Amphotericin B – Pharmacology for Nurses: Practical Apps

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Chapter 42: Antifungal Test, Amphotericin B, Pharmacology for Nurses: Practical Applications

The key terms in the Pharmacology course include Antifungal Test, Chapter 42, Amphotericin B, PRIORITY Intervention, Fungal Infection, Adverse Effects, Pharmacology for Nurses: Practical Applications

What is the PRIORITY intervention for the nurse to complete before administration of intravenous (IV) amphotericin B?

Monitor for cardiac dysrhythmias.

Check for premedication prescriptions.

Monitor IV site for signs of phlebitis.

Assess for nausea and vomiting.

Almost all patients given IV amphotericin B experience fever, chills, hypotension, tachycardia, malaise, muscle and joint pain, anorexia, nausea and vomiting, and headache. Pretreatment with an antipyretic, antihistamine, and antiemetic can minimize or prevent these adverse reactions. The other choices are appropriate nursing actions after the IV infusion has begun.

The nurse providing care to patient with a fungal infection is aware that which drugs is known for the most number of possible adverse effects?

Amphotericin B




The major adverse effects caused by antifungal drugs are encountered most commonly in conjunction with amphotericin B treatment. Drug interactions and hepatotoxicity are the primary concerns in patients receiving other antifungal drugs, but the IV administration of amphotericin B is associated with a multitude of adverse effects.

A patient with a severe fungal infection has orders for voriconazole (Vfend). The nurse is reviewing the patient’s medical record and would be concerned if which assessment finding is noted?

Patient is also taking quinidine

Potassium level of 4.0 mEq/L

Decreased breath sounds in the lower lobes

History of type 2 diabetes

Voriconazole is contraindicated when co-administered with certain other drugs metabolized by the cytochrome P-450 enzyme 3A4 (e.g., quinidine) because of the risk for inducing serious cardiac dysrhythmias.

A patient will be taking fluconazole (Diflucan) 100 mg/day PO for 2 weeks. The patient is unable to swallow tablets, so an oral suspension that contains 10 mg/mL is available. Identify how many milliliters will the nurse administer with each dose. __

Correct Answer

10 mL

10 mg:1 mL :: 100 mg:x mL.
(10 × x) = (1 × 100); 10x = 100; x = 10 mL.

A patient has received a prescription for a 2-week course of antifungal suppositories for a vaginal yeast infection. She asks the nurse if there is an alternative to this medication, saying, “I don’t want to do this for 2 weeks!” Which is a possibility in this situation?

A single dose of a vaginal antifungal cream.

A single dose of a fluconazole (Diflucan) oral tablet.

There is no better alternative to the suppositories.

A one-time infusion of amphotericin B.

A single oral dose of fluconazole may be used to treat vaginal candidiasis. The other options are incorrect.

If a patient is taking fluconazole (Diflucan) with an oral anticoagulant, the nurse will monitor for which possible interaction?

Decreased effectiveness of the antifungal drug

Increased effects of oral anticoagulants


Reduced action of oral anticoagulants

Azole antifungal drugs increase the effects of oral anticoagulants. As a result, increased bleeding may occur. The other options are incorrect.