Other Microbials Flashcards
When taking an anti-tubercular what time consideration is required?
Require at least 6 months of treatment (up to 2 years)
What organ can a anti-tubercular impact?
The liver/ The liver function
What patient teaching is important when taking an anti-tubercular?
Compliance with regimen
Report changes in vision or eye comfort
Avoid Alcohol
Food Limitations
What is the prototype for anti-tubercular?
Isoniazid
What are the adverse effects for Isoniazid?
GI Upset
Hepatotoxicity
Decrease effectiveness of oral contraceptive pill
What administration consideration is important for isoniazid?
Direct observed therapy
Multiple drug resistance TB- treatment should be based on susceptibility studies
Can decrease the effectiveness of oral contraceptives
Vit B6 supplementation may be necessary to prevent or treat peripheral neuropathy
Antifungals have how many indications?
3- Imidazole, Triazoles, Polyenes
What does each anti-fungal indication treat?
Imidazoles- treat fungal skin infections
Triazoles- Treat systemic yeast infections
Have more selective toxicity
Fewer side effects
Polyenes- Topical treatments for yeast infections of skin, mouth, vagina, and intestine.
Systemic treatments for fungal infections
Antifungals Routes?
PO, Topical, and IV
What is mycones?
illness caused by fungi
What is opportunistic?
(some Fungi) cause infections when the host’s immune defenses are compromised not normally caused by healthy individuals.
What should you report when on a antifungal?
Skin Rash
Abdominal Pain
Fever
Diarrhea
Unexplained bruising or bleeding
True or False
It is important to follow dosage instructions and finish a drug when on an antifungal?
True
What are important considerations for antifungals?
Varies depending on the medication
Monitor the response of infected area and pt response
What are the prototypes for antifungals?
Clotrimazole
Fluconazole
Terbinafine
Nystatin
Amphotericin B
What is a very important administration consideration?
CHECK FOR ALLERGIES
What route is Clotrimazole?
Topical
What are the side/adverse effects of clotrimazole?
Topical Skin irritation
Rash
What are the routes for Fluconazole?
PO
IV
Does Fluconazole cause liver or renal dysfunction?
Liver
What harm can fluconazole cause?
Fetal Harm
What type of infection symptoms does fluconazole improve?
Yeast Infection
Fluconazole side/adverse effects?
Hepatotoxicity
The antifungal that is available as a cream or aerosol?
Terbinafine
How do you properly use Terbinafine?
Wash the area with soap and water. Allow drying completely before applying the drug.
What are the therapeutic effects of Terbinafine?
Improves symptoms of athletes foot (tinea corpus), jock itch (tinea cruris) or ring worm
What use is Terbinafine?
External Use only
If Nystatin is ordered PO, what two ways can it be ordered and what instructions should the patient be taught?
Swish and Swallow
Swish and Spit
If ordered “Swish and swallow” instruct pt to hold drug in the mouth for several minutes before swallowing
If ordered “Swish and spit” instruct pt to hold drug in mouth for several minutes then spit it out
True or False
Nystatin Topical medication can be both cream or powder
True
What is the therapeutic effect for Nystatin?
Improves symptoms of yeast infection
True or False
Nystatin is internal use only?
False
External use only
Is Amphotericin B an antifungal?
Yes!
When administering Amphotericin B what is important?
Administer slowly over several hours, monitor VS pre-infusion and at least every 30 minutes
If on Amphotericin B how long may it take to cure?
May take several months to cure infection
What is the caution when taking Amphotericin B?
Caution in renal impairment
What drug may require pre-medication?
Amphotericin B
What is the only route for Amphotericin B?
IV Only
what is the therapeutic effect for Amphotericin B?
Improvement of systemic fungal infection
Side/ Adverse effects of Amphotericin B?
Monitor urine output and renal function (Drug must be stopped with renal function)
Hydrate pt to prevent nephrotoxicity
Obtain liver function at least 2 times per week
Monitor CBC and weekly
Monitor potassium, calcium, and magnesium levels at least two times per week
May be ototoxic
What treats protozoan infections?
Antiprotozoals
What considerations are important for Antiprotozoals?
~Oral is the preferred route for GI infections
~ Can cause seizures, peripheral neuropathy and dizziness
~ Disulfiram reactions
what is the MOA for antiprotozoals?
Inhibit protozoan folic acid synthesis
It is important to teach your patient what about antiprotozoals?
- Can cause dizziness, dry mouth and darkening of the urine
- Avoid alcohol
- If treating an STI partner(s) need to be treated
What are the routes of an antiprotozoal?
- PO
- IV
- Do not give IV push, infuse over 30-60 minutes
- Topical
- Vaginal
What is the prototypes for the antiprotozoal?
Metrogel, Metronidazole
What contraindications are important for a patient who is taking Metrogel or metronidazole?
- In pregnancy
- Hypersensitivity
- Use of alcohol
What is metrogel, metronidazole used to treat?
Used to treat Clostridium difficile, Giardia, and Bacterial Vaginosis
What are the adverse effects for Metrogel, metronidazole?
- Seizures
- Peripheral neuropathy
- Psychotic reactions
- Hepatotoxicity
- Disulfiram Reactions
When should Metrogel, and metronidazole be used cautiously?
Use cautiously in with hepatic impairment, blood discrasias and CNS disease
what are antimalarials considerations?
- May impact hearing and vision*
May cause GI upset - Can take with food
What treats and prevents Malaria?
Antimalarial
-Chloroquine
What is chloroquine administration considerations?
- Check for allergies
- Contraindicated in hypersensitivity
- Contraindicated in pts with retinal or visual field changes
- Use cautiously in pts with severe GI, neurologic or blood disorders, hepatitis disorder or alcoholism, C6PD deficiency, or psoriasis
- Take with food if GI upset occurs
- In severe or persistent cases may need IV medication
What are the Chloroquine therapeutic effects?
- Prevention of malaria
- Improvement of symptoms of malaria
- Malaria Prevention: CDC recommends to take 4 weeks after leaving the area
What are the side/adverse effects of chloroquine?
- Change in vision
- Change in hearing
- Monitor renal function
- Monitor for overdose
- HA
- Drowsiness
- Visual disturbance
- Nausea
- Vomiting
- Cardiovascular collapse
What important considerations is for Antiherpes?
Nephrotoxic
If Acyclovir is given PO and GI upset occurs what should be done?
Give with food if GI upset occurs
If Acyclovir is given IV how long should it be infused for ?
Infuse over 1 hour
When do you start therapy when on Acyclovir?
Start therapy as soon as symptoms occur
What are important patient teaching when in Acyclovir?
Use cautiously in
* Renal impairment
* Neurological impairment
* Dehydration
- Encourage fluid intake
- Avoid sexual contact while lesions present
is Acyclovir a Cure?
Not a cure!
* Improves s/s
- Can be used as maintenance/long term to prevent frequent breakouts
What are the side/adverse effects of acyclovir?
GI- diarrhea
* Monitor renal function in long term use
* Especially with renal impairment
* Lowers seizure threshold
Can antiherpes be given just for herpes infections?
No, can also be given for varicella infections
During replication what happens to DNA?
DNA is terminated
Before giving Anti-influenza what indications are needed?
+influenza culture
exposure to influenza
A positive flu swab must be within what time limit?
48 hours
Must be administered within 48 hours of onset of symptoms
It is important to teach the patient what about anti-influenza?
Medication compliance
Can cause fatigue
True or False
Oseltamivir reduces the duration of flu symptoms?
True
What are the side/adverse effects of oseltamivir?
GI distress
* Skin or hypersensitivity – discontinue use immediately
* Monitor for neuropsychiatric symptoms
* Use cautiously with-
* Renal failure
* Chronic cardiac disorders
* Chronic respiratory disorders
* Medical condition that requires imminent hospitalization
Who is oseltamivir reserved for?
Immuno-compromised patients that the flu might kill.
What is the prototype for Anti-hepatitis?
Adefovir
Can hepatitis kill you?
Yes!
When taking Adefovir how long is prolonged therapy?
> 1 year
when taking an anti-hepatitis what side/adverse effects should be watched?
Can cause severe exacerbation of Hepatitis B
* Nephrotoxicity
* Lactic acidosis
* Hepatomegaly
What are antiretrovirals used to treat?
Use for treatment of viruses with complex life cycles that can be more difficult to treat
* HIV
What organ is impacted with antiretrovirals?
Kidney
What is antiretrovirals MOA?
Impedes virus replication
When a patient is on Lamivudine-Zidovudine when should patient stop taking the medication and what should the patient be taught? (when certain s/s are present)
Pancreatitis
Lamivudine-Zidovudine decrease the chance of?
Decreases chance of developing AIDS and HIV related illnesses