LAB - L6:T3-T4 (Anti-tubercular / viralfungal protozoal..)

What infection is caused by Mycobacterium tuberculosis?

Tuberculosis

What type of bacteria is Mycobacterium tuberculosis?

Acid-fast bacilli

What is the primary site of invasion for Mycobacterium tuberculosis?

The lungs

What complicates the treatment of mycobacterial infections?

Limited information about mechanism of action, development of resistance, intracellular location, chronic nature of the disease, and patient compliance

Name the first line of treatment drugs for tuberculosis.

Isoniazid, rifampicin, ethambutol, pyrazinamide, streptomycin

What is the purpose of using multiple anti-TB drugs?

To prevent resistance

What is the standard duration for tuberculosis treatment?

6 months to 2 years

What is the initial intensive phase of TB treatment?

A 2-month therapy with a 4-drug regimen

What drugs are included in the continuation phase of TB treatment?

Isoniazid and Rifampin, with possible addition of Pyrazinamide or Ethambutol

What is DOTS in TB treatment?

Directly Observed Treatment Short Course

What should patients be advised regarding isoniazid and rifampicin?

They should be taken on an empty stomach

What are common side effects of isoniazid?

Numbness and tingling of extremities, peripheral neuropathy

What should be monitored due to the side effects of ethambutol?

Blurred vision or changes in color or vision field

What are the adverse effects of amphotericin?

Hypokalemia, arrhythmia, kidney damage

What is the recommended nursing responsibility for administering antifungals?

Take oral drugs with food and evaluate liver and kidney functions

What are the common antifungal drugs known as 'AZOLES'?

Ketoconazole, Clotrimazole, Miconazole

What should be monitored in patients receiving amphotericin?

ECG and potassium levels

What is a common indication for antifungal treatment?

Fungal infections, candidiasis, tinea

What is the role of pyridoxine in TB treatment?

To minimize adverse reactions from isoniazid

What should patients report when taking isoniazid and rifampicin?

Yellow eyes and skin, loss of appetite, dark urine, unusual tiredness

What is the general action of antiviral drugs?

They interfere with the DNA or RNA synthesis and replication of viruses.

What are some precautions to consider when administering antiviral drugs?

Hypersensitivity, pregnancy, renal and hepatic impairment.

Name two agents used for Influenza A and respiratory viruses.

Oseltamivir and zanamivir.

What is acyclovir used for?

It is used for treating herpes virus and cytomegalovirus infections.

What are protease inhibitors?

A class of antiviral drugs that inhibit the action of protease, an enzyme critical for viral replication.

List two nonnucleoside reverse transcriptase inhibitors.

Delavirdine and efavirenz.

What are common adverse effects associated with antiviral agents?

Light-headedness, dizziness, insomnia, nausea, orthostatic hypotension, and urinary retention.

What nursing consideration is important for patients receiving agents for influenza?

Start the drug regimen as soon after exposure to the virus as possible.

What should be assessed in patients receiving DNA-active antiviral agents?

History of allergy, renal dysfunction, severe CNS disorders, and pregnancy or lactation.

What is Remdesivir used for?

It is used for the treatment of COVID-19 in hospitalized patients.

What is the mechanism of action of Remdesivir?

It binds to the viral RNA-dependent RNA polymerase and inhibits viral replication.

What are the potential gastrointestinal symptoms of Remdesivir?

Nausea and elevated transaminase levels.

What is the role of dexamethasone in COVID-19 treatment?

It is used for its anti-inflammatory and immunosuppressant effects in critically ill patients.

How does dexamethasone affect mortality in COVID-19 patients on ventilators?

It reduces mortality by about one third.

What should be monitored before and during the administration of Remdesivir?

Liver function tests and prothrombin time.

What is the significance of administering the full course of antiviral drugs?

To obtain the full beneficial effects and decrease the risk of resistant viral strains.

What teaching point should be emphasized to patients regarding antiviral drugs?

These drugs do not cure the disease, so precautions should still be taken to prevent transmission.

What is the importance of monitoring nutritional status in patients receiving antiviral therapy?

To maintain nutrition, especially if gastrointestinal effects are severe.

What should be done if a patient experiences a severe rash while on antiviral medication?

Stop the drug immediately to avert potentially serious reactions.

What is the role of the influenza A vaccine in antiviral therapy?

To decrease the risk of contracting the flu and complications from viral infection.

What is Tocilizumab used for?

Treatment of COVID-19 in hospitalized adults and pediatric patients requiring supplemental oxygen.

When was Tocilizumab granted an EUA?

June 24, 2021

What is the mechanism of action of Molnupiravir?

It mimics a building block of the virus's genetic material, causing mutations that lead to an 'error catastrophe' in the virus.

What is Paxlovid composed of?

Nirmatrelvir and ritonavir

What is the recommended dosage of Paxlovid?

Nirmatrelvir 300 mg with ritonavir 100 mg, taken orally twice daily for 5 days.

What are common side effects of Paxlovid?

Bitter or metallic taste, diarrhea, high blood pressure, muscle aches.

What is the primary vector for malaria?

The Anopheles mosquito.

Name one protozoal parasite that causes malaria.

Plasmodium falciparum

What is Primaquine used for?

Radical cure of malaria by acting against liver parasites.

What are the unwanted effects of Chloroquine?

GI disturbances, dizziness, visual disturbances, hypotension.

What is the main chemotherapeutic agent for P. falciparum?

Quinine.

What is Amebiasis caused by?

Entamoeba histolytica.

What is the dosage for Metronidazole in treating amebiasis?

750 mg PO three times a day for 5-10 days.

What are common side effects of Mebendazole?

Abdominal discomfort, diarrhea, or pain.

How is Ivermectin metabolized?

It is completely metabolized in the liver with a half-life of 16 hours.

What is the dosing schedule for Praziquantel?

Taken in a series of three oral doses at 4- to 6-hour intervals.

What are adverse effects of anthelmintics that are absorbed systemically?

Headache, dizziness, fever, shaking, chills, malaise.

What should be monitored during anthelmintic therapy?

Hepatic and renal function.

What is the role of nursing implementation in antiparasitic therapy?

Ensure correct drug identification, administer complete courses, and monitor for side effects.

What is the effect of high-fat meals on some medications?

They may interfere with drug effectiveness.

What is the significance of stopping conflicting medications while on Paxlovid?

To prevent accumulation of other drugs to potentially unsafe levels.

What is the recommended action if CNS effects occur during treatment?

Provide comfort and safety measures to protect the patient from injury.

What is the effect of taking drugs with food?

It may decrease gastrointestinal upset.

What is the primary purpose of chemoprophylaxis for malaria?

To prevent malaria infection.

What is the role of Pyrantel in anthelmintic therapy?

It is poorly absorbed and primarily excreted unchanged in the feces.

What are the symptoms of Blackwater fever?

It is occasionally associated with quinine use and characterized by dark urine.

What is the treatment for intestinal amebiasis or amebic dysentery with Secnidazole?

Four tablets as a single dose or in 2 divided doses within 4 hours.