objective 4.2 (3) Flashcards

1
Q
  • Tiny micoroorganism that can replicate only inside the living cells of
    organisms; defense mechanism
  • Find a host and take it over to grow and reproduce; intracellular parasites
    Simplest of all organisms; usually many times smaller than bacteria
  • Not suppressed by antibiotics; damage takes place within the cell
A

virus

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2
Q

mature virus particle

A

virion

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3
Q

what are the 4 ways a virus enters the body?

A
  • Inhalation through the respiratory tract
  • Ingestion via gastrointestinal tract
  • Placenta via placental circulation – from mom to babe
  • Inoculation via skin or mucous membranes; occurs various ways
    including sexual contact, blood transfusions, sharing of syringes
    or needles, organ transplants or bites
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4
Q

what are the prominant viral illnesses affecting humans>

A
  • Smallpox (poxviruses)
  • Sore throat and conjunctivitis (adenoviruses)
  • Warts (papovaviruses)
  • Influenza (orthomyxoviruses)
  • Respiratory infections (coronaviruses, rhinoviruses)
  • Gastroenteritis (rotaviruses, Norwalk-like viruses)
  • HIV/AIDS (retroviruses)
  • Herpes (herpesviruses)
  • Hepatitis (hepadnaviruses)
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5
Q

HSV-1

A

oral herpes

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6
Q

HSV-2

A

genital herpes

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7
Q
  • Both highly transmissible through close physical contact
  • Painful skin lesions with periods of dormancy vs acute outbreaks
  • Antivirals do not cure but can speed up the process of remission and
    reduce the duration of painful symptoms
  • Can be life threatening in immunocompromised individuals and
    neonates
A

herpes simplex virus

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8
Q

is highly contagious with transmission
occurring from weeping lesions or droplet inhalation; usually
non invasive but can become complicated if Reye’s syndrome
(condition causing fatty liver and encephalopathy) develops as
a result; usually only treat when immunocompromised; vaccine
helps maintain prevalence

A

chicken pox or varicella

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9
Q

is caused by the reactivation of VZV from its
dormant state; lesions appear along dermatomes (nerve
tracts); very painful; treated with acyclovir which will work best
if started within 72 hours of symptom onset

A

zoster or shingles

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10
Q

are chemicals that kill or suppress viruses by destroying the virions or
by inhibiting their ability to replicate.
* Immune system can potentially control or eliminate a viral infection when the ability
of the virus to replicate itself is suppressed
* Work best in individuals with competent immune systems
* Those with immune systems which are compromised or are immunocompromised
are more susceptible to opportunistic infections which are infections that would not
normally harm an immunocompetent person

A

antiviral drugs

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11
Q

are virucides used to clean equipment and the
body during invasive procedures

A

disinfectants

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12
Q

are concentrated antibodies that attack and destroy viruses; more
commonly thought of as immunity drugs; derived from human or animal blood

A

immunoglobullns

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13
Q

what are the MOAs of antiviral drugs

A
  • Interferes with the ability of the virus to carry out its reproductive functions, hence
    reducing replication
  • Must enter the cell and act at the site of infection to be effective
  • Stops the virus from growing but does not kill it; lowers viral concentrations to allow
    for elimination of virus by the patient’s immune system
  • Cannot cure only lesson symptoms
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14
Q

what are the indications of antiviral drugs?

A
  • Treat a variety of common conditions caused by different viruses
  • Herpes zoster, herpes simplex, genital herpes, varicella and some influenza infections
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15
Q

what are the adverse effects of antiviral drugs?

A
  • Each has its own specific adverse effect profile
  • Selective killing is difficult so many healthy cells are killed in the process, therefore
    more serious toxicities for these drugs
  • Table 45.2 Lists adverse effects by drugs
  • Acyclovir- nausea, vomiting, diarrhea, headache, burning when applied topically
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16
Q

what are the nursing implications for antiviral drugs?

A
  • Consult HCP before taking any other meds
  • Immunocompromised pts should avoid crowds and persons with infections
  • Adherence to meds is crucial to suppress viral infection and stop opportunistic infections from occurring
  • Acyclovir – start at first sign of recurrent episode of herpes
  • Prophylactic treatment may be needed for people that have been in close contact with certain viruses
    (Tamiflu- used for Influenza prevention)
  • Wear gloves when applying topical medications
  • Monitor skin lesions for improvement
  • Educate; symptom management (itch/pain killers), proper storage, and application, prophylaxis (safe sex)
17
Q

are a large and diverse group of microorganisms that include all yeasts and moulds

A

fungi

18
Q

are single-celled fungi that reproduce by budding; moulds are multicellular,
characterized by long, branching filaments

A

yeasts

19
Q

n infection caused by a fungus is called a

A

mycosis

20
Q

what are the routes of fungal infections>

A
  • Ingested orally
  • Grow on or in skin, hair, or nails (integumentary)
  • Inhaled if the fungal spores are airborne
21
Q

what are the 4 general types of fungal infections>

A
  1. Systemic
  2. Cutaneous (skin)
  3. Subcutaneous (skin) dermatophytes  dermatomycoses
  4. Superficial (skin)
22
Q

what are the MOA and drug effects of antifungal drugs?

A
  • Differs between the sub classes
  • Some work much the same as antivirals, some prevent the cells growth and replication and causes cell death
23
Q

what are the indications of antifungal drugs?

A

Orally, intravenously, topically & vaginal fungal infections

24
Q

what are the adverse effects of antifungals?

A
  • Encountered mostly with amphotericin B
  • Drug interactions and hepatotoxicity are the primary concerns. IV administrations is associated with
    a multitude of effects
  • Table 47-2 for selected antifungals w/ common adverse effects
  • “Shake and bake” syndrome r/t amphotericin admin (p. 767)
  • Pre-treatment with antiemetics, antihistamines, antipyretics, and corticosteroids to minimize the
    infusion-related effects.
  • Many reactions to systemic antifungals mimic the disease itself
  • Overdose can include severe nausea, vomiting and diarrhea
25
Q

what are the interactions of antifungals>

A
  • Many interactions some of which can be life threatening
  • Compete for enzyme so one drug ends up accumulating in body
  • Corticosteroid therapy coupled with antifungal use can result in severe superinfection
  • Oral anticoagulant activity is increased when given with some antifungals
  • Alcohol use with antifungals will increase alcohol potency
  • H2 blockers can interfere with the absorption of some antifungals
  • Metronidazole and alcohol –disulfiram –like reaction
  • See page 767 Table 47-3
26
Q

what are the nursing implications of antifungal?

A
  • Educate on the importance of avoiding alcohol
  • Monitor S/S especially if given with steroids
  • Encourage patient to finish entire duration of therapy
  • Shake oral suspensions before use; keep suspension in the mouth for as long as
    possible before swallowing ‘swish & swallow’
  • Keep skin, hair and nails clean
  • Monitor I/V infusion q15 min at the onset to assess for adverse reactions
27
Q
  • TB-infectious disease transmitted by droplets in the air when an affected person
    coughs/sneezes. Difficult to kill because it is a slow growing organism, disrupting metabolism
    is difficult
A

antitubercular drugs

28
Q

what are the MOA and drug effects of antitubercular drugs?

A

Used to treat active TB
* INH ( isoniazid)- primary antitubercular drug used as a prophylaxis to prevent TB spread to
others or in combination with other drugs
* Inhibit protein synthesis, inhibit cell wall synthesis or by other mechanisms

29
Q

what are the 2 phases of antitubercular drugs?

A
  • The initial intensive phase consists of drugs used in combination to achieve raid
    destruction of cells and improvement of patient condition (2 month period)
  • The continuation phase time frame varies depending on risk of relapse
30
Q

what are the common first line antitubercular drugs>

A
  • isoniazid (INH)
  • Rifampin (RMP)
  • Ethambutol (EMB)
  • Pyrazinamide (PZA)
31
Q

what are the second line antitubercular drugs?

A
  • Amikacin sulphate
  • Levofloxacin hemihydrate
  • Moxifloxacin hydrochloride
32
Q

what are the adverse effects of isoniazid?

A

cause pyridoxine deficiency and liver toxicity (Vit B6-pyridoxine supplement taken),
may experience numbness, tingling of extremities, abd pain, jaundice and visual changes

33
Q

what are the adverse effects of rifampin?

A

contact HCP if fever, N&V, loss of appetite, jaundice or bleeding occurs (possible
occurrence of hepatitis or hematological disorder)
* Rifampin may experience red-orange discoloration of sweat, tears, urine, feces, sputum, and
tongue

34
Q

what are the interactions of antitubercular drugs?

A
  • Isoniazid- false positives on urine glucose test and increase in serum levels of liver function
    enzymes
  • Oral contraceptives- infective when taken with rifampin
  • Drug therapy complicated, should not be taking any other drugs, or monitored closely for
    interactions, when swallowing medications do not swallow other meds at the same time
  • Antacids, Dilantin, Anticoagulants, Benzos, Beta blockers, hypoglycemics, contraceptives = all
    alter therapeutic effects of antitubercular drugs
35
Q

what are the nursing implications of antitubercular drugs?

A
  • Educate pt. about disease and need for long term treatment (approx. 1 year or more)
  • Drug must be taken exactly how it is prescribed (strict adherence necessary to drug
    regimen)
  • Avoidance of certain meds (antacids, phenytoin, carbamazepine, B-Blockers, benzos, oral
    anticoagulants, oral antihyperglycemics, oral contraceptives, and theophylline
  • Report to local health department
  • Initial period of illness pt. are contagious
  • Medication is toxic
  • Nausea and vomiting can occur with primary treatment but will usually subside with
    prolonged use.