Module 12 CH12 antiprotozol agent

Question 1

Insect Bites

Answer 1

◦ Malaria
◦ Trypanosomiasis
◦ Leishmaniasis

Question 2

Ingestion or Contact with the Causal Organism

Answer 2

◦ Amebiasis
◦ Giardiasis
◦ Trichomoniasis

Question 3

Risk Factors for Protozoal

Infections

Answer 3

Unsanitary, crowded conditions

Poor hygienic practices

Question 4

Protozoal Parasites Identified as

Causes of Malaria list

Answer 4

Plasmodium falciparum
Plasmodium vivax
Plasmodium malariae
Plasmodium ovale

Question 5

Plasmodium falciparum

Answer 5

◦ Considered the most dangerous type of protozoan

Question 6

Plasmodium vivax

Answer 6

◦ Milder form of the disease; seldom results in death

Question 7

Plasmodium malariae

Answer 7

Endemic in tropical countries; mild symptoms

Question 8

Plasmodium ovale

Answer 8

◦ Rarely seen; in the process of being eradicated

Question 9

Malaria
Signs and Symptoms
Treatment

Answer 9

◦ Related to the destruction of red blood cells and toxicity to the liver
Treatment
◦ Aims at attacking the parasite at the various stages of its development inside and outside the human
body

Question 10

Use of Antiprotozoal Therapy
Across the Life Span
children, adult and older adult

Answer 10

Children
◦ Very sensitive to effects of drugs; more severe
reactions expected
◦ Extreme caution should be used
◦ Avoid travel to endemic areas

Adults
◦ Advise about the need for prophylaxis
◦ Mark calendar as reminder of days drugs should
be taken
◦ Avoid in pregnancy and lactation
◦ Childbearing women should use contraceptives

Older adults
◦ More susceptible to adverse effects; monitor
closely
◦ Hepatic dysfunction at increased risk of
worsening hepatic problems
◦ Dose may need to be lowered

Question 11

Antimalarials (“quin”)

Answer 11

Quinine First drug found effective in treatment of malaria
◦ Absent from the market for a while but now available for treating uncomplicated malaria.

Chloroquine
Mefloquine
Primaquine

Question 12

antimalarias medication list

Answer 12

Chloroquine
Mefloquine
Primaquine

Question 13

Antimalarials

Indications-

Answer 13

Indications- Prevent the acute malarial reaction in individuals who have been infected by the
parasite, or work against tissue schizonts as prophylactic or antirelapse agents

Question 14

Antimalarials Actions

Answer 14

Actions- Enters human red blood cells and changes the metabolic pathways necessary for the
reproduction of the Plasmodium

Question 15

Antimalarials Contraindications and caution

Answer 15

Contraindications- Known allergy, liver disease, alcoholism, pregnancy and lactation
Cautions- Retinal disease or damage; psoriasis or porphyria; damage to mucous membranes

Question 16

Antimalarials
Adverse Effects-

Drug-Drug interactions-

Answer 16

CNS, GI, hepatic dysfunction,
dermatological, blindness, ototoxicity

Drug-Drug interactions- Patient who is
receiving combinations of quinine derivative
and quinine is at increased risk for cardiac
toxicity and convulsions; anti-folate drugs
increase bone marrow suppression

Question 17

Nursing Considerations for
Patients Receiving Antimalarial
Agents ADPIE

Answer 17

Assessment
◦ History and physical exam
◦ Allergy; liver dysfunction or alcoholism; porphyria or psoriasis; retinal disease; pregnancy and lactation
◦ Assess the CNS (reflexes and muscle strength); perform ophthalmic and retinal exams; perform auditory
screening; inspect skin
◦ Obtain blood culture; monitor appropriate labs
Nursing Diagnoses
◦ Acute pain related to GI, CNS, and skin effects of the drug
◦ Disturbed sensory perception (kinesthetic, visual) related to CNS effects
◦ Risk for injury related to CNS changes
◦ Deficient knowledge regarding drug therapy
Implementation
◦ Arrange for appropriate culture and sensitivity tests before beginning
◦ Administer a complete course of the drug
◦ Mark a calendar for prophylactic doses
◦ Monitor hepatic function and perform ophthalmological examination before and periodically during
treatment
◦ Provide comfort and safety measures if CNS effects occur
◦ Provide small, frequent, nutritious meals if GI upset is severe
◦ Provide patient teaching

Question 18

Other Protozoal Infections

Answer 18

Amebiasis
Leishmaniasis
Trypanosomiasis
Trichomoniasis
Giardiasis
Pneumocystic jiroveci pneumonia (PCP)

Question 19

Atovaquone

Answer 19

◦ Especially active against PCP

Question 20

Metronidazole

Answer 20

◦ Treats amebiasis, trichomoniasis, and giardiasis

Question 21

Pentamidine

Answer 21

◦ Treats PCP, trypanosomiasis, and leishmaniasis

Question 22

Tinidazole

Answer 22

◦ Treats trichomoniasis, giardiasis, and amebiasis

Question 23

Benznidazole 9

Answer 23

◦ Pediatric patients with Chagas◦ Treats amebiasis, trichomoniasis, and giardiasis

Question 24

Other Antiprotozoal Drugs

ACTION, contraindications, adverse effect, drug-drg interactions

Answer 24

Actions- Inhibit DNA synthesis in susceptible protozoa

Contraindications- Known allergy, pregnancy

Cautions- CNS disease, hepatic disease, lactation

Adverse Effects- Headache, dizziness, ataxia, peripheral neuropathies, loss of coordination,
nausea, vomiting, and diarrhea

Drug-Drug interaction- Alcohol, anticoagulants, disulfiram

Question 25

Nursing Considerations for
Patients Receiving Antiprotozoal
Agents
ADPIE

Answer 25

Assessment
◦ History and physical exam
◦ Allergy; liver dysfunction; pregnancy and lactation; candidiasis
◦ Evaluate reflexes and muscle strength; skin and mucous membranes
◦ Obtain cultures; monitor appropriate labs
Nursing Diagnoses
◦ Acute pain related to GI and CNS effects of the drug
◦ Imbalanced nutrition: Less than body requirements related to severe GI effects of the drug
◦ Disturbed sensory perception (kinesthetic, visual) related to CNS effects
◦ Deficient knowledge regarding drug therapy

Implementation
◦ Arrange for appropriate culture and sensitivity tests before beginning therapy
◦ Administer a complete course of the drug
◦ Monitor hepatic function before and periodically during treatment
◦ Provide comfort and safety measures if CNS effects occur
◦ Provide oral hygiene and ready access to bathroom facilities as needed
◦ Arrange for the treatment of superinfections as appropriate
◦ Provide small, frequent, nutritious meals if GI upset is severe
◦ Provide patient teaching