Ch. 32 - Antituberculars, Antifungals, Peptides, Metronidazole Flashcards Preview

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Flashcards in Ch. 32 - Antituberculars, Antifungals, Peptides, Metronidazole Deck (34)
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1
Q

Tuberculosis (TB) (1):

A

(Mycobacterium tuberculosis)

1.) Thrives in organs with good O2 supply

  1. ) Dormant stage: 
    - Resistance to immune defenses & drugs
2
Q

Tuberculosis (TB) (2):

A
  1. ) May become active at any time

4. ) Slow growing dug therapy for prolonged periods

3
Q

Drug Therapy:

A
  • Prophylactic therapy

- Treat active infection

4
Q

Prophylactic Tx: (1):

A
  1. ) Close contact with clients with active TB

2. ) Positive HIV test & positive TB skin test

5
Q

Prophylactic Tx: (2):

A

Isoniazid (INH) = drug of choice (Tuberculocidal effect)

6
Q

Active Infection – Tx (1):

A

Multiple - drug therapy recommended (2-3 drugs)

-D/t chance of developing resistance to anti-tubercular drugs

7
Q

Active Infection – Tx (2):

A

First - line drugs (1st choice)

Second - line drugs (2nd choice)

8
Q

First - line Drugs (1):

A
  • More effective

- Less toxic

9
Q

First – line Drugs (2):

A

Combination:

  • isoniazid (INH)
  • Rifampin

INH & Rifampin = classic

10
Q

Second- line drugs:

A
  • Not as effective as 1st – line drugs

- May be combined w/ 1st- line drugs

11
Q

Side effects/Adverse reactions (1):

A

Isoniazid (INH):

  1. ) Skin rashes, hepatotoxicity
  2. ) Peripheral neuropathy
12
Q

Peripheral Neuropathy:

A

-d/t deficiency of pyridoxine (Vit B6)

  • S/S:
    • Numbness, tingling extremties

Pyridoxine supplements

13
Q

Side effects/Adverse reactions (2):

A

Rifampin:

  1. ) Body secretions may turn orange
  2. ) May permanently discolor soft contant lenses
  3. ) Hepatotoxicity
14
Q

Contraindications:

A

Severe hepatic disease

15
Q

Nursing Interventions (1):

A

isoniazid (INH) = 1 hr before or 2 hrs after meals:
-Food decreases absorption rate

  • Give pyridoxine with isoniazid (INH)
    • To prevent peripheral neuropathy
16
Q

Nursing Interventions (2):

A
  • Monitor serum level enzymes

- Compliance

17
Q

Client Teaching (1):

A
  1. ) Take on empty stomach
  2. )No antacids = decrease drug absorption
  3. ) Avoid alcohol
  4. ) Avoid direct sunlight
  5. ) Body fluids may turn orange
18
Q

Client Teaching (2):

A

Report:

-Numbness, tingling, of hands and feet

19
Q

Antifungal Drugs (1):

A

Infection caused by fungus:
-Mycosis

Superficial
Systemic

20
Q

Antifungal Drugs (2):

A

Superficial infection:
-Integumentary system

Systemic:
-Lungs, CNS, abdomen

21
Q

Antifungal Drugs (3):

A

More difficult to tx than bacterial infections:
-Cell structure similar to human cells

Fungistatic or fungicidal

22
Q

Classifications:

A
Polyenes
Azoles
Antimetabolites
Echinocandins
Antiprotozoals
23
Q

Polyenes:

A

Amphotericin B – to treat:

  • Severe systemic fungal infection
  • Not absorbed in GI tract
  • IV
24
Q

Amphotericin B: Side effects;

A
  1. ) Flushing
  2. ) fever, chills
  3. ) n/v
  4. ) Hypotension
25
Q

Amphotericin B (1):

A

HIGHLY TOXIC! =

  • Nephrotoxicity
  • Electrolyte imbalance
26
Q

Amphotericin B (2):

A

Monitor:

  • Urinary output
  • Kidney functioning
27
Q

nystatin (Mycostatin):

A

Tx: candidal infection

Topical:
-Creams, ointment, vaginal supp

Oral suspension: 

  • Candidal infection of mouth (thrush) – in babies/newborns
    • Common form
28
Q

Azoles:

A

Tx: systemic & local infections:
-fluconazole (Diflucan)

Tx: systemic & vaginal candidiasis

PO/IV/Vaginal

29
Q

fluconazole (Diflucan):

A

SE:

  1. ) Po: anorexia, n/v, diarrhea, rash
  2. ) Vaginal: rash, burning
30
Q

Azoles cont….

A
  1. ) miconazole
  2. ) ketoconazole (Nizoral)
    • Topical or systemic
    • Take with food
    • Avoid antacids
31
Q

metronidazole (Flagyl) (1):

A

Tx: protozol infection
*Disorders assoc w/ GI tract

i.e. Helicobacter pylori = peptic ulcers

32
Q

metronidazole (Flagyl) (2):

A

Tx:

  1. ) Protozoal infections
  2. ) Intestinal amebiasis
  3. ) Inflammatory bowel disease
  4. ) Trichomoniasis
  5. ) Bacterial vaginosis
33
Q

Side Effects:

A
  1. ) Dizziness, HA
  2. ) Dark or reddish/brown urine
  3. ) Dry mouth, metallic/bitter taste
  4. ) GI distress
34
Q

Teach Client:

A

Avoid alcohol & meds containing alcohol = drug interaction