Antifungal, Antiprotozoal, Antihelminth

Question 1

amphotericin B

Answer 1

amphotericin B (Fungizone)

• Therapeutic Class: antifungal (systemic type)
  
  • ​Ex: valley fever
• Pharmacologic Class: Polyene
• Indication: systemic fungal infection

Administration:

• Route: IV
  
  • ​infuse slowly because CV collapse may result if infused too rapidly
  • inspect IV site frequently, phlebitis common
• Common Infusion Reaction;
  
  • 1-2 hrs likely pt develop fever and chills
  • Pre-medicate: give acetaminophen or antihistamine prior to administration
• Eval Labs

Assess/Monitor/ADR:

• nephrotoxicity
  
  • monitor: I&O; urinating properly, appearance, volume,
  • draw BUN and creatinine 2-3x a week
  • 80% of pts nephrotoxicity….?
• Electrolytes imbalances (K+, Ca2+, Mg2+)
  
  • calcium and magnesium levels 2x week
  • watch for s/s of HYPOkalemia
• hepatotoxicity/liver failure
  
  • liver function 2-3x weekly
• blood issues - thrombocytopenia, peukopenia, agranulocytosis, anemia
  
  • CBC weekly
• ototoxicity - assess for s/s

Question 2

chloroquine

Answer 2

Indications:

• malaria -
  
  • mild-moderate chloroquine sensitive malaria
  • prevention of malaria
• 2nd line for lupus and rheumatoid arthritis

Caution:

• pregnancy -
• liver disease -

Administration/Interaction:

• do not give with antacids or laxatives - at least 4 hrs before or after

Question 3

meTRONIdazole

Answer 3

Therapeutic Class: anti-infective, antiprotozoan

Pharmacologic Class: drug that disrpts nucleic acid synthesis

Uses:

• Preferred drug for giardiasis, trichomoniasis
• also has abx activity against anaerobic bacteria
• other uses

Black Box Warning:

Contraindications:

Question 4

blood cultures

Question 5

antifungals

Answer 5

amophotericin B

• systemic fungal infections

nystatin - yeast infections

• oral - swish at least a coule minutes before swallowing
• topically - typicaly BID

fluconazole (Diflucan)

• PO, yeast infection, potential for fetal harm, watch for liver dmg

Question 6

meBENDazole (vermox)

Answer 6

• antihelminth
• roundworm and pinworm infections
• most effective when CHEWEd and taken with FATTY MEAL
• GI: diarrhea, abd distension

Patient Teaching:

• good hand hygiene
• changing bed linens and towels daily
• changing undergarments
• watch for worms
• feces
• washing fruits and veggies and/or cooking them well; can carry worms

Question 7

Antitubercular drugs:

isoniazid (INH)

rifampin

Answer 7

Antitubercular Drugs

• extremely hepatotoxicity
• absolutely no alcohol
• assess pt and labs for liver damage
• caution: older adults
• monitor pt for fever, rash, facial swelling,
• pt admitted - airborne isolation

isoniazid (INH)

• inhibit synthesis of vitamin B6; a lot of pts need supplemental B6; any new numbness or tingling

hepatotoxic

• if overdose

give pyridoxine (vitamin B6)

rifampin (Rifadin)

• notify pt of orange-red body fluids
• contact lens will cause permanent stains
• gi distress, n/v/d
• hepatotoxic
• decreases effectiveness of oral contraception