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a_nclex > Antimalarial, Antiprotozoal, and Antihelmintic Drugs > Flashcards

Antimalarial, Antiprotozoal, and Antihelmintic Drugs Flashcards

1
Q

Chloroquine

Chemical Classification

A

Synthetic 4-amino-quinoline derivative

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2
Q

Chloroquine

Mechanism of Action

A

Inhibits parasite replication, transcription of DNA to RNA by forming complexes with DNA of parasite

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3
Q

Chloroquine

Uses

A

Malaria of Plasmodium vivax, P. malariae, P. ovale, P. falciparum (some strains) amebiasis

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4
Q

Chloroquine

Contraindications

A

Hypersensitivity, retinal field changes

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5
Q

Chloroquine

Side Effects

A

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

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6
Q

Chloroquine

Nursing Considerations

A

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
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7
Q

Chloroquine

Overdose Treatment

A

Administer barbiturate (ultrashort-acting), vasopressor; tracheostomy may be necessary

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8
Q

Hydroxychloroquine (Plaquenil)

Functional Classification

A

Antimalarial, antirheumatic (DMARDS)

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9
Q

Hydroxychloroquine (Plaquenil)

Chemical Classification

A

4-Aminoquinoline derivative

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10
Q

Hydroxychloroquine (Plaquenil)

Mechanism of Action

A

Impairs, complement-dependent antigen-antibody reactions

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11
Q

Hydroxychloroquine (Plaquenil)

Uses

A

Malaria caused by susceptible strains of Plasmodium vivax, P. malariae, P. ovale, P. falciparum (some strains); SLE, rheumatoid arthritis

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12
Q

Hydroxychoroquine (Plaquenil)

Contraindications

A

Hypersensitivity to the product or chloroquine; retinal field damage

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13
Q

Hydroxychloroquine (Plaquenil)

Side Effects

A

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

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14
Q

Hydroxychloroquine (Plaquenil)

Nursing Considerations

A

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
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15
Q

Hydroxychloroquine (Plaquenil)

Overdose Treatment

A

Induce vomiting; gastric lavage; administer barbiturate (ultrashort acting), vasopressor, ammonium chloride; tracheostomy may be necessary

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16
Q

Metronidazole (Flagyl)

Functional Classification

A

Antiinfective-miscellaneous

17
Q

Metronidazole (Flagyl)

Chemical Classification

A

Nitroimidazole derivative

18
Q

Metronidazole (Flagyl)

Mechanism of Action

A

Direct-acting amebicide/trichomonacide binds and disrupts DNA structure, thereby inhibiting bacterial nucleic acid synthesis

19
Q

Metronidazole (Flagyl)

Uses

A

Intestinal amebiasis, amebic abscess, trichomoniasis, refractory trichomoniasis, bacterial anaerobic infections, giardiasis, septicemia, endocarditis; bone joint, lower respiratory tract infections; rosacea

20
Q

Metronidazole (Flagyl)

Contraindications

A

Pregnancy 1st trimester, breastfeeding, hypersensitivity to this product

21
Q

Metronidazole (Flagyl)

Side Effect

A

CNS: Headache, Dizziness, confusion, irritability, restlessness, ataxia, depression, fatigue, drowsiness, insomnia, paresthesia, peripheral neuropathy, SEIZURES, incoordination, depression, encephalopathy, ASEPTIC MENINGITIS
CV: flattening of T waves
EENT: blurred vision, sore throat, retinal edema, dry mouth, metallic taste, furry tongue, glossitis, stomatitis, photophobia, optic neuritis
GI: Nausea, Vomiting, Diarrhea, epigastric distress, Anorexia, constipation, Abdominal Cramps, PSEUODMEMBRANOUS COLITIS
GU: darkened urine, vaginal dryness, polyuria, ALBUMINURIA, dysuria, cystitis, decreased libido, NEPHROTOXICITY, incontinence, dyspareunia, candidiasis
HEMA: LEUKOPENIA, BONE MARROW, DEPRESSION, APLASIA, THROMBOCYTOPENIA
INTEG: rash, pruritus, urticaria, flushing, STEVENS-JOHNSON SYNDROME

22
Q

Metronidazole (Flagyl)

Nursing Considerations

A

ASSESS:

  • INFECTION: WBC, wound symptoms, fever, skin or vaginal secretions; start treatment after C&S; for opportunistic fungal infections; superinfection: fever, monilial growth, fatigue, malaise
  • Stools during entire treatment: should be clear at end of therapy; stools should be free of parasites for 1yr before patient considered cured (amebiasis)
  • Vision by ophthalmic exam during, after therapy; vision problems often occur
  • NEUROTOXICITY: peripheral neuropathy, seizures, dizziness, uncoordination, pruritus, joint pain; product may be discontinued
  • ALLERGIC REACTION: fever, rash, itching, chills; product should be discontinued if these occur
  • Renal, reproductive dysfunction: dysuria, polyuria, impotence, dyspareunia, decreased libido, I&O; weight daily
  • SECONDARY MALIGNANCY: used only when indicated; avoid unnecessary use
23
Q

Primaquine

Functional Classification

A

antimalarial

24
Q

Primaquine

Chemical Classification

A

Synthetic 8-aminoquinolone

25
Q

Primaquine

Mechanism of Action

A

Unknown; thought to destroy exoerythrocytic forms by gametocidal action

26
Q

Primaquine

Uses

A

Malaria caused by Plasmodium vivax; in combination with clindamycin for Pneumocystis jiroveci pneumonia

27
Q

Primaquine

Contraindications

A

Lupus erthematosus, rheumatoid arthritis; hypersensitivity to this product or idoquinol

28
Q

Primaquine

Side Effects

A

CNS: headache, dizziness
CV: hypertension, dysrhythmias
EENT: Blurred Vision, Difficulty Focusing
GI: Nausea, Vomiting, Anorexia, cramps
HEMA: AGRANULOCYTOSIS, GRANULOCYTOPENIA, LEUKOPENIA, HEMOLYTIC ANEMIA, LEUKOCYTOSIS, mild anemia, METHEMOGLOBINEMIA
INTEG: pruritus, skin eruptions, pallor, weakness

29
Q

Primaquine

Nursing Considerations

A

ASSESS:

  • Ophthalmic test if patient receiving long-term treatment or product dosage of >/= 150mg/day
  • Hepatic studies weekly: AST, ALT, bilirubin if patient receiving long-term therapy
  • Blood studies: CBC; blood dyscrasias occur
  • Allergic reactions: pruritus, rash, urticaria
  • Blood dyscrasias: malaise, fever, bruising, bleeding (rare)
  • Renal status: dark urine, hematuria, decreased output
  • HEMOLYTIC REACTION: chills, fever, chest pain, cyanosis; product should be discontinued immediately
30
Q

Chloroquine

Functional Classification

A

Antimalarial

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