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28 Cards in this Set
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antimycobacterial (antituberculosis)
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proto: isoniazid (INH, Nydrazid)
other: pyrazinamide (PZA) ethambutol (Myambutol) bacteriostatic only to M. tuberculosis rifapentine (Priftin) |
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antimycobacterial MOA
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highly specific for mycobacteria, Isoniazid inhibits growth of mycobacteria by rpeventing synthesis of mycolic acid in the cell wall
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antimycobacterial use
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indicated for active and latent tuberculosis only
latent: Isoniazid only 6-9 months contraindicated in clients under age 2, HIV, pregnant, clients resistant to either med active: several meds must be used to treat client in order to decrease med resistance- includes Isoniazid for a minimum of 6 months |
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antimycobacterial adverse
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peripheral neuropathy
hepatotoxicity hyperglycemia and decreased glucose control in clients who have diabetes |
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antimycobacterial contraindications
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liver disease
older clients, DM, or alcohol use disorder (caution) |
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antimycobacterial interactions
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isoniazid inhibits metabolism of phenytoin, leading to the buildup of medication and toxicity, ataxia and incoordination may indicate toxicity
concurrent use of alcohol, rifampin, and pyrazinamide increases risk for hepatotoxicity |
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antimycobacterial admin
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inject deeply into large muscle
take isoniazid one hour before meals or 2 hours after |
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rifampin (Rifadin) antimycobacterial MOA
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bactericidal as a result of inhibition of protein synthesis
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rifampin
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broad-spectrum effective for gram + and gram- bacteria M. tuberculosis and M. leprae
given in combination with at least one other antituberculosis med to help prevent antibiotic resistance |
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rifampin adverse
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discoloration of body fluids
hepatotoxicity mild GI discomfort |
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rifampin contraindications
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liver dysfunction
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rifampin interactions
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accelerates metabolism of warfarin, oral contraceptives, protease inhibitors, and NNRTIs (HIV meds) resulting in diminished effectiveness
concurrent use with isoniazid and pyrazinamide increase hepatotoxicity |
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antiprotozoals
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metronidazole (Flagyl)
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metronidazole MOA
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bactericidal acitivty against anaerobic micro-organisms
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metronidazole use
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protozoal infections (intestinal amebiasis, giardiasis, trichomoniasis
obligate anaerobi bacteria- C. dif prophylaxis for clients who will have surgical procedures and are high-risk for anaerobic infection treatment of H. pylori in combination with tetracycline, and bismuth salicylate in clients who have PUD |
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metronidazole adverse
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GI discomfort
darkening of urine CNS symptoms |
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metronidazole contraindications
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active CNS disorders, blood dyscrasias, during lactation, contraindicated in the first trimester of pregnancy in clients who have trichomonaisis
renal, cardiac, or seizure disorder, older adults |
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metronidazole interactions
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alcohol causes a disulfuriam-like reaction
inactivation of warfarin |
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antifungals
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amphotericin B (Fungizone) - polyene antibiotic for systemic mycoses
ketoconazole (Nizoral) an azole for treating both superficial and systemic mycoses |
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antifungal meds
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other: flucytosine (Ancobon)
Nystatin (Mycostatin) miconazole (Monistat) clotrimazole (Lotrimin) terbinafine (Lamisil) fluconazole (Diflucan) greseofulvin (Grifulvin) |
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amphotericin B
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acts on fungal cell membranes to cause cell death
can be fungistatic or fungicidal |
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amphotericin uses
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treatment of choice for systemic fungal infection (Candidiasis, aspergilliosis, cryptococcoids, mucomycosis)
some antifungals treat superficial fungal infections |
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amphotericin B adverse
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infusion reactions 1-3 hours after initiation- pretreat with diphenhydramine (Benadryl) and acetaminophen
thrombophelebitis- administer in large vein and administer heparin before infusing amphotericin B nephrotoxicity hypokalemia bone marrow suppression |
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ketoconazole adverse
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hepatotoxicity
effects on sex hormones- male- gynecomastia, female-menstrual irregularity |
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antifungal contraindications
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renal dysfunction
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antifungal interactions
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aminoglycosides have additive nephrotoxic risk whe nused concurrently with antifungal meds
antifungal effects of flucytosine are potentiated with concurrent use of amphotericin B floconazole contraindicated with amphotericin B azole antibiotics increase levels of multiple medications, including digoxin, warfarin, and sulfonylurea antidiabetic meds |
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antifungal admin
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amphotericin b is highly toxic and should be reserved for severe life-threatening fungal infections
should be infused slowly over 2-4 hr by IV route because oral preparation is poorly absorbed into the GI tract |
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antifungal effectiveness
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improvement of systemic fungal infections
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