candidiasis. It is more commonly used as an oral suspension for candidal infec-
tion in the mouth as a swish and swallow.
Side effects include anorexia, nausea, vomiting, diarrhea (large doses), stom-
ach cramps, rash; vaginal: rash, burning sensation. There are no reported adverse
reactions.
It is used topically and PO at doses of 500,000–1,000,000 U tid or q8h. This
drug has a Pregnancy category: C; PB: UK; t^1 ⁄ 2 : UK.
The Imidazole group is effective against candidiasis (superficial and systemic),
coccidioidomycosis, cryptococcosis, histoplasmosis, and paracoccidioidomycosis.
Antimalarial
Malaria is still one of the most prevalent protozoan diseases in the world.
The mosquito infects the human and the parasite passes through two phases. The
tissue phase causes no clinical symptoms in the human and the erythrocytic
phase invades red blood cells and causes chills, fever, and sweating, In the
United States the 1000 cases reported annually are almost all from interna-
tional travel. Quinine was the only antimalarial drug from 1820 to the early
1940s when synthetic antimalarial drugs were developed. Chloroquine is com-
monly prescribed. If drug resistance develops quinine is used in combination
with an antibiotic such as tetracycline.
Nursing process related to treating patients who have malaria.
- Assessment
° Assess patient’s hearing (drugs may affect 8th cranial nerve)
° Assess for visual changes (should have frequent ophthalmic examina-
tions) - Nursing diagnoses
° Risk of infection
° Risk for impaired tissue integrity
° Risk for sensory disturbances (auditory and visual) - Planning
° Patient will be free of malarial symptoms
CHAPTER 13 Antimicrobials—Fighting Infection^247