Exam 3 - Anti-infectives, Antivirals, Antifungals, Antiprotozoals, Chemotherapy Agents

Antiprotozoal Agents

Metronidazole

• Uses: protozoal/anaerobic bacterial infection, prophylaxis treatment for some surgeries

• MoA: damages DNA in protozoa and anaerobic bacteria (ex. C. diff)

• Contraindications: NO ALCOHOL!

• Adverse Effects: N/V/D, dark urine, peripheral neuropathy, seizures, liver toxicity

• Education: Take full course w/ food, NO ALCOHOL, if using for trichomoniasis —> safe sex practices!

• Nurse Monitoring: culture/sensitivity, baseline liver/neuro, assess alcohol habits

Antineoplastic Agents (Chemotherapy) → Adverse Effects

Chlorambucil, Cisplatin, Methotrexate, Vincristine, Tamoxifen, Imatinib

• CNS → monitor orientation > gabapentin + precautions

• Stomatitis → monitor mucous membranes and food/fluids > “magic mouthwash” + oral care

• Dermatological → skin integrity > skin cream + sun protection

• Pulmonary Toxicity → monitor respiratory status > cough drops (local irritation) + O2 therapy

• Liver Damage → monitor ALT/AST > acetylcysteine (protectant) + avoid alcohol

• Renal Damage → monitor BUN/Cr + uric acid levels, urine output > IV/PO hydration, allopurinol (hyperuricemia)

• GI Effects → monitor food/fluids > antiemetics prophylactically, smaller meals

• Bone Marrow Suppression → monitor CBC > replace RBCs/platelets, immune stimulants, bleeding precaution

• Teratogenicity → monitor pregnancy/reproductive status > contraception use

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