Anti-Infective Drugs Flashcards
Anti-infective agent: Any drug/agent effective against some type of pathogens; umbrella term
All have Sim Goal: Reduce population/amount of invading organisms to allow immune response to eliminate rest - why infections problematic in immunocompromised: anti-infectives aid to own immune sys so if not properly working drugs to treat organisms not as effective so is prob for these pats and want them to avoid infections in first place because drugs only help so much; reduce amount invading organism
Anti-infectives overview
Immune compromised problematic
All have Sim Goal: Reduce population/amount of invading organisms to allow immune response to eliminate rest - why infections problematic in immunocompromised: anti-infectives aid to own immune sys so if not properly working drugs to treat organisms not as effective so is prob for these pats and want them to avoid infections in first place because drugs only help so much; reduce amount invading organism
Drugs cause toxicity due to client status
Immune system cannot fight remaining pathogens
Immune compromised problematic
Occurs with any anti-infectives
Develops through mutation from organ - resistance occurs; when things mutate treatments not helpful or fight as well as once did - problematic because might run out of treatment options; prevention of resistance imp
Accelerated by/occur by sev diff things:
Prevention
Lot resistance already occurring - prob if new ones not created to fight infections
Anti-infective resistance
Inappropriate prescribing (e.g., antibiotic for virus) - taking med for something not have so allows for more resistance of organism
Ineffective dosing - not prescribe long-enough duration to adequately kill bacteria; if happens that gives bacterium more opportunity to mutate and change (sees antibiotic but not killed all way and learns how to evade it)
Widespread use - using lot anti-infectives in lot diff pops; overusing it in diff pops and more used more likely evade treatment options and get around them
Accelerated by/occur by sev diff things:
Appropriate prescribing - imp for HCP be educated on best anti-infective for organism grown
Adequate dosing (maintain therapeutic level) - makes sure organism effectively erradicated
Patient education: vital educate take prescription as prescribed; complete entire prescription; vital that educate patients on this; take for entire duration regardless if feel better/symps away; if end too early allows come back and more risk for resistance and mutation; do not share meds with others
Prevention
Goal: Cause bacterial cell death without causing damage to host cells - hard; kill bacteria without causing probs to other host cells; will have some AE as a result
Treat bacterial infections
Mechanism of Action (MOA)
Big concept: All antibiotics cause cell death of bacteria if effective
Antibiotics
Interfere with biosynthesis of pathogen cell wall (penicillin)
Prevent pathogen growth and reproduction division (sulfonamides)
Interfere with steps involved in protein synthesis (aminoglycosides)
Interfere with DNA synthesis in cell (fluoroquinolones)
Alter permeability of cell membrane - leak essentials (antifungal, antiprotozoal, and some antibiotics)
Mechanism of Action (MOA) - antibiotics
Effective for a wide variety of bacteria
Treat wide variety of bacteria
Based on best guess; used first in treatment - cover lot diff types organisms; not know what causing certain thing give these and feel confident start kill off some organism
Used in sepsis protocol - really sick because infections in bloodstream and need take action quickly; get cultures and once come back change course treatment based on organisms growing - where narrow-spectrum antibiotics come into play
Broad-spectrum antibiotics
Selective group of bacteria
Based on results of C&S - see which antibiotics bacteria sensitive to
Better in that help decrease resistance - not using something that treats number things
Narrow-spectrum antibiotics
Two or more drugs intitially and as infections improve d/c antibitoics over time depending on pat
May need multiple antibiotics
Combination therapy
Identify pathogen
Drug (antibiotic) most effective against pathogen involved - C&S (diff ways to get - to determine which drug most effective)
Drug that will cause least AE/complications for client
Consider patient allergy profile - past history; allergies? Comorbidities - sig renal disease - need ones less toxic
HCP considers factors:
GI effects
Skin effects
Hypersensitivity reactions - allergic rxns
Superinfections/secondary infections
Antibiotics: Common Adverse Effects
Nausea, vomiting, diarrhea (n/v/d) - pretty common on some degree for lot pats; monitor pat for these and decide severity
GI effects (Antibiotics: Common Adverse Effects)
Developing a Rash, hives (hypersensitivity rxn); monitor for both of these
Skin effects (Antibiotics: Common Adverse Effects)
Most commonly occur with very first dose; sometimes also during second dose; first and second dose most crucial for monitoring for severe rxn - but can happen at any time; taken many times risk for rxn much lower; first time watch closer
May be immediate, with next exposure, or delayed allergic (48+ hours out)
Severe cases, anaphylaxis can occur
Cross-sensitivity between classifications of antibiotics (e.g., penicillins & cephalosporins) possible - 2 diff classes and if allergic to 1 likely allergic to other higher; 10% not okay but imp know - imp to monitor closely esp if never taken
Determine what client experienced - true allergy or expected adverse effect - assess rxn; imp have correct: want make sure have availability as many antibiotics classifications as possible to treat appropriately
Hypersensitivity reactions - allergic rxns (Antibiotics: Common Adverse Effects)
EX: C. diff, yeast infections
Superinfections/secondary infections (Antibiotics: Common Adverse Effects)
Cause:
Clinical manifestations vary:
Examples:
superinfections/secondary infections
Occur because Host flora suppressed by antibiotics; Pathogenic microorganisms multiply
More likely occur with certain antibiotics than others
Opportunistic—suppressed immune system - immunocompressed more higher risk
Cause: (superinfections/secondary infections)
Diarrhea/cramping, painful urination, abnormal vaginal discharge, rash…
Clinical manifestations vary:(superinfections/secondary infections)
Clostridium difficile (C. diff) overgrowth
Candida albicans (oral or vaginal yeast)
C.diff and yeast infections more common/imp monitor for
Examples: (superinfections/secondary infections)
Toxicities more likely occur with IV because more potent; if on multiple IV antibiotics risk increases; order toxicities most to least prevalent
Acute kidney injury
Neurotoxicity
Liver toxicity
Potential toxicities with antibiotics (order of probability)
Most likely suffer from renal toxicity; when on IV antibiotics look at creatinine and BUN on reg basis to make sure kidney func not declining; not showing kidney injury; monitor urine output closely
CM: Decrease urine output, protein in urine, elevated creatinine and BUN; decreased GFR
Prevention renal toxicity: adequate hydration; do that: diluting antibiotic; not effecting the effectiveness of antibiotic - helps dilute it out; not as toxic on kidneys or hard renal tubules - may give IV fluids; outpat - stay adequately hydrated
Acute kidney injury
More likely occur for IV antibiotics
Nothing to prevent this
CM: headache, dizziness, confusion, seizures, loss of hearing (ototoxicity), vision damage
Neurotoxicity
CM: Hepatitis (jaundice, elevated liver function tests (LFTs))
Least likely to occur on antibiotics
Liver toxicity
Monitor them closely for allergic reaction (most likely give antibiotic first time taken it - more likely allergic rxns occur with them) and superinfections
Ensure adequate hydration and nutritional status
Children - Antibiotics across the lifespan
Instructions to take all medication as directed or prescribed/do not save or share meds
Females on birth control pill-use additional protection against pregnancy - antibiotics make birth control less effective; if have a female of child-bearing age imp to assess and ask if taking oral contraceptives to prevent pregnancy and know less effective when on antibiotics and use alternate protection and use for up to 7 days after
Adults - Antibiotics across the lifespan
Most antibiotics contraindicated; risk vs. benefit
Gen Most category C
Penicillin: category B
Should be avoided if possible; HCP makes decision on antibiotics appropriate, trimester, etc
Pregnancy - Antibiotics across the lifespan
Higher risk for toxicity (reduced liver, kidney function) - risk for renal toxicity because may have some decline kidney func and more risk for toxicity of med because kidneys not working up to speed
Older adult - Antibiotics across the lifespan
Prior to administration:
When administering antibiotics things to keep in mind depending on route (2 most common listed and most implications to know):
Throughout administration of antibiotics:
Patient Education:
General Nursing Responsibilities
Complete assessment and health history
Obtain cultures as indicated prior to admin - best get samples before admin antibiotics if can
assess/Note s/s of current infection:
Antibiotics may increase anticoagulant effect of warfarin; monitor PT/INR and draw it additionally; increases bleeding time
Prior to administration:
Diseases - know why giving antibiotics (kind infection have), pregnancy, reviewing allergies, drugs (all med history so aware d-d interaction), OTC’s, alcohol, major comorbidities - risk for giving antibiotics - CKD
Complete assessment and health history
Should not delay care; nurse may obtain culture before get cultures-then hold for order
Obtain cultures as indicated prior to admin - best get samples before admin antibiotics if can
Fever, fatigue, elevated WBC count, redness, swelling, discomfort, draw with sharpie… - ways to easily track progress; note any signs of infection
assess/Note s/s of current infection:
One most common routes
Take on empty stomach with full glass of water 1 hour before meals or 2-3 hours after meals
Do not take with/avoid fruit juice, soft drinks, or milk when administering antibiotics
Oral: - When administering antibiotics things to keep in mind depending on route (2 most common listed and most implications to know):
One most common routes
Observe IV site closely esp if admin through peripheral IV
Some can be vasocostic and cause phlebitis - monitor closely
Observe for phlebitis
Check rate of infusion or intravenous push (IVP) - get med should directions from pharmacy how long to infuse over and take note; diff for every antibiotics; same for push rates
Check compatibility with other meds/IV fluids - in same IV must be compatible so can run together without issues so and if not will precipitate and cause probs in line/pat - sometimes add line to present one and antibiotics may be intermittent - attentive to line present and what line putting it in
Some antibiotics central line preferred - Vancomycin - if have central line use it when giving antibiotics; can give through peripheral line - make sure infusing appropriate rate and monitoring site very closely throughout admin to make sure nothing happening at site; but once can go to central line
IV: - When administering antibiotics things to keep in mind depending on route (2 most common listed and most implications to know):
Monitor and report
Peak or trough if appropriate - some have these ordered; watch orders
Ensure adequate hydration to prevent accumulation of drug and reduce risk of AKI
Throughout administration of antibiotics:
Therapeutic effects - infection better, VS improved
Monitor appropriate Lab values
Adverse effects
Throughout administration of antibiotics:
CBC (WBC mainly), kidney function (toxicities), LFTs (toxicities), looking at if WBC down, line drew on leg infection drawing away from line
Monitor appropriate Lab values
Take as directed (entire prescription)
Females taking birth control pills (use alternative protection)
Drink 3 L water per day
Report AE that are expected to HCP - what should do if having AE
Patient Education:
The nurse is educating an older adult female regarding antibiotic therapy. Which information is most important to include in the client’s education?
A.Use alternate protection against pregnancy if taking birth control pills.
B.Report nausea to your healthcare provider.
C.Take with food if experiencing gastrointestinal upset.
D.Drink at least 3 L of water daily.
Answer: D
Rationale: Older adult is at increased risk for renal toxicity. An older adult female is at low to no risk for pregnancy. Nausea and GI upset should be included in the education but are not the priority. older adult: means not of child-bearing age, gone through menopause
The nurse is caring for a client taking a penicillin antibiotic. Several days into the course of therapy the client calls the clinic complaining of a diffuse red rash but otherwise feeling well. What is the client most likely experiencing?
A.Candida yeast infection
B.Anaphylaxis
C.Delayed allergic reaction
D.Steven’s Johnson Syndrome
Answer: C
Rationale: The client is experiencing a delayed allergic reaction which usually occurs several hours to several days into therapy. Candida would be a localized rash with itching. Swelling, itching, and difficulty breathing would accompany anaphylaxis. SJS is a rare complication with a blistering rash and other life-threatening systemic manifestations.
Diffuse - all over
Otherwise feeling well; steer away from Steven’s Johnson - systemic and very serious/critically ill pat
Anaphylaxis - more symptomatic; hypotensive, not being able breath
Yeast - concentrate fungal; underneath breast/in mouth
Aminoglycosides
Carbapenems
Cephalosporins
Fluoroquinolones
Macrolides
Penicillins
Sulfonamides
Tetracyclines
Miscellaneous antibiotics
Classifications: antibiotics
toxic to 8th CN (deals with hearing - monitor for tinnitus (ringing of ears), hearing loss); systemic routes higher risk toxicities - IV - more likely have toxicity
AE: - Aminoglycosides: Prototype: Gentamicin
nephrotoxicity, neurotoxicity - potent antibiotic
Black Box (high alerts): - Aminoglycosides: Prototype: Gentamicin
draw peak; see general slides
Nursing: - Aminoglycosides: Prototype: Gentamicin
Broadest spectrum antibiotic have; Given early on in case sepsis to cover for any organism to start treating pat quickly
Carbapenems: prototype: Ertapenem
See general; systemic routes higher risk toxicities
AE: - Carbapenems: prototype: Ertapenem
Used lot in out-pat
Fluoroquinolone: Prototype: Ciprofloxacin
photosensitivity (sensitivity to sunlight, high risk to sunburns, wear sunscreen and avoid lot time in sunlight); D-D interaction with corticosteroids: at risk for tendon rupture possible with corticosteroids: achilles tendon most common - avoid taking at same time; can cause QT prolongation: dysrhythmias more likely occur with IV route so needs be on telemetry - need able monitor rhythm because at risk for dysrhythmias
Adverse effects: - Fluoroquinolone: Prototype: Ciprofloxacin
Telemetry if indicated; educate wear sunscreen; see general
Nursing: - Fluoroquinolone: Prototype: Ciprofloxacin
Not used systemically; more ophthalmic
Macrolides: prototype: Erythromycin
IV route higher risk for toxicities
AE: - Macrolides: prototype: Erythromycin
cross sensitivity to cephalosporin - note allergies and 10% allergic to both; renal disease; Pregnancy category B (safer antibiotics so often prescribed)
Contraindications: - Penicillins: prototype: Amoxicillin
decreases effectiveness of oral contraceptives - esp true with penicillins; increase anticoagulation effect of warfarin
Drug-Drug: - Penicillins: prototype: Amoxicillin
oldest and resistance started develop quickly and more resistance developing and been around long-time - not used as much because not as effective
Prob: - Penicillins: prototype: Amoxicillin
Contraindications: allergy to/cross sensitivity with penicillin; Pregnancy category B
*Note: there are 5 generations of cephalosporins - lot antibiotics within gens
Cephalosporins (1st gen): prototype: Cefazolin
Alcohol
Drug-food: - Cephalosporins (1st gen): prototype: Cefazolin
see general; systemic routes higher risk toxicities
Adverse effects: - Cephalosporins (1st gen): prototype: Cefazolin
Admin IM in large muscle; avoid alcohol; see general slides
Nursing: - Cephalosporins (1st gen): prototype: Cefazolin
sulfa allergy: contains sulfa - allergy need know; pregnancy/breast feeding
Contraindication: - Sulfonamides: prototype: sulfamethoxazole/trimethroprim (SMZ-TMP)
precautions: folate deficiency; hyperkalemia
(drug-drug) - Sulfonamides: prototype: sulfamethoxazole/trimethroprim (SMZ-TMP)
more likely to cause GI effects compared to other antibiotics, photosensitivity (wear sunscreen and avoid sunlight because burn easily)
AE: - Sulfonamides: prototype: sulfamethoxazole/trimethroprim (SMZ-TMP)
more resistance because not helpful as much anymore; not work like used to so not used as much anymore
Older class: - Sulfonamides: prototype: sulfamethoxazole/trimethroprim (SMZ-TMP)
wear sunscreen; highly resistant; see general slides
Nursing: - Sulfonamides: prototype: sulfamethoxazole/trimethroprim (SMZ-TMP)
teeth discoloration (pronounced affinity for teeth and bones), photosensitivity (highest risk for most severe photosensitivity - avoid sunlight and wear sunscreen because can get severe sunburn)
AE: - Tetracycline: prototype: Doxycycline
Pregnancy - probs to developing fetus (slow fetal skeletal growth, tooth enamel hypoplasia), children under 8 y/o - probs to adequate tooth enamel (tooth enamel hypoplasia); Not in younger kids; avoided in pregnancy than other because of risk to developing fetus and in kids
Contraindication: - Tetracycline: prototype: Doxycycline
decreases effectiveness of oral contraceptives
Drug-Drug: - Tetracycline: prototype: Doxycycline
use sunscreen; see general
Nursing: - Tetracycline: prototype: Doxycycline
Given orally/IV - IV route higher risk for toxicity and superinfection
Superinfection and vanco: higher risk development of superinfections: one is C.diff; treatment for it is oral vanco; IV vanco causes C.diff and oral vanco treats it at same time - use oral: gets directly into GI tract and more effective that way
Miscellaneous Antibiotics: Glycopeptide: prototype: Vancomycin
superinfection; nephrotoxicity; ototoxicity; Red Man Syndrome (allergic response to vanco) – histamine release/anaphylactic response - severe hypotension, fever, chills, paresthesia, and erythema/redness starts on neck and back - distinct rxn for vanco
AE: - Miscellaneous Antibiotics: Glycopeptide: prototype: Vancomycin
Administer over at least 1 hour - incidence red man syndrome likelihood and renal toxicity reduced if given slower - make sure not given too fast; central line preferred: vasocostic - if given through a peripheral - monitor site closely and get to central line ASAP; draw trough levels – dose adjusted by HCP - make sure looked at if enough med (if not contributes to resistance and vanco good against lot organisms) and not nearing toxicity - make sure pats in therapeutic window; liver enzymes, renal function; see general
Nursing: - Miscellaneous Antibiotics: Glycopeptide: prototype: Vancomycin
Can use for C.diff but C.diff becoming resistant - not used as much esp in hospital - rarely used for C.diff; if healthy and develops uses because not at high risk for re-occurrence or comps and C. diff is deadly in some pats
Used for lot diff organisms
Misc. Antibiotics/Antiprotozoal: prototype: Metronidazole
renal/liver dysfunction; preg/lactation
Contraindication: - Misc. Antibiotics/Antiprotozoal: prototype: Metronidazole
anticoagulants (warfarin)
Drug-Drug: - Misc. Antibiotics/Antiprotozoal: prototype: Metronidazole
CNS effects, metallic taste - when take PO but is norm, severe n/v with alcohol intake (chemical rxn with this and alcohol - drink alcohol with it then have severe N&V - imp to know) - educate to avoid while on medication
Adverse effects: - Misc. Antibiotics/Antiprotozoal: prototype: Metronidazole
Teach – no alcohol; see general
Nursing: - Misc. Antibiotics/Antiprotozoal: prototype: Metronidazole
For TB pats Prescribed in combination (two or more agents) to increase effectiveness and decrease emergence of resistant strains by undertreating infection - adequately treat infection
Misc. Antibiotics/Antimycrobial Agents: TB Treatment meds
GI effects (n/v/d); orange tint to body fluids; neuropathy; bone marrow suppression; liver toxicity (be on meds 6 months-2yrs depending on scenario)
Major AE: - Misc. Antibiotics/Antimycrobial Agents: TB Treatment meds
many
Drug-Drug: - Misc. Antibiotics/Antimycrobial Agents: TB Treatment meds
Monitor AE, labs (LFT’s monitored occasionally to make sure liver toxicity not occuring since on prolonged med); educate-take as directed, skip doses, do not stop med could contribute to resistance and not have unlimited amount antibiotics to treat TB; treatment 6 months to 2 years
Nursing: - Misc. Antibiotics/Antimycrobial Agents: TB Treatment meds
The nurse is preparing to administer medications to a client allergic to penicillin. When reviewing the client’s medication list, which medication causes concern for the nurse?
A.Doxycycline
B.Cefazolin
C.Ciprofloxacin
D.Erythromycin
Answer: B
Cross-sensitivities between cephalosporin (Cefazolin) and penicillins
Ciprofloxacin - fluoroquinolones
Rationale: Cross-sensitivity exists between penicillin and cephalosporin drugs in 5-10% of patients. The nurse should monitor the client closely for signs of allergic reaction.
The nurse is preparing to administer vancomycin to a client. Which assessment should the nurse prioritize?
A.Gastrointestinal system
B.Urine output
C.Integumentary system
D.Liver function tests
Answer: B
Rationale: Vancomycin poses the greatest risk for nephrotoxicity. Urine output and renal labs should be monitored closely. Although GI and skin effects may occur, they are lower priority than acute kidney injury. The risk of liver toxicity is lower than renal toxicity.
Vanco Potent IV antibiotic; given via central line
IV antibiotics more potential for toxicities and order: kidneys, neuro, liver
All potential correct answers; monitor LFTs and renal func - monitor both: pick most imp - renal toxicity more likely occur than liver and most likely occur with antibiotics
GI imp but as immediately threatening to pat
A client is receiving intravenous vancomycin and complains of chills and sweating. The nurse assesses the client and observes redden skin over the back and neck; vital signs: temperature 102 F, heart rate 118, respiratory rate 18, and blood pressure 88/58. What does the nurse recognize as the problem the client is experiencing?
A.Red man syndrome
B.Sepsis
C.Nephrotoxicity
D.Drug rash
Answer: A
Is rare but be aware of when admin vanco
Treatment or prophylaxis to decrease influenza symptoms
Indications: - Antiviral: Neuroaminidase inhibitors: prototype: Osteltamivir
pregnancy/breastfeeding
Contraindications: - Antiviral: Neuroaminidase inhibitors: prototype: Osteltamivir
GI effects (n/v/d) - pretty well tolerated
Adverse effects: - Antiviral: Neuroaminidase inhibitors: prototype: Osteltamivir
Tx for influenza with this should be initiated/occur within 48 hours of symptoms onset
Cognisent of influenza vaccine: Do not administer 48 h before influenza vaccine or 2 wks after; not want have vaccine and antivirals against it; may take with food to decrease GI intolerance
Nursing implications: - Antiviral: Neuroaminidase inhibitors: prototype: Osteltamivir
diff types of Herpes, varicella zoster (shingles)
Indications: - Antivirals: Purine Nucleoside Analog: prototype: Acyclovir
determines severity of AE
Routes: - Antivirals: Purine Nucleoside Analog: prototype: Acyclovir
oral: malaise, headache, more GI effects: n/v/d; IV: nephrotoxicity/neurotoxicity possible - higher risk for toxicities
AE: - Antivirals: Purine Nucleoside Analog: prototype: Acyclovir
admin frequently: 4-5 doses/day; need maintain compliance and dosing circ
Has Short duration - Antivirals: Purine Nucleoside Analog: prototype: Acyclovir
Oral: adm. ATC (around the clock) with food; topical: use gloves when applying; IV: infuse over at least 1 h to decrease possibility of renal damage/toxicity; ensure patient hydrated
Nursing: - Antivirals: Purine Nucleoside Analog: prototype: Acyclovir
take when have flare - still at risk for re-occurance of symp
Not a cure: - Antivirals: Purine Nucleoside Analog: prototype: Acyclovir
targets helper T cells; results in major immunodeficiency when progresses into AIDS; HIV have window period initially then infection goes dormant and asymptomatic for 10 yrs then symptomatic later in disease process; timing disease makes treatment diff
HIV:
Antivirals - Sig increased lifespan
Treatment of HIV difficult
Combination of at least three different antiviral drugs is used at once to control virus so not replicate and help pat not progress into AIDS where high risk of infection and death
General AE: GI effects, CNS effects, flu-like syndrome, risk for toxicity
HIV/AIDS: Antiretroviral Drugs
HIV mutates over time - treatment diff - hard control and treat, drug resistance
Length of time the virus can remain dormant within the T cells
Adverse effects of many potent drugs
Treatment of HIV difficult
Further depress immune system
Adverse effects of many potent drugs
Achieve maximum effectiveness with the least amount of toxicity
Highly active antiretroviral therapy (HAART)
Combination of at least three different antiviral drugs is used at once to control virus so not replicate and help pat not progress into AIDS where high risk of infection and death
Goal: reduce the plasma HIV RNA to lowest possible level
Highly active antiretroviral therapy (HAART)
Specific group pats to treat and pats managed in HIV clinics
Take medications exactly as directed/prescribed
Do not to skip a dose - aiding into more HIV resistant strains - want prevent that because then need new drugs or HIV could be more deadly
Take at same times every day
Refill medications before they run out; DO NOT RUN OUT of meds - aiding into more HIV resistant strains - want prevent that because then need new drugs or HIV could be more deadly
AE Report immediately: serious rashes, severed diarrhea/vomiting, extreme drowsiness/dizziness, difficulty breathing - signs of toxicity and need report so adequately address
Keep scheduled labs and HCP appts - monitored appropriately and therapy appropriate so virus is low
Antiretroviral Drugs: Nursing Edu - drugs for HIV
Fungal infections - require more prolonged treatment; fungi hard to treat
OTC
Topical antifungal agents: prototype: Nystatin (Mycostatin)
increases cell wall permeability - cell death
MoA: - Topical antifungal agents: prototype: Nystatin (Mycostatin)
PO, topical
Route: - Topical antifungal agents: prototype: Nystatin (Mycostatin)
Candida infections of vagina, skin (skin folds/breast/groin), mouth
Indications: - Topical antifungal agents: prototype: Nystatin (Mycostatin)
topical: contact dermatitis - skin gets more irritated - rash more red and burn more and worse essentially and need report: rxn to med; oral: n/v/d - GI effects
Adverse effects: - Topical antifungal agents: prototype: Nystatin (Mycostatin)
Oral candida: Direct patients to swish 2 min. and swallow med so coat any candidias in back mouth/throat - not taste great - more med in contact better treatment: needs be recoated: done often; children - swab to try get med coated around mouth
Topical: apply to affected area-always use gloves; how often admin and how much and follow directions
Nursing:- Topical antifungal agents: prototype: Nystatin (Mycostatin)
Can be given for 6 months+; pat on for long-term treatment need have LFTs monitored; most common toxicities for antifungal is liver
Systemic antifungal agents: Azoles: prototype: Fluconazole (Diflucan)
increases cell wall permeability - cell death
MoA: - Systemic antifungal agents: Azoles: prototype: Fluconazole (Diflucan)
systemic or superficial fungal infections
Indications: - Systemic antifungal agents: Azoles: prototype: Fluconazole (Diflucan)
Oral, IV
Route: - Systemic antifungal agents: Azoles: prototype: Fluconazole (Diflucan)
n/v/d; long duration: liver toxicity
Adverse effects: - Systemic antifungal agents: Azoles: prototype: Fluconazole (Diflucan)
pregnancy; liver disease
Contraindications: - Systemic antifungal agents: Azoles: prototype: Fluconazole (Diflucan)
Many! Warfarin (bleeding), anti-diabetics (hypolgycemia)
Drug-Drug: - Systemic antifungal agents: Azoles: prototype: Fluconazole (Diflucan)
Monitor labs (LFTs) - not suffering liver toxicity and monitor for s/s of liver toxicity; long duration common (3-6 months)
Nursing: - Systemic antifungal agents: Azoles: prototype: Fluconazole (Diflucan)
