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

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

Tuberculosis (TB) (1):

(Mycobacterium tuberculosis)

1.) Thrives in organs with good O2 supply

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

2

Tuberculosis (TB) (2):

3.) May become active at any time

4.) Slow growing dug therapy for prolonged periods

3

Drug Therapy:

-Prophylactic therapy
-Treat active infection

4

Prophylactic Tx: (1):

1.) Close contact with clients with active TB

2.) Positive HIV test & positive TB skin test

5

Prophylactic Tx: (2):

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

6

Active Infection – Tx (1):

Multiple - drug therapy recommended (2-3 drugs)

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

7

Active Infection – Tx (2):

First - line drugs (1st choice)

Second - line drugs (2nd choice)

8

First - line Drugs (1):

-More effective
-Less toxic

9

First – line Drugs (2):

Combination:
-isoniazid (INH)
-Rifampin

INH & Rifampin = classic

10

Second- line drugs:

-Not as effective as 1st – line drugs

-May be combined w/ 1st- line drugs

11

Side effects/Adverse reactions (1):

Isoniazid (INH):
1.) Skin rashes, hepatotoxicity
2.) Peripheral neuropathy

12

Peripheral Neuropathy:

-d/t deficiency of pyridoxine (Vit B6)

-S/S:
*Numbness, tingling extremties

Pyridoxine supplements

13

Side effects/Adverse reactions (2):

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

14

Contraindications:

Severe hepatic disease

15

Nursing Interventions (1):

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

*Give pyridoxine with isoniazid (INH)
-To prevent peripheral neuropathy

16

Nursing Interventions (2):

-Monitor serum level enzymes
-Compliance

17

Client Teaching (1):

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

Client Teaching (2):

Report:
-Numbness, tingling, of hands and feet

19

Antifungal Drugs (1):

Infection caused by fungus:
-Mycosis

Superficial
Systemic

20

Antifungal Drugs (2):

Superficial infection:
-Integumentary system

Systemic:
-Lungs, CNS, abdomen

21

Antifungal Drugs (3):

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

Fungistatic or fungicidal

22

Classifications:

Polyenes
Azoles
Antimetabolites
Echinocandins
Antiprotozoals

23

Polyenes:

Amphotericin B – to treat:
-Severe systemic fungal infection
-Not absorbed in GI tract
-IV

24

Amphotericin B: Side effects;

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

25

Amphotericin B (1):

HIGHLY TOXIC! =
-Nephrotoxicity
-Electrolyte imbalance

26

Amphotericin B (2):

Monitor:
-Urinary output
-Kidney functioning

27

nystatin (Mycostatin):

Tx: candidal infection

Topical:
-Creams, ointment, vaginal supp

Oral suspension: 
-Candidal infection of mouth (thrush) – in babies/newborns
*Common form

28

Azoles:

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

Tx: systemic & vaginal candidiasis

PO/IV/Vaginal

29

fluconazole (Diflucan):

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

30

Azoles cont....

1.) miconazole
2.) ketoconazole (Nizoral)
-Topical or systemic
-Take with food
-Avoid antacids

31

metronidazole (Flagyl) (1):

Tx: protozol infection
*Disorders assoc w/ GI tract

i.e. Helicobacter pylori = peptic ulcers

32

metronidazole (Flagyl) (2):

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

33

Side Effects:

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

34

Teach Client:

Avoid alcohol & meds containing alcohol = drug interaction