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343 Pharm Exam 3 > Chapter 30 : Antituberculars, Antifungals, And Antivirals > Flashcards

Chapter 30 : Antituberculars, Antifungals, And Antivirals Flashcards

(84 cards)

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1
Q

What’s the bacteria that causes tuberculosis?

A

Mycobacterium tuberculosis

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2
Q

How is TB spread?

A

Person to person via droplets

Airborne

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3
Q

What an example of droplets?

A

Coughing
Sneezing
Talking

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4
Q

Who are at risk of getting TB?(4)

A

Immunocompromised
Living/working in high risk residential
Injecting illegal drugs
Health care works with these pts

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5
Q

What are common side effects of tuberculosis? (3)

A

Cough
Fever
Night sweats !!
Gi distress
Weight loss!!
Positive acid fast bacilli in the sputum or blood sputum !!

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6
Q

Notes
Tuberculosis
Prophylaxis recommended for those
- close contact with active TB
- HIV positive/ immunosuppressive
- conversion from negative to pos
- latent TB infection
- injection drug users
- recent immigrants

A
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7
Q

Are you gonna get TB when someone behind you coughs at the grocery school?

A

No

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8
Q

Are you gonna get TB when you live with someone who has TB?

A

Yes

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9
Q

What is latent TB?

A

When you’ve been exposed to TB and it’s in your body
But you’re not sick
But you have zero symptoms
You can’t spread it

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10
Q

Can you spread latent TB?

A

No

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11
Q

So let’s say you have latent TB, however you become sick, weak, immunocompromised, what happens?

A

You’re more likely to develop active TB

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12
Q

What percentage are you at when you have latent TB to develop active TB?

A

10%

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13
Q

What do we as nurses do to help latent tb patients?

This helps how?

A

Treat them for TB
Destroying that myobacterium in their lung

To avoid active TB

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14
Q

With latent TB, how is the skin test ?

A

You are negative for years and then suddenly you get positive

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15
Q

Overall latent TB
Are you sick?
are you contagious?

A

Nope!

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16
Q

What’s the vaccine for TB?

A

BCG vaccine

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17
Q

Is latent TB easy to treat?
And how long?

A

Yes
3 months

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18
Q

What is active TB?(4)

A

Positive skin & blood test
Symptoms
X-ray
Contagious

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19
Q

What’s the biggest problem with treating TB is what? (3)

A

Drug resistant
Drug toxicity
Patient no adherence

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20
Q

Since TB is a highly drug resistance bacteria, how do we treat active TB? (3)

A

Take multiple medications
For at least 9 months
Multiple times a day

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21
Q

Notes
Effectiveness depends on
- types of infections
- adequate dosing
- sufficient duration of treatment
- adherence to drug regimen
- selection of an effective drug combination

A
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22
Q

TB medications are so strict to the point that people are paid to go to houses to what?

A

Watch them take it
To avoid resistance !!

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23
Q

What’s the first thing to do when someone has TB? Like labs or tests wise?

A

Cultures

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24
Q

Usually what other tests can we use to see TB?

A

Skin test
X ray test
Blood test

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25
If we suspect a patient who has TB what do we do?
Immediately start on antitubercular drugs and isolation
26
Problems with successful therapy occur because of patient ??
Nonadherencd to drug therapy
27
What are the 4 first line antitubercular drugs ?
Isoniazid Rifampin Purazinamide Ethambutol
28
When taking antitubercular drugs, we usually have to do what?
Combine multiple of these medications because of how bad resistance is with TB
29
What is the initial phase of medication of TB? How long and how many drugs?
2 months 4 drugs
30
What is the continuation phase for TB drugs? How long and how many drugs?
4-7 months 2 drugs
31
How long does it take for a culture for TB to come back?
2 months
32
When the culture hasn’t come back how many drugs will they be on? Then after it comes back?
4 drugs 2 drugs
33
What is the biggest thing of all TB drugs? Causes?
Hepatotoxicity!!
34
When a patient has TB drug and since it causes hepatotoxicty ( liver problem ), what do we do?
Monitor LFTS Before and monitor
35
What is isoniazid (INH) Route : (2)
Oral & IM
36
How do you take isoniazid ? Empty or full stomach? And when?
Empty Before 1 hour 2 hour after meals
37
What are side effects of isoniazid (INH)(5)
Photosensitivity Tinnitus Peripheral neuropathy Heptotoxicty Blurred vision
38
How do we treat peripheral neuropathy in the TB drug INH? How does this aid ?
Vitamin B6 ( pyridoxine ) Stops those parathesia feeling
39
Usually we don’t wait for patients to have that numbness in tingling instead we?
Tell them to take vitamin b6 !
40
What does ethambutol do?
Damage eyes!! Blurred or changed vision
41
Normally when a patient who just got TB and is not taking ethambutol and INH, we usually do what?
Do a visual exam ( baseline ) Since it causes changes in vision!
42
What is rifampin so different?? (2)
Everything comes out orange Fluids orange Sweat, semen, salvia Decrease birth control
43
Again, every TB medication has what?
Hepatotoxicity!!!
44
How do we know that a patient is having liver problems?
Jaundice!!! Yellow everything
45
What are the big nursing considerations regarding TB? (6)
Assess liver functions ( monitor LFTS!) Take orderly INH & ethambutol = eye exams No alcohol! Rifampin = orange everything Pyridoxine = INH & amingoclysides = treatment of neurotoxicity
46
Special populations Pregnancy - latent TB 9 months HIV - latent TB - aggressive treatment Pediatrics - latent TB 9 months
47
Now onto antifungal medications !!
48
Normally fungal infections are local, which means? Examples ?
Like on the skin, mucous membranes, nails, hair Thrush, yeast infection
49
However if a patient has a system. Infection it’s more likely they have? Examples?
Immunosuppression Fungal lung infection or fungal meningitis
50
What’s more severe local or systemic ?
Systemic
51
What are the fungal drugs we are gonna talk about? (2)
Polyenes Azoles
52
Polyenes, what’s the medication we need to know for this group of antifungal ?
Amphotericin B
53
When do we normally give amphotericin B?
Usually never unless it’s like nothing else works Last resort type of med
54
What are the 3 big side effects of amphotericin B ( Polyenes )?
Thrombophlebitis Nephrotoxicity Hypokalemia
55
Since Polyenes, amphotericin B causes thrmobophlebitis, what is the nurse going to do?
We are gonna assess the IV site for any inflammation/redness Try to avoid small vein, use big one
56
What is another drug that causes hypokalemia?? So what we need to monitor ? Side effects Palpitations Heart skipping a beat We check potassium
Digoxin Telemetry
57
Amphotericin B Usually we give an infusion but they can experience flushing fever and chills However we can prevent this but giving 1-3 hours before this infusion what 3 drugs?
Tylenol Benadryl corticosteroid
58
Is Amphotericin B highly protein bound? If we give this to another highly protein bound what happens??
Yes! Toxic!!
59
How long is the half life for Amphotericin B? If they had an allergy reaction, how long will it take to get rid of it?
15 days 15 days!!!
60
Amphotericin B causes bone marrow suppression, so we need to monitor what as well?
CBC
61
How do you give azoles?
Oral, IV, vaginal or topical
62
What treatment come from using azoles?
Athletes foot Yeast infections Thrush
63
What does oral antifungal medications interact with this? (3)
Warfarin Digoxin Statins
64
What are some side effects of azoles? (2)
Hepatotoxicity Nephrotoxicity
65
What’s the biggest drug interaction with azoles? And what does it cause?
Fluconazole Increase PT with warfarin Hypoglycemia with sulfa drugs
66
We usually use oral azole medications are first given since it’s less toxic than what?
Amphotericin B
67
What is the super fetal drug that induced what for azoles?
Ketoconazole Hepatitis
68
Azoles can affect diabetics how?
Glycemic levels
69
Do we give azoles to pregnant woman?
No Cause menstrual abnormalities
70
Overall we want to avoid what with antifungal since it causes Hepatotoxicity?
Alcohol!!
71
Now onto viruses!
72
Does antibacterials kill viruses?
Nope!
73
What are examples of virus ?
Hepatitis Herpes HIV Flu RSV COVID
74
What are some examples of influenza medications? (2)
Tamiflu and relenza
75
What does the antiviral tamiflu and relenza do to the body?
Decrease the viral spread It doesn’t go away Just shortens your symptoms !! Shorten the infection Or prevent the infection
76
What are the big side effects of tamiflu and relenza ! (2)
Abnormal behavior !!!!!! Nausea and vomiting Dizziness & headache
77
When is influenza antiviral medications most effective?
48 hours of onset of illness
78
What’s the common herpes antiviral medication?
Acyclovir ( Zovirax )
79
What’s the biggest 4 side effects of herpes antivirals?
Leukopenia Thrombocytopenia Low hemoglobin Hematocrit
80
Do we do a culture of herpes? Why?
Yes Before we give medication cause it’s gonna help aid symptoms
81
Patients who take herpes medication for like 5 days do we need CBC ? What about 5 months?
No Yes
82
What’s the biggest thing to know about cytomegalovirus ?(2)
Bone marrow suppression and toxicity !!
83
Noyes Flu medications Take medications 48 before, since it’s too much virus in the body So you need to take it early Not candidates for the medications !!
84
Hepatitis antivirals What do you need do know ? (2)
Hepatotoxity & bone marrow suppression !!!

343 Pharm Exam 3 (6 decks)

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