antifungal, antihelmintic, ecoparasiticide

Question 1

superficial fungal infections affect what body components?

Answer 1

skin, scalp, nails, mucus membranes

Question 2

systemic fungal infections affect what body components?

Answer 2

internal organs (lungs, brain, digestive organs)

Question 3

which is more rare and difficult to treat (superficial or systemic fungal infection)?

Answer 3

systemic

Question 4

superficial fungal infections are commonly treated with what type of application?

Answer 4

topical

Question 5

systemic fungal infections are commonly treated with what type of medication application?

Answer 5

pills or IV meds

Question 6

populations most at risk for systemic infections

Answer 6

immunocompromised, debilitated, those with transplants, cancer history or with HIV

Question 7

amphotericin B (amphoterrible) route

Answer 7

IV - central line is preferred

Question 8

3 major adverse effects of ampho B

Answer 8

• nephrotoxicity
• electrolyte imbalance (K + Mg)
• anemia

Question 9

3 labs to monitor with ampho B

Answer 9

• BUN, creatinine
• K and Mg
• CBC (H+H)

Question 10

at what creatinine level should you stop administration of ampho B?

Answer 10

> 3.5

Question 11

describe administration steps for ampho B

Answer 11

*central line*
give 500mL-1L of NS over 1 hour 
premedicate - tylenol + benadryl
change IV tubing for D5
administer ampho B over 4 hours... slooooowwwww
give 500mL - 1L NS over 1 hour
replace K or Mg

Question 12

over how many hours should ampho B be given?

Answer 12

4 hours

Question 13

when administering ampho B, if patient gets rigors, what can you give them?

Answer 13

meperidine (Demerol) or Dantrolene

Question 14

“azoles” can be given via which routes?

Answer 14

topical, oral, parenteral

Question 15

prototype for “azole”

Answer 15

itraconazole

Question 16

3 major adverse events from itraconazole

Answer 16

• GI upset
• cardio suppression
• liver injury

Question 17

based on the adverse event (liver injury) known with itraconazole, which s+s should you look for?

Answer 17

• n/v/d

- RUQ pain, jaundice, anorexia

Question 18

which product can you give with itraconazole to aid with absorption?

Answer 18

cola

“itraCOCAzole”

Question 19

re: itraconazole, how should timing be adjusted for administration?

Answer 19

1 hour before drugs that raise gastric pH (H2 blockers, zantac, prilosec)

Question 20

what is the brand name for itraconazole?

Answer 20

Sporanox

Question 21

brand name for fluconazole?

Answer 21

Diflucan

Question 22

what are the adverse effects of fluconazole?

Answer 22

• GI upset

- Stevens Johnson Syndrome

Question 23

what are the 2 organisms that cause superficial mycoses infections?

Answer 23

• candida species

- dermatophytic infections (ringworm)

Question 24

dermatophytic infections are usually confined to which areas of the body?

Answer 24

skin, hair, nails

Question 25

what are some of the applications you would see for superficial mycoses infections?

Answer 25

cream, ointment, suppository, troche, swish and spit

Question 26

re: superficial mycoses, what is a common problem/example? (3/4 of females will get at least once a lifetime)

Answer 26

yeast infection

Question 27

what are 2 examples of meds used for superficial mycoses infections?

Answer 27

clotrimazole

nystatin

Question 28

re: clotrimazole and nystatin, what are the adverse effects (2)?

Answer 28

local irritation (w/topical)
GI upset (oral)

Question 29

helminths are what?

Answer 29

parasitic worms

Question 30

most frequent site of helminth infection

Answer 30

intestine

Question 31

what is the prototype for antihelminthic drugs?

Answer 31

meBENDazole (“bending intestine”)

Question 32

what is the drug of choice for most intestinal roundworms + mixed infestations?

Answer 32

mebendazole

Question 33

what is the mechanism of action for mebendazole?

Answer 33

prevent glucose uptake by intestinal worms (sloooowww kill)

Question 34

how many days does it take for mebendazole clearance [of worms]?

Answer 34

up to 3 days

Question 35

what adverse effects may you see with mebendazole? why?

Answer 35

RARE diarrhea + abdominal pain

if they had large worm infestation

Question 36

what is infestation with lice called?

Answer 36

pediculosis

Question 37

what is infestation with mites called?

Answer 37

scabies

Question 38

what infestation is characterized by itching worse at bedtime?

Answer 38

scabies

Question 39

what is the prototype for ectoparasiticides?

Answer 39

permethrin (Nix, Elimite)

Question 40

mechanism of action for permethrin

Answer 40

paralysis of insect (doesn’t affect ova as much)

Question 41

adverse effects of permethrin

Answer 41

exacerbation of itching, erythema, edema, burning

Question 42

what is a helpful piece of information to give to clients about tx of scabies? (re: time)

Answer 42

it may take up to 2 weeks for itching to resolve