Antitubercular, Antifungal

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jean
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17236
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Antitubercular, Antifungal
Updated:
2010-05-03 10:46:33
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Antitubercular Antifungal
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Antitubercular, antifungal
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  1. TB is transmitted by
    Droplets
  2. Symptoms of TB
    • cough, anorexia, increased sputum production( hemoptysis), fever, night sweats and weight loss
    • + AFB in sputum
  3. Antitubercular Agents
    • Isoniazid( INH)
    • --Prescribed with pyridoxine (Vit B6) to prevent peripheral neuropathy
    • --Hyperglycemia, hyperkalemia, hypophosphatemia and hypocalcemia
  4. TB drugs that turns body fluids orange?
    Rifampin
  5. Antitubercular drugs that cause Ototoxicity, nephrotoxicity
    Streptomycin
  6. Antitubercular Agents - Other side effects of this class of drugs includes:
    • - hepatoxicity
    • - headaches
    • - blood dyscrasias
    • - GI distress
  7. Antitubercular Agents - Assessment:
    • Last PPD , CXR
    • Allergies to Antitubercular agents
    • Hepatic function
    • Evaluate for peripheral neuropathy
  8. Nursing Implications for TB drugs
    • STRESS THE NEED to complete drug therapy
    • Collect sputum specimens in early am, before eating
    • Assess for weight loss
    • Monitor for hepatotoxicity
    • - Jaundice
    • - clay colored stools
    • - dark urine
    • - elevated liver enzymes
  9. Teaching
    • Complete therapy
    • Do not take meds with antacids
    • Do not drink alcohol
    • Eat foods high in Vit B6
    • How to safely dispose of contaminated tissues
    • Can effect oral contraceptives
    • Avoid direct sunlight
  10. Fungal infections can be
    • superficial or systemic
    • Opportunistic or non-opportunistic
  11. Antifungal Agents
    • Polyenes
    • - Amphotericin B
    • - Nystatin
    • Azoles
    • - Diflucan
  12. Antifungals - Amphotericin B
    • Severe systemic fungal infections
    • Highly toxic
    • Duration of action is 20 hours
    • IV route only
    • Pre-medication sometimes used
    • Contraindicated in hepatic or renal disease
  13. Side effects and Adverse Effects - Antifungals
    • Fever, chills , nausea and vomitin
    • Hypotension
    • Paresthesias
    • Thrombophlebitis
    • Muscle weakness
    • Nephrotoxicity
    • Electrolyte imbalances
    • Cardiac dysrhythmias and seizures
    • anemia
  14. Antifungal - Nystatin
    • Used to treat Candida
    • Topical ointment
    • Oral swish and swallow
    • No liquids after administration
  15. Antifungal - Diflucan (yeast infection)
    • Oral-IV routes
    • oropharyngeal and esophageal candidiasis
    • Vaginal candidiasis
    • Cryptococcal meningitis
    • Pneumonia
    • Peritonitis
  16. Antifungal - Diflucan - Side Effects
    • Reactions not common
    • Allergic
    • Nausea , vomiting, diarrhea & cramps
    • Rash( Stevens-Johnson syndrome)
    • Elevated liver enzymes
    • Increased PT levels if on Coumadin
    • Increased hypoglycemia on antihypoglycemics
    • Elevated levels of antidepressants
  17. Flagyl
    • Active against anaerobic organisms
    • H-Pylori
    • Intestinal amebiasis
    • Trichomoniasis
    • Clostridium difficile
    • Bacterial vaginosis
    • Prophylaxis for colorectal surgery
    • No alcohol for 48 hrs after completed Flagyl
  18. Side and adverse effects of Flagyl
    • GI discomfort, Headache, depression, insomnia, metallic taste, incontinence, paresthesias, decreased libido
    • Inhibits metabolism of anticoagulants
    • Thrombophlebitis IV
    • Do not take in first trimester of pregnancy
  19. Antivirals
    • Flu , Herpes, CMV, and Hepatitis B, HIV are viruses
    • Viruses can only replicate inside living cell
    • Antivirals inhibit viral replication
  20. FLU
    • Relenza and Tamiflu
    • Must be given within 48 hrs. of symptoms
    • Are not the same as “flu shot”
    • Effective against type A and B influenza viruses
    • Many tests are available to diagnose flu within 10-20 minutes
  21. Herpes
    • Acyclovir ( Zovirax)
    • Herpes simplex, herpes zoster, herpes simplex encephalitis and CMV
    • Does not cure, improves pain and decreases healing time of blister formations
    • PO or IV
  22. Valacyclovir ( Valtrex)
    • Treatment of singles ( herpes zoster), HSV
    • Converts to Acyclovir
    • Greater pain control with shingles and increased healing time
    • PO only

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