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Test #4 Chapters 28-40
Antituberculars, Antifungals, Peptides, & Mitronidazole
21
Pharmacology
Undergraduate 2
03/26/2011

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Term
Tuberculosis
Definition

-Droplet transmission

-crowded living conditions, immune-compromised

                                        -TB bacilli found in lungs, kidney, bone, liver, spleen

-need to treat active cases & exposure, HIV+

Term
*Isoniazid (INH)
Definition

-Used for prophylaxsis 6 months – 1 year

-Used in combination for TB treatment (rifampin, ethambutol & pyrazinamide) due to drug resistance 6-9 months

-May use aminoglycosides if further resistance develops

Term
TB symptoms
Definition
SE of anorexia, cough & sputum production, increased fever, night sweats, weight loss, and positive acid-fast bacilli in the sputum, GI distress
Term
*Isoniazid (INH, Nydrazid)
Definition

-dose: 5 mg/kg/day in single dose po or IM 6-9 months; prophylaxis 300 mg 6-12 months

-SE: rash, tremors, tinnitus, photosensitivity, n/v, constipation

-Adverse: peripheral neuropathy, vitamin B6 deficiency, psychosis, hepatotoxic, seizures, bone marrow suppression

-drug-drug: decreased absorption w/ aluminum antacids, increased effect with alcohol, dilantin, rifampin

 

Term
First-line drugs (antituberculars)
Definition

-drugs chosen first

-less toxic, more effective than 2nd line

Term
rifampin (Rifadin)
Definition
-1st line antitubercular that colors contact lens/body fluids orange
Term
ethambutol (Myambutol)
Definition
-1st line antitubercular that has SE of dizziness, joint pain, hallucinations
Term
streptomycin
Definition
-1st line antitubercular that can be ototoxic, nephrotoxic, and hepatotoxic
Term
Second-line Drugs (antituberculars)
Definition

-second choice anti TB drugs used for disseminated (spread throughout the body) TB, more toxic effects & SE

-are not as effective as 1st line drugs

-used when 1st-line drugs fail

-should be used in combination with other anti TB drugs

Term
Cycoserine (Seromycin)
Definition
-2nd line broad spectrum antomycobacteral drug for TB
Term
Antitubercular Nursing Measures
Definition

-monitor compliance w/ therapy

-monitor LFT, CBC, renal function

-monitor for peripheral neuropathy

-add vitamin B6

Term
Antifungals
Definition

-do not mix well w/ other drugs

-treat superficial (Athlete's foot) or systemic (meningitis)

-treat candidiasis, aspergillosis, cryptococcosis, histoplasmosis, coccidiomycosis, blastomycosis

Term
Amphoteracin B
Definition

-treat severe systemic fungal infection

-very toxic

-long half-life: 24 hrs

-IV only

-SE: fever, flushing, chills, n/v, hypotension, thrombophlebitis, parasthesia

-Adverse: nephrotoxic, hypokalemia, hypomagnesemia

Term
Nystatin (Mycostatin)
Definition

-treat oral/vaginal candida & intestinal infections

-orally or topically, available in suspensions

-"swish and swallow" liquid med in mouth for oral thrush

Term
*Fluconazole (Diflucan)
Definition

-treat candida, cryptococcal, meningitis

-dose: 400 mg/day for 1 wk, then 200 mg/day for 4 wk

-po or IV

SE: n/v/d, anorexia, rash, headache, abd cramps

Term
Itraconazole (Sporonox)
Definition
-antifungal for histoplasmosis, blastomycosis
Term
Ketoconazole (Nizoral)
Definition
-antifungal for candida, histoplasmosis, blastomycosis
Term
Miconozole (Monistat)
Definition
-antifungal vaginal suppository/cream or IV for bladder fungal infection
Term
Tinidazole (Tindamax)
Definition
-antifungal for giardiasis, trichomoniasis, bacterial vaginosis
Term
Bacitracin (Bacitin)
Definition

-antibacterial topical ointment for skin infection and opthalmic ointment for eye infection

-IV slowly

-SE: redness, rash, hives (severe local reaction)

-Adverse: renal damage, ototoxicity

Term
Metronidazole (Flagyl)
Definition

-antibacterial for GI tract infections, h. pylori

-prophylaxis (protect) in colorectal surgery

-SE: dizzy, confusion, headache, facial flushing, sweating, malaise (discomfort), weakness, insomnia, depression, metallic taste, brown urine

Adverse: peripheral neuropathy

-CI: avoid alcohol during & 48 hrs after tx, avoid during 1st trimester of pregnancy

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