Tuberculosis Overview

• Tubercle bacilli - cause of TB; nodular; an accumulation of inflammatory cells that become walled off; commonly found in lungs 
• Long term treatment - can occur as long as 24 months
• Transmission - inhaled from another host & spreads through blood streem & lymphatics 
• Primary
• Latent TB infection - positive skin test, not contagious, no symptoms
• Active TB infection - contagious, have symptoms, infectious 

Anti-Infective: TB 

DRUGS:

• isoniazid (INH)- used for prophylaxis (for latent TB), 1st Line Drug (for active TB)
• rifampin (Rifadin)
• pyrazinamide (Tebrazid) 
• ethambutol (Myambutol)  

Therapeutic Use: 

• Prevent & treat active & latent TB 

Adverse Effects: None given 

Contraindications: Renal or liver impairment 

Nursing Education: 

• Take with food
• Strict adherence to regimen 
• Monitor liver function 
• Monitor culture sensitivity 
• Chest Xray findings 
• NO ALCOHOL 

 DOT therapy can be used if nurse is concerned

Anti-infective: Antiviral - Influenza 

"-vir-" 

DRUGS:

• oseltamivir (Tamiflu)

Therapeutic Use: 

• Used to treat influenza A or B (in patients w/ symptoms for 2 days or less only) 

Adverse Effects: bronchospasm 

Contraindications: None given. 

Nursing Education: None given. 

Anti-infective: Antiviral - Herpes

"-vir-"

DRUGS:

• acyclovir (Zovirax)

Routes: IV, PO, topical 

Therapeutic Use: 

• genital herpes / herpes simplex 
• NOT CURATIVE, only decreases lesions & pain 

Adverse Effects: None given. 

Contraindications: None given. 

Nursing Education: None given. 

Resistance: This medication has developed resistance. 

Anti-Infective: Antiviral - HIV/AIDS

Gen. Info:

• Complex management of the medication (includes several expensive drugs w/ many side effects)
• Early treatment can decrease viral load & delay progression from HIV to AIDS 

DRUGS:

• Nucleoside Reverse Transcriptase Inhibitors (NRTI) 
• zidovudine (AZT) [affects granulocytes & creates lactic acid  - bad]
• Non-nucleoside Reverse Transcriptase Inhibitors 
• efavirenz (Sustiva) [prevent unaffected cells from becoming infected] 
• Protease Inhibitor (PI) 
• saquinavir (Invirase) [inhibit enzyme that breaks up chains to protein mocules which are necessary for viral replication] 
• Fusion Inhibitors 
• enfuvirtide (Fuzeon) [suppress fusion process where virus attaches to outer membrane] 

• these medications suppress the disease but do not cure it

Adverse Effects: fatigue / anemia / GI symptoms / weight loss

Contraindications: None given. 

Nursing Education: 

• regular blood tests (viral loads, CD4s, CBCs)
• relieve symptoms
• prevent transmission 

Resistance:  

If treatment isn't finished, live viruses become smarter, change, and may become resistant to future meds. (so no missing doses) 

Anti-Infective - Antifungals 

DRUGS:

• amphotericin B (Fungizone), IV
• leads to nephrotoxicity (temporary), severe chilling, headache, nausea, vomiting, generalized pain --> usually pre-treat patients to combat these
• nystatin (Mycostatin), troche [for oral candidiasis]
• fluconazole (Diflucan), PO, IV [vaginal candidiasis]
• terbinafine (Lamisal), topical, PO [nail fungus] 

Routes: IV, PO

Therapeutic Use: 

• significant fungal infections (life threatening ones) / oral candidiasis / vaginal candidiasis / nail fungus 

Adverse Effects: Listed above. 

Contraindications: None given. 

Nursing Education: None given. 

Resistance: 

Anti-Infective -  Antiparasitic 

DRUGS:

• permethrin (Nix)
• mebendazole (Vermox) 

Therapeutic Use: 

• Head lice / pediculosis / itch mite (scabies) -> Nix
• pin worms (enterobiasis) -> Vermox 

Adverse Effects: None given. 

Contraindications: None given. 

Nursing Education: None given. 

Resistance: None given.