Bacterial, Fungal & Viral Infections Flashcards

Question

Other Antibiotics

Answer 1

Vancomycin: effective against gram positive organisms (staph, strep, MRSA). C.diff infection. Nephrotoxicity, ototoxic, red man syndrome. Patients may be on two different routes Linezolid: MRSA Daptomycin: serious skin and soft tissue infections Imipenem, meropenem (carbapenems)

Answer 2

Upper chest rash but not a true allergic reaction Need to slow down infusion rate of vancomycin Sometimes need to administer Benadryl NEED TO TELL NEXT NURSE

Answer 3

Mycobacterium tuberculosis 25% of the worlds population has latent TB (infected but not ill) Worldwide leading cause of death for HIV+ Typically affect lungs but can be found in other tissues (tubercles found in apex)

Answer 4

First line: ethambutol (N/V), isoniazid (paresthesias, neurotoxicity, hepatotoxicity), pyrazinamide (gout/Uris acid), rifampin (N/V, gastric pain, orange discoloration of body fluids) Typically on all these drugs for 6-12 months

Answer 5

Initial phase: 2 months of all four drugs Continuous phase: 4 months of isoniazid and rifampin Multi drug resistant infections are common

Answer 6

- Money and resources - Drug administration -

Answer 7

Mushrooms Yeast - Candida albicans is responsible for majority of human fungal infections. Histoplasma capsulatum Molds - Aspergillus, Penumocytis jiroveci

Answer 8

Most common route of exposure are inhalation and comtaminged soil. Infection can be: Superficial: scalp skin nail mucous mem Systemic: Spread throughout systems of the body The immunocompromised are most at risk for serious consequences related to fungal incearions Opportunist infection occurs because the immune system is weakened

Answer 9

May. Occurs in anyone Most often treated with topical medications (torches are sucked on) Occasionally oral medication may be required for deep skin or nail infections

Answer 10

Thera topical antifungal Pharm: Polyene Indication: vagina, skin or mouth candida infection MOA; break down fungal cell membrane Adverse: minor skin irritation, given orally (swish and swallow) may cause N/V diarrhea Implications: Do not easy or drink for 30 min after using "swish and swallow" Nystatin powder is best for moist areas. WIth vaginal infection abstain from intercourse until treatment if complete.

Answer 11

``` More common in immunocompromised Often life threatening Requires more prolonged course of treatment Common systemic antifungals -anole drugs -amphotericin B -capsofungin -micafungin ```

Answer 12

Thera: Systemic antifungal Pharm: Triazole Indications: Candida infection, crytoccal infection MOA: inhibits fungal sterol synthesis Adverse:N/V, headache, rash Implications: IV or PO, Fluconazloe and other anoles are tetragenoic

Answer 13

Thera: Systemic anti fungal (big guns) Pharm: Polyene Indications: effective against must fungi, for sever infections MOA: breakdown of fungal cell membrane Adverse: Fever and chills (common), nephrotoxicity, hypokalemia, N/V, diarrhea Implications: Given IV (not absorbed from GI tract). Irritating to veins. Topical formulation for superficial infections. Liposomal formulations avail to decrease toxicity, Avoid concurrent use with other meds which can impair renal function (aminoglycosides, vancomycin, furosemide). START WITH TEST DOSE. May require premedication to decrease adverse effects (Tylenol, Benadryl, corticosteroids, fluid bolus)

Answer 14

Difficult to treat: rapid mutation of viruses renders drugs ineffective. Symptoms often appear after most of the virus particles have replicated Antiviral are often specific to the treatment of specific viruses.

Answer 15

Prevent viral infections Treat active infection Boost immune system to keep viruses in latent state

Answer 16

Flue season Oct-May 70-85% of influenza deaths are in those >65 yo Effects very young too Influenza vaccine causes body to produce antibodies again certain strains of the virus Influenza antiviral drugs are an important adjunct to the vaccine and can be used to treat old prevent the disease Early treatment with antiviral drugs can shorten duration of illness and reduce death in hospitalized

Answer 17

Thera: antiviral Pharm: Neuraminidase Inhibitor Indications: Flu A and B and prophylaxis MOA; Inhibits flu virus neuraminidase which affect viral particle release Adverse: N/V, diarrhea. Young people get neurological effects (confusion and seizure) Implications: best if given within 48 hours of symptom onset. May prevent infection if given prior to exposure. Decrease nausea if given with food.

Answer 18

HSV 1: eye mouth lips HSV 2: genital Cytomegalovirus (CMV): multiple body systems, usually seen in immunocompromised Varicella Zosters: chickenpox (varicella) and shingles (zoster) Epstein-Barr: mono and Burkitts lymphoma

Answer 19

Thera: antiviral Pharmacy: nucleoside analog Indications: HSV 1,2, prophylaxis treatment of acute infections MOA; decreased durations and severity of episode by hibiting viral DNA synthesis. DOES NOT cure and no effect on virus in latent phase Adverse: N/V,diarrhea, headache, irritation of blood vessels Implications: topical, IV or PO

Answer 20

``` Cellular immune deficiency chara by the depletion of helper T cells (CD4). The loss of DC4 cells results in the development of opportunistic infections and neoplastic processes (cancer) Goals Phram: Prolong survival Improve quality of life Preserve immune function Suppress viral load Prevent maternal-child transmission ```

Answer 21

Typicall starts when CD4 count is <350 or when AIDS related illness is identified Once antiretroviral therapy for HIV is started it continues for life

Answer 22

Standard Treatment (combo 3-4 drugs) Antiretroviral drug classes 1. Nucleoside and Nucleotide Reverse Transcriptase Inhibitors 2. Non-nucleosides Reverse Transcriptase Inhibitors 3. Entry inhibitors 4. Integrate Inhibitors 5. Fusion Inhibitors

Answer 23

``` Lipid abnormalities Hepatotoxicity Neuropathy Osteoporosis Cardiovascular disease ```

Bacterial, Fungal & Viral Infections Flashcards

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