Quiz 9/30 Flashcards
HSV type one, HSV type 2, CMV, varicella zoster, Epstein Barr virus
Oral herpes, genital herpes, activates when immune system is down (, shingle, mono
Disease that respond to antiviral meds
Influenza A and some respiratory viruses, herpes virus, cytomegalovirus, Ebstein-Barr, varicella zoster, HIV AIDS, hepatitis B
Drugs used to treat herpes
Systemic: acyclovir, famciclovir, ganciclovir, and valacyclovir
Topical: docosanol
Acyclovir
Suppresses HSV 1 and 2, IV PO or topical, adverse effects IV: nephrotoxicity and neurotoxicity, valacyclovir is the prodrug
Ganciclovir
Treat CMV, given prophylactically (organ transplant pts), toxicity is bone marrow suppression, adverse effects: GI effects headache parenthesis neuropathy, can be toxic to kidneys, avoid in pregnancy and location
Antiviral medications and the flu
Prevention and decreases severity of the flu
Drugs used for influenza
Amantadine, oseltmavir, ribavirin(category x), rimantidine, zanamivir (inhaled)
Amantadine
Adverse effects: CNS effects like insomnia dizziness and confusion, excreted by kidneys, avoid alcohol, also used to treat Parkinson’s, ramantidine has a longer half life
Oseltmavir
Active against influenza A and B, must be started within 48 hrs of symptoms, can shorten duration of illness, should not be used within two weeks of live attenuated vaccine, side effects: n/v and diarrhea
Adverse effects and contraindications of systemic antifungals
Hepatotoxicity, nephrotoxicity, bone marrow suppression, rash GI distress, phlebitis
Pregnancy, lactation, hepatic dysfunction or failure, bone marrow suppression, prolonged QT interval
oral candidiasis is also called
thrush
Amphotericin B
given IV topical or oral, adverse effects: fever chills vomiting headache phlebitis ototoxicity nephrotoxicity hypokalemia hypomagnesaemia, need to pretreat to prevent adverse effects, used for systemic fungal infection
fluconazole
inhibits cell replication, can cause increase AST and ALT, interacts with many drugs due to hepatic enzyme metabolism but also hypoglycemic agents
onochomycosis
toe or nail fungus, treated with terbinafine itraconazole fluconazole
grizeofulvin
prevents reproduction of fungi, 2-4 week treatment, avoid during pregnancy, can cause neutropenia
terbinafine
used topically to treat superficial infections, used orally to treat fungal infections of nails
nursing considerations when giving antifungals
baseline blood counts, baseline liver and renal function tests
Premedicate monitor VS during infusion and monitor for adverse reactions when giving amphotericin B
Metronidazole
antiprotozoal, used for dysentery venereal disease peritonitis bacterial septicemia H. pylori, given PO IV and topical, monitor liver document stools take with meals avoid alcohol inform client of dark red/brown urine
cephalosporins
inhibit cell wall synthesis, if allergy to penicillin may have cross sensitivity, five generations (3 and 4 can cross the BBB), adverse effect: rash diarrhea edema abdominal cramps
first gen cephalosporins
good gram positive coverage, parenteral or oral, Ex. Cefazolin and Cephalexin
second gen cephalosporins
good gram positive coverage, better gram negative coverage than 1st, Ex. cefaclor
third gen cephalosporins
most potent against gram positive, ex. ceftriaxone, given IM and IV long half life
forth gen cephalosporins
broader spectrum, UTI, Ex. cefepime, IM or IV
fifth gen cephalosporins
broader spectrum, effective against MRSA, ex. ceftaroline
carbapenems
broad spectrum some strains of MRSA, reserved for complicated infections, may cause seizures or Gi toxicity, given parenterally, Ex. imipenem/ cilastatin, meropenem, ertapenem
monobactam
ex. aztreonam, synthetic beta-lactam antibiotic, active against aerobic gram negative, bactericidal, parenteral use only, used for UTI and severe systemic infections
Vancomycin
PO or IV, treatment against MRSA, peak and trough levels, pregnancy category B for PO and C for injection, can cause red man syndrome ototoxicity nephrotoxicity
Macrolides
Affect bacterial protein synthesis, bacteriostatic, Ex. Erythromycin azithromycin clarithromycin, used for strep infections URI LRI spirochetal infections gonorrhea
Adverse effects: n/v diarrhea hepatotoxicity jaundice anorexia
Ketolide
Affect bacterial protein synthesis
ex. ketolide: only drug in this class, better coverage than macrolides active against gram positive bacteria, associated with severe liver disease
