Question

I. James received a liver transplant 6 weeks ago and now has been diagnosed with an aspergillosis lung infection and will require IV treatment with systemic antifungals.

a. Which medication should be prescribed for James: amphotericin B (AmBisome) or caspofungin (Cancidas)? Defend your answer.

b. What are the most important nursing actions that should be taken for patients receiving systemic antifungals?

II. Ms. Smith will be receiving chemotherapy for advanced breast cancer. She is 75 years old and resides in a long-term care facility. Her treatment plan will include the use of the hormone goserelin (Zoladex) and capecitabine (Xeloda), which is an antimetabolite.

a. What special monitoring might Ms. Smith require during her treatment?

b. What adjustments to Ms. Smith’s living arrangements might be required?

Answer 1

Answer I. a. : Caspofungin should be given in the treatment for infection. It is the most effective antifungal drug. It works by inhibiting the synthesis of the cell wall of the fungus. The major reason is that the Caspofungin does not have drug to drug interaction and hence doesn't have major side effects or adverse effects. It has increased efficacy of the treatment.

b: The most important nursing actions that should be taken for patients receiving systemic antifungals are:

• Nurse need to monitor the drug response and it's effectiveness.
• Nurse should assess the adverse effects of the drug such as burning sensation, rashes etc.
• Provide education to the patient regarding the drug interaction, side effects.
• It is important to notice the patient compliance to the drug therapy.