McKenna's Pharmacology for Nursing, 2e

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C H A P T E R 1 1  Antifungal agents

BIBLIOGRAPHY

■■ Adverse effects may include hepatic and renal failure. ■■ Local fungal infections include vaginal and oral yeast infections ( Candida ) and a variety of tinea infections, including athlete’s foot and jock itch. ■■ Topical antifungals are agents that are too toxic to be used systemically but are effective in the treatment of local fungal infections. ■■ Proper administration of topical antifungals improves their effectiveness. They should not be used near open wounds or lesions. ■■ Topical antifungals can cause serious local irritation, burning and pain. The drug should be stopped if these conditions occur.

Brouwer, A. E., Rajanuwong, A., Chierakul, W., Griffin, G. E., Larsen, R. A., White, N. J., et al. (2004). Combination antifungal therapies for HIV associated cryptococcal meningitis: A randomised trial. Lancet, 363 , 1764–1767. Chen, S. C. A. & Sorrell, T. C. (2007). Antifungal agents. Medical Journal of Australia , 187, 404–409. Dempsey, J., Hillege, S. & Hill, R. (2014). Fundamentals of Nursing and Midwifery: A Person-centred Approach to Care (2nd Australian and New Zealand edn). Sydney: Lippincott Williams & Wilkins. Farrell, M. & Dempsey, J. (2014). Smeltzer & Bare’s Textbook of Medical-Surgical Nursing (3rd edn). Sydney: Lippincott, Williams & Wilkins. Jen, L., Piacenti, F. J. & Lyakhovetskiy, A. G. (2003). Voriconazole. Clinical Therapeutics, 25, 1321–1381. Johnson, M. D. & Perfect, J. R. (2003). Caspofungin: First approved agent in a new class of antifungals. Expert Opinion on Pharmacotherapy, 4 , 807–823. Kontoyiannis, D. P., Mantadaki, E. & Samonis, G. (2003). Systemic mycoses in immune-compromised host: An update in antifungal therapy. Journal of Hospital Infection, 53 , 243–258. McKenna, L. (2012). Pharmacology Made Incredibly Easy (1st Australian and New Zealand edn). Sydney: Lippincott Williams & Wilkins. McKenna, L. & Mirkov, S. (2014). McKenna’s Drug Handbook for Nursing and Midwifery (7th edn). Sydney: Lippincott Williams & Wilkins. Pfaller, M. A. (2012). Antifungal drug resistance: Mechanisms, epidemiology, and consequences for treatment. American Journal of Medicine, 125, S3–S13. Porth, C. M. (2011). Essentials of Pathophysiology: Concepts of Altered Health States (3rd edn). Philadelphia: Lippincott Williams & Wilkins. Porth, C. M. (2009). Pathophysiology: Concepts of Altered Health States (8th edn). Philadelphia: Lippincott Williams & Wilkins. Van Onselen, J. (2012). Prescribing for superficial fungal skin and nail infections. Nurse Prescribing, 10, 229–234. 2. When administering a systemic antifungal agent, the nurse or midwife incorporates understanding that all systemic antifungal drugs function to: a. break apart the fungus nucleus. b. interfere with fungus DNA production. c. alter cell permeability of the fungus, leading to cell death. d. prevent the fungus from absorbing needed nutrients. 3. After assessing a person, the nurse or midwife would question an order for amphotericin B to prevent the possibility of serious nephrotoxicity if the person was also receiving which of the following? a. digoxin b. oral anticoagulants c. phenytoin d. corticosteroids

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ONLINE RESOURCES

An extensive range of additional resources to enhance teaching and learning and to facilitate understanding of this chapter may be found online at the text’s accompanying website, located on thePoint at http://thepoint.lww.com. These include Watch and Learn videos, Concepts in Action animations, journal articles, review questions, case studies, discussion topics and quizzes.

C H E C K Y O U R U N D E R S T A N D I N G

Answers to the questions in this chapter can be found in Appendix A at the back of this book.

MULTIPLE CHOICE Select the best answer to the following.

1. A person with a fungal infection asks the health professional why she cannot take antibiotics. The health professional explains that the reason for this is that a fungus is resistant to antibiotics because: a. a fungal cell wall has fewer but more selective protective layers. b. the composition of the fungal cell wall is highly rigid and protective. c. a fungus does not reproduce by the usual methods of cell division. d. antibiotics are developed to affect only bacterial cell walls.