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nurs 252 > antifungal drugs > Flashcards

antifungal drugs Flashcards

1
Q

fungal infections are also known as

A

mycoses

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2
Q

infections of integumentary system

A

cutaneous
subcutaneous
superficial

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3
Q

fungi that causes integumentary infections are known as

A

dermatophytes

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4
Q

yeasts

A
  • single cell fungi
  • reproduce by budding
  • can be used for baking bread and brewing alcohol
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5
Q

moulds

A
  • multicellular
  • long branching filaments called hyphae
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6
Q

4 general types of mycotic infections

A
  • cutaneous
  • subcutaneous
  • superficial
  • systemic (life threatening, usually in immunocompromised host)
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7
Q

candida albicans

A
  • may follow antibiotic therapy, antineoplastics or immunosuppressants
  • may result in overgrowth and systemic infections
  • common in newborn infants and immunocompromised pts
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8
Q

candida albicans growth in mouth

A

thrush or oral candidiasis

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9
Q

vaginal candidiasis

A
  • yeast infection
  • pregnant women, women with diabetes, women taking oral contraceptives
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10
Q

aspergillosis infection affects the

A

lungs

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11
Q

meds used to treat systemic fungal infections

A
  • terbinafine and voriconazole
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12
Q

triazoles

A

fluconazole, voriconazole

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13
Q

echinocandins

A

caspofungin

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14
Q

imidazoles

A

ketoconazole (common topical)

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15
Q

polyenes

A

amphotericin B, nystatin

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16
Q

polyenes (amphotericin B and nystatin) moa

A
  • binds to steroles in cell membrane lining
  • results in fungal cell death
  • dont bind to human cell membranes or kill human cells
17
Q

how to take nystatin

A

-swish and swallow and dont eat after for 30 mins

18
Q

imidazoles and triazoles (ketoconazole, fluconazole and voriconazole )

A
  • inhibits fungal cell cytochrome P450 enzymes resulting in cell membrane leaking
  • result is altered cellular metabolism and fungal cell death
19
Q

echinocandins (caspofungin) moa

A
  • prevents synthesis of glucans (part of cell wall)
  • results in fungal cell death
  • adverse effect: hypotension
20
Q

drug of choice for severe systemic fungal infections

A

amphotericin B

21
Q

which drug is used to treat onychomycosis (fungal infection of fingernails and toenails)

A

terbinafine (Lamisil)

22
Q

fluconazole passes through the ____

A

-cerebrospinal fluid and inhibits growth of crytococcal fungi

23
Q

which drug is effective in the treatment of cryptococcal meningitis

A

fluconazole

24
Q

antifungal contraindications

A
  • allergy, liver failure, kidney failure and porphyria (for griseofulvin)
  • itraconazole= cardiac issues
  • voriconazole= preg
25
Q

itraconazole contraindications

A

contraindicated in treatment of onychomycoses in pts with severe cardiac problems

26
Q

voriconazole can cause

A

fetal harm in pregnant women

27
Q

amphotericin B adverse effects

A
  • cardiac dysrhythmias
  • neurotoxicity ( tinnitus, visual disturbances, paresthesias, convulsions)
  • kidney toxicity ( potassium loss, hypomagnesemia)
    -pulmonary infiltrates
  • fever, chills, headache, nausea, occasional hypotension, GI upset, anemia
28
Q

amphotericin B contraindications

A

bone marrow suppression and kidney impairment

29
Q

amphotericin B adverse effects prevention

A
  • premedications (antiemetics, antihistamines, antipyretics, corticosteroids)
  • minimize infusion related reactions
  • reactions can be reduced by using longer than average drug infusion times (2-6 hrs)
30
Q

fluconazole adverse effects

A
  • nausea, vomiting, diarrhea, stomach pain
  • increased liver enzymes
31
Q

use fluconazole with caution in

A

pts with kidney or liver dysfunction

32
Q

nystatin (topical) adverse effects

A

nausea, vomiting, diarrhea, anorexia, rash, urticaria

33
Q

antifungal interactions

A
  • co administration of 2 drugs metabolized by the P450 enzyme may result in competition for this enzyme resulting in higher levels of one of these drugs
34
Q

what to obtain from pt before antifungal administration

A

vitals, complete blood count, liver and renal function studies, electrocardiogram

35
Q

how often to monitor vitals when receiving IV infusions (amphotericin B)

A

every 15-30 mins

36
Q

amphotericin B preferred route

A

IV infusion pumps and the most distal veins

37
Q

voriconazole is given

A

1 hr before or after meals

38
Q
A

nurs 252 (23 decks)

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