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Why are fungal infections not typically transferred from person to person?
Because fungi is slow growing
What is the largest class of antifungal drugs that inhibits ergosterol biosynthesis, which causes the fungal plasma membrane to leak?
What is the drug of choice for systemic or invasive fungal diseases and is usually given IV?
What are the nursing considerations with Amphotericin B?
Infuse slowly to avoid cardiovascular collapse, monitor renal function (I/O), monitor for hypokalemia and dysrhythmias
What drugs are contraindicated while taking Amphotericin B because they contribute to a decrease renal function?
Aminoglycosides, vancomycin, and corboplatin
Which azoles are commonly used for both systemic and superficial infections?
Fluconazole (Diflucan), Itraconazole (Sporanox), or Ketoconazole (Nizoral)
What is the main administration concern when administering Fluconazole (Diflucan) IV?
Do not mix with other drugs***
Fluconazole (Diflucan) has drug to drug interactions with what drugs?
Warfarin (increases chances of bleeding) and sulfonylureas
When Nystatin (Mycostatin) is administered orally, what are the nursing considerations?
Instruct patient to swish and swallow or swish and spit. No food or drink for 30 minutes after administration so it can absorb in the mouth and GI tract
When Nystatin (Mycostatin) is administered topically, what are the nursing considerations?
Don't cover with occlusive dressing
When Nystatin (Mycostatin) is administered vaginally, what are the nursing considerations?
Pt should remain in recumbent position for at least 15-30 minutes after administration.
What medication is indicated for mycoses of the hair, skin, and nails that are unresponsive to topical agents?
What instructions should be given to the patient taking Fulvicin (Griseofulvin)?
Take with or after meals, high fat meals increase absorption, drug may alter taste, txt may take weeks or months. Should have an alternative form of bc besides oral contraceptives.
What are the two types of Protozoal infections?
Malaria and Non-malarial - Giardia, tichomonas vaginalis
Malaria travels to the _____ where it multiplies and transforms into progeny called _______?
The merozoites (Malaria) infect the _______ and cause what types of signs and symptoms?
RBC; fever and chills
What is the prototype drug for Malaria and is used as both prophylactic and in acute attacks?
When and how should Chloroquine (Aralen) be administered?
Immediately before or after meals to decrease GI upset; If given IM give in large muscle
Chloroquine (Aralen) is not contraindicated in which patients?
Patients with G6PD deficiency and alcoholics since it is hepatotoxic
What are the nursing interventions for patients taking Chloroquine (Aralen)?
Monitor for vision changes (retinopathy), muscle weakness and decreased DTRs, may cause rusty discoloration of urine.
What are the nursing considerations when administering Metronidazole (Flagyl)?
ER tabs must be taken whole, Give 1 hour or 2 hours after meals, if given IV...must be given SLOW*** (major incompatibilities).
Metronidazole (Flagyl) should not be taken with what medications or substances?
Oral anticoagulants, lithium, or alcohol
How are the common Helminthic infections classified?
roundworms (nematodes), flukes (trematodes), or tapeworms (cestodes)
Roundworms primarily infect which group of people? Why?
Children aged 3 to 8 years old, because they are most likely to be exposed to contaminated soil without proper hand washing.
What are important nursing interventions for children with pinworms?
Treat everyone in the family with one dose of Mebendazole (Vermox) at the same time.
Mebendazole (Vermox) is most effective when administered how?
When chewed and taken with fatty meals which increases absorption.
Mebendazole (Vermox) should be used cautiously in which patients?
Patients with IBD and children under 2 years
What is the preferred target of the HIV virus once it enters the body?
The CD4 receptor on T4 lymphocytes***
What is unique about the replication of the HIV virus?
HIV uses reverse transcriptase to construct DNA from RNA; all living organisms make RNA from DNA.*****
What is the best lab test to determine when drug therapy should be initiated in patients with HIV?
HIV RNA - which is an estimate of how rapidly the virus is replicating.
What is the nonnucleoside reverse transcriptase inhibitor (Antiretroviral) prototype for HIV?
Efavirenz (Sustiva) - blocks RNA and DNA activities.
What are the side effects of Efavirenz (Sustiva)?
Hepatotoxic**, Stevens-Johnson syndrome**, paresthesia, myalgia, fever, and GI distress
What prototype drug is a nucleoside reverse transcriptase inhibitor used to prevent perinatal mother to fetus transfer of HIV?
Zidovudine (Retrovir, AZT)
How and when is Zidovudine (Retrovir) given to a HIV mother and baby?
Used during pregnancy weeks 14-34, given IV during labor, and given to the infant for 6 weeks.
Frequent lab test should be performed when taking Zidovudine (Retrovir) to detect what?
What is the MOA for Zidovudine (Retrovir)?***
As the reverse transcriptase enzyme begins to synthesize viral DNA, it mistakenly uses zidovudine as one of the nucleosides, thus creating a defective DNA strand.***
What prototype drug is a protease inhibitor that prevents the cleavage of viral polyproteins (final step in HIV maturation) and is used in advanced HIV infections?
Lopinavir with Ritonavir (Kaletra)
What are the adverse effects of Lopinavir with Ritonavir (Kaletra)?
Hepatotoxic, nephrotoxic, and GI distress
Herpesvirus - 6 causes what 3 viruses?
Roseola in children and hepatitis or encephalitis in immunosuppressed patients.
What are some important nursing considerations when administering Acyclovir (Zovirax) via IV?
It may cause painful inflammation of vessels at the site of infusion and may cause nephrotoxicity.
Which antiviral drug is indicated for unvaccinated individuals during a confirmed outbreak of influenza A and is continued for 10 days?
Which antiviral drug is used for influenza A or B symptomatic patients?
Oseltamivir (Tamiflu) - for 2 days
In order for medications to reach the tuberculosis microorganisms isolated in the tubercles, therapy must continue for how long?
6 - 12 months.
In order to treat tuberculosis effectively how many antibiotics should be administered concurrently?
2 - 4 antibiotics
What are the primary first line drugs used to treat tuberculosis?
Isoniazid (INH), Rifampin (Rifadin), and Streptomycin
What are the common side effects of Insoniazid (INH)?
Parathesias to the hands and feet....overdose can be fatal
The patient taking INH should be instructed to avoid which food and drinks?
Foods taking tyramine, aged cheese, beer, red wine, and chocolate.
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