Antimalarial, Antiprotozoal, and Antihelmintic Drugs Flashcards Preview

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Flashcards in Antimalarial, Antiprotozoal, and Antihelmintic Drugs Deck (30):
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Chloroquine
(Functional Classification)

Antimalarial

1

Chloroquine
(Chemical Classification)

Synthetic 4-amino-quinoline derivative

2

Chloroquine
(Mechanism of Action)

Inhibits parasite replication, transcription of DNA to RNA by forming complexes with DNA of parasite

3

Chloroquine
(Uses)

Malaria of Plasmodium vivax, P. malariae, P. ovale, P. falciparum (some strains) amebiasis

4

Chloroquine
(Contraindications)

Hypersensitivity, retinal field changes

5

Chloroquine
(Side Effects)

CNS: headache, stimulation, fatigue, SEIZURES, psychosis, hallucinations, insomnia
CV: hypotension, HEART BLOCK, ASYSTOLE WITH SYNCOPE, ECG changes, cardiomyopathy
EENT: Blurred Vision, Corneal Changes, Retinal Changes, Difficulty Focusing, tinnitus, vertigo, deafness, photophobia, corneal edema
GI: Nausea, Vomiting, Anorexia, diarrhea, cramps
HEMA: THROMBOCYTOPENIA, AGRANULOCYTOSIS, HEMOLYTIC ANEMIA, LEUKOPENIA
INTEG: pruritus, pigmentary changes, skin eruptions, lichen-planus-like eruptions, eczema, EXFOLIATIVE DERMATITIS

6

Chloroquine
(Nursing Considerations)

ASSESS:
-INFECTION: resistance is common, not to be used for P. falciparum acquired in areas of resistance or where prophylaxis has failed
-Ophthalmic test if long-term treatment or dosage of >150mg/day
-Blood studies: CBC, since blood dyscrasias occur
-ECG during therapy; watch for depression of T waves, widening of QRS complex
-ALLERGIC REACTIONS: pruritus, rash, urticaria
-BLOOD DYSCRASIAS: malaise, fever, bruising, bleeding (rare)
-FOR OTOTOXICITY (tinnitus, vertigo, change in hearing); audiometric testing should be done before, after treatment
-FOR TOXICITY: blurred vision; difficulty focusing; headache; dizziness; decreased knee, ankle reflexes; seizures, CV collapse; product should be discontinued immediately and IV fluids given

7

Chloroquine
(Overdose Treatment)

Administer barbiturate (ultrashort-acting), vasopressor; tracheostomy may be necessary

8

Hydroxychloroquine (Plaquenil)
(Functional Classification)

Antimalarial, antirheumatic (DMARDS)

9

Hydroxychloroquine (Plaquenil)
(Chemical Classification)

4-Aminoquinoline derivative

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Hydroxychloroquine (Plaquenil)
(Mechanism of Action)

Impairs, complement-dependent antigen-antibody reactions

11

Hydroxychloroquine (Plaquenil)
(Uses)

Malaria caused by susceptible strains of Plasmodium vivax, P. malariae, P. ovale, P. falciparum (some strains); SLE, rheumatoid arthritis

12

Hydroxychoroquine (Plaquenil)
(Contraindications)

Hypersensitivity to the product or chloroquine; retinal field damage

13

Hydroxychloroquine (Plaquenil)
(Side Effects)

CNS: headache, stimulation, fatigue, irritability, SEIZURES, bad dreams, dizziness, confusion, psychosis, decreased reflexes
CV: hypotension, heart block, ASYSTOLE WITH SYNCOPE
EENT: Blurred Vision, Corneal Changes, Retinal Changes, Difficulty Focusing, tinnitus, vertigo, deafness, photophobia, corneal edema
GI: Nausea, Vomiting, Anorexia, diarrhea, cramps
HEMA: THROMBOCYTOPENIA, AGRANULOCYTOSIS, LEUKOPENIA, APLASTIC ANEMIA
INTEG: pruritus, pigmentation changes, skin eruptions, lichen-planus -like eruptions, eczema, EXFOLIATIVE DERMATITIS, alopecia, STEVENS-JOHNSON SYNDROME, photosensitivity

14

Hydroxychloroquine (Plaquenil)
(Nursing Considerations)

ASSESS:
-SLE, MALARIA SYMPTOMS: before treatment and daily
-RHEUMATOID ARTHRITIS: pain, swelling, ROM, temp of joints
-Ophthalmic exam at baseline and q6mo if long-term treatment or product dosage >150mg/day
-Hepatic studies q wk: AST, ALT, bilirubin if patient receiving long-term treatment
-BLOOD DYSCRASIAS: blood studies: CBC, platelets; WBC, RBC, platelets may be decreased; if severe product should be discontinued; assess for malaise, fever, bruising, bleeding (rare)
-For decreased reflexes: knee, ankle
-ECG during therapy: watch for depression of T waves, widening QRS complex
-ALLERGIC REACTIONS: pruritus, rash, urticaria
-FOR OTOTOXICITY (tinnitus, vertigo, change in hearing); audiometric testing should be done before, after treatment
-FOR TOXICITY: blurred vision, difficulty focusing, headache, dizziness, knee, ankle reflexes; product should be discontinued immediately

15

Hydroxychloroquine (Plaquenil)
(Overdose Treatment)

Induce vomiting; gastric lavage; administer barbiturate (ultrashort acting), vasopressor, ammonium chloride; tracheostomy may be necessary

16

Metronidazole (Flagyl)
(Functional Classification)

Antiinfective-miscellaneous

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Metronidazole (Flagyl)
(Chemical Classification)

Nitroimidazole derivative

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Metronidazole (Flagyl)
(Mechanism of Action)

Direct-acting amebicide/trichomonacide binds and disrupts DNA structure, thereby inhibiting bacterial nucleic acid synthesis

19

Metronidazole (Flagyl)
(Uses)

Intestinal amebiasis, amebic abscess, trichomoniasis, refractory trichomoniasis, bacterial anaerobic infections, giardiasis, septicemia, endocarditis; bone joint, lower respiratory tract infections; rosacea

20

Metronidazole (Flagyl)
(Contraindications)

Pregnancy 1st trimester, breastfeeding, hypersensitivity to this product

21

Metronidazole (Flagyl)
(Side Effect)

CNS: Headache, Dizziness, confusion, irritability, restlessness, ataxia, depression, fatigue, drowsiness, insomnia, paresthesia, peripheral neuropathy, SEIZURES, incoordination, depression, encephalopathy, ASEPTIC MENINGITIS
CV: flattening of T waves
EENT: blurred vision, sore throat, retinal edema, dry mouth, metallic taste, furry tongue, glossitis, stomatitis, photophobia, optic neuritis
GI: Nausea, Vomiting, Diarrhea, epigastric distress, Anorexia, constipation, Abdominal Cramps, PSEUODMEMBRANOUS COLITIS
GU: darkened urine, vaginal dryness, polyuria, ALBUMINURIA, dysuria, cystitis, decreased libido, NEPHROTOXICITY, incontinence, dyspareunia, candidiasis
HEMA: LEUKOPENIA, BONE MARROW, DEPRESSION, APLASIA, THROMBOCYTOPENIA
INTEG: rash, pruritus, urticaria, flushing, STEVENS-JOHNSON SYNDROME

22

Metronidazole (Flagyl)
(Nursing Considerations)

ASSESS:
-INFECTION: WBC, wound symptoms, fever, skin or vaginal secretions; start treatment after C&S; for opportunistic fungal infections; superinfection: fever, monilial growth, fatigue, malaise
-Stools during entire treatment: should be clear at end of therapy; stools should be free of parasites for 1yr before patient considered cured (amebiasis)
-Vision by ophthalmic exam during, after therapy; vision problems often occur
-NEUROTOXICITY: peripheral neuropathy, seizures, dizziness, uncoordination, pruritus, joint pain; product may be discontinued
-ALLERGIC REACTION: fever, rash, itching, chills; product should be discontinued if these occur
-Renal, reproductive dysfunction: dysuria, polyuria, impotence, dyspareunia, decreased libido, I&O; weight daily
-SECONDARY MALIGNANCY: used only when indicated; avoid unnecessary use

23

Primaquine
(Functional Classification)

antimalarial

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Primaquine
(Chemical Classification)

Synthetic 8-aminoquinolone

25

Primaquine
(Mechanism of Action)

Unknown; thought to destroy exoerythrocytic forms by gametocidal action

26

Primaquine
(Uses)

Malaria caused by Plasmodium vivax; in combination with clindamycin for Pneumocystis jiroveci pneumonia

27

Primaquine
(Contraindications)

Lupus erthematosus, rheumatoid arthritis; hypersensitivity to this product or idoquinol

28

Primaquine
(Side Effects)

CNS: headache, dizziness
CV: hypertension, dysrhythmias
EENT: Blurred Vision, Difficulty Focusing
GI: Nausea, Vomiting, Anorexia, cramps
HEMA: AGRANULOCYTOSIS, GRANULOCYTOPENIA, LEUKOPENIA, HEMOLYTIC ANEMIA, LEUKOCYTOSIS, mild anemia, METHEMOGLOBINEMIA
INTEG: pruritus, skin eruptions, pallor, weakness

29

Primaquine
(Nursing Considerations)

ASSESS:
-Ophthalmic test if patient receiving long-term treatment or product dosage of >/= 150mg/day
-Hepatic studies weekly: AST, ALT, bilirubin if patient receiving long-term therapy
-Blood studies: CBC; blood dyscrasias occur
-Allergic reactions: pruritus, rash, urticaria
-Blood dyscrasias: malaise, fever, bruising, bleeding (rare)
-Renal status: dark urine, hematuria, decreased output
-HEMOLYTIC REACTION: chills, fever, chest pain, cyanosis; product should be discontinued immediately