17. Antifungals and Antivirals

What is the brand name for ketoconazole?

Nizoral

What is the generic name for Nizoral?

Ketoconazole

What drug class is ketoconazole?

Azole antifungal

What is the brand name for nystatin?

Mycostatin, Nystop

What is the generic name for Mycostatin?

Nystatin

What is the generic name for Nystop?

Nystatin

What drug class is nystatin?

Polyene antifungal

What is nystatin commonly used to treat?

Candida infections

What is the brand name for fluconazole?

Diflucan

What is the generic name for Diflucan?

Fluconazole

What drug class is fluconazole?

Azole antifungal

What is the brand name for amphotericin B?

AmBisome

What is the generic name for AmBisome?

Amphotericin B

What drug class is amphotericin B?

Polyene antifungal

What is the brand name for micafungin?

Mycamine

What is the generic name for Mycamine?

Micafungin

What drug class is micafungin?

Echinocandin antifungal

Which antifungals in this section are azoles?

Ketoconazole and fluconazole

What is the memory key for antifungals?

Azoles such as ketoconazole and fluconazole have interaction potential; amphotericin B is a potent IV antifungal; nystatin is common for Candida

What enzyme-related interaction concern is associated with azole antifungals?

They can inhibit CYP enzymes

What cardiac electrical adverse effect can azole antifungals cause?

QT prolongation

Why should interacting medications be checked with azole antifungals?

Because azoles can inhibit CYP enzymes and prolong QT

Which antifungal is especially known for nephrotoxicity?

Amphotericin B

What electrolyte effect can amphotericin B cause?

Electrolyte wasting

What administration-related adverse effect can amphotericin B cause?

Infusion reactions

What are the signature toxicities of amphotericin B?

Nephrotoxicity, electrolyte wasting, and infusion reactions

Which antifungal in this section is a potent IV antifungal?

Amphotericin B

Which antifungal is commonly used for Candida?

Nystatin

How is nystatin oral suspension commonly used for oral candidiasis?

Swished in the mouth before swallowing or spitting as directed by the prescription

Which drug matches Nizoral?

Ketoconazole — azole antifungal

Which drug matches Mycostatin/Nystop?

Nystatin — polyene antifungal

Which drug matches Diflucan?

Fluconazole — azole antifungal

Which drug matches AmBisome?

Amphotericin B — polyene antifungal

Which drug matches Mycamine?

Micafungin — echinocandin antifungal

Which antifungal class has important CYP interaction potential and QT prolongation risk?

Azole antifungals

Which antifungal has nephrotoxicity electrolyte wasting and infusion reactions as signature risks?

Amphotericin B

Which antifungal oral suspension may be swished for oral candidiasis?

Nystatin

What is the brand name for bictegravir/emtricitabine/tenofovir?

Biktarvy

What is the generic name for Biktarvy?

Bictegravir/emtricitabine/tenofovir

What drug class is bictegravir/emtricitabine/tenofovir?

Combination antiretroviral therapy

Which component of Biktarvy is an integrase inhibitor?

Bictegravir

What is the brand name for efavirenz/tenofovir/emtricitabine?

Atripla

What is the generic name for Atripla?

Efavirenz/tenofovir/emtricitabine

What drug class is efavirenz/tenofovir/emtricitabine?

Combination antiretroviral therapy

What is the brand name for raltegravir?

Isentress

What is the generic name for Isentress?

Raltegravir

What drug class is raltegravir?

Integrase strand transfer inhibitor antiretroviral

What is the brand name for acyclovir?

Zovirax

What is the generic name for Zovirax?

Acyclovir

What drug class is acyclovir?

Antiviral

What is the brand name for valacyclovir?

Valtrex

What is the generic name for Valtrex?

Valacyclovir

What drug class is valacyclovir?

Antiviral

What is the brand name for oseltamivir?

Tamiflu

What is the generic name for Tamiflu?

Oseltamivir

What drug class is oseltamivir?

Neuraminidase inhibitor antiviral

What is oseltamivir primarily used to treat?

Influenza

What is the brand name for nirmatrelvir/ritonavir?

Paxlovid

What is the generic name for Paxlovid?

Nirmatrelvir/ritonavir

What drug class is nirmatrelvir/ritonavir?

Combination antiviral

Which component of Paxlovid is a strong CYP3A inhibitor?

Ritonavir

What is the major interaction concern with Paxlovid?

Ritonavir strongly inhibits CYP3A and can cause many clinically significant drug interactions

What enzyme does ritonavir strongly inhibit?

CYP3A

Why is medication interaction screening especially important with Paxlovid?

Because ritonavir is a strong CYP3A inhibitor

What renal consideration applies to acyclovir and valacyclovir?

Renal dose adjustment may be required

Why is adequate hydration important with acyclovir and valacyclovir?

To reduce crystalluria and nephrotoxicity risk

What urinary crystal complication can occur with acyclovir or valacyclovir?

Crystalluria

What kidney toxicity can occur with acyclovir or valacyclovir?

Nephrotoxicity

Which antivirals in this section require attention to renal dosing and hydration?

Acyclovir and valacyclovir

What type of substances can interact with integrase inhibitors?

Polyvalent cations

What administration adjustment may be needed when integrase inhibitors are used with polyvalent cations?

Product-specific dose spacing

Which antiretroviral in this section is an integrase inhibitor by itself?

Raltegravir

Which component of Biktarvy is an integrase inhibitor?

Bictegravir

Why should antiretroviral combination products be carefully checked for duplicate ingredients?

To avoid accidental partial therapy or duplicate antiretroviral components

What is the memory key for HIV and other antivirals?

Antiretrovirals are combination-heavy; avoid accidental partial therapy or duplicate ingredients

When is oseltamivir most useful in influenza illness?

When started early

Can oseltamivir still be indicated later in influenza illness?

Yes, especially in severe or high-risk cases

Which antiviral is most effective when started early for influenza?

Oseltamivir

Which drug matches Biktarvy?

Bictegravir/emtricitabine/tenofovir — combination antiretroviral

Which drug matches Atripla?

Efavirenz/tenofovir/emtricitabine — combination antiretroviral

Which drug matches Isentress?

Raltegravir — integrase inhibitor antiretroviral

Which drug matches Zovirax?

Acyclovir — antiviral

Which drug matches Valtrex?

Valacyclovir — antiviral

Which drug matches Tamiflu?

Oseltamivir — neuraminidase inhibitor antiviral

Which drug matches Paxlovid?

Nirmatrelvir/ritonavir — combination antiviral

Which antiviral combination contains ritonavir?

Paxlovid

Which antiviral combination has many CYP3A drug interactions because of ritonavir?

Paxlovid

Which antivirals require hydration to reduce crystalluria and nephrotoxicity risk?

Acyclovir and valacyclovir

Which antiretroviral class can interact with polyvalent cations?

Integrase inhibitors

Which influenza antiviral is most useful when started early?

Oseltamivir

Which antiretroviral products in this section are fixed-dose combinations?

Biktarvy and Atripla

Which antiretroviral should be recognized as an integrase inhibitor?

Raltegravir

Which two antifungal drugs in this section are azoles?

Ketoconazole and fluconazole

Which antifungal is an echinocandin?

Micafungin

Which antifungal is commonly associated with serious nephrotoxicity?

Amphotericin B

Which antiviral has a strong CYP3A inhibitor as one of its components?

Paxlovid