Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
45 Cards in this Set
- Front
- Back
Antifungals: Prototype
|
Amphotericin B
|
|
Amphotericin B: Action
|
Fungicidal or fungistatic. Very toxic
|
|
Amphotericin B: Therapeutic Uses
|
1. Effective against systemic severe fungal infections
2. Examples: Valley Fever Crytococcosis, Histoplasmosis, Coccidiomycoses/ Aspergillosis / Candida |
|
Amphotericin B: Adverse Effects
|
1. Almost all get Sx
2. Headache, chills, fever, malaise, muscle/joint pain (avoid by premedicating 30min before ie, with Aspirin or Benadryl) 3. Sever thrombophlebitis!!! (Best given through central line) 4. Nephrotoxicity 5. Anemia |
|
Amphotericin B: Dosage
|
1. Start with IV test dose to see if pt tolerates w/o allergic reaction
2. Infused very slowly (4-6 hrs) 3. Long treatment 4. Dilute w/ D5W (NOT SALINE) and only use infusion pump to safely deliver. |
|
Amphotericin B: Nursing Implications
|
1. Light sensitive drug; must be covered w/ light (ie foil)
2. Watch closely for side effects and toxicity. Take temp 3. Watch serum blood levels (RBC) for anemia as well as KIDNEY tests 4. Check K+ level - may need supplemental K+ |
|
Antivirals: Prototype
|
Acyclovir
|
|
Acyclovir: Action
|
1. Prevents replication of viral DNA (preferentially taken up by herpes virus cells)
2. Not a cure; simply a treatment |
|
Acyclovir: Therapeutic Uses
|
1. Primarily against Herpes Simplex Viruses 1 8 2 & Herpes Zoster (Shingles); also, Flu, West Nile Virus, SARS, Pertussis
2. Topical, parenteral, oral forms (oral is absorbed poorly/slowly) -Immunocompromised (ie AIDS pts) usually use IV |
|
Acyclovir: Adverse Effects
|
Few
|
|
Acyclovir: Nursing Implications
|
Use topically with gloves so don't spread. Teach pt that it is a treatment, not a cure: episodes may reoccur. Most antivirals are expensive.
|
|
Other antivirals?
|
Virazole or Ribaviran for Respiratory Syncytial Virus (RSV) in new babies
|
|
Anti-Helminthic Drugs: Therapeutic Uses
|
Worms (helminths); ie pinworms; ⅓ of world population is infected - often if poor sanitation & may show no clinical symptoms.
|
|
Anti-Helminthic Drugs: Nursing Implications
|
1. Worms easily spread through family, so all may need treatment
2. Sanitation Teaching - Meticulous handwashing, esp after disposal of feces and urine, and before and after eating - Change bed linens, night clothes, and towels daily - Keep fingernails short - Toilet disinfection |
|
Anti-Malarial Drugs: Prototype
|
Chlorquine.
Another is Quinine, used for leg cramps |
|
Chloroquine: Action
|
Inhibit DNA enzymes essential to protein synthesis by parasite cells
|
|
Chloroquine: Therapeutic Uses
|
1. Kill Plasmodium organisms (parasite that cause malaria)
2. Should start Rx 1-2 weeks prior to going to endemic area and continue for 6-8 weeks after leaving. |
|
Chloroquine: Contraindications
|
Allergy - rule this out first. Might require reduced dosages
|
|
Chloroquine: Adverse Effects
|
1. GI Upset - nausea, stomach pain, anorexia, vomiting
2. Retinopathy (vision disturbance) 3. May bleach scalp and body hair after several mos. of use 4. May exacerbate psoriasis |
|
Chloroquine: Nursing Implications
|
OVERDOSE can cause death; common with children
If this occurs, induce vomiting |
|
Anti-Amebicide: Prototypes
|
Metroniazole (Flagyl) & Pentamidine.
|
|
Metroniazole: Generic Name
|
Flagyl
|
|
Metroniazole: Action
|
Interferes with microbial DNA synthesis
|
|
Metroniazole: Therapeutic Uses
|
Rx for Trichomonas (STD) or Giardiasis (intestinal parasite) effective for Gm (-) & anaerobes. Often used with aminoglycosides to treat mixed aero and anaerobic organisms (bowel surgeries) DOSAGE/ROUTE: 60-80% absorbed from GI tract; PO or IV
|
|
Metroniazole: Interactions
|
1. Alcohol - avoid!!
2. Phenobarb (sedative) 3. Anticoagulants 4. Cimetidine (anti-ulcer med) Check before giving together. |
|
Metroniazole: Adverse Effects
|
Nausea, overgrowth of other super-infections (Candida or thrush); may get dizzy, metallic taste in mouth
|
|
Metroniazole: Nursing Implications
|
1. Pt may want to suck on hard candy if metallic taste
2. Patient teaching: how to watch for superinfection, don’t stop or interrupt schedule without asking Dr 3. Warn pt not to drink alcohol - including in Elixirs and OTC meds! |
|
Pentamidine: Action
|
Inhibits protein and nucleic acid synthesis
|
|
Pentamidine: Therapeutic Uses
|
Treat various protozoal infections; or Pneumocystis Carinii (AIDS patients at risk)
|
|
Pentamidine: Routes
|
IM, IV, or nebulized (fine particle dispersion inhaled)
|
|
Pentamidine: Adverse Effects
|
May lower BP and cause nephrotoxicity
|
|
Pentamidine: Nursing Implications
|
1. Avoid nebulized exposure if pregnant
2. If IM route: change site daily to avoid abscesses |
|
Tuberculosis
|
Bacterial infection caused by Mycobacterium tuberculosis. Infection occurs primarily in lungs, but can also be in brain, abdomen (peritoneum) or GU tract.
Long treatment, often multiple drugs. = The organism has poor blood supply and encapsulates; rapidly becomes resistant to ABX |
|
Tuberculosis Symptoms
|
Coughing bloody sputum, night sweats, persistent cough, anorexia
|
|
INH (Isoniazid): Action
|
Bactericidal that kills the mycobacteria by disrupting cell wall synthesis
|
|
INH (Isoniazid): Therapeutic Uses
|
1. Treatment of active TB (most widely used drug) w/ other antituberculars
2. Prophylaxis as single drug (ie for family members) 3. Well absorbed in GI tract |
|
INH (Isoniazid): Contraindications
|
1. Acute liver disease
2. Genetic factors may affect absorption |
|
INH (Isoniazid): Adverse Effects
|
Peripheral neuropathy / neuritis (numb feet) lead to clumsiness, pain in hands and feet; liver toxicity; GI irritation
|
|
Rifampin: Action
|
Broad-spectrum bactericidal drug - inhibits protein synthesis
|
|
Rifampin: Therapeutic Uses
|
Prevention of TB, or for Methicillin resistant Staph Aureus (Staph A)
|
|
Rifampin: Contraindications
|
Renal dysfunction
|
|
Rifampin: Adverse Effects
|
1. Headache, drowsiness, visual disturbances, fever
2. Red/orange color to sweat, tears, urine (not harmful and not a reason to stop the drug) |
|
Rifampin: Nursing Implications
|
Many drug interactions - check! This includes birth control pills
Discolors contact lenses- do not wear |
|
Pyrazinamide: Therapeutic Uses
|
To treat the peripheral neuropathies (ie, feet go numb) associated with INH therapy. Used with at least one other TB drug.
|
|
Pyrazinamide: Adverse Effects
|
Hepatotoxicity (dose related)
--> Elevated uric acid, so pts may get GOUT attacks |