paracoccidiodomycosis, and 6 months for other mycoses, chronic mucocutaneous candidiasis. In children over 2 years of age, ketoconazole a single-dose of (3.3 - 6.6 mg/kg/d should be given for candidiasis. Ketoconazole should be administered with food to promote absorption and minimize GI irritation, and should be taken with acid drinks in patients with hypochlorhydria or ahlorhydria. It can be dissolved in cola or seltzer water or taken with these fluids. The suspension should be well shaken before measuring with a calibrated liquid-measuring device, and stored at room temperature. 8. What is hypochlorhydria? - Correct Answer Hypochlorhydria refers to states where there is reduced production of hydrochloric acid in gastric secretions of the stomach and other digestive organs is absent or low. Most azole antifungals require the acidic environment of the stomach for absorption, and should not be administered with h2 blockers of protein pump inhibitors (Cooper, 2018).