Antituberculars, Antifungals, Peptides and Metronidazole

Question 1

What is the etiology of tuberculosis?

Answer 1

mycobacterium tuberculosis (acid-fast bacillus)

Question 2

How is tuberculosis transmitted?

Answer 2

airborne droplets - coughing sneezing

Question 3

Who is at increased risk for tuberculosis?

Answer 3

Alcohol addicted
debilitated
immunocompromised

Question 4

What are the symptoms of tuberculosis?

Answer 4

Cough
sputum
fever, night sweats, weight loss
GI distress

Question 5

Prophylaxis recommended in the first 6mn to 1yr

Answer 5

Close contact w/ diagnosed TB pt
HIV+ with TB test
Converted from - to + TB test
Contraindicated in liver disease

Question 6

Drug combinations for antitubercular drugs

Answer 6

single drug therapy is ineffective

multidrug therapy increases the bacterial resistance to drugs, Treatment duration is decreased.

Question 7

First-line drugs for antitubercular drugs are

Answer 7

isoniazid, rifampin, ethambutol, streptomycin

more effective and less toxic than second-line

Question 8

Second-line drugs antitubercular drugs are

Answer 8

capreomycin, cycloserine, ethionamide, kanamycin, amikacin, ciprofloxacin, pyrazinamide
Less effective and more toxic than first-line drugs

Question 9

What is the treatment regimen for tuberculosis?

Answer 9

Depends on resistance
Typically INH and rifampin
divided into 2 phases
phase 1 - 2 months
phase 2 - 4 to 7 months

Question 10

The action of isoniazid (INH) is

Answer 10

inhibition of bacterial wall synthesis

Question 11

The route for isoniazid (INH) is

Answer 11

oral, IM

Question 12

The side effects/adverse reactions for isoniazid (INH) are

Answer 12

Photosensitivity, Blurred vision
Tinnitus, dizziness
GI distress, constipation
Peripheral neuropathy
psychotic behavior, seizures
blood dyscrasias, hepatotoxicity

Question 13

Drug interactions for isoniazid (INH) are

Answer 13

• Alcohol, rifampin, cycloserine, phenytoin increase effect of INH
• decreases phenytoin when concurrent
• antacids decrease absorption
• Alcohol increases risk of neuropathy, hepatotoxicity

Question 14

Teaching for isoniazid

Answer 14

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

Question 15

When administering streptomycin, monitor

Answer 15

ototoxicity and renal function

Question 16

When taking rifampin, teach the patient

Answer 16

that body fluids may be red-orange

Question 17

When taking ethambutol, teach the patient

Answer 17

to only take a single daily dose to avoid visual disturbances

Question 18

antifungals treat

Answer 18

superficial infections (skin, mucous membranes,) and systemic infections (Lungs, CNS)

Question 19

What are the antifungal (antimycotic) drug groups?

Answer 19

Polyenes, Azoles, Antimetabolic, Antiprotozoals, Echnocandins

Question 20

Polyene antifungal drugs include

Answer 20

amphotericin B

nystatin

Question 21

Azoles antifungals include

Answer 21

Fluconazole

miconazole

Question 22

Antimetabolic antifungals include

Answer 22

flucytosine

Question 23

Antiprotozoals antifungals include

Answer 23

atovaquone

Question 24

Echinocandins antifungals include

Answer 24

caspofungin

Question 25

Amphotericin is used to treat

Answer 25

several fungal infections

Question 26

the action of amphotericin is

Answer 26

it binds to fungal cell membranes, causing leakage of contents (fungicidal, fungistatic)

Question 27

the route of administration of amphotericin is

Answer 27

IV over 2-6 hours

Question 28

side effects/ adverse reactions to amphotericin B is

Answer 28

``` flushing, fever, chills, HA, dyspnea Hypotension, hypertension, tachycardia GI distress, pseudo. colitis seizures, paresthesia, thrombophlebitis nephrotoxicity, electrolyte imbalance, ototoxicity ```

Question 29

Interventions for amphotericin B are

Answer 29

``` 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 ```

Question 30

The action of nystatin is

Answer 30

increases the permeability of fungal cell membrane | fungistatic, fungicidal

Question 31

Administration of nystatin is via

Answer 31

oral, topical

Question 32

Teaching for nystatin is

Answer 32

swish and swallow | gargle if throat is affected

Question 33

Fluconazole is used to treat

Answer 33

candidiasis, cryptococcosis, histoplasmosis

Question 34

the route of administration for fluconazole is

Answer 34

topical, oral, IV, vaginal

Question 35

Flucytosine is used to

Answer 35

(in oral combination) increase effectiveness and toxicity

Question 36

Atovoquone is used to treat

Answer 36

mild to moderate pneumocystitis carinii pneumonia

Question 37

the route of administration for atovoquone is

Answer 37

oral

Question 38

Caspofungin is used to treat

Answer 38

candida, aspergillosis

Question 39

the route of administration for caspofungin is

Answer 39

IV

Question 40

Polymyxin B is used to treat

Answer 40

p. aeruginosa, E. coli, Klebiella, shigella

Question 41

the route of administration for polymyxins B is

Answer 41

slow IV

Question 42

Adverse effects of polymyxins B are

Answer 42

nephrotoxicity and neurotoxicity

Question 43

Bacitracin is used to treat

Answer 43

meningitis

Question 44

the route of administration for bacitracin is

Answer 44

IM and topical

Question 45

the adverse effects of bacitracin are

Answer 45

GI distress, renal damage

Question 46

Metronidazole is used to treat

Answer 46

various disorders associated with organisms in the GI tract | Can be used prophylactically in colorectal surgery

Question 47

side effects of metronidazole are

Answer 47

dark or reddish brown urine (high doses) | w/ alcohol (facial flushing, sweating, HA, slurred speech)

Question 48

When taking metronidazole patients should avoid

Answer 48

alcohol and use during 1st trimester