A nursing student asks a nurse about flucytosine (Ancobon). Which ...

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A nursing student asks a nurse about flucytosine (Ancobon). Which statement by the nurse is correct?
 
  a. Flucytosine has a broad antifungal spectrum.
  b. Irreversible neutropenia and thrombocytopenia may occur with this drug.
  c. Resistance is common with this medication.
  d. Severe hepatic injury is common and limits this drug's use.

Question 2

A patient with HIV contracts herpes simplex virus (HSV), and the prescriber orders acyclovir (Zovirax) 400 mg PO BID for 10 days. After 7 days of therapy, the patient reports having an increased number of lesions.
 
  The nurse will expect the provider to:
  a. extend this patient's drug therapy to BID for 12 months.
  b. give intravenous foscarnet every 8 hours for 2 to 3 weeks.
  c. increase the acyclovir dose to 800 mg PO 5 times daily.
  d. order intravenous valacyclovir (Valtrex) 1 gm PO BID for 10 days.

[ankilker]

Answer to Question 1

ANS: C
The development of resistance during flucytosine therapy is common and is a serious clinical problem. Flucytosine has a narrow antifungal spectrum. Neutropenia and thrombocytopenia may occur but are reversible. Severe hepatic injury is rare; mild and reversible hepatic dysfunction is common.

Answer to Question 2

ANS: B
Foscarnet is active against all known herpesviruses and is used in immunocompromised patients with acyclovir-resistant HSV or VZV. This patient is demonstrating resistance to acyclovir, so extending acyclovir therapy or increasing the acyclovir dose will not be effective. Valacyclovir is not approved for use in immunocompromised patients because of the risk for thrombotic thrombocytopenic purpura/hemolytic uremic syndrome.

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Gracias!

[shewald78]

TYSM