Pharmacology Chapter 24 Part 2 --DRUG THERAPY- RECHECKED
fluconazole
"?" is commonly used in children with Candida infections & is routinely administered to older patients with Candida infections.
griseofulvin
"?" is contraindicated in patients with a known hypersensitivity reaction. It is also contraindicated with liver disease, *porphyria*, and pregnancy.
terbinafine
"?" is not recommended for patients with chronic or active liver disease, and serum ALT and AST should be checked before starting the drug.
long
"long/short" term use of amphotericin is necessary.
griseofulvin
Avoid exposure to sunlight or extreme artificial light with "?".
griseofulvin
Avoid exposure to sunlight or extreme artificial light with this drug
terbinafine
Common adverse effects with oral "?" include headache, diarrhea, and abdominal discomfort, and with long-term use for onychomycosis, skin reactions and liver failure may also occur.
fluconazole
During a study in Denmark, researchers found the admin of "?" 400 to 800 mg/d for the treatment of a yeast infection during pregnancy increased the woman's risk of miscarriage (FDA released an alert).
caspofungin
Pts suffering from any cardiovascular disease warrant assessment for increasing weight and peripheral edema when taking this:
fluconazole
With this drug, elevation of liver enzymes & hepatic necrosis have reportedly occurred, and *alopecia* often occurs in patients receiving prolonged, high-dose treatment.
amphotericin B
Women who are lactating should not take this drug except in life-threatening situations.
amphotericin B
active against most types of pathogenic fungi and is fungicidal or fungistatic, depending on the concentration in body fluids and the susceptibility of the causative fungus.
terbinafine
an antimicrobial drug for a skin disorder is "?".
amphotericin B
the *prototype* polyene
terbinafine
"?" has been used mainly for topical treatment of ringworm infections
terbinafine
"?" has fungicidal activity against dermatophytes
terbinafine
"?" is a broad-spectrum antifungal that inhibits an enzyme needed for synthesis of ergosterol, a structural component of fungal cell membranes.
caspofungin
"?" is administered in the acute care setting
caspofungin
*prototype* echinocandins is
fluconazole
*prototype* for azoles
griseofulvin
*prototype* for miscellaneous antifungal agents class
aspergillosis
A 53-year-old man has asthma. He is admitted to the emergency department with wheezing, dyspnea, muscle aches, and a high fever. He owns and operates a swimming pool business in which he sells above-ground swimming pools and hot tubs. His business has a showroom with functioning pools and hot tubs. What fungal infection do you suspect the patient is suffering from? blastomycosis histoplasmosis aspergillosis candidiasis
amphotericin B
A patient was diagnosed with cryptococcal meningitis. Which of the following medications is administered to treat cryptococcal meningitis? amphotericin B Rocephin bleomycin mupirocin
amphotericin B
Adverse effects of "?" are often severe, w/the most serious being multiple organ failure, respiratory arrest, and cardiac arrest.
monthly
All of the azoles cause hepatotoxicity with an elevation of the AST and ALT levels. Thus, it is necessary to assess hepatic enzymes "how often" during therapy.
hepatic
Although the main concern with amphotericin B is nephrotoxicity, monitoring of "?" function during use is recommended.
is
Amphotericin B deoxycholate "is/is not" nephrotoxic
terbinafine
BLACK BOX WARNING ♦ for this drug regarding the risk of hepatotoxicity.
amphotericin B
BOX WARNING ♦ issued by FDA states that "?" should be reserved for progressive or potentially fatal infections. It is not recommended for use in noninvasive disease due to the risk of toxicity.
topical
Be aware that "?" administration of amphotericin may cause staining of clothes.
amphotericin B
Because of its toxicity, this drug is used only for serious fungal infections
3
Caspofungin is approved for use in children older than "?" months of age for the treatment of candidemia and invasive candidiasis.
electrolytes
Children may take amphotericin B, but such use requires assessment of "?" due to magnesium wasting. (Health care providers have used the drug successfully to treat children with serious fungal infections, without unusual or severe adverse effects).
griseofulvin
Estrogen increases effects of this drug; possible breakthrough bleeding
surface area
It is recommended that the dosage of caspofungin be established based on body "? ?" rather than weight.
terbinafine
Hepatotoxicity is uncommon but has occurred in people with and without pre-existing liver disease and has led to liver transplant or death with this drug.
3
If ALT and AST increase to more than "?" times the normal range, the azole should be discontinued
antibiotics
If given with amphotericin B, what increases the risk of nephrotoxicity?
caspofungin
It is essential to administer "?" intravenously, and the drug is incompatible with any other IV medication, including dextrose.
sodium
It is essential to assess the "?" balance throughout the administration of amphotericin B.
immune
It is important the home care nurse assess the pt's "?" function with the administration of amphotericin B.(The pt's home should be kept meticulously clean & free of mold-producing substances such as potted plants, fresh flowers, and adhesive nonslip bathtub appliques).
bone marrow depression
It is necessary to check leukocyte and differential counts weekly as well as platelet counts to rule out "? ? ?"
terbinafine
Lamisil is trade name for "?".
griseofulvin
Nurse assesses for dermatologic reactions such as rash, *photosensitivity*, or urticaria with this drug
amphotericin B
Nurse gives ASA, antihistamines, and antiemetics, which are used to manage adverse effects, prior to the administration of what drug?
azoles
Other drugs in this class include: ketoconazole itraconazole (drug of choice for many fungal infs) posaconazole voriconazole
griseofulvin
Patients with hepatic impairment should not take the drug.
caspofungin
Prior to administering the first dose of "?", the nurse assesses baseline liver and renal function along with electrolytes, complete blood count, and platelet count.
amphotericin B
Prior to beginning TX, it is necessary to obtain a culture of the infection. However, TX with what drug should begin prior to the culture results.
amphotericin B
Renal impairment occurs in most patients (up to 80%) within the first 2 weeks of therapy but usually subsides with dosage reduction or d/c of what drug?
griseofulvin
Safety has not been established in children 2 years of age and younger for this medication
echinocandins
The "?" have fungal activity against Candida, including *azole-resistant* organisms, and fungistatic activity against Aspergillus
azoles
The "?" may cause hepatotoxicity, ranging from mild elevations in ALT and AST to clinical hepatitis, cholestasis, hepatic failure, and death. (Fatal hepatic damage has occurred mainly in patients with serious underlying conditions, such as AIDS or malignancy, and with multiple concomitant medications)
dermatophyte
The *miscellaneous antifungal agents* are administered for "?" infections of the scalp and nails.
azoles
The largest group of commonly used antifungal agents
fluconazole
The nurse should never mix "?" (IV) with any other medications.
test
The patient should receive a "?" dose to assess tolerance for the drug/amphotericin B.
aspergillosis
These spores are found in hot water faucets, saunas, hot tubs, and swimming pools
fluconazole
This drug binds to sterols in the fungal cell membrane; this action changes the membrane's permeability, producing a *fungicidal or fungistatic* effect depending on the drug concentration and the fungal organism.
amphotericin B
This drug binds to the sterols within the fungal cell membrane, resulting in a change in the membranes permeability; this destroys the fungal cells and prevents them from reproducing. Depending on the concentration of the medication, it has *either a fungicidal or fungistatic effect*.
amphotericin
This drug has lipid formulations available that are less nephrotoxic.
caspofungin
This drug inhibits the synthesis of the fungal cell wall, interfering with the reproduction and growth of susceptible fungi.
fluconazole
This drug is also used for long-term suppression of cryptococcal meningitis in patients with AIDS, after initial use of amphotericin B. It is used prophylactically in the prevention of candidiasis in patients with bone marrow transplants.
caspofungin
This drug is also used to treat Candida infections r/t intra-abdominal, pleural space, or esophageal abscesses or peritonitis. In addition, it is given to febrile neutropenic patients who possess a suspected fungal infection.
amphotericin B
This drug is reserved for patients with progressive and potentially fatal infections resulting from cryptococcosis, North American blastomycosis, systemic candidiasis, disseminated moniliasis, coccidioidomycosis, and histoplasmosis.
griseofulvin
This drug is used for the treatment of susceptible tinea infections of the skin, hair, and nails.
caspofungin
This drug is used to treat invasive aspergillosis in patients who *do not tolerate* other antifungal drugs.
fluconazole
This drug penetrates tissues well, including CSF
nystatin
This is used only for topical therapy of oral, intestinal, and vaginal candidiasis because it is too toxic for systemic use.
nystatin
What drug has the same mechanism of action as amphotericin B
aspirin
When administering amphotericin B, what drug is administered to prevent the development of chilling, fever, malaise, and nausea? aminophylline ibuprofen penicillin G aspirin
griseofulvin
clinicians have reported hypersensitivity reactions in patients who are allergic to penicillin with this drug
fluconazole
contraindicated in pregnancy and lactation
griseofulvin
drug TX for dermatophytosis
terbinafine
drug TX for onychomycosis of fingernails or toenails
terbinafine
drug TX for tinea infections
terbinafine
oral treatment of onychomycosis.
terbinafine
therapeutic effects of this drug may not be evident until months after drug therapy is stopped, because of the time required for growth of healthy nail.
griseofulvin
this drug disrupts the metaphase of cell division by binding to keratin, making it resistant to fungal invasion.
lamisil
trade name for terbinafine