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50 Cards in this Set
- Front
- Back
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What is Tuberculosis (TB)?
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Mycobacterium tuberculosis
Invected by person to person with inhaled aerosol Screening with skin test or blood test Secondary testing with cytology and/or chest xray |
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Treatment of TB
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Induction phase: ~2 months
Daily Therapy with RIPE (Rifampin, Isoniazid, Pyrazinamide, Ethambutol) Continuation Phase: ~4 months Daily or biweekly therapy with Isoniazid and Rifampin |
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Phases of TB
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Induction Phase: Active Replication - Eliminate active tubercle bacilli
Continuation Phase: Dormant - Eliminate intracellular "persisters" |
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ISONIAZID
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Main drug of choice for TB
Bactericidal Adverse Effects: Peripheral Neuropathy, Hepatotoxicity, Optic Neuritis, Anemia Drug Interactions: Dilantin, Alcohol, Rifampin, and Pyrazinamide |
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RIFAMPIN
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Broad spectrum antibiotic
Adverse Effects: Hepatotoxicity, and Fluid Alterations (turns red/brown color) Drug Interactions: BCP, Warfarin, HIV medications |
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ETHAMBUTOL
(Myambutol) |
Used for TB only
Bacteriostatic Adverse Effects: Optic Neuritis, Allergy, Hyperuricemia (will cause Gout to get worse) |
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Mycobacterium avium Complex
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Often confused with TB
Use Azithromycin (preferred) and Clarithromycin as prophylaxis |
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Patients at risk for TB
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Diabetic
HIV patients Chronic renal disease Leukemia Immunosuppressed Undergone GI bypass surgery |
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METRONIDAZOLE (Flagyl)
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Mech of Action: Reacts with DNA of bacteria and converts to active form Flagyl
Bactericidal (to anaerobic bacteria) Uses: Anaerobic, Protozoal, CNS, Bone/joint, Abdominal organ, and vaginal infections Adverse Effects: N/V, diarrhea - monitor kidney function, K+ levels, alcohol intake, teratogenic effects (Cat. B) Drug interactions: Warfarin |
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AMPHOTERICIN B
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*Administation Precautions*
- Needs inline filter - Each infusion can take 6-8 hours - Treatment can be as long as 6-8 weeks - Watch IV site for extravasation Adverse Effects: Infusion Reaction (Shake & Bake): High fever, chills, muscle tightening, nausea, headache - Nephrotoxicity |
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KETOCONAZOLE (Nizoral)
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Broad spectrum antifungal
Fungistatic at low concentration Fungicidal at high concentration Used as alternative to Amphotericin B for superfical infections (PO, topical, shampoo) *When given PO, must sweat out antibiotic and allow to dry on skin to be effective |
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ACYCLOVIR (Zovirax)
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Inhibits Viral Replication (cannot kill)
Uses: Herpes Simplex I & II and Varicella-Zoster Adverse Effects: Mild GI upset |
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VALACYCLOVIR (Valtrex)
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Inhibits Viral Replication (cannot kill)
Pro-drug of Acyclovir Uses: Herpes Simplex I & II and Varicella-Zoster - not recomm. for HIV patients |
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GANCICLOVIR (Cytovene, Vitrasert)
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Synthetic antiviral agent
Teratogenic Uses: Herpes Simplex, CMV, and Epstein-Barr virus (most common) Adverse Effects: Granulocytopenia (monitor CBC), Thrombocytopenia |
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Types of Histamine and Effects
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H1: Vasodilation - skin (allergic reaction)
- Increased permeability (swelling) - Causes bronchial constriction - Causes itching and pain at nerve endings H2: Promotes gastric acid secretion (acid reflux disease) |
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1st generation
Antihistamine |
Promethazine (Phenargen)
Diphenhydramine (Benadryl) - OTC Chlorpheniramine (Chlor-Trimetron) - OTC Causes CNS depression (drowsiness, sedation), dry mouth (anticholinergic effect) |
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2nd generation
Antihistamine |
Only PO, dissolvable tabs, or nasal spray
Cetirizine (Zyrtec) - OTC Loratadine (Claritin) - OTC Fexofenadine (Allergra) Does not cross blood-brain barrier - should not cause sedation |
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HYDROXYZINE HYDROCHLORIDE (Atarax)
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PO tablet only
Action: CNS depression and primary muscle relaxation Symptomatic relief from anxiety, tension associated, psychoneurosis, uticaria **Extremely sedating |
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HYDROXYZINE PAMOATE (Vistaril)
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IM component of Atarax
Used as sedative when used as pre-medication and following anesthesia**used to dry up nasal passages |
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What is ANALGESIC?
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Medicine that helps relieve pain
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What is Neuropathic Pain?
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Nerve pain
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What is Opioid antagonist?
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Blocking opioid receptor
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Top three nursing roles and responsibilities
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#1 Patient Safety
#2 Advocating for the patients needs #3 Educating the patient about their medication |
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What is an Opioid?
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The base of narcotics
Properties of drugs similar to naturally occuring Morphine within CNS and peripheral tissue |
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Opioid Receptor
MU |
When stimulated (activated):
- acts as an Analgesic - causes respiratory depression**(this can be dangerous-death) - causes euphoria - causes constipation - causes sedation |
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Opioid Receptor
Kappa |
When stimulated (activated):
- acts as an Analgesic - causes diuresis - causes dysphoria - causes sedation |
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Uses for Opioids
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Pure Opioid Agonists: activates MU and Kappa
Opioid Agonist-Antagonist: have both MU and Kappa for helping and blocking Opioid Antagonist blocking agents for opioids (MU and Kappa receptors) - Naloxone (Narcan) (IV, IM, SC) - used for overdose |
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MORPHINE SULFATE
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Action: binds to Mu and Kappa receptors enhancing the analgesic effect and euphoria
Adverse Effects: N/V (if pushed too fast), Hypotension, Sedation, Constipation, and Respiratory Depression (can start in 7 min) Contraindicated: Gallbladder: causes spasm at sphincter of Oddi Head Injury: can cause ICP secondary to resp. depression Labor: can cause fetal resp. depression GI: caution with ulcerative colitis |
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MORPHINE SULFATE LIPOSOMAL PF-INJECTION
(Depodur) |
Epidural Only
-suspension of fat-soluble particles containing morphine |
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MEPERIDINE (Demerol)
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Action: Binds MU and Kappa receptors, CNS depression, and short acting with half life 3-4 hrs
Adverse Effects: Toxicity secondary to contained active metabolites (dysphoria, tremors) |
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METHADONE
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Action: Depresses impulse, long acting, binds to opioid receptors
Used to treat opioid addictions |
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FENTANYL
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IV, transdermal, and transmucosal
100X more potent than Morphine Sulfate Same adverse effects as Morphine |
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HYDROMORPHONE (Dilaudid)
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8X more potent than Morphine Sulfate
Used to treat severe pain - biliary colic, burns, cancer, heart attack, soft tissue or bone injury, surgery, and renal colic (drug of choice) |
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HYDROCODONE (Vicodin, Lortab, Norco)
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Used to treat moderate to severe pain
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CODEINE
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Used to treat moderate pain
Sch. III drug Usually combined with aspirin, tylenol, or NSAID |
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OXYCODONE
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synthetic morphine
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Cancer Pain Management
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A: Ask and assess
B: Believe C: Choose appropriate control measures D: Deliver interventions in a timely manner E: Empower and Enable patients to control their treatment |
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Migraine Headaches
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Symptoms: unilateral pain with photophobia, visual changes, and N/V
Treatment: prevent and relieve symptoms |
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Treatment of Migraines
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Medications:
- Anti-inflammatories: PO, Acetaminophen and caffeine, Ibuprofen - Narcotics: prevent giving (only acts as a band-aid) - Ergots: block inflamm. associated with the trigeminal vascular system (has adverse effects) - Selective Serotonin agonists (Triptans): enhances the receptor action (serious adverse effects) |
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Cluster Headaches
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Throbbing pain usu. over one eye, nasal congestion, and may occur 1-2x daily
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Treatment of Cluster Headaches
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Oxygen
Anti-inflammatories Prednisone Selective Serotonin agonists Ergots |
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Tension Headaches
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Band type feeling around the head, tight feeling, pressure 'inside' feeling
- Look at precipitating factors: stress, fatigue, depression, insomnia, prolonged position, ergonomics of work area, computer work, vision problems |
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Treatment of Tension headaches
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Prevention
Anti-inflammatories Antianxiolytics Antidepressants |
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Complementary Treatment for Rheumatoid Arthritis and Gout
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Exercise
Physical Therapy Acupuncture Surgery |
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What are DMARDS?
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Disease-modifying antirheumatic drugs
- reduce/decrease joint destruction - retard disease progression |
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METHOTREXATE (Rheumatrex)
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PO or IM every week
3-6 weeks for therapeutic effect Watch for hepatic fibrosis and bone marrow suppression with CBC, LFT, and Kidney function |
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HYDROXYCHLOROQUINE (Plaquenil)
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Combined with Methotrexate
- works on inflammatory portion of Rheumatitis, does not slow progression - Irreversible retinopathy can occur |
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CYCLOOXYGENASE INHIBITOR (COX-1/COX-2)
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Inhibits cyclooxygenase to inhibit production of prostaglandins
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COX-1 INHIBITOR
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- Protects gastric mucosa
- Promotes platelet aggregation - Assists renal function **BODY FUNCTION** |
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COX-2 INHIBITOR
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- Mediates inflammation
- Mediates pain - Mediates fever **BODY RESPONSE** usu. stimulated with disease or injury |
