Antifungals / Antiparasitics / Antivirals Flashcards
______ refers to an infection caused by fungus
Mycosis
Fungi are ______
Eukaryotic
What are the causes of candida albicans? (3)
- Antibiotics
- Antineoplastics
- Immunosuppressants
Onychomycoses affects the ______
Nail bed
Tinea capititis affects the ______
Scalp
Tinea cruris affects the ______
Groin
Tinea pedis affects the ______
Feet
What is the primary indication of Amphotericin B?
Fungal infections
What are the side effects of Amphotericin B? (3)
- Fever
- Hypotension
- Muscle / joint pain
What are the adverse effects of Amphotericin B? (2)
- Nephrotoxicity
- Hypokalemia
Amphotericin B treatment takes ______
6 - 8 weeks
Amphotericin B is recommended to be administered with ______ to decrease renal impact
IVF
Describe the monitoring associated with Amphotericin B (2)
- Renal function
- Potassium
______ provides broad fungal coverage
fluconazole (Diflucan)
What is the primary indication of fluconazole (Diflucan)?
Fungal infections
What is the primary benefit associated with fluconazole (Diflucan)?
Great bioavailability
What is the primary side effect associated with fluconazole (Diflucan)?
GI complications
What is the primary adverse effect associated with fluconazole (Diflucan)?
Liver impairment
What is the primary indication of ketoconazole (Nizoral)?
Fungal infections
What are the adverse effects of ketoconazole (Nizoral)? (5)
- Hepatotoxicity
- Cardiovascular events
- Thrombocytopenia
- Hemolytic anemia
- Leukopenia
What drug interactions decrease absorption of ketoconazole (Nizoral)? (3)
- Antacids
- H2 antagonists
- Proton pump inhibitors
What drug interactions increase risk of ketoconazole (Nizoral) toxicity? (3)
- Digoxin
- Warfarin
- Sulfonylureas
What is the primary topical antifungal? (not systemic)
nystatin (Mycostatin)
What types of fungal infections is nystatin (Mycostatin) used to treat? (3)
- Cutaneous
- Intestinal
- Oral
Since antifungals are metabolized by cytochrome P450, they are …
Highly protein bound - many interactions
What are the common protozoal infections? (4)
- Amebiasis
- Giardiasis
- Trichomoniasis
- Toxoplasmosis
______ patients are at higher risk of developing protozoal infections
Immunocompromised
What are the routes of metronidazole (Flagyl)? (2)
- PO
- IV
What type of protozoal infection is metronidazole (Flagyl) used to treat?
Trichomoniasis
______ are used to treat non-HIV viruses
Antivirals
______ are used to treat HIV
Antiretrovirals
What are the indications of oseltamivir (Tamiflu)? (2)
- Influenza A
- Influenza B
What is the route of oseltamivir (Tamiflu)?
PO
What is the goal of oseltamivir (Tamiflu)?
Reduce the duration of illness (several days)
What is the primary side effect of oseltamivir (Tamiflu)?
Nausea / vomiting
oseltamivir (Tamiflu) treatment should begin within ______ of influenza symptom onset
48 hours
Describe the primary nursing consideration associated with oseltamivir (Tamiflu)
Renal dose adjustments required
What is HSV-1?
Oral herpes
What is HSV-2?
Genital herpes
What is VZV?
Chickenpox / singles
What is HHV-4?
Epstein-Barr (mono)
What is HHV-5?
Cytomegalovirus
What is HHV-8?
Kaposi’s sarcoma
What are the indications of acyclovir (Zovirax)? (3)
- HSV-1
- HSV-2
- VZV
What are the adverse effects of acyclovir (Zovirax)? (2)
- Renal failure
- Neurotoxicity
What are the manifestations of neurotoxicity? (3)
- Agitation
- Delirium
- Hallucinations
Describe the nursing interventions associated with acyclovir (Zovirax) (2)
- Wear gloves with topical administration
- Monitor for phlebitis with IV administration
What are the indications of valacyclovir (Valtrex)? (3)
- HSV-1
- HSV-2
- VZV
When should valacyclovir (Valtrex) be taken?
At the first sign of an outbreak
What is the primary indication of ganciclovir (Cytovene)?
Cytomegalovirus (transplant patents)
Describe the black box warning associated with ganciclovir (Cytovene)
Extreme risk of toxicity
What are the manifestations of ganciclovir (Cytovene) toxicity? (3)
- Anemia
- Neutropenia
- Thrombocytopenia
Describe the risks associated with ganciclovir (Cytovene) (3)
- Carcinogenic
- Teratogenic
- Infertility
What is the primary class of antiretrovirals?
Nucleotide reverse transcriptase inhibitors (NRTI)
What is the standard treatment for HIV?
Highly active antiretroviral therapy (HAART)
HAART consists of ______ medications
3
Describe HAART (3)
- Starts immediately after diagnosis
- NOT curative
- Prophylactic
HAAART is highly ______
Toxic
What are the goals of HAART? (4)
- Decrease replication
- Decrease opportunistic infections
- Increase T cells
- Prolong life
What is the drug class of zidovudine (AZT, Retrovir)?
NRTI
Describe the primary nursing intervention associated with zidovudine (AZT, Retrovir)
Renal dose adjustments required
What is the primary risk associated with hepatitis C?
Thromboembolic events
Hepatitis C may reactivate ______
Hepatitis B infection
What is the therapeutic dosage used for treatment of hepatitis C?
ledipasvir 90 mg / sofobuvir 400 mg = Harvoni