Chapter 30: Antitubercular, Antifungal & Antiviral Drugs

Antitubercular, Antifungal & Antiviral Drugs explores the complex pharmacological management of infectious diseases caused by mycobacteria, fungi, and viruses, emphasizing a patient-centered nursing process approach. The text begins with a detailed analysis of Tuberculosis (TB), an infection caused by the acid-fast bacillus Mycobacterium tuberculosis, covering its airborne droplet transmission, pathophysiology, and the distinction between latent infection and active disease. To combat the rise of Multidrug-Resistant TB (MDR TB), the chapter outlines rigorous multidrug regimens involving first-line antitubercular agents such as Isoniazid (INH), Rifampin, Pyrazinamide, and Ethambutol. Critical nursing considerations are highlighted, including the administration of pyridoxine (vitamin B6) to prevent INH-associated peripheral neuropathy, the monitoring of liver enzymes for hepatotoxicity, and the necessity of Direct Observation Therapy (DOT) to ensure adherence. The discussion transitions to mycosis, categorizing fungal infections into opportunistic types like Candidiasis and Aspergillosis, and systemic primary infections. It examines major antifungal classes, including Polyenes like the highly potent but nephrotoxic Amphotericin B and Nystatin, Azoles such as Fluconazole which inhibit ergosterol synthesis, Antimetabolites, and Echinocandins. Significant attention is given to patient safety during Amphotericin B infusions, requiring premedication to mitigate severe reactions and close monitoring of renal function and electrolytes. Finally, the chapter addresses non-HIV antiviral pharmacotherapy, detailing mechanisms that inhibit viral replication for Influenza, Herpesviruses, and Hepatitis. It covers the time-sensitive administration of neuraminidase inhibitors like Oseltamivir for influenza types A and B, the use of nucleoside analogues like Acyclovir and Valacyclovir for Herpes Simplex and Varicella-Zoster viruses, and the evolving treatment landscape for chronic Hepatitis B and C using interferons and direct-acting antivirals to prevent hepatic failure.