Module 12 CH12 antiprotozol agent Flashcards
Insect Bites
◦ Malaria
◦ Trypanosomiasis
◦ Leishmaniasis
Ingestion or Contact with the Causal Organism
◦ Amebiasis
◦ Giardiasis
◦ Trichomoniasis
Risk Factors for Protozoal
Infections
Unsanitary, crowded conditions
Poor hygienic practices
Protozoal Parasites Identified as
Causes of Malaria list
Plasmodium falciparum
Plasmodium vivax
Plasmodium malariae
Plasmodium ovale
Plasmodium falciparum
◦ Considered the most dangerous type of protozoan
Plasmodium vivax
◦ Milder form of the disease; seldom results in death
Plasmodium malariae
Endemic in tropical countries; mild symptoms
Plasmodium ovale
◦ Rarely seen; in the process of being eradicated
Malaria
Signs and Symptoms
Treatment
◦ 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
Use of Antiprotozoal Therapy
Across the Life Span
children, adult and older adult
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
Antimalarials (“quin”)
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
antimalarias medication list
Chloroquine
Mefloquine
Primaquine
Antimalarials
Indications-
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
Antimalarials Actions
Actions- Enters human red blood cells and changes the metabolic pathways necessary for the
reproduction of the Plasmodium
Antimalarials Contraindications and caution
Contraindications- Known allergy, liver disease, alcoholism, pregnancy and lactation
Cautions- Retinal disease or damage; psoriasis or porphyria; damage to mucous membranes
Antimalarials
Adverse Effects-
Drug-Drug interactions-
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
Nursing Considerations for
Patients Receiving Antimalarial
Agents ADPIE
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
Other Protozoal Infections
Amebiasis Leishmaniasis Trypanosomiasis Trichomoniasis Giardiasis Pneumocystic jiroveci pneumonia (PCP)
Atovaquone
◦ Especially active against PCP
Metronidazole
◦ Treats amebiasis, trichomoniasis, and giardiasis
Pentamidine
◦ Treats PCP, trypanosomiasis, and leishmaniasis
Tinidazole
◦ Treats trichomoniasis, giardiasis, and amebiasis
Benznidazole 9
◦ Pediatric patients with Chagas◦ Treats amebiasis, trichomoniasis, and giardiasis
Other Antiprotozoal Drugs
ACTION, contraindications, adverse effect, drug-drg interactions
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
Nursing Considerations for
Patients Receiving Antiprotozoal
Agents
ADPIE
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
