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343 Pharm Exam 3 > Chapter 30 : Antituberculars, Antifungals, And Antivirals > Flashcards

Chapter 30 : Antituberculars, Antifungals, And Antivirals Flashcards

1
Q

What’s the bacteria that causes tuberculosis?

A

Mycobacterium tuberculosis

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2
Q

How is TB spread?

A

Person to person via droplets

Airborne

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3
Q

What an example of droplets?

A

Coughing
Sneezing
Talking

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4
Q

Who are at risk of getting TB?(4)

A

Immunocompromised
Living/working in high risk residential
Injecting illegal drugs
Health care works with these pts

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5
Q

What are common side effects of tuberculosis? (3)

A

Cough
Fever
Night sweats !!
Gi distress
Weight loss!!
Positive acid fast bacilli in the sputum or blood sputum !!

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6
Q

Notes
Tuberculosis
Prophylaxis recommended for those
- close contact with active TB
- HIV positive/ immunosuppressive
- conversion from negative to pos
- latent TB infection
- injection drug users
- recent immigrants

A
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7
Q

Are you gonna get TB when someone behind you coughs at the grocery school?

A

No

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8
Q

Are you gonna get TB when you live with someone who has TB?

A

Yes

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9
Q

What is latent TB?

A

When you’ve been exposed to TB and it’s in your body
But you’re not sick
But you have zero symptoms
You can’t spread it

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10
Q

Can you spread latent TB?

A

No

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11
Q

So let’s say you have latent TB, however you become sick, weak, immunocompromised, what happens?

A

You’re more likely to develop active TB

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12
Q

What percentage are you at when you have latent TB to develop active TB?

A

10%

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13
Q

What do we as nurses do to help latent tb patients?

This helps how?

A

Treat them for TB
Destroying that myobacterium in their lung

To avoid active TB

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14
Q

With latent TB, how is the skin test ?

A

You are negative for years and then suddenly you get positive

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15
Q

Overall latent TB
Are you sick?
are you contagious?

A

Nope!

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16
Q

What’s the vaccine for TB?

A

BCG vaccine

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17
Q

Is latent TB easy to treat?
And how long?

A

Yes
3 months

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18
Q

What is active TB?(4)

A

Positive skin & blood test
Symptoms
X-ray
Contagious

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19
Q

What’s the biggest problem with treating TB is what? (3)

A

Drug resistant
Drug toxicity
Patient no adherence

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20
Q

Since TB is a highly drug resistance bacteria, how do we treat active TB? (3)

A

Take multiple medications
For at least 9 months
Multiple times a day

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21
Q

Notes
Effectiveness depends on
- types of infections
- adequate dosing
- sufficient duration of treatment
- adherence to drug regimen
- selection of an effective drug combination

A
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22
Q

TB medications are so strict to the point that people are paid to go to houses to what?

A

Watch them take it
To avoid resistance !!

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23
Q

What’s the first thing to do when someone has TB? Like labs or tests wise?

A

Cultures

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24
Q

Usually what other tests can we use to see TB?

A

Skin test
X ray test
Blood test

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25
Q

If we suspect a patient who has TB what do we do?

A

Immediately start on antitubercular drugs and isolation

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26
Q

Problems with successful therapy occur because of patient ??

A

Nonadherencd to drug therapy

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27
Q

What are the 4 first line antitubercular drugs ?

A

Isoniazid
Rifampin
Purazinamide
Ethambutol

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28
Q

When taking antitubercular drugs, we usually have to do what?

A

Combine multiple of these medications because of how bad resistance is with TB

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29
Q

What is the initial phase of medication of TB?
How long and how many drugs?

A

2 months
4 drugs

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30
Q

What is the continuation phase for TB drugs?
How long and how many drugs?

A

4-7 months
2 drugs

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31
Q

How long does it take for a culture for TB to come back?

A

2 months

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32
Q

When the culture hasn’t come back how many drugs will they be on?

Then after it comes back?

A

4 drugs

2 drugs

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33
Q

What is the biggest thing of all TB drugs? Causes?

A

Hepatotoxicity!!

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34
Q

When a patient has TB drug and since it causes hepatotoxicty ( liver problem ), what do we do?

A

Monitor LFTS
Before and monitor

35
Q

What is isoniazid (INH)
Route : (2)

A

Oral & IM

36
Q

How do you take isoniazid ?
Empty or full stomach?

And when?

A

Empty

Before 1 hour
2 hour after meals

37
Q

What are side effects of isoniazid (INH)(5)

A

Photosensitivity
Tinnitus
Peripheral neuropathy
Heptotoxicty
Blurred vision

38
Q

How do we treat peripheral neuropathy in the TB drug INH?

How does this aid ?

A

Vitamin B6 ( pyridoxine )

Stops those parathesia feeling

39
Q

Usually we don’t wait for patients to have that numbness in tingling instead we?

A

Tell them to take vitamin b6 !

40
Q

What does ethambutol do?

A

Damage eyes!!
Blurred or changed vision

41
Q

Normally when a patient who just got TB and is not taking ethambutol and INH, we usually do what?

A

Do a visual exam
( baseline )
Since it causes changes in vision!

42
Q

What is rifampin so different?? (2)

A

Everything comes out orange
Fluids orange

Sweat, semen, salvia

Decrease birth control

43
Q

Again, every TB medication has what?

A

Hepatotoxicity!!!

44
Q

How do we know that a patient is having liver problems?

A

Jaundice!!!
Yellow everything

45
Q

What are the big nursing considerations regarding TB? (6)

A

Assess liver functions
( monitor LFTS!)

Take orderly

INH & ethambutol = eye exams

No alcohol!

Rifampin = orange everything

Pyridoxine = INH & amingoclysides = treatment of neurotoxicity

46
Q

Special populations
Pregnancy
- latent TB 9 months

HIV
- latent TB
- aggressive treatment

Pediatrics
- latent TB 9 months

A
47
Q

Now onto antifungal medications !!

A
48
Q

Normally fungal infections are local, which means?

Examples ?

A

Like on the skin, mucous membranes, nails, hair

Thrush, yeast infection

49
Q

However if a patient has a system. Infection it’s more likely they have?

Examples?

A

Immunosuppression

Fungal lung infection or fungal meningitis

50
Q

What’s more severe local or systemic ?

A

Systemic

51
Q

What are the fungal drugs we are gonna talk about? (2)

A

Polyenes
Azoles

52
Q

Polyenes, what’s the medication we need to know for this group of antifungal ?

A

Amphotericin B

53
Q

When do we normally give amphotericin B?

A

Usually never unless it’s like nothing else works

Last resort type of med

54
Q

What are the 3 big side effects of amphotericin B ( Polyenes )?

A

Thrombophlebitis
Nephrotoxicity
Hypokalemia

55
Q

Since Polyenes, amphotericin B causes thrmobophlebitis, what is the nurse going to do?

A

We are gonna assess the IV site for any inflammation/redness

Try to avoid small vein, use big one

56
Q

What is another drug that causes hypokalemia??

So what we need to monitor ?

Side effects
Palpitations
Heart skipping a beat

We check potassium

A

Digoxin

Telemetry

57
Q

Amphotericin B
Usually we give an infusion but they can experience flushing fever and chills
However we can prevent this but giving 1-3 hours before this infusion what 3 drugs?

A

Tylenol Benadryl corticosteroid

58
Q

Is Amphotericin B highly protein bound?

If we give this to another highly protein bound what happens??

A

Yes!

Toxic!!

59
Q

How long is the half life for Amphotericin B?

If they had an allergy reaction, how long will it take to get rid of it?

A

15 days

15 days!!!

60
Q

Amphotericin B causes bone marrow suppression, so we need to monitor what as well?

A

CBC

61
Q

How do you give azoles?

A

Oral, IV, vaginal or topical

62
Q

What treatment come from using azoles?

A

Athletes foot
Yeast infections
Thrush

63
Q

What does oral antifungal medications interact with this? (3)

A

Warfarin
Digoxin
Statins

64
Q

What are some side effects of azoles? (2)

A

Hepatotoxicity
Nephrotoxicity

65
Q

What’s the biggest drug interaction with azoles? And what does it cause?

A

Fluconazole

Increase PT with warfarin
Hypoglycemia with sulfa drugs

66
Q

We usually use oral azole medications are first given since it’s less toxic than what?

A

Amphotericin B

67
Q

What is the super fetal drug that induced what for azoles?

A

Ketoconazole

Hepatitis

68
Q

Azoles can affect diabetics how?

A

Glycemic levels

69
Q

Do we give azoles to pregnant woman?

A

No
Cause menstrual abnormalities

70
Q

Overall we want to avoid what with antifungal since it causes Hepatotoxicity?

A

Alcohol!!

71
Q

Now onto viruses!

A
72
Q

Does antibacterials kill viruses?

A

Nope!

73
Q

What are examples of virus ?

A

Hepatitis
Herpes
HIV
Flu
RSV
COVID

74
Q

What are some examples of influenza medications? (2)

A

Tamiflu and relenza

75
Q

What does the antiviral tamiflu and relenza do to the body?

A

Decrease the viral spread

It doesn’t go away
Just shortens your symptoms !!

Shorten the infection
Or prevent the infection

76
Q

What are the big side effects of tamiflu and relenza ! (2)

A

Abnormal behavior !!!!!!
Nausea and vomiting
Dizziness & headache

77
Q

When is influenza antiviral medications most effective?

A

48 hours of onset of illness

78
Q

What’s the common herpes antiviral medication?

A

Acyclovir ( Zovirax )

79
Q

What’s the biggest 4 side effects of herpes antivirals?

A

Leukopenia
Thrombocytopenia
Low hemoglobin
Hematocrit

80
Q

Do we do a culture of herpes? Why?

A

Yes

Before we give medication cause it’s gonna help aid symptoms

81
Q

Patients who take herpes medication for like 5 days do we need CBC ?

What about 5 months?

A

No

Yes

82
Q

What’s the biggest thing to know about cytomegalovirus ?(2)

A

Bone marrow suppression and toxicity !!

83
Q

Noyes
Flu medications
Take medications 48 before, since it’s too much virus in the body

So you need to take it early

Not candidates for the medications !!

A
84
Q

Hepatitis antivirals
What do you need do know ? (2)

A

Hepatotoxity & bone marrow suppression !!!

343 Pharm Exam 3 (6 decks)

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