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145 Cards in this Set
- Front
- Back
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main class of drugs used to treat CV diseases (heart failure and HTN)
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diuretics
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most commonly used class of diuretics
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thiazide
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What is the main adverse effect of hydrochlorothiazide (HCTZ)?
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hypokalemia
*Teach patient to drink a lot of OJ and eat a lot of bananas! |
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What is the pharm class of Furosemide (Lasix)?
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loop diuretic
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What should you do before giving Lasix IV?
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Make sure the patient's potassium is above 3.5.
*If not, replace potassium first before giving Lasix. |
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Never push Lasix faster than _____ mg/min.
Why? |
10
It would dehydrate the auditory nerve and cause ototoxicity. |
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Is Lasix used for acute or chronic treatment?
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acute
*giving it chronically causes hypokalemia |
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What is the pharm class of Spironolactone (Aldactone)?
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potassium sparing diuretic
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How does Spironolactone (Aldactone) work?
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it blocks the release of aldosterone
counteracts potassium loss caused by other diuretics |
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type of diuretic used in closed head injuries when needing to decrease fluid in the brain; also used for burn patients and patients taking cisplatin (toxic chemo agent)
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osmotic
ex. Mannitol (Osmitrol) |
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What is the main adverse effect of Mannitol (Osmitrol)?
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dehydration
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What are the 2 main problems with diuretics?
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dehydration
hypokalemia |
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When the T wave is flat, the patient's potassium is:
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low
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When the T wave is peaked, the patient's potassium is:
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high
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What groups are people are most likely to get infections?
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children under age 6
people in enclosed spaces |
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What groups of people should receive prophylactic antibiotic therapy?
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people who travel
people with mechanical/artificial parts people about to have surgery |
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When I assume you have an infection from physical assessment findings and I treat it, I am giving you:
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empiric therapy
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Which group of antibiotics blocks the synthesis of components necessary for bacterial cell metabolism and growth?
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sulfonamides
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Which groups of antibiotics inhibit the formation of bacterial cell walls?
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penicillins
cephalosporins |
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Which group of antibiotics inhibits DNA gyrase, an enzyme required for bacterial reproduction?
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fluoroquinolones
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Which groups of antibiotics bind to bacterial ribosomes and inhibit production of essential proteins?
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aminoglycosides
macrolides ketolides tetracyclines |
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What lab tests should you check before giving any antibiotic?
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BUN
creatinine *b/c most antibiotics are nephrotoxic |
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Fluoroquinolones are contraindicated in:
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children under 18 b/c they will cause joint damage
*only exception is children with cystic fibrosis |
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Tetracyclines are contraindicated in:
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children under 8 b/c they will permanently discolor their teeth gray
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Aminoglycosides should only be given for the treatment of:
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MRSA
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What are the main adverse effects of aminoglycosides?
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nephrotoxicity
ototoxicity |
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What is the pharm class of Piperacillin-Tazobactam (Zosyn)?
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extended spectrum penicillin
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What is the prototype for the first generation cephalosporins?
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Cephalexin (Keflex)
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What is the prototype for the second generation cephalosporins?
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Cefaclor (Ceclor)
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What is the prototype for the third generation cephalosporins?
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Cefotaxime (Claforan)
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What is the prototype for the fourth generation cephalosporins?
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Cefepime (Maxipime)
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When should penicillins be given?
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may be given WITHOUT regard to meals
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When should cephalosporins be given?
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may be given around the clock, without regard to meals
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Which antibiotic causes the most allergic reactions?
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penicillin
*because it is a mold |
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What muscle should you give penicillin in?
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vastus lateralis or gluteal
*NEVER give in the deltoid |
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What is the only reason to use fourth generation cephalosporins (ex. Cefepime)?
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septic shock
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What happens if the level of antibiotic in the blood gets above peak level?
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it is toxic to the kidneys and ears
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What happens if the level of antibiotic in the blood gets below trough level?
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the bacteria may develop resistance to the drug
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Are penicillins and cephalosporins safe to use in children?
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yes
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What are the CI of using cephalosporins?
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hypersensitivity to cephalosporins OR pencillins
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What is the pharm class of Amikacin (Amikin)?
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aminoglycoside
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What is the pharm class of Gentamicin (Garamycin)?
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aminoglycoside
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What are aminoglycosides used to treat?
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ONLY serious infections (ex. MRSA)
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What 2 classes of antibiotics are vesicant drugs?
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aminoglycosides (ex. Amikin)
macrolides (ex. Zithromax) |
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What 2 problems can infusing aminoglycosides too quickly cause?
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red man syndrome
paralysis (neurotoxicity) |
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Do not give _______________ for longer than 10 days because they will cause the patient to get a superinfection (c. dificile).
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aminoglycosides
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What are the main adverse effects of aminoglycosides?
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nephrotoxicity
ototoxicity *especially in neonates |
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What is the pharm class of Ciprofloxacin (Cipro)?
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fluoroquinolone
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What is the pharm class of Levofloxacin (Levaquin)?
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fluoroquinolone
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the drug class of choice for use in biological warfare
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fluoroquinolones (Cipro and Levaquin)
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Which group of antibiotics causes refractory hypoglycemia in diabetic patients?
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fluoroquinolones (Cipro and Levaquin)
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What group of antibiotics should not be given together with Amnioderone?
Why? |
fluoroquinolones (Cipro and Levaquin)
it will cause v-tach |
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What is the 2nd most common cause of Steven-Johnson syndrome?
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antibiotics, especially:
penicillins cephalosporins aminoglycosides fluoroquinolones |
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bacteriostatic drugs that are often used in people who are penicillin allergic
much weaker and less effective than penicillin or cephalosporins |
tetracyclines
ex. Doxycycline (Vibramycin) |
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What is the most common reason for using tetracyclines?
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acne
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Do NOT give tetracyclines with:
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dairy products
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group of drugs that are commonly used to prevent and treat UTIs
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sulfonamides (ex. Bactrim)
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What group of antibiotics causes esophagitis if they get stuck in the esophagus?
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sulfonamides (ex. Bactrim)
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What is the pharm class of Doxycycline (Vibramycin)?
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tetracycline
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What is the pharm class of Bactrim?
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sulfonamide
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What is the pharm class of Phenazopyridine (Pyridium)?
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urinary tract analgesic
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What is a common adverse effect of Pyridium?
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orange-red urine and tears
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Don't use Pyridium for more than:
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48 hours
*because all you're doing is covering up the symptoms |
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What 2 antibiotic drug classes are associated with photosensitivity?
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tetracyclines
sulfonamides |
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How long does it take a TB culture to grow?
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30 days
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What is the pharm class of Azithromycin (Zithromax)?
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macrolide
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What is the main AE of Zithromax?
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explosive diarrhea
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What are the CI of giving Flagyl?
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use with caution in pregnancy and in patients with CNS or blood disorders
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What lab work should you check before giving Flagyl?
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liver function
kidney function CBC |
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What are the 3 drugs used to treat TB?
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INH
Rifampin Pyrizinamide |
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A patient's metabolism of ______ is genetically determined.
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INH
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What are the main adverse effects of INH?
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hepatotoxicity
peripheral neuropathy |
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Which TB drug has a lot of drug-drug interactions?
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Rifampin
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What is the main AE of Rifampin?
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red body fluids
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What is the drug of choice for treating multi-drug resistant TB?
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fluoroquinolones
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Penicillins work better on gram _________ than gram ________ bacteria.
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positive
negative |
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Cephalosporins gain gram _________ activity and lose gram __________ activity as they move from 1st generation to 3rd generation.
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negative
positive |
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Aminoglycosides and fluoroquinolones are used to treat ___________ bacteria:
aerobic or anaerobic gram postive or negative |
aerobic
gram-negative |
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Tetracyclines and sulfanomides are active against gram negative or gram positive bacteria?
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both!
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What type of antibiotics are active against gram positive bacteria and some anaerobic species?
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macrolides (Zithromax)
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Flagyl is active against:
gram negative or positive anaerobic or aerobic bacteria? |
gram negative AND positive
anaerobic |
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Vancomycin is active against gram negative or gram positive bacteria?
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gram positive only!
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type of herpesvirus that can cause severe problems in neonates whose mothers have it
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CMV (cytomegalovirus)
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When do viruses become more virulent?
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when they change species
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What type of virus does Acyclovir (Zovirax) treat?
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herpes
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What type of virus does Ganciclovir (Cytovene) treat?
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herpes
*especially CMV retinitis |
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What type of virus does Valacyclovir (Valtrex) treat?
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herpes (particularly genital)
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What drug is particularly effective in treating influenza A?
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Amantadine (Symmetrel)
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Amantadine (Symmetrel) is only effective if given:
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within the first 48 hours of symptoms
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pneumonia-causing virus that is treated only in children under 8
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RSV (respiratory syncytial virus)
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What type of virus does Ribavirin (Virazole) treat?
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RSV
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What is the pharm class of Delavirdine (Rescriptor)?
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Non-Nucleoside Reverse Transcriptase Inhibitor
(NNRTI) |
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What is the major AE of Delavirdine (Rescriptor)?
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Steven-Johnson syndrome
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What is the pharm class of Zidovudine (AZT)?
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Nucleoside reverse transcriptase inhibitor
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What is the only anti-retroviral drug that can be used in pregnancy?
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AZT
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What are the AE of AZT?
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severe anemia and granulocytopenia, peripheral neuropathy, pancreatitis
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What is the pharm class of Tenofovir (Viread)?
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Nucleotide Reverse Transcriptase Inhibitor
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What other virus is Viread effective against besides HIV?
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Hep B
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What is the pharm class of Nelfinavir (Viracept)?
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protease inhibitor
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Use Viracept with caution in:
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patients with impaired liver function
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What is the main AE of Viracept?
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diarrhea
*patients should be prescribed Immodium to take with Viracept! |
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What is the pharm class of Enfuvirtide (Fuzeon)?
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fusion inhibitor
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Which anti-retroviral drug is used for needle prophylaxis?
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Fuzeon
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What lab value should you monitor with AZT?
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serum amylase
*b/c it causes pancreatitis |
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What lab values should you monitor to see if HIV drugs are working?
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CD4 count
total T count SGOT (liver function) viral load (to see what HIV antibody count is) CBC kidney function |
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antifungal drug used for blood-borne infections
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Amphotercin B (Fungizone)
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What is the main AE of Amphotercin B (Fungizone)?
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nephrotoxicity
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Which antifungal drug is particularly effective against candidiasis?
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Caspofungin (Cancidas)
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Which antifungal drug is given to treat yeast (in the mouth or genitalia)?
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Fluconazole (Diflucan)
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What are the main AE of Diflucan?
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hepatotoxicity
Steven Johnson syndrome |
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A major risk factor for serious fungal infections is:
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immunosuppression
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What drug may be used to treat oral candidiasis (thrush)?
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Diflucan
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What medication is given with IV amphotericin B to decrease infusion reactions?
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antihistamine
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What drug is used for prophylaxis and treatment of acute attacks of malaria; treatment of amebiasis (protozoa)?
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Chloroquine (Aralen)
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Chloroquine (Aralen) may be toxic to:
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people of African or Mediterranean descent
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OTC drug used to treat head lice, scabies, and crabs
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Permethrin (Nix)
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What is the most common worm in the U.S., and who does it most often infect?
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pinworm
toddlers |
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Antihelmintic drug used to treat pinworms and other worms
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Mebendazole (Vermox)
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drug given to treat anaerobic infections as well as protozoal infections (traveler's diarrhea)
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Flagyl
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A client being treated for amebiasis should be informed that what AE may occur?
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nausea
vomiting diarrhea |
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For a client taking Flagyl for trichomoniasis, what is important for him to remember?
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DON'T DRINK ALCOHOL!
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The drug of choice for prevention/treatment of Pneumocystis pneumonia is:
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Bactrim
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Clients taking antiparasitic drugs should be taught:
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ways to prevent reinfection
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What are the 3 times in life when you are most vulnerable to developing cancer?
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rapid growth spurts in preschool
early 20s over age 70 |
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How are chemotherapy doses calculated?
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4 times using body surface area
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Most chemotherapy drugs are:
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vesicants if they extravasate
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low point and high point that are important to measure when giving chemo
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nadir
zenith |
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syndrome that occurs when large numbers of cancer cells are killed or damaged and release their contents into the bloodstream. As a result, hyperkalemia, hyperphosphatemia, hyperuricemia, hypomagnesemia, hypocalcemia, and acidosis develop
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tumor lysis syndrome
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Which two chemo drugs have a total lifetime dose?
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Adriamycin
Bleomycin |
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What is the main AE of Adriamycin?
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cardiomyopathy
*must do echocardiogram before giving |
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What is the pharm class of Cisplatin (Platinol)?
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alkylating agent
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Which chemo drug do you give Mannitol with?
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cisplatin (Platinol)
it is given to decrease the nephrotoxicity of cisplatin |
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What is the pharm class of Paclitaxel (Taxol)?
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taxane
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With which 2 chemo drugs do you give Tylenol and Benadryl beforehand?
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Bleomycin
Taxol |
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What is the main AE of Bleomycin?
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toxic to lungs
*do pulmonary function tests before giving |
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What are the AE of Taxol?
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bone marrow suppression, N/V, hypotension, bradycardia
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What veins does a CVL go through to get to the superior vena cava?
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external jugular
subclavian |
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If a patient's CVL infiltrates, what will be the s/s?
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chest pain
difficulty breathing hypotension |
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What is the pharm class of Rituximab (Rituxan)?
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monoclonal antibody
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What type of cancer is Rituxan especially useful in treating?
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non-Hodgkin's lymphoma
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What chemo drug is given to women post-breast cancer to prevent recurrence?
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Tamoxifen (Nolvadex)
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What are the AE of Nolvadex?
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premature menopause
hot flashes |
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Which chemo drug is given post-prostate cancer to prevent recurrence?
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Leuprolide (Lupron)
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What is the main AE of Lupron?
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decreased libido
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What group of people CANNOT take chemo?
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pregnant women
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