mycobacterial, fungal, & parasitic infections medications for infection adn 110/cohort 131

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OVERVIEW Mycobacterium tuberculosis (TB) ◦ Slow growing ◦ Minimum 2 medications Parasitic infections ◦ metronidazole Systemic & superficial mycoses ◦ Antifungal medications ADN 110/cohort 133

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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

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