Asepsis Meds - Antifungal & Antiviral - Level 1

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What are ANTIFUNGALS?

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Target for destruction with meds: Inhibit synthesis of DNA & RNA, inhibit mitosis

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Antifungal Medications

Back 2

Polyenes-Amphotericin B (Fungazone)

Azole-Fluconazole (Diflucan)

Front 3

What are the interactions/Precautions for Amphotericin B (Fungazone)?

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Route: IV

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What are the side effects for Amphotericin B (Fungazone)?

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Interactions/Precautions: Highly toxic solution; binds to tissue rather than blood, thereby increasing tissue damage; long half-life because not excreted well; fat soluble; use caution when used with K+ depleting diuretics & digitalis

IV only and used only in the most serious and severe fungal infections Serious kidney damage possible side effect.

Front 5

What is the route for Amphotericin B (Fungazone)?

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SE: renal damage, fever, HA, N/V, anemia, F&E imbalance, nephrotoxicity, hypokalemia

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What are examples of Azole?

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Fluconazole (Diflucan), Nystantin (Mycostatin),
Clotrimazole (Gyne-Lotrimin), Miconazole (Monistat),
Ketoconazole (Nizoral)

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What are the interactions/Precautions for Azole?

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Interactions/Precautions: do not give within 2 hours of antacids, hepatotoxicity, depends on stomach acidity for proper absorption, may inhibit testosterone & cortisol,
raise blood concentration of certain meds & lower others

Has an 8 hour half life:

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What are the side effects for Azole?

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SE: N/V/D, dizziness, nervousness, HA, rashes, puritis thrombocytopenia, allergic reaction, CNS effects

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What is the route for Azole?

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Route: PO & Topical

Fluconazole(IV or orally)

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What are the interactions/Precautions for Fluorinated Pyrimidine?

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Interactions/Precautions: use caution with renal damage; may have to use hemodialysis to remove drug from system; caution with bone marrow depression.

Front 11

What are the side effects of Fluorinated Pyrimidine?

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SE: N/V/D, anemia, thrombocytopenia, hepatotoxicity, bruising

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What is the route for Fluorinated Pyrimidine?

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Route: PO

Front 13

Drugs for destroying dermatophytic infection?

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Griseofulvin (Fulvicin),

Tolnaftate (Tinactin)

Front 14

What is the route for Griseofulvin (Fulvicin),Tolnaftate (Tinactin)?

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Route: PO

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What are the side effects for Griseofulvin (Fulvicin),Tolnaftate (Tinactin)?

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SE: HA, GI problems, neuritis, allergies, hepatotoxicity

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What are the Interactions/Precautions for Griseofulvin (Fulvicin),Tolnaftate (Tinactin)?

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Interactions/Precautions: long therapy, caution with oral contraceptives & warfarin

Dermatophytic infection=Bacterial Skin infection Warfarin (Coumadin)—blood thinner
Inform patients of the importance to complete treatment as prescribed to avoid relapse.

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What are ANTIVIRALS?

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“Avirs” - Protease inhibitors

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What are examples of antivirals?

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Indinavir (Crixivan), Ritonavir (Norvir), Squinavir (Invirase)

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What are protease inhibitors?

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Protease Inhibitor=Antiviral Drug(s) used against HIV; interupts HIV replication by binding and blocking HIV protease; inhibits viral protease.

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What is the route for protease inhibitors?

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Route: PO

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What are the side effects of protease inhibitors?

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SE: kidney stones, abdominal pain, N/V/D, HA, weakness, and altered taste

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What are the Interactions/Precautions of protease inhibitors?

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Interactions/Precautions: caution liver damage, hepatotoxicity

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What are the uses of Azole?

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First PO antifungal. It is effective for systemic fungal infections. Can be used for athletes foot or systemic infections

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Why is it important to correctly calculate the dosage of antivirals?

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Antiviral drugs need to have the dosage checked closely because the window of effectiveness is very small. If the dose is to low they will be ineffective and if the dose is to high they will be toxic.

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What are examples of “ine’s” - Reverse Transcriptase Inhibitors?

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Didanosine (DLL, Videx), Lamivudine (3TC, Epivir)
Stavudine (D4T, Zerit), Zalcitabine (ddC, Hivid)
Zidovudine (AZT, Retrovir)

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What are the side effects of Reverse Transcriptase Inhibitors?

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SE: blood disorders, HA, insomnia, muscle pain, N/V, ataxia, fatigue, nystagmus

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What are the Interactions/Precautions of Reverse Transcriptase Inhibitors?

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Interactions/Precautions: neurotoxicity, caution with liver damage & bone marrow depression

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What is the route for Reverse Transcriptase Inhibitors?

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Route: PO

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What are uses for Reverse Transcriptase Inhibitors?

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Pregnant women + for HIV can take AZT to decrease the risk of transmission to the infant.

These medication slow down the progression of HIV infection.

Reverse T.I.=are antiretroviral drugs used to treat HIV, infection, tumors, and cancer. They interfere with the conversion of RNA to DNA (this is what HIV causes); RT is an enzyme.

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What are examples of Non-nucleoside Reverse Transcriptase Inhibitors?

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Neverapine (Viramune), Delaviradine (Rescriptor)

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What are the side effects of Non-nucleoside Reverse Transcriptase Inhibitors?

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SE: N/V/D, fatigue, HA, rashes, stomach pain, mouth ulcers

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What are the Interactions/Precautions of Non-nucleoside Reverse Transcriptase Inhibitors?

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Interactions/Precautions: must be used in combo therapy due to resistance, hepatotoxic, caution when used with meds & antibiotics

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What is the route for Non-nucleoside Reverse Transcriptase Inhibitors?

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Route: PO

Front 34

Why is it important to correctly calculate the dosage of antivirals?

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Antiviral drugs need to have the dosage checked closely because the window of effectiveness is very small. If the dose is to low they will be ineffective and if the dose is to high they will be toxic.

Front 35

What are examples of “ine’s” - Reverse Transcriptase Inhibitors?

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Didanosine (DLL, Videx), Lamivudine (3TC, Epivir)
Stavudine (D4T, Zerit), Zalcitabine (ddC, Hivid)
Zidovudine (AZT, Retrovir)

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What are the side effects of Reverse Transcriptase Inhibitors?

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SE: blood disorders, HA, insomnia, muscle pain, N/V, ataxia, fatigue, nystagmus

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What are the Interactions/Precautions of Reverse Transcriptase Inhibitors?

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Interactions/Precautions: neurotoxicity, caution with liver damage & bone marrow depression

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What is the route for Reverse Transcriptase Inhibitors?

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Route: PO

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What are uses for Reverse Transcriptase Inhibitors?

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Pregnant women + for HIV can take AZT to decrease the risk of transmission to the infant.

These medication slow down the progression of HIV infection.

Reverse T.I.=are antiretroviral drugs used to treat HIV, infection, tumors, and cancer. They interfere with the conversion of RNA to DNA (this is what HIV causes); RT is an enzyme.

Front 40

What are examples of Non-nucleoside Reverse Transcriptase Inhibitors?

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Neverapine (Viramune), Delaviradine (Rescriptor)

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What are the side effects of Non-nucleoside Reverse Transcriptase Inhibitors?

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SE: N/V/D, fatigue, HA, rashes, stomach pain, mouth ulcers

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What are the Interactions/Precautions of Non-nucleoside Reverse Transcriptase Inhibitors?

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Interactions/Precautions: must be used in combo therapy due to resistance, hepatotoxic, caution when used with meds & antibiotics

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What is the route for Non-nucleoside Reverse Transcriptase Inhibitors?

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Route: PO

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What are uses of Non-nucleoside Reverse Transcriptase Inhibitors?

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Used to slow progression of HIV. Is the 3rd class of HIV meds; blocks reverse transcriptase in a different way; but results are the same—viral suppression.

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What are uses of Acyclovir (Zovirax), Ribavirin* (Virazole), Interferons?

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Used for Herpes treatment.

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What are side effects of Acyclovir (Zovirax), Ribavirin* (Virazole), Interferons?

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SE: coma, confusion, N/V/D, phlebitis, seizures, tremor, dizziness, CNS effects, slurred speech, anorexia, constipation, dry mouth, HA, fatigue, blood dyscrasias, skin rashes

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What are Interactions/Precautions of Acyclovir (Zovirax), Ribavirin* (Virazole), Interferons?

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Interactions/Precautions: nephrotoxic, hepatotoxic, neurotoxic, cardiopulmonary toxicity, caution with epileptics or Parkinsonism, caution with thyroid dysfunction, DM, cardiac problems

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What is the route of Acyclovir (Zovirax), Ribavirin* (Virazole), Interferons?

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Route: PO, IV, IM, SQ, inhalation