Antituberculars, Antifungals, Peptides and Metronidazole Flashcards
What is the etiology of tuberculosis?
mycobacterium tuberculosis (acid-fast bacillus)
How is tuberculosis transmitted?
airborne droplets - coughing sneezing
Who is at increased risk for tuberculosis?
Alcohol addicted
debilitated
immunocompromised
What are the symptoms of tuberculosis?
Cough
sputum
fever, night sweats, weight loss
GI distress
Prophylaxis recommended in the first 6mn to 1yr
Close contact w/ diagnosed TB pt
HIV+ with TB test
Converted from - to + TB test
Contraindicated in liver disease
Drug combinations for antitubercular drugs
single drug therapy is ineffective
multidrug therapy increases the bacterial resistance to drugs, Treatment duration is decreased.
First-line drugs for antitubercular drugs are
isoniazid, rifampin, ethambutol, streptomycin
more effective and less toxic than second-line
Second-line drugs antitubercular drugs are
capreomycin, cycloserine, ethionamide, kanamycin, amikacin, ciprofloxacin, pyrazinamide
Less effective and more toxic than first-line drugs
What is the treatment regimen for tuberculosis?
Depends on resistance Typically INH and rifampin divided into 2 phases phase 1 - 2 months phase 2 - 4 to 7 months
The action of isoniazid (INH) is
inhibition of bacterial wall synthesis
The route for isoniazid (INH) is
oral, IM
The side effects/adverse reactions for isoniazid (INH) are
Photosensitivity, Blurred vision Tinnitus, dizziness GI distress, constipation Peripheral neuropathy psychotic behavior, seizures blood dyscrasias, hepatotoxicity
Drug interactions for isoniazid (INH) are
- Alcohol, rifampin, cycloserine, phenytoin increase effect of INH
- decreases phenytoin when concurrent
- antacids decrease absorption
- Alcohol increases risk of neuropathy, hepatotoxicity
Teaching for isoniazid
Take INH 1 hour before or 2 hours after meals Take all meds collect sputum specimen every morning Take pyridoxine (VB6) to prevent peripheral neuropathy Check liver inzymes, CBC Frequent eye exams Report numbness, tingling, burning Teach sun precautions avoid antacids
When administering streptomycin, monitor
ototoxicity and renal function
When taking rifampin, teach the patient
that body fluids may be red-orange
When taking ethambutol, teach the patient
to only take a single daily dose to avoid visual disturbances
antifungals treat
superficial infections (skin, mucous membranes,) and systemic infections (Lungs, CNS)
What are the antifungal (antimycotic) drug groups?
Polyenes, Azoles, Antimetabolic, Antiprotozoals, Echnocandins
Polyene antifungal drugs include
amphotericin B
nystatin
Azoles antifungals include
Fluconazole
miconazole
Antimetabolic antifungals include
flucytosine
Antiprotozoals antifungals include
atovaquone
Echinocandins antifungals include
caspofungin
Amphotericin is used to treat
several fungal infections
the action of amphotericin is
it binds to fungal cell membranes, causing leakage of contents (fungicidal, fungistatic)
the route of administration of amphotericin is
IV over 2-6 hours
side effects/ adverse reactions to amphotericin B is
flushing, fever, chills, HA, dyspnea Hypotension, hypertension, tachycardia GI distress, pseudo. colitis seizures, paresthesia, thrombophlebitis nephrotoxicity, electrolyte imbalance, ototoxicity
Interventions for amphotericin B are
Give IV over 2-6 hours Monitor VS q30min (ESP. BP!) Prevent febrile rxns and anaphylaxis Increase fluids Monitor output, weight Monitor electrolytes, renal and liver fx
The action of nystatin is
increases the permeability of fungal cell membrane
fungistatic, fungicidal
Administration of nystatin is via
oral, topical
Teaching for nystatin is
swish and swallow
gargle if throat is affected
Fluconazole is used to treat
candidiasis, cryptococcosis, histoplasmosis
the route of administration for fluconazole is
topical, oral, IV, vaginal
Flucytosine is used to
(in oral combination) increase effectiveness and toxicity
Atovoquone is used to treat
mild to moderate pneumocystitis carinii pneumonia
the route of administration for atovoquone is
oral
Caspofungin is used to treat
candida, aspergillosis
the route of administration for caspofungin is
IV
Polymyxin B is used to treat
p. aeruginosa, E. coli, Klebiella, shigella
the route of administration for polymyxins B is
slow IV
Adverse effects of polymyxins B are
nephrotoxicity and neurotoxicity
Bacitracin is used to treat
meningitis
the route of administration for bacitracin is
IM and topical
the adverse effects of bacitracin are
GI distress, renal damage
Metronidazole is used to treat
various disorders associated with organisms in the GI tract
Can be used prophylactically in colorectal surgery
side effects of metronidazole are
dark or reddish brown urine (high doses)
w/ alcohol (facial flushing, sweating, HA, slurred speech)
When taking metronidazole patients should avoid
alcohol and use during 1st trimester
