Acute malaria attacks (not effective against relapses)

discoid lupus erythematosus

RA

extraintestinal amebiasis

Increases blood PH and disrupts the synthesis of RNA and DNA in the parasite.

Antagonizes histamine and serotonin inhibiting prostaglandin synthesis and an anti-inflammatory effect

Hypersensitivity

Patients with pre-existing eye disease

(can cause opacities)

What are the common adverse effects of 

Chloroquine (Aralen)

Nausea, vomiting and diarrhea

abdominal pain

hypotension

blurred vision, difficulty focusing and changes in accommodation.(retinopathy)

 Tinnitius and reduced hearing

seizures

 agranulocytosis, aplastic anemia, pancytopenia, neutropenia, thrombocytopenia

Chloroquine (Aralen) is taken:

A. daily 

B. weekly

C. monthly

Chloroquine (Aralen) should be taked with food.

True or False

True

·        May take with meals to decrease GI symptoms

check for blood dyscrasias

may turn urine red or brown, schedule eye and ear exams periodically, notify provider of sore throat, bruising, fever, unusual fatigue.

When should a pt start taking Chloroquine (Aralen) 

for prophylaxis

·        Cane be use in treatment of trichomoniasis, amebiasis and giardiasis.  Is also an antibacterial against anaerobic infections. 

·        Crohn disease

·        antibiotic associated diarrhea

Inhibits DNA synthesis in bacteria

Drug crosses placenta and into breast milk

A pt who is taking METRONIDAZOLE (Flagyl) reports to drink daily.

What education should the nurse provide for this pt?

Drug and alcohol should be separated by at least 1 day to prevent disulfiram-like interaction.

METRONIDAZOLE (Flagyl) should be used cautiously in what types of patients

 use cautiously in patients with compromised hepatic or bone marrow function 

What are the common adverse effects of 

METRONIDAZOLE (Flagyl)

Nausea, vomiting, xerostomia(dry mouth), altered sense of taste, and abdominal pain.

Blood dyscrasias

CNS toxicity:  ataxia, mood changes, encephalophathy

 IV formula has high sodium content and can exacerbate CHF

Administer with meals to decrease GI irritation

Use ice chips or hard candies to moisten mouth

What should a nurse know about METRONIDAZOLE (Flagyl)

infusion rate?

What are the common side effects of

Pentamidine isethionate (Pentam 300)

cough and Bronchospasm

severe hypotension

thrombocytopenia, leucopenia, anemia

 teachycardia, and arrhythmias

Severe hypoglycemia- especially in DM patients.

What percations should a nurse fallow when giving a pt

Pentamidine isethionate (Pentam 300)

Have patient lying down and have resuscitation equipment available. Monitor vital signs before, during and for 2 hours after administration.

A pt taking Pentamidine isethionate (Pentam 300) has an IM injection of Rocfen. How should the nurse proced.

Why?

Do not give

Do not give IM injections to patients receiving drug as may cause bleeding, bruising or hematomas.(related to drug induced thrombocytopenia.)

Pentamidine isethionate (Pentam 300) should not be given at bedtime 

Why?

Do not administer at bedtime due to risk of hypoglycemia.

A pt on Pentamidine isethionate (Pentam 300) has N/V/D

do you need to notify the MD? 

YES

Contact provider for N/V/D that does not subside

Ingest small, frequent meals despite nausea due to risk of hypoglycemia

·        Protect drug from light- use within 24 hours.

·        Do not mix with other drugs

What medication should you give before giving

Pentamidine isethionate (Pentam 300)

 If given by inhaler- given bronchodilator first.

·        s/s of infection, anemia

client should have liver enzymes, CBC  and EKG periodically.

·        hypersensitivity

·        Inflammatory bowel disease or hepatic disease

·        Pregnancy and breastfeeding

·        Rarely systemic toxicity due to poor absorption.

·        abdominal pain, diarrhea, dizziness, headache and fever

·        rash, flushing

·        leucopenia, thrombocytopenia, and eosinophilia.

·        may elevate liver enzymes

monitor for sore throat, fever and fatigue.

A pt is taking Mebendazole (Vermox)

what should the nurse teach the pt about avoiding re-exposure

·        Teach to avoid further infestations by washing fruits and vegetables.

·        Lice

·        Scabies (Elmite)

·        External use only.

·        Apply to scalp and leave in place 10 minutes.

·        Apply a second treatment in 10 days.

·        Use nit comb to remove lice and nits 

Apply on skin as ordered

What caustion should be given to a pt using Permethrin (Elmite)

that has yung kids

·        Teach clients to wash all clothing, bedding etc. in very hot water, and by using hot dryer at least 20 minutes.  Any articles that cannot be washed should be dry cleaned or sealed in an airtight plastic bag for 2 weeks.

·        Clean house by vacumning furniture etc.