Exam 2 Drugs

Front 1

Azithromycin (Zithromax)

Back 1

Antiinfective for atypical mycobacterium/macrolides

Indication: gonorrhea and prevention of disseminated Mycobacterium avium (MAC) in pt w/advanced HIV

Bacteriostatic [↓protein synthesis] action against susceptible bacteria

SE: abd pain, diarrhea, nausea, pseudomembranous colitis, angioedema

Assess for s/s of infection [VS, appearance, sputum, urine, stool WBC], obtain C/S, observe for anaphylaxis [rash, puritus, laryngeal edema, wheezing], may cause ↑serum bilirubin/AST/ALT/LDH/K+/PT/BUN/CR/serum glucose, ↓WBC/platelet

Do not take w/food or antacids, may cause drowsiness/dizziness, sunscreen for photosensitivity rx, report chest pain/palpitations, yellowing skin/eyes, signs of superinfection [black furry overgrowth on tongue, vaginal itching/discharge/loose foul smelling stool. Notify HCP for fever, diarrhea, stool containing pus/blood/mucous/DO NOT TX DIARRHEA

Front 2

Allopurinol (Alloprim)

Back 2

Antigout agent, antihyperuricemic/xanthine oxidase inhibitor

Indication: tx of secondary hyperuricemia which may occur in tx of tumors/leukemia

↓uric acid production/serum levels

SE: rash [d/c at first sign]

Monitor I/O, maintain adequate fluid intake [min. 2500-3000ml/day to ↓kidney stone formation], assess for rash/hypersensitivity, monitor for pain/swelling [gout], monitor uric acid levels [start to ↓ in 2-3 days], monitor for hypoglycemia in pt w/diabetes, may cause ↑AST/ALT, ↓CBC/platelets [bone marrow depression], ↑BUN/CR/CCr [nephrotoxicity]

Alkaline diet may be ordered [urinary acidification + vit. C/other acids may ↑kidney stone formation], promote ↑fluid intake, cause occasional drowsiness, report skin rash/blood in urine/influenza symptoms [chills, fever, muscle aches, pain, n/v, EtOH ↑uric acid and ↓effectiveness

Front 3

Aldesleukin (Interleukin-2)

Back 3

Antineoplastic/interleukin

Indication: metastatic renal cell carcinoma

SE: dyspnea, pulmonary congestion/edema, arrhythmias, hypotension, tachycardia, diarrhea, jaundice, n/v, oliguria/anuria, proteinuria, pruritus, acidosis, hypocalcemia/kalemia/magnesesemia/phosphatemia, anemia, leucopenia, thrombocytopenia, chills, fever, apnea, respiratory failure, cardiac arrest, CHF, MI, stroke, bowel perforation, capillary leak syndrome

Front 4

Acyclovir (Zovirax)

Back 4

Antiviral/purine analogues

Indication: genital herpes

↓viral replication/shedding/↓lesion healing time

SE: dizziness, HA, diarrhea, n/v, pain, phlebitis, seizures, renal failure, thrombotic thrombocytopenic purpura/hemolytic uremic syndrome

Assess lesions qd, monitor neuro status in pt w/herpes encephalitis, monitor BUN/CR/CCr, should be started ASAP after onset of symptoms and w/in 24hr. of outbreak.

Additional OTC creams/lotions/ointments may delay healing or spread of lesions, acyclovir is not a cure [virus lays dormant in ganglia], will not prevent spread to others, condoms should be used, and no sexual contact w/lesions present.

Front 5

Benztropine (Cogentin)

Back 5

Antiparkinson agent/anticholinergic

Indication: Parkinson’s disease/drug induced extrapyramidal effects/acute dystsonic rx

↓of rigidity and tremors by blocking cholinergic activity in CNS

SE: blurred vision, dry eyes, constipation, dry mouth

Assess pakinsonian/extrapyramidal symptoms [restlessness, desire to keep moving, rigidity, tremors, pill rolling, mask like face, shuffling gait, muscle spasms, twisting motion, difficulty speaking/swallowing, loss of balance control], monitor constipation/abd pain/distention/absence of BS, monitor I/O, urinary retention [dysuria/distended abd, infrequent voiding of small amounts or urine, overflow incontinence]. Pt w/mental illness are at risk for developing exaggerated symptoms of disorder [notify behavior changes]

Taper when d/c or withdrawal symptoms may occur [anxiety, trachycardia, insomnia, parkinsonian/extrapyramidal symptoms], may cause drowsiness/dizziness, frequent mouth rinsing/sugarless gum/good oral care will ↓ dry mouth, change positions slowly to avoid hypotension, notify HCP with difficulty urinating/constipation/abd discomfort/heart palpitations/confusion/eye pain/rash, avoid antacids/antidiarrheals w/in 1-2hr. of medication

Front 6

Carbamazepine (Tegretol)

Back 6

Anticonvulsant/mood stabilizer

Indication: tx tonic – clonic/mixed/complex – partial seizure, management of acute/mixed mania

Prevention of seizures and ↓ mania by ↓ CNS transmission via Na+ channels

SE: ataxia, drowsiness, agranulocytosis, aplastic anemia, thrombocytopenia

Assess for seizure activity, assess mood/orientation/behavior, monitor CBC/platelet/reticulocyte count/serum ion [monitor for bone marrow depression], monitor ↑AST/ALT/urine protein and glucose/BUN/bilirubin, may ↑cholesterol and false + pregnancy test

Gradually d/c to prevent seizure, may cause dizziness/drowsiness, NOTIFY HCP of fever/sore throat/mouth ulcer/easy bruising/petechiae/unusual bleeding/abd pain/chills/rash/pale stool/dark urine/jaundice, avoid EtOH, use sunscreen for photosensitivity, good oral care can prevent dry mouth, use nonhormonal contraception with

Front 7

Chlorpromazine (Thorazine)

Back 7

Antiemetic/antipsychotic, phenothiazine

Indication: 2nd tx for schizophrenia/psychoses after failure of atypical antipsychotics

↓s/s of psychosis, relief of n/v by altering effects of dopamine in CNS

SE: sedation, blurred vision, dry eyes, hypotension, constipation, dry mouth, photosensitivity, neuroleptic malignant syndrome, agranulocytosis

Assess mental status, BMI, CBG and cholesterol [nutrition and weight management], positive [hallucinations, delusions, agitation] and negative [social withdrawal] symptoms, monitor CV status after does adjustment, observe pt taking med not hoarding, assess bowel function, monitor for akathsia [restlessness or desire to keep moving], extrapyramidal effects, REPORT IMMEDIATEY for tardive dyskenesia [uncontrolled rhythmic movement of mouth/face/extremities] and neuroleptic malignant syndrome [fever, respiratory distress, tachycardia, convulsions, diaphoresis, HTN or hypotension, pallor, tiredness, muscle stiffness, loss of bladder control. Monitor for ↓ HCT/Hgb/leukocytes/granulocytes/platelets and ↑bilirubin/AST/ALT, agranulocytosis may occur at 4-10 wk tx

Pt recumbent for 30 min following tx, if missed does can take up to 1hr. after, abrupt withdrawal may cause gastritis, n/v, dizziness, HA, tachycardia, insomnia, change positions slowly, avoid EtOH, good oral care will ↓ dry mouth, sunscreen to prevent pigment changes, may turn urine pink/reddish/brown, no not take antacids/antidiarrheal w/in 2hr.

Front 8

Doxycycline (Doryx)

Back 8

Antiinfective

Indication: tx of gonorrhea and syphilis in PNC allergic pt

Bacteriostatic action against susceptible gram – bacteria via ↓ of protein synthesis

SE: dizziness, vestibular rx, diarrhea, n/v, photosensitivity

Assess for s/s of infection [VS, sputum, urine, stool, WBC], C/S, assess IV for thrombophlebitis, may cause ↑ AST/ALT/bilirubin/amylase/BUN, may cause yellow/brown discoloration/softening of teeth and bones

Avoid dairy products, antacids, use nonhormonal contraception, sunscreen for photosensitivity, REPORT s/s of superinfection, rash, pruritus, urticaria [allergic rx w/swelling]