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Drug Mechanism Uses Adverse/SE Nursing Implications

-caution w/ nephrotoxic drugs
- binds to ergosterol in fungal -severe systemic infections -toxic at therapeutic doses -IV only—very irritating

membrane-causes leakage -fever & chills, N/V -incompatible in NaCl solution-D5W

-thrombophlebitis only
AMPHOTERICIN B -nephrotoxic -assess for side effects; monitor VS
-seizures, anemia, hypokalemia -monitor IV infusion-too rapid
leads to cardiac toxicity
-give antiemetics 30 min before drug
-acetaminophen before to treat HA

AZOLE ANTIFUNGALS -broad-spectrum antifungal Ketoconazole& Itraconazole

-blocks synthesis of ergosterol -GI, hepatoxicity, itching,
For vaginal infections: rashes, HA -monitor lab inc LFT
-take full course of therapy -inhibits steroid/drug -avoid H2 blockers or antacids
-avoid tampons during therapy metabolism w/i 2 hr period
-continue during period -avoid ETHOL
-wash hands before & after using
fluconazole med
-dose in evening Fluconazole
ketoconazole -avoid douching -monitor BUN, LFT
-avoid sexual intercourse or use (hepatoxicity)
itraconazole condom -monitor for exfoliative skin
Prevention: disorders, thrombocytopenia, GI,
-wear clean cotton underwear daily HA
-wipe from front to back
-don’t douche
-avoid bubble baths/soaps
-use water-soluble lubricants

-disrupts fungal cell membrane -problems of nails & scalp -anorexia, diarrhea, N/V,
-avoid ETHOL
Terbinafine stomach pain, change in taste -avoid high doses of vit A or niacin
-avoid inducers—barbiturates,
LAMISIL griseofulvin, phenytoin, rifampin
-avoid inhibitors—cimetidine,
estrogen, erthromycin, INH, azole
antifungals, fluroquinolones

-vaginal tablets may be given PO

-binds to sterols in fungal cell -oral & vaginal candidiasis -usually mild—N/V, epigastric, (leave in mouth until dissolved)
Nystatin membrane diarrhea -oral-swish & swallow—don’t drink
-fungistatic & fungicidal after
-vaginal-continue med during
-given PO
-inhibits fungal mitosis -dermatophytes of hair, skin & -HA, hepatoxicity,
-absorbtion improved w/ fatty
Griseofulvin nails photosensitivity, altered taste,
N/V, decr. memory & judgment
-binds to keratin of growing
-use birth control