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pathophar exam finaL
chapter 93 ANTIVIRALS 92 ANTIFUNGAL
| Question | Answer |
|---|---|
| VIRUS | RELICATED THROUGH HOSST CELL HARD TO SUPPRESS W/O HARMING HOST ANTIVIRAL VIRAL SUPPRESS THE BIOCHEMICAL PROCESS OF VIRAL REPLICATION |
| TEACHING-ACYCLOVIR(ZOVIRAX) | ACTIVE ONLY A/G MEMBERS OF HERPES SIMPLEX VIRUS OR VARICELLA-ZOSTER VIRUS-SIMPLEX GENITALIS(COLD SORES) HAS RESISTANCE TO ACYCLOVIR VARICELLA ZOSTER REACTIVATE A/G NERVE =SHINGLES |
| TEACHING | ORAL THERAPY *GI-NVD AND VERTIGO TOPICAL THERAPY STINGING ADR IV THERAPY PHLEBITIS, REVERSIBLE NEPHROTOXICITY, NEUROTOXICITY |
| TEACHING | TOPICAL HERPES LABIALIS(COLD SORE) DOCUSANOL OCCULAR HERPES VIROPTIC-EYE DROP GANCICLOVIR-GEL |
| Hepatitis C | Chronic, Leading cause for herpes virus Leading reason of liver transplant |
| Teaching | Transmitted through blood exchanges I.e sexual Transmissible in incubation phase Slow progression = liver failure, cancer, death Drug-ribavarin +interferon Alfa |
| Hepatitis B | 11,000 hospitalized for jaundice, deep fatigue and muscle pain |
| Teaching | Chronic in 3-5% Lead to cirrhosis, hepatic failure , hepatocellular carcinoma, death Transmitted through blood and semen Take vaccine to prevent |
| Influenza (flu) | Severe respiratory tract infection Major cause of mortality and mobility worldwide Influenza virus Mutated randomly, evolve constantly Type A more infectious than B |
| Teaching Live-used in nose spray-not given to immunocompromised patients | Prevent with vaccination Vaccine-depends on yearly strains Inactivated-can’t cause flu(immune response-develop antibiotics and low fever) Live attenuated Begin protection1-2 weeks after and last 6months Small risk for guillan-barre syndrome |
| TEACHING | CAUTION ACUTE FEBRILE ILLNESS-DEFER VACCINATION EGG ALLERGY VACCINATE EXTREME IN AGE-WEAK IMMUNE SYSTEM GIVEN IN THE FALL |
| TEACHING | NEURAMINIDASE INHIBITORS OSELTAMIVIR (TAMIFLU) DOSE FOR PROPHYLASIS AND SICK OF FLU--MUST BE STARTED 48H OR EARLIER AFTER ONSET |
| RESPIRATORY SYNCYTIAL VIRJUS INFECTION | RIBAVIRIN(INHALED) BROAD SPECTRUM ANTIVIRAL DRUG PALIVIZUMAB(SYNAGIS) MONOCLONAL ANTIBODY , PREVENT RSV IN NEWBORNS |
| A patient is prescribed acyclovir [Zovirax] by mouth. The nurse should assess the patient for which adverse effects associated with oral acyclovir therapy? | Stomatitis and gastritis B.Nausea, vomiting, and diarrhea C.Hives, difficulty breathing, and angioedema D.Tinnitus and decreased hearing |
| A patient asks the nurse what he can do to prevent influenza. What should the nurse do? | Instruct the patient to obtain an influenza vaccination. |
| Which statement about oseltamivir [Tamiflu] does the nurse identify as true? | Oseltamivir can be used to treat and prevent influenza. |
| ANTIFUNGAL | SYSTEMIC MCOSES DIFFICULT TO TREAT=RESISTANCE PROLONGED THERAPY TOXIC |
| SYSTEMIC MYCOSES | OPPORTUNISTIC IMMUNOCOMPROMSED HOST-CANDIDIASIS NONOPPORTUNISTIC HAPPEN IN ANY HOST |
| TEACHING | USES DRUG OF CHOICE FOR SYSTEMIC MYCOSES SYSTEMIC FUNGAL INFECTION WERE FATAL BEFORE THIS DRUG BROAD-SPECTRUM AGAINT FUNGAL OR PROTOZOA INFECTION HIGHLY TOXIC INFUSION OR RENAL DAMAGE-IV, NO PO |
| TEACHING | ADR BONE MARROW SUPPRESSION NEPHROTOXICITY KYPOKALEMIA AVOID NEHROTOXIC DRUG(AMINOGLYCOSIDE, NSAID) MONITOR CBC-WBC SERUM CREATINE Q3-4D REDUCE DOSAGE IF >3.5MG/DL |
| AZOLES | BROASD SPECTRUM ALTERNAIVE OF AMPHOTERICIN B |
| TEACHING | PO LOWER TOXICITY INHIBIT P450 DRUG-METABOLIZNG ENZYME INCREASE DRUG LEEL OF OTHER DRUGS |
| FLUCONAZOLE(DIFLUCAN) | PO FUNGISTATIC SAME AS ITRACONAZOLE-IV , WELL BY PO HEADACHE, N/V/D |
| SUPERFICIAL MYCOSIS | CAUSED BY CANDIDIA THRUSH-DIAPER RASH-SKIN FOLD CHRONIC SCALP, SKIN, NAIL DERMATOPHYTIC INFECTIONS(RINGWORM) TINEA-PEDIS, CORPORIS, CRUSIS(GROIN) CAPITIS(SCALP) |
| TEACHING | PO THRUSH VULVOVAGINAL CANDIDIASIS 75% WOMEN QYEARLY RISK FACTORS PREGNANCY, DIABETES, HIV, ORAL |
| TEACHING-CHANGE TOOTH BRUSH AND LIP GLOSS | VULVOVAGINAL CANDIDIASIS 1-3 DAYS TOPICAL OTD-FLUCONAZOLE ORAL NYSTATIN-4-6H SWISH AND SALLOW DO NOT EAT AFTER THIS DRUG TABLET=KETOCAZOLE OR FLUCONAZOLE |
| ONYCHOMYCOSIS | FUNGALINFECTION OF THE NAIL PO LAMISIL AND ITRACONAZOLE -MONITOR AST HEPATOXICITY TOPICAL CICLOPIROX |
| NYSTATIN | POLYENE ANTIBIOTIC ONLY CANDIDIASIS DRUG OF CHOICE FOR INSTESTINAL CANDIASIS-SKIN,MOUTH,ESOPHAGUS, VAGINA PO, TOPICAL |
| A patient is receiving amphotericin B to treat a systemic fungal infection. To prevent renal damage, it is most important for the nurse to do what? | Administer 1000 mL of 0.9% saline. Kidney damage can be minimized by infusing 1 L of saline on the days amphotericin is infused. |
| Which statement by a new nurse about intravenous administration of amphotericin B indicates the nurse needs more education? Diphenhydramine plus acetaminophen can minimize rigors associated with amphotericin B therapy. | TRUE Heparin can be used in the infusion site to prevent phlebitis associated with amphotericin B therapy Meperidine or dantrolene is used to treat rigors associated with amphotericin B therapy. |
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