STUDENT ACTIVITY SHEET

CHELSY SKY M. SACAN

LESSON TITLE: ANTIFUNGAL & ANTIPROTOZOAL

Pharmacology
BS NURSING / SECOND YEAR
Session 4

Materials:
DRUGS
LEARNING OUTCOMES:
At the end of the lesson, the nursing student can:
1. List common fungal infection and protozoal infections including cause and clinical presentation;

Cryptosporidiosis: Cryptosporidiosis is a disease that causes watery diarrhea. It is caused by microscopic

germs—parasites called Cryptosporidium. The most common symptom of cryptosporidiosis is watery
diarrhea. Symptoms include: Watery diarrhea. Stomach cramps or pain.

Amoebic dysentery: Amoebic dysentery is an intestinal infection caused by a protozoan parasite called
Entamoeba histolytica. Infection by Entamoeba histolytica may be asymptomatic. For patients who
develop amoebic dysentery, symptoms include fever, chills, diarrhoea, abdominal pain and passing stool
with blood and/or mucus,

Malaria: Symptoms of malarial infection are nonspecific and may manifest as a flulike illness with fever,
headache, malaise, fatigue, and muscle aches. Tumor necrosis factor has been implicated in malaria and
free oxygen radicals which can cause tissue injury in the liver, pancreas and intestine are enhanced
during malaria infection; this can result in various disorders of the digestive system including diarrhea and
intestinal bleeding.

Toxoplasmosis: Symptomatic disease may be characterized as follows: Patients may have cervical
lymphadenopathy with discrete, usually nontender, nodes smaller than 3cm in diameter. Fever, malaise,
night sweats, and myalgias have been reported. Patients may have a sore throat.

2. Describe the five groups of antifungal drugs;

Azole: The use of imidazoles is limited to treating superficial mycoses and is only briefly discussed (see
“Superficial fungal infections”).
Echinocandins: Penetration into tissue is good, although CSF levels are low. Caspofungin is available
only as an intravenous formulation (oral bioavailability, < 0.2%). Owing to the long half-life, it can be
administered once daily.
Allylamine and Morpholine Antifungal Drugs: Allylamines (naftifine, terbinafine) inhibit ergosterol
biosynthesis at the level of squalene epoxidase. The morpholine drug, amorolfine, inhibits the same
pathway at a later step.
Antimetabolite Antifungal Drugs: 5-Fluorocytosine acts as an inhibitor of both DNA and RNA synthesis via
the intracytoplasmic conversion of 5-fluorocytosine to 5-fluorouracil.

CHECK FOR UNDERSTANDING (30 minutes)

You will answer and rationalize this by yourself. This will be recorded as your quiz. One (1) point will
be given to correct answer and another one (1) point for the correct rationalization. Superimpositions
or erasures in you answer/ratio is not allowed. You are given 25 minutes for this activity:

Multiple Choice
1. A patient receiving topical antifungal complains of blisters in her perineum. Which is/are a
possible explanation(s) for this?
a. Fungal infection is not healing.
b. Patient is allergic to the drug.
c. Both A and B
d. None of the above
ANSWER: C
RATIO: Antifungal creams, liquids or sprays (also called topical antifungals) These are used
to treat fungal infections of the skin, scalp and nails. They include clotrimazole, econazole,
ketoconazole, miconazole, tioconazole, terbinafine, and amorolfine. They come in various
different brand names.

2. Which of the following will alert the nurse for possible adverse effect in patients receiving
long-term itraconazole therapy?
a. Central obesity
b. Cataract
c. Thickening of the skin
d. Pathologic U wave
ANSWER: A
RATIO: As visceral fat is supplied by the portal blood system, excess fat in this area can lead
to the release of fatty deposits into the bloodstream.

3. An eight (8) month old infant is receiving antifungals. Which should be included in the nurse’s
health teaching to the mother?
a. Cover the area of lesions with diaper to prevent additional infection.
b. Make sure area is free from occlusive dressings.
c. Apply more topical cream on draining areas because it is where fungi are most
d. Advise that redness and rashes are negligible side effects of antifungal therapy and should not
be a cause of worry. ANSWER: B
RATIO: The latest innovation in wound management by using occlusive dressings can
prevent infections, improve healing time and patient's comfort.

4. Which of these antifungals can be used in pregnant women?

a. Fluconazole
b. Nystatin
c. Ketoconazole
d. Amphotericin B
ANSWER: D
RATIO: Amphotericin B is an antifungal medication that fights infections caused by fungus.

5. Arvic, a 16-year-old student, has acquired systemic fungal infection, he should

be treated with: a. Amphotericin B
b. Miconazole (Monistat IV)
c. Ketoconazole
d. Griseofulvin (Fulvicin)
ANSWER: A
RATIO: Amphotericin B is used to treat serious, life-threatening fungal infections.

6. Which of the following must always be present before beginning antifungal therapy?
a. Coagulation profile
b. Confirmed diagnosis
c. Biopsy of infected site
d. Urinalysis
ANSWER: B
RATIO: Your doctor can confirm this diagnosis and arrange suitable treatment.

7. A 32-year-old woman presents to her gynecologist with a 4 days history of perineal pruritus and
a non-malodorous, thick, cheesy vaginal discharge. The only medication the woman is taking is an
oral contraceptive. A wet preparation of vaginal secretion shows budding yeast cells and
pseudohyphae. Which of the following drugs, given locally, would be appropriate for this patient?
a. Mebendazole
b. Metronidazole
c. Miconazole
d. Saquinavir
ANSWER: C
RATIO: This medication is also used to treat a skin condition known as pityriasis (tinea
versicolor), a fungal infection that causes a lightening or darkening of the skin of the neck,
chest, arms, or legs. Miconazole is an azole antifungal that works by preventing the growth of
fungus.

8. The nurse sees a patient in the clinic who has been taking chloroquine for the treatment of
malaria. While the nurse measures vital signs, the patient repeatedly rubs her eyes. When the
nurse questions why, the patient says, "I guess it's time for a trip to the eye doctor. My glasses
don't seem to work very well and I'm having trouble with my vision." What does the nurse suspect is
happening with this patient?
a. Adverse effect of medication
b. Muscles controlling the eye are impacted by malaria
c. Chemical actions of the medication are reducing aqueous humor
d. Malaria infection is damaging optic tissue
ANSWER: A
RATIO: Rapid detection and recording of adverse drug reactions is of vital importance so that
unrecognised hazards are identified promptly and appropriate regulatory action is taken to
ensure that medicines are used safely.

9. The nurse is caring for a patient taking antimalarials for prophylaxis while serving in the Peace
Corps in Africa. The patient has taken the medication for 2 months and is continuing to lose
significant weight due to the GI effects of the drug. What recommendations can the nurse make to
reduce GI adverse effects and promote healthy nutrition for this patient? (Select all that apply.)
a. Avoid alcohol.
b. Add extra fat to diet for calories.
c. Take the drug immediately after meals.
d. Eat 5 to 6 small meals a day.
ANSWER: C
RATIO: To reduce side effects of stomach irritation, including indigestion, stomach
inflammation or ulcers. Some medicines can irritate the stomach, and taking them with food
will reduce this effect.

10. An instructor is describing the action of primaquine. What would the instructor include?
a. The drug blocks the use of folic acid.
b. It changes the metabolic pathways for reproduction.
c. The drug increases the acidity of plasmodial food vacuoles.
d. It disrupts the mitochondria, killing the gametocytes.
ANSWER: D
RATIO: Primaquine is used alone or with another medication to treat malaria (a serious
infection that is spread by mosquitoes in certain parts of the world and can cause death) and
to prevent the disease from coming back in people that are infected with malaria.

LESSON WRAP-UP (5 minutes)

You will now mark (encircle) the session you have finished today in the tracker below. This is simply
a visual to help you track how much work you have accomplished and how much work there is left
to do.

You are done with the session! Let’s track your progress.

MINUTE PAPER
Compose two to three sentences to explain what she/he has leaned using the key ideas

listed in lesson review. For next session review antiviral and anthelmintic.