Antimalarial, Antiprotozoal, and Antihelmintic Drugs Flashcards
Chloroquine
Functional Classification
Antimalarial
Chloroquine
Mechanism of Action
Inhibits parasite replication, transcription of DNA to RNA by forming complexes with DNA of parasite
Chloroquine
Uses
Malaria of Plasmodium vivax, P. malariae, P. ovale, P. falciparum (some strains) amebiasis
Chloroquine
Contraindications
Hypersensitivity, retinal field changes
Chloroquine
Side Effects
CNS: headache, stimulation, fatigue, SEIZURES, psychosis, hallucinations, insomnia
CV: hypotension, HEART BLOCK, ASYSTOLE WITH SYNCOPE, ECG changes, cardiomyopathy
EENT: Blurred Vision, Corneal Changes, Retinal Changes, Difficulty Focusing, tinnitus, vertigo, deafness, photophobia, corneal edema
GI: Nausea, Vomiting, Anorexia, diarrhea, cramps
HEMA: THROMBOCYTOPENIA, AGRANULOCYTOSIS, HEMOLYTIC ANEMIA, LEUKOPENIA
INTEG: pruritus, pigmentary changes, skin eruptions, lichen-planus-like eruptions, eczema, EXFOLIATIVE DERMATITIS
Chloroquine
Nursing Considerations
ASSESS:
- INFECTION: resistance is common, not to be used for P. falciparum acquired in areas of resistance or where prophylaxis has failed
- Ophthalmic test if long-term treatment or dosage of >150mg/day
- Blood studies: CBC, since blood dyscrasias occur
- ECG during therapy; watch for depression of T waves, widening of QRS complex
- ALLERGIC REACTIONS: pruritus, rash, urticaria
- BLOOD DYSCRASIAS: malaise, fever, bruising, bleeding (rare)
- FOR OTOTOXICITY (tinnitus, vertigo, change in hearing); audiometric testing should be done before, after treatment
- FOR TOXICITY: blurred vision; difficulty focusing; headache; dizziness; decreased knee, ankle reflexes; seizures, CV collapse; product should be discontinued immediately and IV fluids given
Chloroquine
Overdose Treatment
Administer barbiturate (ultrashort-acting), vasopressor; tracheostomy may be necessary
Hydroxychloroquine (Plaquenil)
Functional Classification
Antimalarial, antirheumatic (DMARDS)
Hydroxychloroquine (Plaquenil)
Chemical Classification
4-Aminoquinoline derivative
Hydroxychloroquine (Plaquenil)
Mechanism of Action
Impairs, complement-dependent antigen-antibody reactions
Hydroxychloroquine (Plaquenil)
Uses
Malaria caused by susceptible strains of Plasmodium vivax, P. malariae, P. ovale, P. falciparum (some strains); SLE, rheumatoid arthritis
Hydroxychoroquine (Plaquenil)
Contraindications
Hypersensitivity to the product or chloroquine; retinal field damage
Hydroxychloroquine (Plaquenil)
Side Effects
CNS: headache, stimulation, fatigue, irritability, SEIZURES, bad dreams, dizziness, confusion, psychosis, decreased reflexes
CV: hypotension, heart block, ASYSTOLE WITH SYNCOPE
EENT: Blurred Vision, Corneal Changes, Retinal Changes, Difficulty Focusing, tinnitus, vertigo, deafness, photophobia, corneal edema
GI: Nausea, Vomiting, Anorexia, diarrhea, cramps
HEMA: THROMBOCYTOPENIA, AGRANULOCYTOSIS, LEUKOPENIA, APLASTIC ANEMIA
INTEG: pruritus, pigmentation changes, skin eruptions, lichen-planus -like eruptions, eczema, EXFOLIATIVE DERMATITIS, alopecia, STEVENS-JOHNSON SYNDROME, photosensitivity
Hydroxychloroquine (Plaquenil)
Nursing Considerations
ASSESS:
- SLE, MALARIA SYMPTOMS: before treatment and daily
- RHEUMATOID ARTHRITIS: pain, swelling, ROM, temp of joints
- Ophthalmic exam at baseline and q6mo if long-term treatment or product dosage >150mg/day
- Hepatic studies q wk: AST, ALT, bilirubin if patient receiving long-term treatment
- BLOOD DYSCRASIAS: blood studies: CBC, platelets; WBC, RBC, platelets may be decreased; if severe product should be discontinued; assess for malaise, fever, bruising, bleeding (rare)
- For decreased reflexes: knee, ankle
- ECG during therapy: watch for depression of T waves, widening QRS complex
- ALLERGIC REACTIONS: pruritus, rash, urticaria
- FOR OTOTOXICITY (tinnitus, vertigo, change in hearing); audiometric testing should be done before, after treatment
- FOR TOXICITY: blurred vision, difficulty focusing, headache, dizziness, knee, ankle reflexes; product should be discontinued immediately
Hydroxychloroquine (Plaquenil)
Overdose Treatment
Induce vomiting; gastric lavage; administer barbiturate (ultrashort acting), vasopressor, ammonium chloride; tracheostomy may be necessary