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51 Cards in this Set

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What is empiric therapy?
When someone has a good idea of what bacteria is and the treat it before the culture comes back.
What is Angioedema ?
Angioedema is a swelling, similar to hives. It is an allergic response.
What is urticaria?
It is another hives like rash and a common allergic reaction.
What are common adverse effects with antibiotics?
Allergic reactions such as rashes.
N/V/D.
What is selective toxicity?
ability for drug to attack invading orgaanism without harming host.
• Difference in spectrum of activity of generations of cephalosporins?
Classified by “generations”: later generations are more active against gram-neg and more able to distribute into cerebrospinal fluid
Adverse effects of vancomycin?
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
Important patient teaching with cipro?
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
What is a superinfection?
infection following a previous infection, especially when caused by microorganisms that are resistant or have become resistant to the antibiotics used earlier.
Cipro: drug type, pharmicodynamics, implications, resistant strains,
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
Nursing Implications Cipro?
Full pt. history
Pregnancy status
Take until GONE!
Report tendon pain STAT
Small frequent meals
Drugs for UTIs?
Sulfonamides
Quinolones/Fluoroquinolones
SMZ-TMP
Basic antimicrobil drug administration info?
Use antibiotics only when necessary
Use proper dose and duration of antibiotic therapy
Use narrow-spectrum antibiotics
Do not use newer drugs unless necessary
Latent TB skin test interpratation?
Interpretation:
High risk: >5mm
Moderate: >10mm
Low risk: >15mm
Differnce in treating latent and active TB?
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
What is the difference in dx latent and active TB?
Active:Chest x-ray and microbiologic evaluation of sputum
Latent: TB skin test
What is Isoniazid (INH) used for?
drug of choice for all M. tuberculosis-sensitive strains, either active or latent
What are adverses effectsw of INH?
Hepatotoxicity
CNS effects: optic neuritis, seizures, dizziness, ataxia, psychologic disturbances, anemia, GI distress
What four drugs are used for TB
Ionizid (INH)
Rifampin
Pyrazinamide
Ethambutol
What are all TB trugs toxic to?
Hepatotoxicity
What is the most serious adverse effects of opioids?
Respiratory depression
and cough suppression in people who need to cough such as post op.
What is the pharmkodynamics of Imitrex?"
it binds to 5ht and causes vasoconstriction to cranial vessels.
What are the adverese effects, contraindications, and suffix of triptans(IMITREX)
suffix- iptan
chest sx, dizziness, weakness, warm/hot sensations
Contraindicated for patients with risk for heart disease, basilar or hemiplegic migraine, or uncontrolled HTN
What are guidlines for abortive thearpy of migrane headaches and drugs for them?
Do not take more then two per week to avoid rebound headaches.
Triptans, erogamines, opioids.
What are indications and contraidications for prophalactic medications for migranes?
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
What are some overall guidlines for migrane treatment?
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
What are drugs used in preventive thearpy for migranes?
Beta Blockers
Antidepressants
Anticonvulsants
NSAIDs
Serotonergic agents
Calcium channel blockers
What are the guidlines for giving pain meds?
1. Simplest dosage schedule and least invasive modality first
2. Use analgesic ladder for drug selection
3. Monitor for side effects and treat prophylactically
What is the diffence in inhibiting cox enzymes?
Inhibition of COX-1  gastric erosion/ulceration, bleeding tendencies, ARF,  platelet aggregation
Inhibition of COX-2  pain relief,  fever, and  inflammation
What are nonselective cox inhibitors?
First generation NSAIDs
What is a selective cox 2 inhibtror?
celebrex is the only one.
Long term use of cox 2 inhibtors caused CV events.
What does COMT do?
COMT, which breaks down dopamine in the periphery of the body
what are two comt inhibitors?
Entacapone (COMTAN): must be given with carbidopa-levodopa
Tolcapone (TASMAR):
What is the aim in treating parkinsons?
Aim is to restore dopamine levels or dopamine activity in the brain by using:
Dopamine precursors
Dopamine agonists
MAO inhibitors
Anticholinergics
What does levod dopa do?
crosses bbb and turns into dopamine
takes months to work
stoping abrutly can cause neuroleptic malignant syndrome (NMS)
What does carbidopa-levodopa do?
Carbidopa does not cross BBB
Peripheral s/e are reduced
Similar contraindications to levodopa
Limits the “on-off” phenomena
What is the goal for treating siezure disorders?
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
What type of drug is Dilantin?
AED: Suppress Sodium Influx
Delays influx of Na ions across neuron membranes
What are the adverse effects of Dilantin?
  
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
What are nursing implications of Dilantin?
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
Children and pregos with the use of AEDs?
most AEDs are prego Ds
and not to be used in children under the age of 18 or 16
What are Benzodiazepines?
Clonazepam (Klonopin)
Lorazepam (Ativan)
Diazepam (Valium)
One of the most widely prescribed classification of drugs
What is the pharmicodynamics of benzodiazepines?
Bind to GABA receptor-chloride channel molecule.
Intensify effect of GABA

They treat anxiety and sleep dizorders
What are adverse effects of benzodiazpines?
loss of coordination
drowsiness,
What does TCA, SSRI, and MAOI stand for?
Tricyclic antidepressants (TCAs)
Selective serotonin reuptake inhibitors (SSRIs)
Monoamine oxidase inhibitors (MAOIs)
What are two important TCA's?
Amitriptyline (ELAVIL)
Imipramine (TOFRANIL)
What do TCAs do?
inhibit re-uptake of 5ht.
What to know about TCA and overdose?
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
What nursing implications are there for TCAa?
Monitor patient’s condition
Patient drug education
Contraindications
Precautions
Pregnancy category C or D
What do penicillins destroy on bacteria?
cell walls
What do penicillins do to aminoglycosides"
inactivates them