On completion of this chapter, the student will:
• Distinguish between superficial and systemic fungal infections
• Discuss the uses, general drug action, adverse reactions, contraindications, precautions, and interactions of antifungal drugs.
• Discuss important preadministration and ongoing assessment activities the nurse should perform on the patient receiving an antifungal drug.
• List some nursing diagnoses particular to a patient taking an antifungal drug.
• List possible goals for a patient taking an antifungal drug.
• Discuss ways to promote an optimal response to therapy, how to manage adverse reactions, and important points to keep in mind when educating the patient and the family about the antifungal drugs.
Fungal infections range from superficial skin infections to life-threatening systemic infections. Systemic fungal infections are serious infections that occur when fungi gain entrance into the interior of the body.
A fungus is a colorless plant that lacks chlorophyll. Fungi that cause disease in humans may be yeastlike or moldlike; the resulting infections are called mycotic infections or fungal infections.
Mycotic (fungal) infections may be one of two types:
1. Superficial mycotic infections
2. Deep (systemic) mycotic infections
The superficial mycotic infections occur on the surface of, or just below, the skin or nails. Superficial infections include tinea pedis (athlete's foot), tinea cruris (jock itch), tinea corporis (ringworm), onychomyco-
sis (nail fungus), and yeast infections, such as those caused by Candida albicans. Yeast infections or those caused by C. albicans affect women in the vulvovaginal area and can be difficult to control. Women who are at increased risk for vulvovaginal yeast infections are those who have diabetes, are pregnant, or are taking oral contraceptives, antibiotics, or corticosteroids.
Deep mycotic infections develop inside the body, such as in the lungs. Treatment for deep mycotic infections is often difficult and prolonged. The Summary Drug Table: Antifungal Drugs identifies drugs that are used to combat fungal infections.
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