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Flashcards in AntiFungal Drugs Deck (14):
0

Amphotericin B
(Functional Classification)

Antifungal

1

Amphotericin B
(Chemical Classification)

Amphoteric polyene

2

Amphotericin B
(Mechanism of Action)

Increases cell membrane permeability in susceptible fungi by binding sterols; alters cell membrane, thereby causing leakage of cell components, cell death

3

Amphotericin B
(Uses)

Histoplasmosis, blastomycosis, aspergillosis, coccidioidmycosis, cryptococcosis, aspergillosis, zygomycosis, candidiasis, sporotrichosis, cryptococcal meningitis; mucomycosis caused by mucormycosis, Rhizopus, Absidia, Entomorphthora, Basidiobolus

4

Amphotericin B
(Contraindications)

Hypersensitivity, severe bone marrow depression

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Amphotericin B
(Side Effects)

CNS: Headache, Fever, Chills, peripheral nerve pain, paresthesias, peripheral neuropathy, SEIZURES, dizziness
CV: bradycardia, hypotension, CARDIAC ARREST
EENT: tinnitus, deafness, diplopia, blurred vision
GI: Nausea, Vomiting, Anorexia, diarrhea, cramps, HEMORRHAGIC GASTROENTERITIS, ACUTE LIVER FAILURE
GU: Hypokalemia, azotemia, hyposthenuria, RENAL TUBULAR ACIDOSIS, nephrocalcinosis, PERMANENT RENAL IMPAIRMENT, ANURIA, OLIGURIA
HEMA: normochromic, normocytic anemia, THROMBOCYTOPENIA, AGRANULOCYTOSIS, LEUKOPENIA, EOSINOPHILIA, hypokalemia, hyponatremia, hypomagnesemia
INTEG: Burning, Irritation, pain, necrosis at inj site with extravasation, flushing, dermatitis, skin rash (topical route)
MS: Arthralgia, myalgia, generalized pain, weakness, weight loss
SYST: STEVENS-JOHNSON SYNDROME, TOXIC EPIDERMAL NEUROLYSIS, EXFOLIATIVE DERMATITIS, ANAPHYLAXIS

6

Amphotericin B
(Nursing Considerations)

ASSESS:
-VS q15-30min during first inf; note changes in pulse, BP
-I&O ratio; watch for decreasing urinary output, change in specific gravity; discontinue product to prevent permanent damage to renal tubules
-Blood studies: CBC, K, Na, Ca, Mg q2wk, BUN, creatinine 2-3x/wk
-Weigh weekly; if weight increases by more than 2lb/wk, edema is present; renal damage should be considered
-FOR RENAL TOXICITY: increasing BUN, serum creatinine; if BUN is >40mg/dl or if serum creatinine is >3mg/dl, product may be discontinued, dosage reduced
-FOR HEPATOTOXICITY: increasing AST, ALT, alk phos, bilirubin
-FOR ALLERGIC REACTION: DERMATITIS, RASH; PRODUCT SHOULD BE DISCONTINUED, ANTIHISTAMINES (MILD REACTION), or EPINEPHrine (SEVERE REACTIONS) ADMINISTERED
-FOR HYPOKALEMIA: anorexia, drowsiness, weakness, decreased reflexes, dizziness, increased urinary output, increased thirst, paresthesias
-FOR OTOTOXICITY: TINNITUS (RINGING, ROARING IN EARS), VERTIGO, LOSS OF HEARING (RARE)

PERFORM/PROVIDE:
-Acetaminophen and diphenhydrAMINE 30 min before inf to reduce fever, chills, headache

7

Fluconazole
(Functional Classification)

Antifungal, systemic; azole

8

Fluconazole
(Chemical Classification)

Triazole

9

Fluconazole
(Mechanism of Action)

Inhibits ergosterol biosynthesis, causes direct damage to fungal membrane phospholipids

10

Fluconazole
(Uses)

Oropharyngeal candidiasis, chronic mucocutaneous candidiasis; systemic, vaginal, urinary candidiasis; cryptococcal meningitis; prevention of candidiasis in bone marrow transplant in those who receive chemotherapy and/or radiation therapy; cystitis, fungal prophylaxis, peritonitis, pneumonia, pyelonephritis

11

Fluconazole
(Contraindications)

Hypersensitivity to this product or azoles, pregnancy (D)

12

Fluconazole
(Side Effects)

CNS: headache, SEIZURES
CV: QT PROLONGATION, TORSADES DE POINTES
GI: nausea, vomiting, diarrhea, cramping, flatus, increased AST, ALT, HEPATOTOXICITY
HEMA: AGRANULOCYTOSIS, EOSINOPHILIA, LEUKOPENIA, NEUTROPENIA, THROMBOCYTOPENIA
INTEG: STEVENS-JOHNSON SYNDROME, ANGIOEDEMA, ANAPHYLAXIS, EXFOLIATIVE DERMATITIS, TOXIC EPIDERMAL NECROLYSIS

13

Fluconazole
(Nursing Considerations)

ASSESS:
-INFECTION: clearing of CSF and other culture during treatment, obtain C&S baseline and throughout treatment, product may be started as soon as culture is taken
-HEPATOTOXICITY: increasing AST, ALT, periodically alk phos, bilirubin; for renal status: BUN, creatinine