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Pharma > Week 4 Antiviral/fungal/protozoa/elmintic > Flashcards

Week 4 Antiviral/fungal/protozoa/elmintic Flashcards

1
Q

Antiviral Drug Category Example and MOA/Indication

A

Oseltamivir

MOA: stops the shedding of the virus’s protein coat
Indication: Tx and reduction of influenza
-is only given to high risk pt, (COPD, immunocompromised)

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2
Q

Antiviral Oseltamivir
SE/AE

A

SE/AE Dizzy, insomnia, nausea and vomiting, orthostatic, hypotension and urinary retention

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3
Q

Oseltamivir Nsg implications

A

Tx needs to start within 2 days of the flu symptoms
immunocompromised children/adults may be given oseltamivir if they show symptoms

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4
Q

Herpes Antivirals
Example, MOA, Indication

A

Acyclovir (can be PO, IV, Topical)

MOA: inhibit viral DNA replication by competing with viral substrates to form shorter non-effective DNA chains.

Indication: herpes simplex AND Varicella Zoster

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5
Q

Herpes Antivirals Acyclovir SE AE

A

NEPHROTOXICITY , headache, paresthesia’s (pins and needles sensation)

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6
Q

Herpes Antiviral Acyclovir
Interactions Contraindications

A

Interactions: aminoglycosides, NEPHROTOXIC DRUGS
Contraindications:
Highly toxic in pregnancy/lactation, Renal disease (due to nephrotoxicity)

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7
Q

Herpes Antiviral acyclovir Nsg Implications pt edu

A

Topical route: apply gloves because it causes burning sensations
IV: admin slowly/over 1 hour to decrease AE, gives the body a chance to properly eliminate the acyclovir
Pt Edu:
-use as prescribed
-using barrier contraception (toxic fetal effects)
-gloves: prevent “burning” and infections (STI )
-Avoid sex while lesions are present,
-Keep area clean, soap/water 3-4x a day

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8
Q

Antivirals used for HIV/AIDS (3 examples)

A

-zidovudine AZT
-raltegravir
-enfuvirtide

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9
Q

antiviral for HIV/AIDS zidovudine MOA, Indication, Nsg, SE/AE

A

zidovudine
-reduces HIV by stopping DNA synthesis

Indication: First tx of HIV
SE/AE: headache, N/V, rash, chills, diarrhea, flu-like, BONE MARROW SUPPRESSION

Nsg: zidovudine CAN be given to preg women to stop viral infection to baby
Notify if rash develops (all)

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10
Q

Raltegravir HIV/AID antiviral
MOA/Indication

A

integrase inhibitor: raltegravir
MOA: inhibits enzymes integrase needed for viral replication
indication: first-line tx of HIV, cocktailed with 2-3 antiretroviral drugs

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11
Q

Antiviral HIV/AID enfuvirtide
MOA Indication

A

MOA: prevents FUSION of virus and human host cell
Indication: is used when HIV tx is not responding to other antiretrovirals cocktails

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12
Q

FOR ALL Antiviral HIV/AIDS

A

notify provider if rash develops
(watch for bone marrow suppression in zidovudine)

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13
Q

Hep B and prevention

A

-can be mild or result in chronic hepatitis/liver failure/death
-transmitted through blood/body fluid exposure
-transmitted to baby
-Hep B vax to prevent HBV

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14
Q

Hep B Tx and Nsg considerations

A

Tx: lamivudine, tenofovir, and telbivudine
and alfa-interferon

Nsg: LFT’s and RENAL function test, assess for jaundice and LOC or level of consciousness
LOC is impacted by bilirubin

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15
Q

Hep C

A

-leading cause of liver failure, will need a liver transplant
-transmitted by blood and sexual contact
-alcoholics may develop Hep C!

Prevention : avoid exposure
Tx: interferon, ribavirin, simeprevir, and sofosbuvir

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16
Q

Antifungals 4 examples

A

nystatin
amphotericin B
terbinafine
fluconazole

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17
Q

Nystatin antifungals
Indication SE AE

A

-suspension, lozenge (dissolve in mouth) or troche
Indication: treats candidiasis

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18
Q

What are the SE/AE of antifungals?
Interactions?

A

SE N/V is MOST common, diarrhea, dizzy, HA
AE- HEPATOXICITY, NEPHROTOXICITY,
-is teratogenic, causes peripheral neuropathy, tinnitus

Interactions: will increase the effects of anticoagulants

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19
Q

Antifungals terbinafine will treat?

A

onychomycosis

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20
Q

fluconazole antifungal can treat what?

A

yeast infections, meningitis

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21
Q

As a nurse what should you know about antifungals?

A

antifungal have hepatic and nephrotoxicity,
monitoring kidney/renal function is vital
monitor I&O, k levels
lozenge- instruct not to chew or swallow, let it dissolve
suspension- swish and swallow/sip
Diflucan 1 dose for yeast infections
amphotericin B-pretreat with antipyretic, fever reducer, Tylenol
administer antiemetics, and corticosteroids to lower infusion-related rxns.

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22
Q

Antifungals
nystatin, amphotericin, terbinafine, fluconazole evaluations, and pt edu

A

-ease infection symptoms
-improve energy
-homeostasis
pt edu
-report any odd bleeding/ bruising (indicates liver problems!)
-report yellowing of eyes or skin, (jaundice and liver function)
-preventing reinfection

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23
Q

RECAP name for antifungals and their purpose

A

nystatin-candidiasis
amphotericin B-systemic infections
terbinafine-onychomycosis
fluconazole- yeast infections, meningitis

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24
Q

Antiprotozoals
examples (2)

A

hydroxychloroquine
metronidazole

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25
Q

antiprotozoal hydroxychloroquine
MOA
Indication

A

Hydroxychloroquine works by attacking the parasite during its development

Indication: prophylactic (prevention) of malaria, systemic lupus erythematosus, and off label autoimmune disorders.

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26
Q

hydroxychloroquine antiprotozoal
SE AE
Nsg

A

SE/AE: N/V, diarrhea, anorexia, abdominal pains, VISUAL disturbances
NSG
to prevent malaria etc, the drug should be taken 1-2 weeks prior to exposure and 4-8 weeks after leaving
-take the med with 8oz water
-WILL NEED eye exams every 6-12 months

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27
Q

metronidazole
MOA
Indication

A

MOA: inhabits DNA of protozoa
Indication: trichomoniasis and giardiasis (dirty water), C-diff, H, pylori.

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28
Q

Metronidazole SE/AE
Interactions
Contraindications

A

SE/AE dizzy, metallic taste, N/V, diarrhea, peripheral neuropathy

Interactions: alcohol, anticoagulants

Contraindications: Hepatic diseases

29
Q

NSG Implications of metronidaxole

A

AVOID Alcohol ETOH
Trichomoniasis infections should have partner treated as well
avoid driving until effects are known

30
Q

Anthelmintic agents
example

A

mebendazole

31
Q

mebendazole
MOA
Indication
SE/AE

A

MOA: interferes with worms normal function
Indication: used against pinworms, round/whip/hookworms
SE/AE: abdomen hurts, headache dizzy

32
Q

mebendazole anthelmintic
contraindications
nsg implications

A

contraindicated by pregnancy, hepatic and renal disease
Nsg implications: stool culture for ova and parasites- BEFORE Tx
Assess hgb and hct (may be decreased)

Infection control
short nails
hand hygiene
AM shower
Cleanings linens
toilet disinfections

33
Q

Carbapenems

A

-penem

Imipenem

34
Q

What is carbapenems MOA and treatment for?

A

Imipenem
MOA inhibits cell membrane synthesis killing the bacteria

severe infection/bacterial pneumonia

35
Q

Carbapenems imipenem
SEAE

A

imipenem
C-diff,
Superinfections-thrush, vaginal yeast
N/V

36
Q

What is the possible interactions/contraindications of imipenem?
What food helps with nausea and vomiting due to carbapenem? What should you do before administering the drug?

A

-cross-sensitivity to PCN or Cephalosporins,
-harmful in pregnancy cat D
Nursing implications
Probiotic yogurt can help with N/V.
ASSESS C&S, PCN allergies, pregnancy always!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

37
Q

Cephalosporins

A

cephalexin PO
cefazolin IV
cefaclor PO
ceftriaxone IV

38
Q

Cephalosporins
cephalexin, cefazolin, cefaclor, ceftriaxone MOA and Indication

A

MOA-stop cell wall building in bacteria, -cidal and static
Indication: UTI, prevention of post-op infections

39
Q

Cephalosporins
Cephalexin cefazolin cefaclor ceftriaxone
SE/AE

A

GI-TRACK BLEEDING!
Rash, renal function decreases, bleeding

40
Q

Cephalexin cefazolin cefaclor ceftriaxone
Interactions/contraindications

A

Allergies to PCN, hepatic/renal impaired, ETOH, aminoglycosides, PCN

41
Q

for cephalexin cefazolin cefaclor ceftriaxone, what would you asses as a nurse?
What would be the pt edu?

A

ASESS C&S, renal function

Creatine: should be (0.5-1.1)
liver function ALT is (10-55)
Pt edu
- because of the harsh effect/metabolized in liver, avoid Alcohol,
Alcohol + Cephalosporin= Antabuse/disulfiram effect!
-give the med w/ food to ease any upset

42
Q

PCN: examples

A

Penicillin G or V obsolete
Amoxicillin
can be combo with clavulanate -PO
Piperacillin/ tazobactam

43
Q

PCN MOA and indications

A

MOA: messes up the bacterial cell wall
Indication: strep throat, prevention of endocarditis (dental), sinus infections, peritonitis, Zosyn

44
Q

PCN SE/AE outside of allergic rxns?

A

Anaphylaxis, then…
angioedema, itching, renal impairment,
hyperkalemia, dysthymias, hypernatremia

45
Q

What contraindicates pcn?
What interacts with pcn?

A

allergies, renal disease
cephalosporins, NSAIDS, oral contraceptives, warfarin
it will reduce Vit K
Warfarin interaction and Vit K reduction = blood too thin

46
Q

PCN nsg implications pt edu

A

assess allergies to cephalosporins and PCN
Take 1 hr before, or 2hr after food, with 8oz of water. No juice, the juice will inhibit drug effect
report s/s of allergic rxns, Dyspnea, hives
watch for 30min p admin
use additional birth control

47
Q

Sulfonamides

A

Sulfadiazine
sulfamethoxazole

47
Q

Sulfonamides

A

Sulfadiazine

48
Q

sulfonamides
MOA
indication

A

sulfadiazine : inhibit folic acid synthesis required for synthesis of purine and nucleic acid , a static
indication: UTI, E.coli, klebsiella, Staph CA MRSA

49
Q

Sulfonamides SE.AE/ interactions contraindications, nsg

A

photosensitivity, steven Johnson syndrome skin peeling and blistering, N/V, diarrhea, renal effects
Interactions/contra: thiaside diuretics, oral hypoglycemic
sulfonamides will lower blood sugar
drink 8-10 glasses of h2o
-renal damage, minimizes crystal formation in urine

50
Q

tetracycline

A

tetracycline
doxycycline
minocycline

51
Q

How does tetracycline treat the patient and what is is used to treat?

A

stops protein syth susceptible bacteria preventing replication a static
Acne vulgaris, chlamydia, pneumonia, Lyme disease

52
Q

tetracycline SEAE contra

A

N/V, diarrhea, superinfection, bone discoloration, photosensitive
Preg cat D, children under 8 or lactating women
-causes permanent tooth stain because the medicine binds to Ca of teeth

53
Q

What would a tetracycline patient want to incorporate and avoid into there lifestyle and the way the administer the drug?

A

-use sun protection
-avoid dairy, iron preparations
antacids 2 hrs before —-admin because it inactivates tetracycline
-take with water 6-8oz
-food can help with stomach upset not dairy
-alt BC!

54
Q

Macrolides 3 examples

A

Clindamycin
Erythromycin
Azithromycin

55
Q

Macrolides
MOA-
Indication

A

MOA stop protein syth, cidal static bacterial
Indication: for patients with PCN allergy, strep, gonorrhea, chlamydia

56
Q

macrolide mcyin drugs indications
clindamycin-
erythromycin-
azithromycin-
SE/AE
interactions/contra

A

Erythromycin: CNA and GI upset hepatoxicity, superinfections
Azithromycin: fewer GI AE longer duration of action and better efficacy
Clindamycin: c-diff
Inter/Contra: hepatic impairment, warfarin and digoxin

57
Q

Aminoglycosides

A

Gentamin, neomycin, tobramycin

58
Q

Aminoglycosides
gentamicin, neomycin, tobramycin
MOA
Indication

A

MOA: protein syth inhibition of gram negative bacteria, these bacteria cause serious toxicity
Indication: E. Coli, pseudomonas, klebsiella pneumonia

59
Q

aminoglycosides gentamicin, neomycin, tobramycin
SE/AE (black box warning) (most common)
contraindications:
Interactions
Nsg/pt edu

A

SE/AE: OTOTOXICITY, NEPHROTOXICITY BLACK BOX WARNING
dizzy-most common
contraindicated by renal/hepatic disease, hearing loss
interactions: loop diuretics which increase ototox,
do not mix with PCN in the same IV solution
Nsg implications: Peak and trough
P=30min after IV
T=right before next does
-in order to prevent ototoxicity, perform renal function tests, hematuria, BUN and creatine
-drink plenty water, report tinnitus

60
Q

As a nurse, what would you want to be sure/know pertaining to antibiotic use?
What would you want your patient to know?

A

get C&S before admin of therapy!!!!!
-Superinfections: yeast, c-diff (s/s of yeast: foul odor, redness in stomach folds, yellow on tongue)
-take as prescribed
-common AE is N/V, diarrhea
Therapeutic effect
-improved signs of infection, lowered WBC, normal vitals, negative C&S, no fever/lethargy, drainage, redness.
Monitor Adverse reactions/hypersensitivity
-SOB, hives, itching swelling

-drink plenty fluids! avoid kidney damage
-take as prescribed
-report hives, breathing problems, severe headache, changed urine output

61
Q

Antitubular ppd and indication

A

PPD purified protein derivative
PPD Mantoux test
indication: screening for exposure to TB

62
Q

antitubular drug

A

isoniazid*
rifampin*
rifabutin
pyrazinamide
rifapentine

63
Q

isoniazid
rifampin
rifabutin
pyrazinamide
rifapentine
MOA Indication

A

act on DNA of bacteria
tx of TB

64
Q

What are the SE/AE of antitubular drugs?
What are they contraindicated by

A

SEAE
*peripheral neuropathy, hepatoxicity
*Rifampin: orange-colored body fluid is normal

Contraindicated: by using both isoniazid and rifampin leading to hepatotoxicity and increase drug effects
isoniazid + phentoin= phenytoin

65
Q

What should you know as a nurse about antitubular drugs?
What would you want to include in patient education?

A

Monitor therapeutic effect: decreased s/s of TB, C&S, improved chest XRT
pt edu
Rifampin-orange color in body fluid is normal
avoid alcohol (hepatotoxicity)
take med at the same time/day
report fever, diarrhea, peripheral neuropathy, or bloody stool/jaundice
Tx can last 12 months*
contagious initially
**use alternate BC! because it decreases the effectiveness.

66
Q

purified protein derivative Mantoux

A

+ result is indicated by redness at site of injection
if the skin test is pos a chest x-ray needs to be completed, if the chest XR shows +, must obtain C&S of sputum
10mm tall bump
Bacille Calmette guerine BCG is a vaccine for TB can cause false positives

67
Q

Retinoid and indication

A

isotretinoin /Acutane
severe nodulocystic acne vulgaris

68
Q

isotretinoin inter/contra labs, nsg

A

contraindicated by pregnancy: Category X
females need 2 neg preg tests
Liver function tests, lipid panel, Complete Blood Count
Nsg
preg test each month before refills, use multi BC
watch for yellow skin jaundice
avoid alcohol, use sunscreen

Pharma (12 decks)

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