antifungal drugs: chapter 47

Question 1

what are the four types of fungal infections

Answer 1

systemic, cutaneous, subcutaneous, superficial

Question 2

what drugs are considered polyenes

Answer 2

amphotericin B, nystatin

Question 3

mechanism of action of amphotericin B and nysatin

Answer 3

bind to ergosterol in the cell membranes of fungi

Question 4

how does the mechanism of action of amphotericin b and nystatin have an effect

Answer 4

causes a loss in potassium and magenisum which kills the fungal cell

Question 5

mechanism of aciton of ketoconazole, fluconazole, and variconazole

Answer 5

inhibit fungal cell cytochrome p450 enzymes

Question 6

how does the mechanism of action of ketoconazole, fluconazole, and voriconazole have an effect

Answer 6

inhibit growth so that there is no ergosterol

Question 7

mechanism of action and effect of terbinafine

Answer 7

inhibit fungal cell cytochrome p450 enzyme which inhibits growth due to no ergosterol

Question 8

mechanism of action and effect of caspofungin

Answer 8

prevent the synthesis of glucans which leads to cell death due to no cell wall

Question 9

what is the drug of choice for severe systemic infections

Answer 9

amphotericin B

Question 10

which drug can enter cerebral spinal fluid to inhibit growth of cryptococcal fungi

Answer 10

fluconazole

Question 11

3 contraindications for antifungal drugs

Answer 11

liver failure, kidney failure, voriconazole can cause fetal harm

Question 12

6 adverse effects of amphotericin b

Answer 12

dysrhythmia, tinnitus, kidney toxicity, potassium loss, hypomagnesmia, fever, anemia

Question 13

2 adverse effects of fluconazole

Answer 13

increased liver enzymes, dizziness

Question 14

2 adverse effects of nystatin (topical)

Answer 14

cramps, rash

Question 15

what syndrome can be experienced when amphotericin B is administered via IV. what are 5 things that characterize this syndrome

Answer 15

shake and bake syndrome

fever, chills, hypotension, tachycardia, body aches

Question 16

what must be done to the dosage of caspofungin if the patient has impaired liver function

Answer 16

decrease the dose

Question 17

indication for nystatin

Answer 17

candidiasis

Question 18

indication for terbinafine

Answer 18

onychomycoses

Question 19

what drugs should not be taken alongside voriconazole. why?

Answer 19

other drugs metabolized by CYP3A4 due to the risk of serious dysrhythmias

Question 20

what is the only antifungal that is contraindicated during pregnancy

Answer 20

voriconazole

Question 21

how often should you monitor vitals when there is IV administration of amphotericin B. what should you do if adverse effects occur

Answer 21

monitor vitals every 15min. discontinue the infusion if adverse effects occur

Question 22

what weight changes can indicate medication induced kidney damage while a patient is taking amphotericin B

Answer 22

gain of 1kg or more in 24hrs or 2.3kg or more in 1 week

Question 23

what tests are important to run while a patient is on caspofungin (3)

Answer 23

liver function tests, hemoglobin, hematocrit

Question 24

a patient receiving IV fluconazole develops itching and a rash. what should the nurse do

Answer 24

stop the infusion

Question 25

when should voriconazole be administered in consideration of meals

Answer 25

1hr before or after a meal

Question 26

what are 2 important patient teachings that must be given to females taking antifungal drugs

Answer 26

refrain from sex, take during their period