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Week 4 Antiviral/fungal/protozoa/elmintic Flashcards

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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
antiprotozoal hydroxychloroquine MOA Indication
Hydroxychloroquine works by attacking the parasite during its development Indication: prophylactic (prevention) of malaria, systemic lupus erythematosus, and off label autoimmune disorders.
26
hydroxychloroquine antiprotozoal SE AE Nsg
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
27
metronidazole MOA Indication
MOA: inhabits DNA of protozoa Indication: trichomoniasis and giardiasis (dirty water), C-diff, H, pylori.
28
Metronidazole SE/AE Interactions Contraindications
SE/AE dizzy, metallic taste, N/V, diarrhea, peripheral neuropathy Interactions: alcohol, anticoagulants Contraindications: Hepatic diseases
29
NSG Implications of metronidaxole
AVOID Alcohol ETOH Trichomoniasis infections should have partner treated as well avoid driving until effects are known
30
Anthelmintic agents example
mebendazole
31
mebendazole MOA Indication SE/AE
MOA: interferes with worms normal function Indication: used against pinworms, round/whip/hookworms SE/AE: abdomen hurts, headache dizzy
32
mebendazole anthelmintic contraindications nsg implications
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
Carbapenems
-penem Imipenem
34
What is carbapenems MOA and treatment for?
Imipenem MOA inhibits cell membrane synthesis killing the bacteria severe infection/bacterial pneumonia
35
Carbapenems imipenem SEAE
imipenem C-diff, Superinfections-thrush, vaginal yeast N/V
36
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?
-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
Cephalosporins
cephalexin PO cefazolin IV cefaclor PO ceftriaxone IV
38
Cephalosporins cephalexin, cefazolin, cefaclor, ceftriaxone MOA and Indication
MOA-stop cell wall building in bacteria, -cidal and static Indication: UTI, prevention of post-op infections
39
Cephalosporins Cephalexin cefazolin cefaclor ceftriaxone SE/AE
GI-TRACK BLEEDING! Rash, renal function decreases, bleeding
40
Cephalexin cefazolin cefaclor ceftriaxone Interactions/contraindications
Allergies to PCN, hepatic/renal impaired, ETOH, aminoglycosides, PCN
41
for cephalexin cefazolin cefaclor ceftriaxone, what would you asses as a nurse? What would be the pt edu?
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
PCN: examples
Penicillin G or V obsolete Amoxicillin can be combo with clavulanate -PO Piperacillin/ tazobactam
43
PCN MOA and indications
MOA: messes up the bacterial cell wall Indication: strep throat, prevention of endocarditis (dental), sinus infections, peritonitis, Zosyn
44
PCN SE/AE outside of allergic rxns?
Anaphylaxis, then... angioedema, itching, renal impairment, hyperkalemia, dysthymias, hypernatremia
45
What contraindicates pcn? What interacts with pcn?
allergies, renal disease cephalosporins, NSAIDS, oral contraceptives*, warfarin it will reduce Vit K* Warfarin interaction and Vit K reduction = blood too thin
46
PCN nsg implications pt edu
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
Sulfonamides
Sulfadiazine sulfamethoxazole
47
Sulfonamides
Sulfadiazine
48
sulfonamides MOA indication
sulfadiazine : inhibit folic acid synthesis required for synthesis of purine and nucleic acid , a static indication: UTI, E.coli, klebsiella, Staph CA MRSA
49
Sulfonamides SE.AE/ interactions contraindications, nsg
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
tetracycline
tetracycline doxycycline minocycline
51
How does tetracycline treat the patient and what is is used to treat?
stops protein syth susceptible bacteria preventing replication a static Acne vulgaris, chlamydia, pneumonia, Lyme disease
52
tetracycline SEAE contra
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
What would a tetracycline patient want to incorporate and avoid into there lifestyle and the way the administer the drug?
-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
Macrolides 3 examples
Clindamycin Erythromycin Azithromycin
55
Macrolides MOA- Indication
MOA stop protein syth, cidal static bacterial Indication: for patients with PCN allergy, strep, gonorrhea, chlamydia
56
macrolide mcyin drugs indications clindamycin- erythromycin- azithromycin- SE/AE interactions/contra
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
Aminoglycosides
Gentamin, neomycin, tobramycin
58
Aminoglycosides gentamicin, neomycin, tobramycin MOA Indication
MOA: protein syth inhibition of gram negative bacteria, these bacteria cause serious toxicity Indication: E. Coli, pseudomonas, klebsiella pneumonia
59
aminoglycosides gentamicin, neomycin, tobramycin SE/AE (black box warning) (most common) contraindications: Interactions Nsg/pt edu
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
As a nurse, what would you want to be sure/know pertaining to antibiotic use? What would you want your patient to know?
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
Antitubular ppd and indication
PPD purified protein derivative PPD Mantoux test indication: screening for exposure to TB
62
antitubular drug
isoniazid* rifampin* rifabutin pyrazinamide rifapentine
63
isoniazid rifampin rifabutin pyrazinamide rifapentine MOA Indication
act on DNA of bacteria tx of TB
64
What are the SE/AE of antitubular drugs? What are they contraindicated by
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
What should you know as a nurse about antitubular drugs? What would you want to include in patient education?
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
purified protein derivative Mantoux
+ 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
Retinoid and indication
isotretinoin /Acutane severe nodulocystic acne vulgaris
68
isotretinoin inter/contra labs, nsg
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

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