Pharmacology Pp

PHARMACO LOGY IMM UNE SYSTE M DRUGS JULIA LEONOR HUARINGA LAGOMARSINO, RN February 13, 2009

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IMMUN E SY STE M D RUG S ANTI-INF ECTIVES

IZONIAZID INH

PYRAZINAMIDE PMS

ETHAMBUTOL Myambutol

RIFAMPIN Rifadin Rofact

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THERAP EUT ICPHARMACOLOG IC CLAS S

•Antitubercular •Bacteriostatic, •Bactericidal

IN DICAT IO NS • First line of active tuberculosis, in combination with other agents (Multi-drugs regimen prevents resistance • Preventive treatment(expose to active TB)may be accomplished with monotheraphy). ACTION •Bacteriostatic, •Bactericidal KEEP IN MIND

ADVERSE REACTIONS Teach the client: SIDE EFFECTS CNS: Psychosis ,seizures, optic • Take the medication exactly as directed, Therapy may be continued for 6 month to 2 neuritis year. EENT: visual disturbances.

•Report numbness of extremities or GI: Drug induced, hepatitis, nausea, decrease in vision. Take pyridoxine(B6) to vomiting decrease neuropathy. DERM: Rashes. •Avoid the use the alcohol. •Avoid tyramine-containing foods. ENDO: Gynecomastia. •Maintain appointments for regular followHEMAT: Bone marrow changes . MI SCE LAN IE : Fever MAKE THE CONNECTION up. NEURO: Pheripheral neuropathy. withmay differential, liver DRUG THAT BEGING WITH “R” ••Monitor Be aware CBS the urine change color(“r” function CAUSES URINE TO BE drug= red)test, and uric acid levels. •Teach the client carefully about the DISCOLORED RED(r=red) regimen public health concerns, and possible side effects. •Monitor vision and for nerve pain/ 3 paresthesias.

IMMUN E SY STE M D RUG S ANTI-INF ECTIVES

FLUCONAZOLE (Diflucan)

AMPHOTERICIN B DEOXYCHOLATE (Fungizone, Amphotec )

TERBINAFINE (Lamisil)

Ketoconazole (Systemic) Nizoral 4

THERAP EUTIC PHARM ACO LOG IC CLA SS

•Antifungal (Systemic)

AC TI ON •Fungistatic: At regular doses. • Fungicidal: At higher doses.

IN DICAT IO NS

• PO • Treatment of fungal infections caused by susceptible organisms.

ADVERSE REACTIONS SIDE EFFECTS

KEEP IN MIND

GI: Hepatotoxicity, abdominal discomfort, diarrhea, nausea, vomiting. DERM: Exfoliate skin disorders. ENDO: Hypocalcemia, Hypocalcemia, Hypomagnesaemia, Hypertriglyceridimia. CV: Hypotension, arrhytmias, with amphotericin B MISCE LANI E: NEURO: Pheripheral neuropathy with Allergic reactions, including amphoter. anaphylaxis, acute infusion MS: Arthralgia, Myalgia with amphotericin. reactions.

rash, abdominal pain, fever, diarrhea, unusual fatigue, anorexia, nausea, vomiting, jaundice, unusual bruising, bleeding, palpitations, dark urine, or pale stools occur. • Report development of a rash immediately.

Teach the client: CNS: Headache, dizziness, tremor, • Take medication as directed. • Notify health - care professional if skin seizures.

NURSIN G DIAGN OSIS •Risk for impaired skin integrity •Risk for infection •Pain

MAKE THE CONNECTION

•Monitor vital signs every 15 min during test dose and every 30 min for 2-4 hr after administration of amphotericin may need to premedicate with Meperidine, Dantrolene, and Diphenhydramine. •Monitor liver and renal functions test and CBC with differential.

IMMUN E SY STE M D RUG S ANTI-INF ECTIVES

ABACAVIR Ziagen

LAMIVUDINE Epivir, Epivir HBV, 3TC

DIDANOSINE Dideoxynoisine Videx, Videx EC

ZIDOVUDINE AZT, Retrovir Apo-Zidoudine 6

THERAP EUT IC PHARMACOLOG IC CLAS S

•Antiretroviral •Nucleoside reverse transcriptase inhibitor(NRTI)

INDI CAT IO NS Management of HIV infection (AIDS) in combination with other antiretroviral. ACTION S • Inhibit the activity of HIV-=1.

KEEP IN MIND ADVERSE REACTIONS Teach the client: SIDE EFFECTS CNS: Headache, • Take the medication as directed.

•Always use a condom, and avoid sharing needles EENT: visual or donating blood. •Report any signs of allergic reaction. disturbances. •Maintain appointments for regular follow-up exams GI: Hepatotoxicity, and blood counts (CD4 and Viral Load counts. diarrhea, nausea, vomiting, anorexia. •These medications do not cure HIV/AIDS, but DERM: Rashes. control disease progression F andMI E:SCE Lactic acidosis . LAN IE MAKE T HE CONN ECT ION •Assess client for change in severity of HIV Hypersensitivity symptoms and for symptoms of opportunistic Reactions Insomnia

NU RSIN G DIA GNOSI S •Risk for infection

infection throughout therapy. •Assess for signs of hypersensitivity reactions. •Monitor liver function test, serum glucose, lipid panel, and serum lactate levels. 7 •Monitor viral load and CD4 cell count regularly

IMMU NE SYST EM DRU GS AN TI -INFLA MMA TO RY and DISEA SE MO DULA TI NG DR UGS

MESALAMINE Asacol, Canasa, Rowasa, Salofalk

OLSALAZINE Dipentum 8

THERAP EUTICPHARM ACO LOG IC CLA SS

• Gastrointestinal antiflamatory • Cyclo - Oxigenase 1 and 2 inhibitor.

IN DICAT IONS •Treatment of inflammatory bowel diseases including ulcerative colitis. ACT ION •Locally acting anti- Inflammatory action in the colon, where activity is probably due to inhibition of prostaglandin synthesis.

KEEP IN MIND ADVERSE REACTIONS Teach client: SIDE EFFECTS CNS: Headache , Dizzines, • May cause dizziness. malaise, weakness. DERM: Hair • Notify health-care professional if skin rash, sore throat, fever, mouth sores, unusual loss, rashes. bleeding or bruising, wheezing, fever, or hives EENT: Pharyngitis, Rhinitis. occur. CV: Pericarditis. MS: Back pain . • May take 1-2 months for full effect. GI: Diarrhea, eructation, flatulence, •If cramping, acute abdominal pain, bloody nausea, vomiting diarrhea, fever, headache, or rash occur, GU: Interstitial, nephritis, discontinue therapy and notify health care Pancreatitis, Renal failure. professional immediately. LOCAL: Anal irritation (Enema, • Increase MAKE oral intake fluids to prevent renal THE of CONNECTION MI SCE LANI E: Anaphylaxis suppository) •lith. Assess the client for allergy to Acute intolerance syndrome, sulfonomamides and salicylates. fever. • Fluid intake should be 1500-2000 ml/day. NURSIN G DIAGN OSIS Monitor daily weight and intake/output •Readiness for enhanced bowel •Monitor blood chemistries for liver and renal elimination pattern. function and CBC with differential 9 •Diarrhea • Monitor amylase and lipase levels

IM MUNE SYSTE M DR UGS Anti- In fl amma to ry and Disease-Mo dulatin g A gents

ALLOPURINOL Zyloprin, Alloprim Apo-Allopurinol

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THERAP EUTICPHARM ACO LOG IC CLA SS

AC TIO NS •Prevention of attacks of gouty arthritis and nephropathy. •Treatment of secondary hyperuricemia, which may occur during treatment of tumor or leukemias.

ADVERSE REACTIONS SIDE EFFECTS

KEEP IN MIND Teach client: • Dietary changes must be made (alkaline ash

•Antigout •Antihyperurecemic agent, •Xanthine oxidase inhibitor.

CNS: Drowsiness GI: Nausea, diarrhea, Hepatitis. GU: Renal Failure DERM: Rash, Urticaria. HEMAT: Bone marrow suppression . MI SCE LAN IE

Hypersensitivity Reactions NURSIN G DIAGN OSIS

•Risk for Infection •Acute pain •Knowledge deficit.

diet) alcohol must be avoided to avoid gouty attacks. •Report skin rash or influenza symptoms to the HCP immediately, this may indicate hypersensitivity. •Take with food to minimize gastric distress. •Increase daily fluid intake as directed.

MAKE THE CONNECTION

• Minimum fluid intake for person being treated for gout is 2500-3000 ml/day. • Monitor for clinical signs of toxicity or hypersensitivity (Vomiting, diarrhea, or rash). •Monitor the CBC with the differential, RFTs, LFTs, and blood Glucose. 11

THANKS FOR YOUR ATTENTION!! Now lets go back to our favori te subj ect NCLE X – RN

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