Pharm Exam 4- Management Of Infections

Front 1

*ciprofloxacin (Cipro)
-type?
-Indications (1)?
-adverse effect? (2)
-Contrainidcations (5)-Under what age children?

-What OTC drug cause a dec abs of Cipro? What happens to oral contraceptives?

-How should you take Cipro and why? What causes a inc in CNS stimulation and CV adverse effects when you take Cipro with?

-Assess (4)

-What basic two lab tests?

-Reduce dosage in what age group and the two reasons why?

-Assess what drink and drug intake?

-Take cipro on an______?

-Pt and family (8)

Back 1

-TYPE: FLUROQUINOLONES
-INDICATIONS: UTI

-ADVERSE: ARTHROPATHY (JOINT PAIN) CHILDREN <18 YEARS OF AGE), SEIZURES

-CONTRAINDICATIONS: PREGNANCY, LACTATION AND CHILDREN <18, RENAL AND LIVER DYSFUNCTION

-ANTACIDS: DEC ABS OF CIPRO
-ORAL CONTRACEPTIVES: DEC ORAL EFFICACY

-FOOD: DEC ABS OF CIPRO
-CAFFEINE: DEC METABOLISM OF CAFFEINE AND INC CNS STIMULATION AND CV ADVERSE EFFECTS

-ASSESS FOR ALLERGIES, SEIZURES, RENAL OR HEPATIC DS

-CULTURE AND SENSITIVITY TESTS

-REDUCE DOSE IN ELDERLY- RENAL OR HEPATIC DYSFUNCTION

-ASSESS CAFFEINE AND OTC (ANTACID) USE.

-TAKE CIPRO ON A EMPTY STOMACH

-PT AND FAMILY:
1. AVOID DURING PREGNANCY
2. ADMINISTER ANTACIDS AND CIPRO 2HRS APART
3. TAKE CIPRO ON AN EMPTY STOMACH
4. USE AN ALTERNATIVE METHOD OF BIRTH CONTROL
5. COMPLETE THE FULL COURSE OF THE ANTIBIOTIC
6. CONTACT PRESCRIBER IF NO IMPROVEMENT AFTER 3 DAYS
7. SUPER INFECTION

Front 2

*daptomycin (Cubicin)
-type?
-indications (3)
-adverse (2)- causes what pathy and elevates what levels?

-contraindications (1)

-baseline (3) labs

-reduce dose in what group and why?

-Before administer you want to make sure the medicine is not?

-Administer w/ what type of isotonic soln?

-Monitor ____pain and what lab level?

-Pt and family (2)- Caution if taking what type of medicine b/c it could cause a increase in what adverse rxn w/ Cubicin?

Back 2

-Cyclic lipopeptides
-Indications: Manage complicated skin infections. MRSA, gram+ infections that are resistance to vancomycin and linezolid

-Adverse: myopathy (muscle pain) and elevates CK levels

-contraindications: renal dysfunction

-baseline CK, renal, and LFTs

-Reduce dose in elderly (renal dysfunction)

-Before administration, visually inspect daptomycin for particulate matter and discoloration

-Administer daptomycin with 0.9% NaCl injection or LR soln

-Monitor muscle pain and CK level

-pt and family:
1. report muscle pain
2. Caution if taking HMG-CoA reductase inhibitors

Front 3

*trimethoprim-sulfamethoxazole (TMP-SMZ, Bactrim DS)

-type
-Inidcations (2)
-Adverse effect (3)
-Contrainidcations (3)-When and deficiency of?

-What causes disulfiram-like exn w/ this drug?

-What juice w/ this drug causes a inc risk of crystalluria? What causes a dec abs of TMP-SMZ abs?

-Baseline lab test?

-Avoid during when b/c it could cause what type of adverse effect in a baby?

-Assess the intake of (2)

-What type of sensitivity could occur?

-Administer TMP_SMA on ____ w/ a full glass of ____to enhance abs.

-Wear what outdoors and why?

-Pt and family (5)

Back 3

-Sulfanamides
-Indications: UTIs and systemic infections
-Adverse: anemia, crystalluria (med crystallize in tubules)

-Contrainidcations: pregnancy, lactation, deficiency of folate or glucose-6-phosphate dehydrogenase (G6PD)

-Alcohol-disulfirm-like rxn
-cranberry juice: acidifies the urine, inc risk of crystalluria
-Food: dec TMP_SMA abs

-baseline CBC

-avoid during pregnancy and lactation (kernicterus-causes brain damage as bilirubin inc)

-assess cranberry juice and alcohol intake

-photosensitivty may occur

-administer TMP-SMZ on an empthy stomach w/ a full glass of water to enhance the abs of the drug

-maintain adequate hydration by drinking at least 1.5L/day of water b/c of crystalluria

-wear protective clothing and sunscreen when outdoors

-Pt and family
1. take on an empty stomach
2. avoid alochol
3. avoid cranberry juice
4. report sore thoart, fever, bruising or bleeding (anemia)
5. Wear protective clothin and sunscreen when outdoors (photosensitivity)

Front 4

*phenazopyridine (Pyridium)

-Type?
-Indications (3)
-Mech?
-Colors the pt urine what 2 colors?

Back 4

-URINARY TRACT ANALGESICS

-INDICATIONS: SYMPTOMATIC RELIEF OF PAIN, BURNING, FREQUENCY AND URGENCY ASSOCIATED W/ UTI

-Mech: EXCRETED IN THE URINE, WHERE IT EXERTS A TOPICAL ANALGESIC EFFECT. NO ACTIVITY.

-COLOR'S THE PT URINE "ORANGE OR RED"

Front 5

*isoniazid (INH, Nydrazid)
-type?
-Indications (2)
-Mech- inhibits what activity?

-Adverse effect (1) and 1 black box warning?

-Contraindications (1)

-What intake causes a increase risk for hepatotoxicity?

-Tyramine-rich foods interact w/ INH causing what crisis?

-Assess for what ds? Baseline what lab?

-How long is this therapy?

-If you are over 35 what dysfunction could INH cause?

-Assess intake of and why? Avoid what two rich foods and why?

-How should you take this drug? Full or empty?

-Report and monitor for any signs of what and list the four signs?

-Report signs of ____-pathy and 4 s&s?

-Pt and family (6)

-For active TB what kind of therapy would you do? Improvement of TB symptoms usually take up to how many months?

Back 5

-ANTITUBERCULAR DRUG
-INDICATIONS: ACTIVE OR LATENT TB

-MECH: SOME MAO INHIBITOR ACTIVITY

-ADVERSE: PEIPHERAL NEUROPATHY
-BLACK BOX WARNING: HEPATOTOXICITY

-CONTRAINIDCATIONS: HEPATIC DS

-ALCOHOL: INC RISK OF HEPATOTOXICITY
-TYRAMINE RICH ROODS: HTN CRISIS

-ASSESS FOR HEPATIC DS. BASELINE LFT.

-LONG THERAPY UP TO 24 MONTHS.

-PT>35 YEARS COULD CAUSE INDUCED HEPATIC DYSFUNCTION

-ASSESS ALCOHOL COMSUMPTION (HEPATOTOXICITY)

-AVOID TYRAMINE-RICH FOODS (HTN) AND HISTAMINE-RICH FOODS (HA, PALPITATIONS, DIARRHEA)

-ADMINISTER INH ON AN EMPTY STOMACH

-REPORT ANY SYMPTOMS OF "HEPATITIS- ANOREXIA, FATIGUE, JAUNDICE, NAUSEA"

-REPORT SIGNS OF NEUROPATHY (BURNING OR PAIN IN EXTREMITIES, NUMBNESS AND TINGLING)

-PT AND FAMILY
1. TAKE THE DRUG ON AN EMPTY STOMACH
2. AVOID ALCOHOL
3. AVOID THRYAMINE AND HISTAMINE RICH FOODS
4. REPORT SIGNS OF HEPATITIS
5. REPORT SIGNS OF NEUROPATHY
6. IMPORTANCE OF COMPLETING THERAPY DESPITE ABSENCE OF SYMPTOMS

-FOR ACTIVE TB, DIRECT OBS THERAPY IS DONE TO ENSURE COMPLIANCE.
-IMPROVEMENT OF TB SYMPTOMS USUALLY TAKE 3-6 MONTHS.

Front 6

*rifampin (Rifadin)

-type
-indications-tx of (2)
-adverse (3)
-contraindications (1)

-What intake causes a inc risk for hepatotoxicity?

-Rifadin causes a dec efficacy of what?

-assess for what dysfunction? baseline what lab?

-Assess what consumption of and why?
-Discolors what and use the alternative form?

-Oral formulation should be given how?

-Pt and family (5)

Back 6

-antimycobacterial

-INDICATIONS: TX OF TB AND LEPROSY

-ADVERSE: HEPATOTOXICITY, DISCOLORS BODILY FLUIDS (URINE, SALIVA, TEARS) AND DISCOLORS SOFT CONTACT LENSES

-CONTRAINDICATIONS: HEPATIC DYSFUNCTION

-ALCOHOL: INC RISK OF HEPATOTOXICITY
-ORAL CONTRACEPTICES: DEC EFFICACY OF CONTRACEPTICES

-ASSESS FOR HEPATIC DYSFUNCTION (HEPATOTOXICITY).
-BASELINE LFT

-ASSESS ALCOHOL CONSUMPTION (HEPATOTOXICITY) AND

-DISCOLORS CONTACTS (USE ALTERNATE FORM OF LENSES OR GLASSES)

-ORAL FORMULATION SHOULD BE GIVEN ON AN EMPTY STOMACH

-PT AND FAMILY
1. DISCOLORS BODILY FLUIDS
2. DISCOLORS CONTACTS
3. ALTERNATIVE METHOD OF BIRTH CONTROL DURING THERAPY
4. IMPORTANCE OF COMPLETING THERAPY DESPITE ABSENCE OF SYMPTOMS
5. REPORT SIGNS OF HEPATOTOXICITY

Front 7

*amphotericin B (Fungizone)

-Indications (2)

-Adverse: 6

-Amphotericin B has an extensive adverse effect and sometime known as what?

-Contraindications (3)

-assess (3)

-baseline (2) lab tests

-What group is at higher risk for nephrotoxicity?

-assess what intake and why? monitor what and why?

-ensure patient is what?

-Pt and family (3)

-monitor (3) things throughout therapy

Back 7

-POLYENE ANTIFUNGAL

-INDICATIONS: TREAT SEVERE SYSTEMIC FUNGAL OR PROTOZOAL INFECTIONS

-ADVERSE: NEPHROTOXICITY, HYPOKALEMIA, HYPOMAGNESEMIA, HYPOCHLOREMIA, HYPOCALCEMIA, AND ANEMIA

-AMPHOTERICIN B IS KNOWN AS "AMPHOTERRIBLE"

-CONTRAINDICATIONS: RENAL DS, ANEMIA, ELEC. IMBALANCE

-ASSESS RENAL DS, ELEC IMBALANCE, AND ANEMIA

-BASELINE CBC, LFT

-ELDERLY-HIGHER RISK FOR NEPHROTOXICITY. ASSESS FLUID INTAKE (DEHYDRATION CAUSES A INC RISK FOR NEPHROTOXICITY)

-MONITOR I&O (NEPHROTOXICITY)

-ENSURE PT IS WELL HYDRATED

-PT AND FAMILY
1. INFUSION SITE RXNS
2. ACCURATE I&O RECORD
3. FREQUENT BLOOD TESTS

-MONITOR I&O, CBC, AND LFT

Front 8

*nystatin (Mycostatin)

-Indication (1)
-What do you do w/ oral suspension?

-Why is it not used to treat systemic infections?

-Some oral preparations contain what and caution in what ds?

-do not ___ or ____ lozenges

Back 8

-indications: TX FUNAL INFECTIONS (OROPHARYNGEAL CANDIDIASIS)

-ROUTE: ORAL SUSPENSION (SWISH AND SWALLOW)

-NOT USED TO TX SYSTEMIC INFECTIONS (POORLY ABS IN GI TRACT)

-SOME ORAL PREPARATIONS CONTAIN SUCROSE (CAUTION IN DIABETES)

-D/N CHEW OR SWALLOW LOZENGES

Front 9

*fluconazole (Diflucan)
-type
-indications- tx of two things in what type of pt?

-adverse- pain of what and elevates what levels?

-contraindications (2 ds)

-dec effect of what contraceptives?

-assess for (2 ds)
-baseline 2 lab tests

-assess what intake and why?

-How do you take this drug and why?

-pt and family (4)

Back 9

-AZOLE ANTIFUNGAL

-INDICATIONS: TX OF CANDIDIASIS AND PROPHYLAXIS IN IMMUNOCOMPROMISED PT

-ADVERSE: ABD PAIN AND ELEVATES LIVER ENZYME LEVELS

-CONTRAINIDCATIONS: RENAL AND HEPATIC DS

-ORAL CONTRACEPTICS: DEC ORAL CONTRACEPTIVE EFFICACY

-ASSESS FOR RENAL AND HEPATIC DS
-BASELINE RENAL AND LFT

-ASSESS ALCOHOL INTAKE (HEPATOTOXICITY)

-TAKE W/ FOOD (GI DISTRESS)

-PT AND FAMILY
1. ALLERGIES
2. IMPORTANCE OF COMPLETING THERAPY
3. ALTERNATIVE METHOD OF BIRTH CONTROL DURING THERAPY
4. SECONDARY BACTERIAL INFECTION

Front 10

*acyclovir (Zovirax)
-type

-Indication (1)

-Mech?

-adverse (2)

-contraindications (2)

-assess for what ds and disorder?

-baseline what test?

-causes renal dysfunction what group?

-mode of transmission?

-administer acyclovir how? how do you administer IV?
-ENSURE ADEQUATE WHAT B/C OF WHAT TOXICITY?

-monitor what?

-pt and family (6)

Back 10

-ANTIVIRAL

-INDICATIONS: TX OF HERPES VIRUS

-MECH: UNDERGOES PHOPHORYLATION BY THE VIRAL ENZYME THYMIDINE KINASE. ONCE INCORPORATED IN TO TEH VIRUS, IT TERMINATES DNA SYNTHESIS.

-ADVERSE: SEIZURES, NEPHROTOXICITY

-CONTRAINIDCATIONS: SEIZURE DISORDERS AND RENAL DS

-ASSESS RENAL DS AND SEIZURE DISORDERS

-BASELINE RENAL FUNCTION TEST

-ELDERLY-RENAL DYSFUNCTION

-CAN TRANSMIT HERPES TO OTHERS

-ADMINISTER ACYCLOVIR W/ A FULL GLASS OF WATER, W/ OR W/O FOOD. ADMINISTER IV ACYCLOVIR
OVER 60 MINS.

-ENSURE ADEQUATE HYDRATION (NEPHROTOXICITY)

-MONITOR I&O

-PT AND FAMILY
1. ALLERGIES
2. IMPORTANCE OF COMPLETING THERAPY EVEN IF LESIONS RESOLVE
3. ACYCLOVIR DOES NOT PREVENT THE TRANSMISSION OF INFECTION TO ANOTHER PERSON AND D/N CURE THE INFECTION
4. ENSURE GOOD HYDRATION
5. SECONDARY BACTERIAL INFECTION
6. WEAR GLOVES WHEN APPLYING TOPICAL ACYCLOVIR THEN WASH HANDS