Pages 19-23
Pharmacotherapy 2823 with Cox at Lipscomb University
About this deck
By: Audrey Wolski
Created: 2011-05-14
Size: 32 flashcards
Views: 8
Created: 2011-05-14
Size: 32 flashcards
Views: 8
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Epstein Barr Virus and Amoxicillin
• >90% of EBV infected pts given Amoxicillin or Ampicillin have a pruritic maculopapular rash • Treatment: – Supportive only
Pin Worm
Enterobius vermicularis
• Treatment: – Mebendazole (Vermox) • 100mg PO x1 – Albendazole (Valbazen) • 400mg PO x1 – Pyrantel pamoate (Pin-Rid) • 11mg/kg PO x 1 • Repeat in 2 weeks to prevent • Re-infection • Autoinfection
Hook Worm
• Treatment: • DOC: Albendazole 400mg PO x1 – Mebendazole 100mg PO BID x 3 days – Mebendazole 500mg PO x1 (less effective) – Pyrantel pamoate effective • Supplemental: – Iron replacement – RBC transfusion
Ascariasis Treatment:
• Albendazole 400mg PO x1 • Mebendazole 100mg BID x 3 days • Mebendazole 500mg PO x1 • Pyrantel pamoate 1mg/kg PO x 3 days
CMV Treatment
• Vision Threatening Lesion: – Intraocular ganciclovir implant + valganciclovir (Valcyte ®) 900mg BID X3weeks then once daily – Peripheral Lesions: – Valganciclovir 900mg BID x3weeks then once daily
Histoplasmosis Treatment
• Preferred Treatment: – Liposomal AmphoB 3mg/kg/day X2weeks – After 2 weeks then itraconazole 200mg tidx3day – After 3 days then itraconazole 200mg BID x12 months
Histo: Primary Prophylaxis
• Typically not indicated • May consider with occupational histo exposure – Itraconazole 200mg daily
or
– Fluconazole 200mg dailyCryptococcus neoformans Treatment
• Preferred Regimen: – Liposomal Amphotericin B 4-6mg/kg/day + fluctyosine 100mg/kg/day for 2 weeks • After 2 weeks – D/C Ampho B anf fluctyosine – Initiate fluconazole 400mg daily X8weeks • After 8 weeks – Decrease fluconazole to 200mg daily – Continue for life
Crypto: Primary Prophylaxis
• Not typically indicated • May consider if patient consistently works with soil – Fluconazole 200mg daily
or
Itraconazole 200mg daily (capsuleInitial Regimen: Preferred Regimens
• NNRTI Based – EFV/TDF/FTC (Atripla) • PI Based – ATV/r +TDF/FTC – DRV/r (once daily)+TDF/FTC • Integrase Based – RAL +TDF/FTC
Initial Regimen: Do NOT Use
• Monotherapy • Dual NRTIs only • Triple NRTIs • Regimens containing – AZT + d4T – ddI + d4T – 3TC + FTC
HIV Treatment:
Pregnant Women
– LPVr + ZDV/3TC • Alternative – (DRVr or ATVr) + (ABC or ZDV)/3TC or TDF/FTC
Optimal Therapeutic regimen should be selected
nPEP
• Preferred:
– LPVr + ZDV/3TC – EFV + ZDV/3TC or TDF/FTC • Alternative – Boosted PIs plus ZDV/3TC or TDF/FTC
PCP: Primary Prophylaxis
• Preferred Medication(s): – TMP-SMZ DS daily • Alternative – TMP-SMZ DS 3x weekly – TMP-SMZ SS daily – Dapsone 100mg daily – Atovaquone 1500mg daily – Aerosolized pentamidine monthly
PCP: Treatment
• Preferred: – TMP 15mg/kg/d + SMZ 75mg/kg/d po or IV in 3-4 divided doses for 21 days • Alternative: – Atovaquone 750mg po BID – TMP 15mg/kg/d + dapsone 100mg daily – Pentamidine 4mg/kg/d IV – Clindamycin 600mg IV q8h + primaquine 30mg daily
MAC: Primary Prophylaxis
• Should be initiated when CD4 <50 cells/mm3 • Preferred medication(s) – Azithromycin 1200mg po qweek – Alternative medication(s) – Clarithromycin 500mg po BID Rifabutin + Azithromycin
MAC: Treatment
• Should be continued indefinitely • Preferred: – Clarithromycin 500mg po BID + ethambutol 15mg/kg/d po +/- rifabutin 300mg po qd • Alternative: – Azithromycin 600mg po qday + ethambutol +rifabutin +/-amikacin or ciprofloxacin
Toxo: Primary Prophylaxis
• Indicated for pts: – CD4 <100cells/mm3 – Positive toxoplasmosis IgG serology • Preferred meds: – TMP/SMZ DS daily • Alternative – TMP/SMZ DS 3x weekly – TMP/SMZ SS daily – Dapsone + Pyrimethamine + Folic Acid
Toxo: Treatment
• Preferred: for 6 weeks – Pyrimethamine 100-200mg Loading Dose then 50-100mg daily + folinic acid 10mg daily + sulfadiazine 4-8g/d q6 hours • Alternative: – Pyrimethamine + folinic acid + clindamycin – Pyrimethamine + folinic acid + azithromycin or atovaquone – Azithromycin daily
Darunavir
Sulfa Allergy
Tenofovir
Renal Problems
Emtricitabine
Hep B
M184 resistance
Lactic Acidosis
Hperpigmentation
Atzanavir
Hperbiliremia
Needs acid
Raltegravir
Clean and well tolerated
Efavirenz
Sleepy
CNS dreams
Need consistent schedule
CI in preggo, depressed and bipolar
Abacavir
if HLA + cant take
Zidovudine
Available in oral and tablet
No CYP interactions
Bone Marrow suppression
Lamivudine
Dose adjust for renal
lactic acidosis
M184 resistance
Cant use with Emticitabine
Lopinavir
Causes N/V
Hepatotoxic
Nevirapine
worst diarrhea ever
lipodystrophy
Saquinavir
Prolonged QT
Elevated LFT
Lipodystrophy
Grapefruit juice increases levels
Dexamethasone decreases levels
'Basic'
AZT/3TC
TDF/ 3TC
AZT/FTC
TDF/FTC
Alternative basic:
d4T/3TC
ddl/3TC
d4T/FTC
ddl/FTC
About this deck
By: Audrey Wolski
Created: 2011-05-14
Size: 32 flashcards
Views: 8
Created: 2011-05-14
Size: 32 flashcards
Views: 8
About StudyBlue
STUDYBLUE makes things that make you better at school.
Things like online flashcards with photos and audio.
Things like personalized quizzes and friendly reminders about when (and what) to study next.
Think of it as a digital backpack™: access to all of your study materials online and on your phone.
STUDYBLUE exists to make studying efficient and effective for every student, for free. Join us.
“I have been getting MUCH better grades on all my tests for school. Flash cards, notes, and quizzes are great on here. Thanks!”
Kathy
Kathy