Immunodeficiency Flashcards
Symptoms usually associated with acute viral infections
Fever, headache, cough, malaise, muscle pain, nausea and vomiting, diarrhea, insomnia, and photophobia. WBC counts usually remain normal.
Use of ribavirin for pts on ventilators
Not recommended because it precipitates and may block breathing tubes, including ET tubes.
Black Box Warnings regarding drugs for viral hepatitis infections (adefovir, entecavir, interferon, lamivudine, and telbivudine)
They increase risk of lactic acidosis and severe enlargement and accumulation of fat in the liver, including fatal cases
Sexual intercourse with genital herpes
Avoid when visible lesions are present and always wash hands after touching any lesion
Use of amantadine to prevent or treat influenza A in children
Must be 1 year or older. Rimantadine is given only for prevention.
Zanamivir use in children
Must be 7 years or older.
Oseltamivir use in children.
Must be 1 year or older.
Measures to prevent spread of fungal infection
Superficial infections (ringworm, etc) are highly contagious and can be spread by sharing towels and hairbrushes.
Decrease pt exposure to environmental fungi. For inpatients who are neutropenic or otherwise immunocompromised, do not allow soil-containing plants in the room and request regular cleaning and inspection of air conditioning systems. Aspergillosis has occured after inhalation of airborne mold spores from air conditioning units and hospital water supplies. For outpatients, assist to identify and avoid areas of potential exposure (soil contaminated by chicken, bird, or bat droppings; areas where buildings are being razed, constructed, or renovated). If exposure is unavoidable, instruct to spray areas with water to minimize airborne spores and wear disposable clothing and a face mask. For pts at risk of exposure to sporotrichosis (those who garden or work in plant nurseries), assist to identify risk factors and preventative measures (wearing gloves and long sleeves)
For obese pts with skin candidiasis, apply dry padding to intertriginous areas to help prevent irritation and candidial growth.
For pts with oropharyngeal ulcerations, provide soothing oral hygiene, nonacidic fluids, and soft, bland foods.
For pts with systemic fungal infections, monitor respiratory, cardiovascular, and neurologic status at least every 8 hours. Provide comfort measures and medications for pts receiving IV amphotericin B (analgesics, antihistamines, antipyretics, antiemetics)
How to use vaginal antifungal preparations
Read instructions. Insert high into the vagina, except during pregnancy. Continue use through menstruation (wear minipad to avoid staining clothing, do not use a tampon). Wash applicator with mild soap and rinse after each use. Avoid sexual intercourse.
How to use nystatin suspension for mouth lesions (thrust)
Swish the med around in the mouth and then swallow it.
Amphotericin B deoxycholate (Fungizone) use in renal impairment
It is nephrotoxic. Renal impairment occurs in most pts (up to 80%) within the first 2 weeks of therapy. If BUN exceeds 40 milligrams per deciliter or serum creatinine exceeds 3mg per deciliter, d/c it or reduce dosage.
Hemodialysis does not remove amphotericin.
