Drugs For Immune, Neuro, And Reproductive

Front 1

Epinephrine is given how and used for what?

Back 1

IV, SC, and IM. Used for anaphylactic reactions

Front 2

Antineoplastic/Anti-rheumetic methotrexate is used for what?

Back 2

psoriasis, RA and many cancers

Front 3

Antineoplastic/Anti-rheumetic methotrexate may cause?

Back 3

Bone marrow suppression

Pulmonary Fibrosis

Liver Toxicity

GI ulcerations

GI Bleed

Immune Suppression

Front 4

How do anti virals work?

Back 4

Interfere with DNA synthesis needed for replication

Front 5

Examples of diseases that anti virals are used for?

Back 5

herpes and varicella

Front 6

Use anti virals with caution when patient has?

Back 6

Renal disease

Front 7

Generic drugs for antivirals usually end in these letters?

Back 7

"ivir"

acyclovir

Front 8

Side effects of anti virals?

Back 8

NVD

HA

Front 9

How do anti-retroviral therapy drugs work? (ARV)

Back 9

Nucleoside/Nucleotide reverse transcriptase inhibitors.

Non-nucleoside reverse transcriptase inhibitors.

Protease inhibitors

Fusion or Entry inhibitors

Integrase Inhibitors

Front 10

Why is ARV so complex?

Back 10

It consists of multiple drugs for the perfect concoction.

Front 11

Side effects of ARV?

Back 11

Body fat changes

Insulin resistance

Hyperglycemia

Diabetes

Hyperlipidemia

Lactic Acidosis

Hepatic steatosis

Osteopenia

Avascular necrosis

Front 12

What are the cons to ARV?

Back 12

Very toxic: so check renal labs to make sure no damage.

Accessibility: can they pay/obtain meds

Incomplete efficacy: does not completely wipe out virus, often requires adjustment of regimen.

Viral resistance: must adhere to regimen or resistance will develop.

Front 13

Types of anticonvulsants/antiepiliptic drugs

Back 13

Phenytoin (Dilantin)

Fosphenytoin (Cerebyx)

Front 14

How do phenytoin and fosphenytoin work?

Back 14

Reduces motor cortex activity by altering transport of NA ions, prevents seizures.

Front 15

Therapeutic range for phenytoin and fosphenytoin?

Back 15

10-20mcg/ml

Front 16

Side effects of phenytoin and fosphenytoin?

Back 16

HA

Confusion

Sluggishness

Decreased Coordination

Gingival Hyperplasia

Front 17

phenytoin and fosphenytoin decrease the effects of what drugs?

Back 17

Anticoagulants

Oral Contraceptives

Corticosteroids

Front 18

Times that phenytoin and fosphenytoin is taken?

Back 18

PO: 2-3 times a day

IV: 1-2 times a day

Front 19

Carbamazepime (Tegretol) is another anticonvulsant/antiepiliptic med. What are its side effects?

Back 19

Visual disturbances

Fluid retention

Skin rash

Bone marrow suppression

Front 20

Carbamazepime (Tegretol) should not be taken with these drugs/food.

Back 20

Grapefruit Juice

Antifungals

Some antibiotics decrease plasma levels

Front 21

Carbamazepime taken with ______ may increase levels.

Back 21

Phenytoin common for pt to be on both phenytoin and carbamazepime.

Front 22

Gabapentin/neurotin is another anticonvulsant.antiepileptic drug. What is it used for?

Back 22

Use as adjuvant for partial seizures, neuralgia, restless leg syndrome.

Also potential efficacy in fibromyalgia, MS and neuropathic pain and neuropathy.

Front 23

Side effects of Gabapentin?

Back 23

Blurred vision

Dizziness

Dry mouth

Front 24

Types of anti parkinson drugs?

Back 24

Levodopa/Carbidopa (sinemet)

Front 25

What does Levodopa/Carbidopa help with?

Back 25

Relieves tremors and rigidity

Front 26

Side effects of Levodopa/Carbidopa?

Back 26

GI disturbances

NV

Dyskinesia (trouble moving)

Orthostatic hypotension

Increased HR

Drowsy

Unusual or intense urges (sexual, gambling etc)

Front 27

Do not take Levodopa/Carbidopa with MAOI's if you have?

Back 27

Glaucoma, melanoma or other unusual skin lesions

Front 28

Another antiparkinson drug is Benztropine mesylate (Cogentin). What does it do and how is it different than Levodopa?

Back 28

Reduces rigidity and tremors, minimal affect on dyskinesia

Front 29

Side effects of Benztropine mesylate?

Back 29

Dry mouth

Secretions

Urinary retention

constipation

blurred vision

Increase HR

Postural hypotension

Drowsiness

Front 30

What medications should you avoid while on Benztropine?

Back 30

Avoid anti-diarrheal or antacids w/in 2hrs before or after

Front 31

Type of acetylcholinesterase inhibitor

Back 31

Neostigmine (Prostigmin Bromide)

Front 32

What does neostigmine do?

Back 32

Improves muscle strength for MG patients

Front 33

Side effects of Neostigmine?

Back 33

Seizures

Bronchospasm

Excess salivation/secretions

Bradycardia

Front 34

Type of osmotic diuretic?

Back 34

Mannitol

Front 35

What does mannitol do?

Back 35

Used to stimulate urine production in ARF; Used to reduce ICP.

Front 36

What do you want to monitor the patient for that is on mannitol?

Back 36

Urine output

Monitor for increased cerebral flow

Front 37

Mannitol is contraindicated in patients with?

Back 37

anuria due to ARF, and severe dehydration

Front 38

Type of corticosteroid?

Back 38

Dexamethasone (Decadron)

Front 39

What is Dexamethasone used for?

Back 39

Used for allergic disorders, skin conditions, ulcerative colitis, lupus

Front 40

Dexamethasone interacts with what drugs?

Back 40

aspirin, coumadin, dilantin

Front 41

Nursing considerations for dexamethasone?

Back 41

Avoid situations sick or infected people.

Do not receive live vaccine while on med. May include MMR, oral polio, typhoid, varicella and some flu.

Do not stop suddenly

Front 42

What is benzothiazole used to treat?

Back 42

ALS

Extends survival and or time to tracheostomy

Front 43

Nursing considerations for benzothiazole (Riluzole)?

Back 43

Watch Liver enzymes

Watch for signs of infection

May decrease alertness

Front 44

Patient should avoid these things when on benzothiazole (Riluzole)

Back 44

Avoid caffeine

Smoking

Both make it less effective

Front 45

Type of broad spectrum antibiotic?

Back 45

Vancomycin

Front 46

What is vancomycin used to treat?

Back 46

Used in treatment of bacterial meningitis and many other infections including MRSA.

Front 47

When giving vancomycin, what routes are used? Special considerations?

Back 47

IV/PO

Oral only works in colon, not systemically

Red man syndrome (allergic response) if given too rapidly IV

Front 48

Nursing considerations for vancomycin?

Back 48

Therapeutic level 10-20

Monitor for ototoxicity (hearing loss) and nephrotoxicity (decreased renal function)

Front 49

Side effects of vancomycin?

Back 49

N or stomach pain

Front 50

Oral contraceptives are _____ and ______ combined?

Back 50

Estrogen and Progestin

Front 51

How do oral contraceptives work?

Back 51

Pregnancy prevention by suppressing FSH and LH.

Front 52

What is the Goal of oral contraceptives?

Back 52

Best combination with minimal side effects.

Front 53

Four oral contraceptive types?

Back 53

Mono

Bi phasic

Tri phasic

Extended

Front 54

What is transdermal contraceptives?

Back 54

Mostly for menopausal symptoms; apply to trunk

Change weekly X3 (no patch week 4)

Front 55

Information about Injectable contraceptives?

Back 55

Depo-Provera 150 mcg IM within 5 days of menses

Repeat every 3 months

Front 56

Information about intrauterine contraceptives?

Back 56

Inserted by professional. Changed every 5 years.

Front 57

Information about the vaginal ring?

Back 57

Insert ring on or prior to day 5 of cycle.

Leave in place X3 weeks, remove 1 week repeat

Front 58

Contraceptive contraindications (for women)

Back 58

Pregnancy

Breastfeeding

Front 59

Contraceptive contraindications (medical issues)

Back 59

HTN
Hx stroke

CVA

DVT

Angina

At risk for CV disease: age, smoke, DM, HTN

Active viral hepatitis, cirrhosis, liver tumors

Family hx of breast cancer

Front 60

Contraceptive contraindications (recreational)

Back 60

Smoker >15 cig/day or >35yrs)

Front 61

Signs and symptoms of Excess estrogen?

Back 61

NV

Dizziness

Fluid retention

Edema

Bloating

Breast enlargement or tenderness

Leg cramps

Visual changes

Vascular HA

HTN

Front 62

Signs and symptoms of decreased estrogen?

Back 62

Breakthrough vaginal bleeding

Oligiomenorrhea

Nervousness

Dyspareunia

Front 63

Signs and symptoms of excess progestin?

Back 63

Increased appetite

Weight gain

Oily skin

Acne

Depression

Vaginitis

Increase hair growth

Decrease breast size

Front 64

Signs and symptoms of decrease estrogen?

Back 64

Dysmenorrhea

Bleeding late in cycle

heavy menstrual flow with clots or amenorrhea

Front 65

Lab values for progestin and estrogen?

Back 65

Thyroid

Liver functions

Blood glucose

Triglycerides

Front 66

Severe side effects for progestin and estrogen?

Back 66

DVT

PE

CVA

MI

Front 67

What are the dangerous side effects of Oral contraceptives?

Back 67

Aches

Abd pain

Chest pain or SOB

HA

Severe neuro like numbness

Eyes blurred or loss of vision

Severe leg pain or calf, thigh swelling

Front 68

What do you want to teach your pt about oral contraceptives regarding contraindications and scheduled time to take med?

Back 68

Take same time each day

Herbal interactions: St. John's Wort, Saw Palmetto

Front 69

Non pharmacologic treatment for premenstrual syndrome?

Back 69

Decreased salt food, alcohol, caffeine, chocolate, stabilize blood sugars by decreasing sweets, eat 6 small meals, low fat meal, decrease stress, exercise

Front 70

Pharmacologic treatment for premenstrual syndrom?

Back 70

Many undocumented tx:

Vit b6

Progesterone vag or rectal suppositories

Fluoxetine HCL Only drug FDA approved for PMS

Front 71

What does phytoestrogen do?

Back 71

Foods that have estrogenic effects but are not estrogen examples: soy, flaxseed

Front 72

What does chasteberry do?

Back 72

Used to ease menstrual problems such as PMS, Infertility and acne

Stimulate the production of breast milk.

Front 73

What is black cohosh?

Back 73

Used for rheumatism

Hot flashes

night sweats

vaginal dryness

Front 74

testosterone levels?

Back 74

250-1000

Front 75

What does exogenous mean in regards to testosterone?

Back 75

Short half life & need high dose due to first pass thru liver.

Front 76

What does synthetic mean in regards to testosterone?

Back 76

Has longer half life

Front 77

What does hypogonadism mean?

Back 77

Testes not producing enough testosterone

Front 78

What is depo testosterone?

Back 78

Androgenic anabolic steroid

(Controlled substance)

Front 79

What does Depo Testosterone do?

Back 79

Develop and maintain male sex organs

USES: female breast ca, low sperm count, impotence, osteoporosis, delayed male puberty.

Front 80

Routes for Depo Testosterone?

Back 80

IM: Deep gluteal q2-3 weeks

Transdermal patch: @24hr shave and dry area, skin of back, upper arms, thighs and abdomen, reapply after bathing Q24hrs

Transdermal Gel: Apply daily to upper arms or abdomen, reapply after bathing

Buccal: no chewing or swallowing. Above incisor tooth, rotate sides place open packet against gum, hold firmly X 30 secs @12 hrs before meals. If it falls off reapply

Front 81

Used testosterone with caution if you have a hx of:

Back 81

HTN

CAD
Renal Disease

Seizure disorders

Increased Cholesterol

Older adults

Prepubescents

Front 82

Testosterone is contraindicated with what?

Back 82

Pregnancy

Renal and hepatic dysfunction

Prostate cancer

some breast cancers

hx of MI

Front 83

Side effects of testosterone

Back 83

Abd pain

hives

Injection site irritation

Decreased libido

Insomnia

Aggressive behavior

Pruitis

Front 84

Adverse reactions of testosterone

Back 84

Acne

Masculinization
Irregular menses
Urgency
Jaundice
allergic reaction

Depression

Front 85

Nursing interventions for the patient on testosterone?

Back 85

Daily weight: report weight gain

I&O

VS

Check for edema & HTN

Labs: electrolytes, hepatic studies

Mental status: affect, mood, behavior

May cause hypercalcemia, hypoglycemia

Male sex characteristics in females

Front 86

What is saw plametto?

Back 86

Mainly for urinary symptoms associated with an enlarged prostate gland. (BPH)

Used for decreased for sex drive, hair loss, and hormone imbalances.

Front 87

What is Yohimbe?

Back 87

Used in africa as aphrodisiac

Erectile dysfunction

MANY SIDE EFFECTS