Antifungal Drugs

Question 1

what are yeasts

Answer 1

single- cell fungi
reproduced by budding
can be used for:
- baking breads
- brewing alcoholic beverages

Question 2

what are moulds

Answer 2

• multicellular
• characterized by one, branching filaments called hyphae

Question 3

what are the four types of myotic infections

Answer 3

• cutaneous
• subcutaneous
• superficial
• systemic (can be life-threatening, usually occurs in immunocompromised host).

Question 4

Myoctic infections - Candida albicans

Answer 4

• may follow antibiotic therapy, antineoplastics, or immunosuppressants (corticosteroids)
• may result in overgrowth and systemic infections
• growth in the mouth is called thrush or oral candidiasis.
  Common in newborn infants and immunocompromised patients

Question 5

Mycotic infections - Vaginal candidaisis

Answer 5

• Yeast infection
• Pregnant women, women with diabetes, women taking oral contraceptives

Question 6

what are antifungal drugs?

Answer 6

Medications used to treat infections caused by fungi, broken down into major groups based on their chemical structure.

Question 7

types of systemic antifungal drugs

Answer 7

terbinafine, voriconazole

Question 8

since the drugs are broken down into major groups based on their chemical structure what drugs are in TRIAZOLES?

Answer 8

Fluconazole, voriconazole

Question 9

since the drugs are broken down into major groups based on their chemical structure what drugs are in ECHINOCANDINS?

Answer 9

Caspofungin

Question 10

since the drugs are broken down into major groups based on their chemical structure what drugs are in IMIDAZOLES?

Answer 10

Ketoconazole (common topical)

Question 11

since the drugs are broken down into major groups based on their chemical structure what drugs are in Poleynes?

Answer 11

Amphotericin B, nystatin

Question 12

flucytosine

Answer 12

• Also known as 5-fluorocytosine (antimetabolite)
• Taken up by fungal cells; interferes with deoxyribonucleic acid (DNA) synthesis
• Result: fungal cell death
  Older drug; newer drugs are more commonly used

Question 13

griseofulvin

Answer 13

• Disrupts cell division
• Result: inhibited fungal mitosis (cell division)
• Older drug; newer drugs are more commonly used.

Question 13

Polyenes: amphotericin B and nystatin

Answer 13

• Bind to sterols in cell membrane lining
• Result: fungal cell death
• Do not bind to human cell membranes or kill human cells

Question 14

caspofungin

Answer 14

• Prevent the synthesis of glucans (essential components of fungal cell walls)
• Result: fungal cell death

Question 15

what to use for systemic and topical fungal infections?

Answer 15

Amphotericin B

Question 16

what does fluconazole do?

Answer 16

passes into the cerebrospinal fluid and inhibits the growth of cryptococcal fungi; effective in the treatment of cryptococcal meningitis

Question 17

Contraindications for antifungal drugs

Answer 17

most common: drug allergy, liver failure, kidney failure, and porphyria (for griseofulvin)

Question 18

itraconazole contrainidcations?

Answer 18

itraconazole: contraindicated treatment of onychomycoses in patients with severe cardiac problems

Question 19

which can cause fetal harm in pregnant women?

Answer 19

Voriconazole

Question 20

Amphotericin B adverse effects?

Answer 20

• Cardiac dysrhythmias
• Neurotoxicity; tinnitus; visual disturbances; paresthesias; convulsions
• Kidney toxicity, potassium loss, hypomagnesemia
• Pulmonary infiltrates
• Fever, chills, headache, nausea, occasional hypotension, gastrointestinal upset, anemia

Question 21

Amphotericin B Adverse Effects: Prevention

Answer 21

• Prescribers commonly order various premedications: antiemetics, antihistamines, antipyretics, and corticosteroids
• Prevent or minimize infusion-related reactions to amphotericin B
• Likelihood of such reactions can also be reduced by using longer-than-average drug infusion times (i.e., 2 to 6 hours)

Question 22

what are the adverse effects of fluconazole?

Answer 22

Nausea, vomiting, diarrhea, stomach pain,
Increased liver enzymes
Use with caution in patients with kidney or liver dysfunction

Question 23

what are the adverse effects of nystatin?

Answer 23

Nausea, vomiting, anorexia, diarrhea, rash, urticaria

Question 24

Antifungal Drugs: Interactions

Answer 24

Many antifungal drugs are metabolized by the cytochrome P450 enzyme system.
- Co-administration of two drugs that are metabolized by this system may result in competition for these enzymes and thus higher levels of one of the drugs.

Question 25

Nursing Implications (1 of 5)

Answer 25

Before beginning therapy, assess for hypersensitivity, possible contraindications, and conditions that require cautious use.
Obtain baseline vital signs, complete blood count, liver and renal function studies, and electrocardiogram.
Assess for other medications used (prescribed and over the counter), to avoid drug interactions
Some oral forms should be given with meals to decrease gastrointestinal upset; others require an empty stomach. Be sure to check.

Question 26

Nursing implications 2 of 5

Answer 26

Monitor vital signs of patients receiving intravenous (IV) infusions every 15 to 30 minutes.

Question 27

amphotericin B nursing implications?

Answer 27

To reduce the severity of the infusion-related reactions, pretreatment with an antipyretic (acetaminophen), antihistamines, antiemetics, and corticosteroids may be given.
Use IV infusion pumps and the most distal veins possible.

Question 28

what to monitor for antifubgals?

Answer 28

Monitor therapeutic effects.
Easing of symptoms of infection
Improved energy levels
Normal vital signs, including temperature
Watch for and carefully monitor adverse effects.