Mycobacterial, Fungal, & Parasitic Infections Medications for Infection ADN 110/cohort 131.
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Transcript of Mycobacterial, Fungal, & Parasitic Infections Medications for Infection ADN 110/cohort 131.
Mycobacterial, Fungal, & Parasitic Infections
Medications for Infection
ADN 110/cohort 13 1
ADN 110/cohort 13 2
OVERVIEWMycobacterium tuberculosis (TB)
◦Slow growing◦Minimum 2 medications
Parasitic infections◦metronidazole
Systemic & superficial mycoses◦Antifungal medications
ADN 110/cohort 13 3
ANTIMYCOBACTERIAL (ANTITUBERCULOSIS)
IsoniazidOther
PyrazinamideEthambutolRifapentine
ADN 110/cohort 13 4
Tuberculosis TB close to eradication; new
resistant strain developed in immunocompromised individuals and immigrants to the U.S.
Drug therapy is given in two forms:◦Preventive therapy◦Active therapy
ADN 110/cohort 13 5
Antitubercular AgentsTuberculosis (TB)
◦ Mycobacterium tuberculosis An aerobic bacillus Requires oxygen to survive
Antitubercular agents treat all forms of Mycobacterium
ADN 110/cohort 13 6
PurposeExpected Action
◦ Highly specific for mycobacterium
◦ Inhibits growth
Therapeutic Use◦ Active & latent TB
ADN 110/cohort 13 7
TB: Preventive TherapyPreferred agent
◦INH (Isoniazid)◦Known as chemoprophylaxis
Safest Low cost Action: tuberculostatic and tuberculocidal Treatment: 18 months to 2 years
ADN 110/cohort 13 8
ComplicationsPeripheral neuropathyHepatotoxicityHyperglycemiaNauseaSkin rashes
Contraindications/Precautions◦Contraindicated – liver disease◦Caution – geriatrics, DM, alcohol use
disorderADN 110/cohort 13 9
InteractionsPhenytoinAlcohol
ADN 110/cohort 13 10
ANTIMYCOBACTERIAL(ANTITUBERCULOSIS)
Rifampin
ADN 110/cohort 13 11
PurposeExpected Action
◦ BactericidalTherapeutic Uses
◦ Gram positive & gram negative bacteria
◦ Combined with at least one other antituberculosis medication
ADN 110/cohort 13 12
ComplicationsDiscoloration of body fluidsHepatotoxicityMild GI
Contraindications/Precautions◦Caution – liver dysfunction
ADN 110/cohort 13 13
InteractionWarfarin, oral contraceptives,
protease inhibitors & NNRTIsIsoniazid & pyrazinamide
ADN 110/cohort 13 14
ANTIPROTOZOALS
Flagyl
ADN 110/cohort 13 15
PurposeExpected Action
◦ Bactericidal activity
Therapeutic Use◦ Protozoal
infections◦ Obligate bacteria◦ Prophylaxis for
surgical procedures in high risk clients
◦ H. pylori
ADN 110/cohort 13 16
ComplicationsGIDarkening of urineCNS symptoms
Contraindications/Precautions◦Contraindicated – active CNS
disorders, blood dyscrasias, lactation, first trimester
◦Caution – renal, cardiac, or seizure disorders, geriatrics
ADN 110/cohort 13 17
InteractionsAlcoholWarfarin
ADN 110/cohort 13 18
ANTIFUNGALS
Amphotericin BKetoconazoleOtherFlusytosineNystatinMiconazoleClotrimazoleTerbinafineFluconazoleGriseofulvin
ADN 110/cohort 13 19
FungiContracted
◦Air◦Skin to skin
Due to normal flora being killed off:◦Antibiotics ◦Corticosteroid therapy◦Antineoplastic agents◦Suppressed immune system
ADN 110/cohort 13 20
Mycotic InfectionsThree general types
◦Cutaneous◦Subcutaneous◦Systemic (can be life threatening
ADN 110/cohort 13 21
Antifungal AgentsTreatment
◦Antibiotic therapy will not work.◦Requires prolonged treatment
Human cell structure resembles fungi cell structure.
Action◦Antifungal agents take advantage of
the slight differences of the cell structu.res
ADN 110/cohort 13 22
PurposeExpected Action
◦ Acts on fungal cell membranes
◦ Fungistatic or fungicidal
Therapeutic Use◦ Systemic fungal
infection◦ Nonopportunistic
mycoses◦ Superficial fungal
infections
ADN 110/cohort 13 23
ComplicationsInfusion reactionsThrombophlebitisNephrotoxicityHypokalemiaBone marrow suppressionKetoconazole
◦Hepatotoxicity◦Effects on sex hormones
ADN 110/cohort 13 24
Contraindications/PrecautionsContraindicated – renal
dysfunction
ADN 110/cohort 13 25
InteractionsAminoglycosidesAmphotericin BMultiple medications
◦Digoxin◦Warfarin◦sulfonylurea
ADN 110/cohort 13 26