What are some antifungal drug classes?

Polyenes, Azoles, and Pyrimidine analogs

What is the prototype drug for polyenes?

amphotericin B deoxycholate (also called ampB)

What does amphotericin B deoxycholate do

it disrupts the fungal membrane, stopping reproduction

Amphotericin B deoxycholate has a BBW. What is it?

it should only be used for potentially fatal infections due to its various side effects

What are some nursing considerations for amphotericin B deoxycholate?

"ampho-terrible" (bc of its various side effects). Renal impairment is common(so keep pt hydrated with IV sodium chloride), organ failure, cardiac arrest, respiratory arrest, N/V (premedicate to treat before manifestations)

What should you always use for amphotericin B deoxycholate?

ALWAYS have a dedicated IV line and filter.

If you are administering amphotericin B deoxycholate in its lipid formulation, what should you NOT have?

an in line filter (the filter will remove the medication)

What is the prototype drug for azoles?

fluconazole

What does fluconazole do?

it disrupts membrane permeability

What would we use fluconazole for?

candida infections (it is the drug of choice)

What are some nursing considerations when using fluconazole?

Use half of the dose if the pt has poor renal function, it is hepatotoxic, and is an enzyme inhibitor (meaning it lowers drug metabolism, increasing the effect of some drugs leading to a risk of toxicity, so watch out for drug interactions)

What is the prototype drug for pyrimidine analog?

flucystosine

What does flucystosine do?

It affects the fungus CM resulting in cell death

How would you use flucytosine?

in combination with amphotericin B deoxycholate to treat candida and crytococcus

Flucystosine has a BBW. What is it?

you have to use caution if giving it to someone with renal dysfunction

What are some nursing considerations when it comes to flucytosine?

hepatotoxic and bone marrow toxicity are dependent on the dose, so monitor labs closely for dose adjustment if needed.

What are some drugs classes used for parasites?

amebicides, antimalarials, antihelmintics, scabicides and pediculicides

What is the prototype drug for ambecides?

metronidazole

How does metronidazole work?

it diffuses across the parasite Cm, resulting in cell death

What would you use metronidazole for?

intestinal amebiases, trichomoniasis

What are some nursing considerations for metronidazole?

metallic taste, dark urine, AVOID ALCOHOL DURING TREATMENT AND 3 DAYS AFTER (if taken w alcohol will cause disulfiram), assess stools for diarrhea (hopefully it stops)

What is the prototype drug for antimalarials?

chloroquine phosphate

What do all antimalarials end in?

"-quine"

What does chloroquine phosphate do?

it interferes with parasite's DNA, RNA, and metabolism

What is chloroquine phosphate used for?

treatment and prophylaxis (prevention) of malaria

What are some nursing considerations for chloroquine phosphate?

visual disturbances, ECG changes (QTC interval prolongation), take same day every week for prophylaxis, take daily for treatment.

What is the prototype drug for antihelmintics?

Mebendazole

What does mebendazole do?

it blocks glucose uptake of worms

What is mebendazole used to treat?

worms (pinworms, hookworm, roundworm, whipworm)

What are some nursing considerations for mebendazole?

chew/crush and swallow. It is teratogenic so don't give to pregnant people.

Pinworms are also known as?

Enterobius vermicularis

What are signs/symptoms and need to known information of Enterobius vermicularis (pinworms)?

- perianal itching

- disinfect toilet after use, clean clothes, sheets, towels daily, and wash hands because it is CONTAGIOUS as HELL.

What is the prototype drug for scabicides and pediculicides?

permethrin

What does permethrin do?

stops the influx of sodium, killing/paralyzing the parasites

What would we use permethrin for?

scabies and lice

What is another name for having lice?

pediculosis

How would we use permethrin for lice?

wash hair, apply cream, let it sit for 10 minutes, rinse, use lice comb. if they persist, repeat in a week but keep the drug in hair overnight.

How would we use permethrin for scabies?

apply head to toe amd leave on for 8-14 hours.