A patient is being treated for a systemic fungal infection with ...

[Alygatorr01285]

A patient is being treated for a systemic fungal infection with amphotericin B (Abelcet) and will be discharged home from the hospital to complete every other day infusions of the medication for 6 to 8 weeks.
 
  The nurse provides discharge teaching before dismissal. Which statement by the patient indicates a need for further teaching?
  a. I may experience headaches and pain in my lower back, legs, and abdomen.
  b. I may need to take potassium supplements while taking this drug.
  c. I should take acetaminophen and diphenhydramine before each infusion.
  d. I will need to have blood drawn for serum creatinine and BUN levels every 3 to 4 days.

Question 2

A patient is being treated with amphotericin B (Abelcet) for a systemic fungal infection. After several weeks of therapy, the provider orders flucytosine (Ancobon) in addition to the amphotericin.
 
  The nurse understands that the rationale for this combination is that it:
  a. broadens the antifungal spectrum.
  b. improves the effectiveness of the amphotericin B.
  c. lowers the dose of amphotericin B and reduces toxicity.
  d. treats fungal central nervous system (CNS) infection.

[upturnedfurball]

Answer to Question 1

ANS: A
Headaches, lower back pain, leg pain, and abdominal pain occur with intrathecal administration of amphotericin B. Patients taking amphotericin may experience hypokalemia and may need potassium supplements. Acetaminophen and diphenhydramine should be taken to minimize infusion reaction effects. Renal function should be monitored every 3 to 4 days during treatment.

Answer to Question 2

ANS: C
Amphotericin potentiates the antifungal actions of flucytosine, and combining flucytosine with low-dose amphotericin can produce antifungal effects equivalent to those of high-dose amphotericin. By allowing a reduced dose of amphotericin, the combination also reduces the risk of amphotericin-induced toxicity. Flucytosine does not affect the effectiveness of amphotericin. The combination does not broaden the antifungal spectrum or alter the ability to treat CNS infections.

[Alygatorr01285]

TYSM

[xthemafja]

Excellent