A nursing student asks a nurse to explain the differences between ...

[jazziefee]

A nursing student asks a nurse to explain the differences between amphotericin B (Abelcet) and the azoles group of antifungal agents. Which statement by the nurse is correct?
 
  a. Amphotericin B can be given orally or intravenously .
  b. Amphotericin B increases the levels of many other drugs.
  c. Azoles have lower toxicity than amphotericin B.
  d. Only the azoles are broad-spectrum antifungal agents.

Question 2

A nurse is caring for a patient who is receiving amphotericin B (Abelcet) for a systemic fungal infection. In spite of receiving diphenhydramine and acetaminophen before initiation of treatment, the patient has fever and chills with rigors.
 
  The nurse will contact the provider to discuss the addition of which drug?
  a. Aspirin
  b. Dantrolene
  c. Hydrocortisone
  d. Omeprazole

[patma1981]

Answer to Question 1

ANS: C
The azoles class of antifungals is less toxic than amphotericin B. Amphotericin B may only be given parenterally. The azoles, not amphotericin B, inhibit hepatic P450 drug-metabolizing enzymes, so they increase the levels of many other drugs. Both classes are broad-spectrum antifungal agents.

Answer to Question 2

ANS: B
Patients receiving amphotericin frequently experience infusion reactions, with fever, chills, rigors, nausea, and headache. Pretreatment with diphenhydramine and acetaminophen can reduce mild reactions. If rigors occur, the patient should receive dantrolene or meperidine. Aspirin would be effective for pretreatment but can increase kidney damage. Hydrocortisone is also effective, but it causes immune suppression. Omeprazole is not indicated.

[jazziefee]

TYSM

[bigsis44]

Gracias!