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TB is transmitted by
Droplets
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Symptoms of TB
- cough, anorexia, increased sputum production( hemoptysis), fever, night sweats and weight loss
- + AFB in sputum
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Antitubercular Agents
- Isoniazid( INH)
- --Prescribed with pyridoxine (Vit B6) to prevent peripheral neuropathy
- --Hyperglycemia, hyperkalemia, hypophosphatemia and hypocalcemia
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TB drugs that turns body fluids orange?
Rifampin
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Antitubercular drugs that cause Ototoxicity, nephrotoxicity
Streptomycin
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Antitubercular Agents - Other side effects of this class of drugs includes:
- - hepatoxicity
- - headaches
- - blood dyscrasias
- - GI distress
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Antitubercular Agents - Assessment:
- Last PPD , CXR
- Allergies to Antitubercular agents
- Hepatic function
- Evaluate for peripheral neuropathy
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Nursing Implications for TB drugs
- STRESS THE NEED to complete drug therapy
- Collect sputum specimens in early am, before eating
- Assess for weight loss
- Monitor for hepatotoxicity
- - Jaundice
- - clay colored stools
- - dark urine
- - elevated liver enzymes
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Teaching
- Complete therapy
- Do not take meds with antacids
- Do not drink alcohol
- Eat foods high in Vit B6
- How to safely dispose of contaminated tissues
- Can effect oral contraceptives
- Avoid direct sunlight
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Fungal infections can be
- superficial or systemic
- Opportunistic or non-opportunistic
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Antifungal Agents
- Polyenes
- - Amphotericin B
- - Nystatin
- Azoles
- - Diflucan
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Antifungals - Amphotericin B
- Severe systemic fungal infections
- Highly toxic
- Duration of action is 20 hours
- IV route only
- Pre-medication sometimes used
- Contraindicated in hepatic or renal disease
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Side effects and Adverse Effects - Antifungals
- Fever, chills , nausea and vomitin
- Hypotension
- Paresthesias
- Thrombophlebitis
- Muscle weakness
- Nephrotoxicity
- Electrolyte imbalances
- Cardiac dysrhythmias and seizures
- anemia
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Antifungal - Nystatin
- Used to treat Candida
- Topical ointment
- Oral swish and swallow
- No liquids after administration
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Antifungal - Diflucan (yeast infection)
- Oral-IV routes
- oropharyngeal and esophageal candidiasis
- Vaginal candidiasis
- Cryptococcal meningitis
- Pneumonia
- Peritonitis
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Antifungal - Diflucan - Side Effects
- Reactions not common
- Allergic
- Nausea , vomiting, diarrhea & cramps
- Rash( Stevens-Johnson syndrome)
- Elevated liver enzymes
- Increased PT levels if on Coumadin
- Increased hypoglycemia on antihypoglycemics
- Elevated levels of antidepressants
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Flagyl
- Active against anaerobic organisms
- H-Pylori
- Intestinal amebiasis
- Trichomoniasis
- Clostridium difficile
- Bacterial vaginosis
- Prophylaxis for colorectal surgery
- No alcohol for 48 hrs after completed Flagyl
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Side and adverse effects of Flagyl
- GI discomfort, Headache, depression, insomnia, metallic taste, incontinence, paresthesias, decreased libido
- Inhibits metabolism of anticoagulants
- Thrombophlebitis IV
- Do not take in first trimester of pregnancy
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Antivirals
- Flu , Herpes, CMV, and Hepatitis B, HIV are viruses
- Viruses can only replicate inside living cell
- Antivirals inhibit viral replication
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FLU
- Relenza and Tamiflu
- Must be given within 48 hrs. of symptoms
- Are not the same as “flu shot”
- Effective against type A and B influenza viruses
- Many tests are available to diagnose flu within 10-20 minutes
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Herpes
- Acyclovir ( Zovirax)
- Herpes simplex, herpes zoster, herpes simplex encephalitis and CMV
- Does not cure, improves pain and decreases healing time of blister formations
- PO or IV
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Valacyclovir ( Valtrex)
- Treatment of singles ( herpes zoster), HSV
- Converts to Acyclovir
- Greater pain control with shingles and increased healing time
- PO only
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