Drug Cards Study Notes

Chapter 6 & 7 Drug Cards

Antitubercular Drugs

Suffix or Prefix
  • Rifapentine (RPT)
    • Red/orange urine and bodily fluids may stain contacts.
Generic Drug Names
  1. Isoniazid (INH)
  2. Moxifloxacin
    • Classification: Fluoroquinolone
    • Side Effects: Constipation.
  3. Pyrazinamide (PZA)
    • Side Effects: Sun sensitivity; increases uric acid.
  4. Ethambutol (EMB)
    • Side Effects: Increases uric acid.
  5. Amikacin
    • Classification: Aminoglycoside
Mechanism of Action (MOA) / Therapeutic Use
  • Rifapentine and Isoniazid inhibit the ability of TB bacteria to reproduce, leading to cell death.
  • Moxifloxacin kills mycobacteria by inhibiting DNA synthesis, particularly effective against dormant bacteria within macrophages and granulomas.
  • Ethambutol limits protein production by binding to ribosomes and reducing lipid-like substances, preventing the reproduction of mycobacterial cells.
Interactions / Contraindications
  • Avoid during pregnancy and with other antitubercular agents due to severe interactions.
  • Rifapentine has specific limitations; it should be taken at least 1 hour before or 2 hours after meals or taking antacids.
Side Effects / Complications
  • Common Effects: Nausea, vomiting, diarrhea, headache, sleeping issues, rash, redness, Stevens-Johnson Syndrome, abdominal pain, fever, chills.
  • Rifampin poses risks of birth defects when taken during pregnancy; it pressures use of soft lenses due to staining.
Nursing Administration / Patient Education
  • Treatment duration lasts several months; patients should refrain from alcohol during treatment.
  • Teach patients how to monitor their pulse and instruct reporting if pulse exceeds 100 bpm or goes below 60 bpm.
  • Premedication with antihistamines, antipyretics, steroids, or opioids may be needed to reduce fever, chills, or rigor.

Antifungal Drugs

Generic Drug Names
  1. Ketoconazole
    • Classification: Azoles
  2. Fluconazole
    • Adverse Effects: Stomach upset, rash.
  3. Nystatin
    • Classification: Polyenes
  4. Amphotericin B
    • Has numerous adverse reactions and requires premedication with antihistamines, antipyretics, and steroids prior to administration.
    • Closely monitor patients.
Mechanism of Action (MOA)
  • Ketoconazole and Fluconazole disrupt fungal cell membranes, affecting permeability; they can be either fungistatic or fungicidal depending on the organism and dosage.
  • Amphotericin B binds to fungal cell membranes and can lead to severe adverse reactions, including electrolyte imbalances and nephrotoxic effects.
Interactions
  • Notable interactions with other antifungals and anticoagulants, increasing risk of hypoglycemia when used with oral hypoglycemic agents.
Side Effects / Complications
  • Common Effects: Nausea, vomiting, diarrhea, headache, sleeping issues, rash, chills, abdominal pain.

Antiparasitic Drugs

Generic Drug Names
  1. Griseofulvin
    • Mechanism: Disturbs fungal cell division by binding to keratin; inhibits mitosis.
  2. Metronidazole
    • Disrupts DNA synthesis in protozoa and anaerobic bacteria.
  3. Iodoquinol
  4. Chloroquine
    • Inhibits parasite growth in RBC.
  5. Praziquantel
Interactions / Contraindications
  • Contraindications include alcohol consumption and certain drug interactions (e.g., warfarin, oral contraceptives, liver disease).
Side Effects / Complications
  • Common effects: Headache, gastrointestinal upset, metallic taste, abdominal pain, dark urine, hepatotoxicity, and potential rash reactions.

Antiviral Drugs

Generic Drug Names
  1. Acyclovir
  2. Famciclovir
  3. Oseltamivir
  4. Ganciclovir
    • Inhibits viral DNA polymerase.
  5. Ribavirin
    • Inhibits viral RNA synthesis.
  6. Nirmatrelvir/ritonavir
    • Inhibits SARS-CoV-2 protease.
Pharmacological Effects
  • Each drug varies in its ability to inhibit viral synthesis and release.
Interactions / Contraindications
  • Interactions with other renal or hepatotoxic medications, and contraindicated during pregnancy.
Side Effects / Complications
  • Common effects: Nephrotoxicity, gastrointestinal upset, headache, phlebitis (especially with acyclovir), and rare neuropsychiatric effects.

Nursing Administration / Patient Education

  • Advise patients on the importance of adherence to drug regimens, and the use of barrier contraceptives, particularly for women of childbearing age.
  • Monitor liver function tests (LFTs) and kidney function regularly, especially in those receiving long-term therapy or having severe liver disease.
  • Educate that antiviral medications do not cure infections but rather reduce the severity and frequency of outbreaks.
  • Use of sunscreen is recommended due to photosensitivity risks with certain drugs.
  • Monitor vital signs and report any worsening symptoms, especially shortness of breath and adverse effects promptly.