Pharm Study Guide Exam 2

Front 1

What is empiric therapy?

Back 1

When someone has a good idea of what bacteria is and the treat it before the culture comes back.

Front 2

What is Angioedema ?

Back 2

Angioedema is a swelling, similar to hives. It is an allergic response.

Front 3

What is urticaria?

Back 3

It is another hives like rash and a common allergic reaction.

Front 4

What are common adverse effects with antibiotics?

Back 4

Allergic reactions such as rashes.
N/V/D.

Front 5

What is selective toxicity?

Back 5

ability for drug to attack invading orgaanism without harming host.

Front 6

• Difference in spectrum of activity of generations of cephalosporins?

Back 6

Classified by “generations”: later generations are more active against gram-neg and more able to distribute into cerebrospinal fluid

Front 7

Adverse effects of vancomycin?

Back 7

Can cause ototoxicity and nephrotoxicity
Anaphylactoid reaction
“red neck” or “red man” syndrome due to histamine release
Phlebitis at IV site
Highly toxic; reserved for serious infections

Front 8

Important patient teaching with cipro?

Back 8

Contraindicated in pregnant or breastfeeding women and children <18

Tendon rupture (e.g., Achilles): Let HCP know first sighn of tendon pain.

Arthropathy, esp in children <18

Front 9

What is a superinfection?

Back 9

infection following a previous infection, especially when caused by microorganisms that are resistant or have become resistant to the antibiotics used earlier.

Front 10

Cipro: drug type, pharmicodynamics, implications, resistant strains,

Back 10

Its a Fluoroquinolones
Inhibits bacterial DNA synthesis: bacterialcidal

Uses: UTI; respiratory, bone, or joint infections; severe skin infections; STDs; diarrhea, anthrax prevention, typhoid fever

Resistance has developed in strains of Pseudomonas, S. aureus, and Pneumococcus

Front 11

Nursing ImplicationsCipro?

Back 11

Full pt. history
Pregnancy status
Take until GONE!
Report tendon pain STAT
Small frequent meals

Front 12

Drugs for UTIs?

Back 12

Sulfonamides
Quinolones/Fluoroquinolones
SMZ-TMP

Front 13

Basic antimicrobil drug administration info?

Back 13

Use antibiotics only when necessary
Use proper dose and duration of antibiotic therapy
Use narrow-spectrum antibiotics
Do not use newer drugs unless necessary

Front 14

Latent TB skin test interpratation?

Back 14

Interpretation:
High risk: >5mm
Moderate: >10mm
Low risk: >15mm

Front 15

Differnce in treating latent and active TB?

Back 15

Active: Minimum of 6 months, as long as 24 months
Directly Observed Therapy
Always use 2 or more drugs.

Latent:Minimum of 6 months, preferably 9 months
Short-course therapy of rifampin + pyrazinamide
Short-course therapy with rifampin alone

Front 16

What is the difference in dx latent and active TB?

Back 16

Active:Chest x-ray and microbiologic evaluation of sputum
Latent: TB skin test

Front 17

What is Isoniazid (INH) used for?

Back 17

drug of choice for all M. tuberculosis-sensitive strains, either active or latent

Front 18

What are adverses effectsw of INH?

Back 18

Hepatotoxicity
CNS effects: optic neuritis, seizures, dizziness, ataxia, psychologic disturbances, anemia, GI distress

Front 19

What four drugs are used for TB

Back 19

Ionizid (INH)
Rifampin
Pyrazinamide
Ethambutol

Front 20

What are all TB trugs toxic to?

Back 20

Hepatotoxicity

Front 21

What is the most serious adverse effects of opioids?

Back 21

Respiratory depression
and cough suppression in people who need to cough such as post op.

Front 22

What is the pharmkodynamics of Imitrex?"

Back 22

it binds to 5ht and causes vasoconstriction to cranial vessels.

Front 23

What are the adverese effects, contraindications, and suffix of triptans(IMITREX)

Back 23

suffix- iptan
chest sx, dizziness, weakness, warm/hot sensations
Contraindicated for patients with risk for heart disease, basilar or hemiplegic migraine, or uncontrolled HTN

Front 24

What are guidlines for abortive thearpy of migrane headaches and drugs for them?

Back 24

Do not take more then two per week to avoid rebound headaches.
Triptans, erogamines, opioids.

Front 25

What are indications and contraidications for prophalactic medications for migranes?

Back 25

Two or more attacks per month that cause 3 or more days of disability
Contraindication to, or failure of, abortive treatments
Abortive treatment needed more than twice per week
Presence of uncommon migraine conditions

Front 26

What are some overall guidlines for migrane treatment?

Back 26

NSAIDs are first-line therapy for most migraine sufferers
If no response, use migraine-specific agents (triptans or DHE)
Use a non-oral route for persons with N/V accompanying migraine. Also use an antiemetic.
Evaluate patient for preventive therapy

Front 27

What are drugs used in preventive thearpy for migranes?

Back 27

Beta Blockers
Antidepressants
Anticonvulsants
NSAIDs
Serotonergic agents
Calcium channel blockers

Front 28

What are the guidlines for giving pain meds?

Back 28

1. Simplest dosage schedule and least invasive modality first
2. Use analgesic ladder for drug selection
3. Monitor for side effects and treat prophylactically

Front 29

What is the diffence in inhibiting cox enzymes?

Back 29

Inhibition of COX-1  gastric erosion/ulceration, bleeding tendencies, ARF,  platelet aggregation
Inhibition of COX-2  pain relief,  fever, and  inflammation

Front 30

What are nonselective cox inhibitors?

Back 30

First generation NSAIDs

Front 31

What is a selective cox 2 inhibtror?

Back 31

celebrex is the only one.
Long term use of cox 2 inhibtors caused CV events.

Front 32

What does COMT do?

Back 32

COMT, which breaks down dopamine in the periphery of the body

Front 33

what are two comt inhibitors?

Back 33

Entacapone (COMTAN): must be given with carbidopa-levodopa
Tolcapone (TASMAR):

Front 34

What is the aim in treating parkinsons?

Back 34

Aim is to restore dopamine levels or dopamine activity in the brain by using:
Dopamine precursors
Dopamine agonists
MAO inhibitors
Anticholinergics

Front 35

What does levod dopa do?

Back 35

crosses bbb and turns into dopamine
takes months to work
stoping abrutly can cause neuroleptic malignant syndrome (NMS)

Front 36

What does carbidopa-levodopa do?

Back 36

Carbidopa does not cross BBB
Peripheral s/e are reduced
Similar contraindications to levodopa
Limits the “on-off” phenomena

Front 37

What is the goal for treating siezure disorders?

Back 37

Goal is to control or prevent seizures and maintain a reasonable quality of life
Suppress excessive electrical discharge from abnormally functioning neurons in the CNS

Front 38

What type of drug is Dilantin?

Back 38

AED: Suppress Sodium Influx
Delays influx of Na ions across neuron membranes

Front 39

What are the adverse effects of Dilantin?

Back 39

  
CNS effects: therapeutic levels (10-20 g/ml)– mild sedation and CNS effects
At plasma levels above 20 g/ml – toxic effects – nystagmus, ataxia, diplopia, cognitive impairment
GINGIVAL HYPERPLASMI
 SKIN RASH
 Use in Pregnancy (Category D)
Injury due to extravasation of IV phenytoin

Front 40

What are nursing implications of Dilantin?

Back 40

1. Take with meals to avoid GI upset
2. Shake oral suspension before dosing
3. IV – infuse slowly, no faster than 50µg/ml
4. Flush IV site with saline after infusion
5. Teach oral hygiene
6.Warn about ETOH and other CNS depressant drugs
7. Decreases effects of coumadin & OCP’s – need to increase dose of these meds

Front 41

Children and pregos with the use of AEDs?

Back 41

most AEDs are prego Ds
and not to be used in children under the age of 18 or 16

Front 42

What are Benzodiazepines?

Back 42

Clonazepam (Klonopin)
Lorazepam (Ativan)
Diazepam (Valium)
One of the most widely prescribed classification of drugs

Front 43

What is the pharmicodynamics of benzodiazepines?

Back 43

Bind to GABA receptor-chloride channel molecule.
Intensify effect of GABA

They treat anxiety and sleep dizorders

Front 44

What are adverse effects of benzodiazpines?

Back 44

loss of coordination
drowsiness,

Front 45

What does TCA, SSRI, and MAOI stand for?

Back 45

Tricyclic antidepressants (TCAs)
Selective serotonin reuptake inhibitors (SSRIs)
Monoamine oxidase inhibitors (MAOIs)

Front 46

What are two important TCA's?

Back 46

Amitriptyline (ELAVIL)
Imipramine (TOFRANIL)

Front 47

What do TCAs do?

Back 47

inhibit re-uptake of 5ht.

Front 48

What to know about TCA and overdose?

Back 48

Overdose with TCA’s is life-threatening: heart block, dysrhythmias, tachycardia, hypotension, seizures, coma
Rx of overdose: activated charcoal, Na bicarb, gastric lavage, antiseizure drugs
Watch for cardiac problems for up to 5 days

Front 49

What nursing implications are there for TCAa?

Back 49

Monitor patient’s condition
Patient drug education
Contraindications
Precautions
Pregnancy category C or D

Front 50

What do penicillins destroy on bacteria?

Back 50

cell walls

Front 51

What do penicillins do to aminoglycosides"

Back 51

inactivates them