Pharm Antiviral, Antifungal, Cardiac

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Author:
cswett
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138098
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Pharm Antiviral, Antifungal, Cardiac
Updated:
2012-02-27 13:56:39
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Pharm Antiviral Antifungal Cardiac
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Pharm Antiviral, Antifungal, Cardiac
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  1. Antiviral (Antiherpetic) drugs
    used for
    PD
    teaching
    nurses safety
    • - suffix - clovir
    • - Acyclovir/ Zovirax
    • - Ganciclovir/ Cyloveue

    Tx for: Herpies Simplex 1, Simplex 2, Varicella (Chix pox & Shingles), Roseola, Estein-Barr, Kaposi Sarcoma

    PD: Terminate vDNA synthesize

    • Toxic: risk of alopecia,
    • -bone marrow suppression
    • -gut ulceration and erosion - N & V

    • Teaching:
    • Take on time
    • Do not share
    • No Pregnancy
    • Refill on time

    • Nurses Safety:
    • Ganciclovir IV - requires biohazard sticker
    • - if leaky have to use biohazard spill kit
    • Teratogenicity - monster making - birth defects
    • Males - aspermia (no sperm)
    • Ganciclovir requires specialized training
  2. Antifungal/ Anticandidal
    • - Suffix - Azole
    • weakest to strongest
    • ketoconazole/ Nizoral
    • fluconazole/ diflucan
    • itreconazole/ sporanox

    PD: perforate fungal/ yeast cell membranes

    PK: all potent enzyme inhibitors (hepatic) - can increase toxicity of other drugs

    • Teaching:
    • Ketoconazole requires an acidic envrionment to be absorbed PO- take with orange juice or cola (acidic)

    • IV antifungals - for serious infections
    • Amphoteracin (B) - antifungal of last resort - really nasty infection
    • Emulsion - if separates return to pharmacy
    • Light sensitive - wrap something around it
    • Nephrotoxic -Causes extreme rigors - shaking uncontrolably
  3. Retrovirus - HIV
    • HIV active infection - can make up to 5 billion copies of virus in a day -
    • mutations happens
    • NULL - mutations - don't do anything
    • Stillborn mutations - wont work

    Viral load - how much virus is there?

    • Teaching
    • Take as perscribed - 3x days means q 8 hrs-missing one dose can increase chance of viral mutation-Make sure you dont run out - refill regularly
  4. Cardiovascular
    • - hypertension >120/ >80
    • diastolic > 110 - MI waiting to happen

    • Essential Hypertension: body declared "new" homeostasis body will fight medications that try to lower BP
    • NEW homeostasis of high BP, compensatory mechanisms will try to counteract the drug

    Pharmacologically: 3 main parts Heart, Vessels, & Kidneys (control fluid volume)

    Orthostatic Hypotension -All PO meds cause this BUT vasodilators are worse than others
  5. ACE inhibitors
    • ACE inhibitors have effect on two different parts of cardiovascular systems
    • vasodilators (systemically)
    • prevent fluid retention (in kidneys)
  6. Vasodilators
    • alpha-blockers
    • New Calcium Channel Blockers
    • ACE Inhibitors
    • Nitrates

    • Orthostatic hypotension
    • all BP meds cause it but vasodilators are the worst
  7. Compensatory System
    Heart, Vessles, Kidneys

    BP low - vasoconstriction, kidneys retain water

    BP High - vasodilation, kidneys get rid of water

    Kidney intervetnion is slower than vascular
  8. SNS VS PNS
    • SNS = Energy Expenditure
    • EPI, NOR
    • Vasodilation & bronchodilation (need O2 fast so let it move quickly)

    • PNS = Energy Conservation
    • ACH
    • Vasoconstricts (uses less energy to move blood - decreases heart rate)

    Vasoconstriciton = increased BP

    • ACH inhibitors - anticholenergics (anti PNS)
    • lower stomach acid
    • lower mucus production
    • increase energy expentiture
  9. 3 Main SNS receptors
    alpha - vasculature - agonist (makes things happen) -

    • beta1 -heart - agonist (increases HR & strength)
    • (beta blockers lower HR & strength)

    beta2 - lungs - agonist bronchodilation

    EPI = alpha, beta1 and beta2

    NOR = alpha & beta1


    • Shock = low BP
    • Anaphalactic shock = low BP + difficult breathing

    EPI Pen = opens airways

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