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NRSG 220 > Chapter 49: Fungal Infections > Flashcards

Chapter 49: Fungal Infections Flashcards

1
Q

Fungal Infection characteristics

A

fungal infections not easily transmitted through casual contact
Love dark, moist environments and lots of sugar
serious fungal infections are uncommon in people with healthy immune defenses
treatment may require weeks to months of therapy

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2
Q

how do fungal infections affect immunocompromised pts

A

systemic fungal infections may be rapidly fatal
may experience frequent fungal infections and require aggressive pharmacotherapy

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3
Q

Mycoses can be classified as

A
  1. Superficial & subcutaneous - topical agents
    - affect the scalp, skin, nails, and mucous membranes
  2. Systemic - oral or parenteral medications
    - affect internal organs (typically lungs, brain, digestive organs)
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4
Q

Antifungal drugs MOA

A

act by disrupting the fungal cell membrane or wall, affecting fungal enzymes or disrupting replication

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5
Q

Systemic Fungal Infections prototype

A

amphotericin B deoxycholate

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6
Q

amphotericin B deoxycholate uses

A

severe systemic mycoses
prophylactic antifungal therapy

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7
Q

amphotericin B deoxycholate MOA

A

binds to ergosterol in fungal cell membrane

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8
Q

Amphotericin B deoxycholate ADEs

A

acute fever
chills
vomiting
anorexia
headahce
phlebitis
potassium deficiency
electrolyte imbalance

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9
Q

Amphotericin B deoxycholate

A

Cardiac arrest
ototoxicity
nephrotoxicity
hepatotoxicity
anaphylaxis
blood abnormalities
dysrhythmias

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10
Q

Amphotericin B deoxycholate contraindications/precautions

A

blood urea nitrogen (BUN) 40mg/dL
serum creatinine above 3mg/dL
hypotension
hypokalemia
shock is medication administered to rapidly

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11
Q

Amphotericin B deoxycholate considerations

A

complete health Hx
perform infection-focused physical examination
premeditate with antipyretics, antihistamines, antiemetics, corticosteroids
perform baseline C&S tests prior to therapy
reduce or discontinue drug if BUN over 40mg/dL or serum creatinine over 3mg/dL
monitor cardio and resp status
check VS Q30 minutes for at least 4 hours after test dose
record I&O and weight
assess for erythema
administer IV over 2-6 hours
observe for injection sit for inflammation or thrombosis
assess for ototoxicity an immediately report any hearing loss or tinnitus, vertigo, or unsteady gait

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12
Q

General fungal infection

A

Azoles

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13
Q

Azoles

A

Largest and most versatile group of antifungals
broad spectrums
can be administered PO and have superior safety profile

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14
Q

Two chemical classes of azaleas

A

Imidazoles
Triazoles

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15
Q

Categorization of azoles by utility

A

systemic agents
topical agents
some agents used for systemic and topical

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16
Q

Systemic azoles

A

spectrum similar to amphotericin B
less toxic
administered PO
ADEs: N/V in 10-20% of pts

17
Q

Azole prototype:

A

Fluconazole

18
Q

Fluconazole Uses

A

Candida albicans
cryptococcal meningitis
mycoses resistant to other antifungals

19
Q

Fluconazole MOA

A

interferences with synthesis of ergosterol

20
Q

Fluconazole ADEs

A

N/V/D

21
Q

Fluconazole Serious ADEs

A

SJS in immunosuppressed patients

22
Q

Fluconazole contraindications

A

hypersensitivity to the drug or another azole
hepatic impairment
hypokalemia
pre existing renal impairment

23
Q

Fluconazole considerations

A

monitor BUN, serum creatinine, and liver function lab tests
assess for hepatotoxicity

24
Q

fluconazole treatment of OD

A

no specific therapy
dialysis to lower serum drug level

25
Q

Superficial fungal infections

A

superficial anti fungal drugs safer than systemic counterparts
many are available as over the counter (OTC) creams, gels, and ointments
may take weeks to months to treat
sometimes used with PO to treat extensive

26
Q

Dematomycoses

A
  1. Tinea corporis (ringworm)
  2. Tine curries (jock itch)
  3. Tinea pedis (athletes foot)
  4. Tinea capitis (head, eyebrows, eyelashes infected)
27
Q

Onychomycosis (tine unguium)

A

infection of the nail

28
Q

Superficial candidasis

A

oropharyngeal candidasis (thrush)

29
Q

Superficial prototype drug

A

Nystatin

30
Q

nystatin uses

A

candida infections of vagina skin mouth throat and GI

31
Q

nystatin MOA

A

binds to sterols in the fungal cell membrane
allows leakage of intracellular content across the weakened membrane

32
Q

nystatin ADEs

A

minor skin irritation and burning
contact dermatitis
D/N/V

33
Q

nystatin contraindications/precautions

A

hypersensitivity to the drug
pregnancy and lactation
cream/topicals (Cat B)
Oral suspension or tablets (Cat C)

34
Q

Nystatin Drug interactions

A

unknown

35
Q

Nystatin treatment if OD

A

symptomatic

36
Q

Nystatin considerations

A

Hx and assessment
avoid occlusive dressing or ointment on moist, dark areas of the body
teach pt to avoid sharing towels, shoes, or personal objects

37
Q

Griseofulvin

A

Drugs similar to nystatin
used to treat skin infections such as jock itch athletes foot and ringworm, fungal infections of scalp, fingernails and toenails

38
Q

Griseofulvin SE

A

phytotoxicity, , urticaria, dizziness, decreased OCP, alcohol = disrulfiram

NRSG 220 (8 decks)

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