Term
| What is the MOA of Amphotericin B ? |
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Definition
| Binds to components of fungal cell membrane (ergosterol), increasing permeability resulting in leakage of intracellular contents; may be fungicidal or fungistatic depending on drug concentration and susceptibility of fungus |
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Term
| What are the adverse effects of Amphotericin B? |
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Definition
1.(flu-like symptoms) fever, chills, rigors, nausea, and headache; 2.Nephrotoxicity - monitor I&O & BUN/C
3. Hypokalemia
4. Bome marrow suppression |
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Term
| What do you use to manage adverse effects of Amphotericin B? |
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Definition
| manage with pretreatment with diphenhydramine and acetaminophen; use meperidine or dantrolene for rigors. High incidence of phlebitis. (Pretreat with Benadryl 30min-1hr before the infusion |
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Term
| Important nursing implication for Amphotericin B are: |
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Definition
Administration: IV. The lipid based formulations (AmBisome, Abelcet, and Amphotec) have less nephrotoxicity and infusion reactions than conventional form but are much more expensive.
Monitoring: Monitor signs and symptoms of infection to evaluate effectiveness. Monitor for adverse effects. Monitor renal function (BUN and creatine). Infuse slow; make sure well hydrated before,during, and after infusion |
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Term
| Adverse effects of Fluconazole (Diflucan) are: |
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Definition
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Term
| What are the important drug interacions that take place with Fluconazole (Diflucan)? |
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Definition
Increase levels of warfarin, phenytoin, cyclosporine, and sulfonylurea oral hypogycemics
Important drug interaction: oral hypoglycemic because frequently diabetes will develop fungal infections that are frequently treated with Diflucan **(Watch for hypoglycemia-shaky, sweat, HA, irritable, nausea) |
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Term
| Itraconazole is like what prototype? What are the adverse effects? |
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Definition
| Fluconazole. GI (N/V/D), rash HA, abd pain, edema; liver failure, cardiac suppression |
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Term
| Voriconazole has some unique adverse effects, what are they? |
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Definition
| NVD, fever, rash, HA; visual disturbances (reversible, dose-related changes in visual acuity, altered color perception, photophobia), hepatotoxicity (hepatitis, hepatic failure—rare and usually reversible but should monitor LFTs), hypersensitivity reactions, teratogenic (Category D) |
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Term
| Caspofungin(Cancidias) has adverse effects that include: |
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Definition
| fever, phlebitis (at injection site), rash, pruritus, flushing, nausea, vomiting, and headache |
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Term
| Patients taking topical azoles need teaching on what in regard to their symptoms? |
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Definition
| it should be applied 1 week beyond symptoms! |
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Term
| What is Clotrimazole? What are the adverse effects? |
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Definition
topical azole; topical- stinging, erythema, edema, urticarial, pruritus, and peeling;
intravaginal- burning and lower abdominal cramps. |
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Term
| What are some important drugs for oral Candidasis and their implications? |
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Definition
i. White patchy spots and areas of redness of tongue and throat
ii. Nystatin (healthy patients), clotrimazole and amphotericin B (mouth, throat, and esophagus) are used in healthy population
iii. Fluconazole or ketoconazole is usually used if the patient is immunocompromised. |
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Term
| What are some important drugs for vulvovaginal Candidasis and their implications? |
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Definition
i. Itchy discharge from the vaginal vault. Can have a cottage cheese appearance to discharge. White patches with area of redness noted in vaginal vault.
ii. Pregnancy, obesity, diabetes, HIV, oral contraceptives, antibiotics, glucocorticoids, and immunosuppressants can predispose a patient to developing a yeast infection |
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Term
| Explain treatment for vulvovaginal candidiasis: |
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Definition
Single dose of oral diflucan
1.More side effects: HA, rash, GI upset
1-3 days of topical medication
1.Fewer side effects but takes longer to resolve. |
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Term
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Definition
Keratin precursor
Administered orally to treat superficial mycoses of skin, hair and nails |
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Term
| What are important nursing implications regarding Griseofulvin? |
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Definition
Needs to be taken orally with fatty meal for absorption.
Degreases effects of Warfarin(Coumadin)
Get very sick on empty stomach. |
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Term
| What are adverse effects of Griseofulvin? |
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Definition
| HA, rash, insomnia, tiredness, N/V/D |
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