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52 Cards in this Set
- Front
- Back
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what is the mechanism of action for acyclovir?
-works by ____ |
works by DNA polymerase inhibitors which supressess synthesis of viral DNA
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what is the mechanism of action for Valacyclovir
works through _____ |
works through active metabolism in the liver and converts to acyclovir which inhibits viral replication
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what is the primary choice for the treatment of herpes simplex and varicella zoster?
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Acyclovir
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when is Acyclovir used?
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to treat herpes simplex 2
-genitals -oralpharynx/face AND varicella zoster -chicken pox -shingles |
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when is Valacyclovir used?
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herpes zoster
herpes simplex genitalis herpes simplex labialis (oral lesions/cold sores) |
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Can Acyclovir & Valacyclovir be used prophylacticly?
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yes you can use them to try and prevent outbreaks
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Acyclovir & Valacyclovir - what is the best one for compliance?
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Valacyclovir because it neeeds to be taken less often. When it is metabolized there is more available than there would be acyclovir which makes it a stronger drug
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Hepatitis B and C
-what Hepatitis can a person be immunized for? What is it for infants? What is it for adults? |
B
For infants it is 1st done given b4 they leave the hospital 2nd dose is given 4 weeks after the 1st dose 3rd dose is 8 weeks after the 2nd dose ADULTS -1st dose -2nd dose is 1 month later -3rd dose is 6 months after the first dose |
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Interferon: how does this drug work in the treatment of Hepatitis C?
what is it classified as? --------------------------------------- the best treatment for Hep C is Ribavirin and Interferon together to help suppress. -Tell me about Ribairin |
helps supresses the replication of the virus. it's not a cure but it will preserve function.
--it is classified in the alpha class and blocks viral entry into the liver cell -------------------------------------------------------------------------------------- is an oral medication that decreases inflammation but doesn't stop replication so you need another medication.. |
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TB
what drugs are used in the induction phase? what drugs are used in the continuation phase? |
TB
-isoniazid rifampin pyrazinamide ethambutol continuation -isonizid rifampin |
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Who might be at risk for exposure to TB? (what kind of patients)
what kind of professional people? |
HIV patient
IV drug uses Diabetics chronic renal disease leukemia immunosuppresion by drugs people who had GI bypass surgery recently people who work in hospitals, clinics, nursing homes and prisons |
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Typically how long does treatment for TB last?
-tell me about the induction phase: -active or dormat? -what are they tryign to eliminate? tell me about continuation -active or dormat? -what are they trying to eliminate? |
induction phase- 2 months
-active -eliminate tubercle bacilli continuation phase- 4 months -dormat (stilll shows up in lungs) -eliminate intracellular persisters |
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what is a big concern with the drug Isoniazid?
--what must the nurse do? |
hepatotoxicity
liver function tests because of the active metabolites that cause hepatotoxicity |
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what monitoring is done for long term usage of Isoniazid medications? (6)
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affects the CNS --toxicity ---seizures
-CBC- look for anemia -Liver function tests -Peripheral neuropathy -Optic neuritis -Signs and symptoms of liver inflammation (anorexia, fatigue, nausea, skin color changes, RUQ pain) |
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Rifampin- when is this given?
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TB (induction and constinuation phase)
Leprosy Haemophilus influenzae Legionella Neisseria meningitidis |
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Rifampin- what patient education needs to be included? (3)
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the nurse must education the patient about the side effects of fluid alterations which can turn urine, salivra, tears, vaginal secretions red/brown color. (it will last 14-16 hours after the last pill was taken)
contacts will become stained by aqueous humor of the eye hepatotoxicity- alocholics and patients with liver disease are predisposed |
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Rifampin
-what drug interactions occur (4) |
interacts with oral contraceptives and decreases its effectiveness.
interacts with warfarin and inhibits proper metabolism of high levels of circulating blood which increases the potential for bleeding to occur interactions with drugs for HIV infections and the viral load increases any drug that uses P450 to breakdown it down is increased which causes rapid metabolism of those drugs |
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Rifampin
-what is the risk of taking this drug with warfarin? |
inhbits proper metbaolism of high levels of blood and increases the potential for bleeding to occur
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Metronidazole (Flagyl)
what type of organism is this antibitotic used to treat? |
treats:
anaerobic infections protozoal infections CNS infections, bone/joint infections abdominal organ infections vaginal infections cap vab |
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Metronidazole (Flagyl)
Common side effects to monitor the patient on? (4) what must you educate the patient on? (1) |
N&V
diarrhea abdominal cramping kidney problems and improper K+ levels must education the patient that they will have antabuse like reactions if taken with alcohol (projectile vomitting) |
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Metronidazole (Flagyl)
pregnancy category? when should it not be taken? |
B
during the 1st trimester |
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What does the term mycoses mean?
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fungus
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Amphotericin B
ADVERSE EFFECTS -what causes the reaction in the patient when this is administered IV? when are the S&S? when does this occur? |
(anti-fungal)
the release of cytokines from monocytes and macrophages (Shake and Bake) fever, chills, nausea, H/A, and muscle tightening 1-3 hours after infusion started |
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Amphotericin B
what is the patient premedicated with before the infusion is started |
bendaryl and tylenol
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Amphotericin B
why is the patient hydrated during the infusion of this drug? -what's a concern? -what should the nurse monitor? |
nephrotoxicity
beacuse the drug can kill the nephrons in the kidneys (it's toxic) so the patient is given 1000cc of normal saline to flush the kidneys potassium (hypokalemia can be a problem) and serum creatinine |
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what is the education that needs to be given to the patient who is taking Ketoconazole in order to for it to be ffective on a superficial skin infection?
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when given PO, the patient needs to work up a good sweat, let it dry on the skin for it to be effective because the bacteria is on the skin, not in the body
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Fluconazole -what type of infection does this treat?
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vaginal candidiasis and oropharyngeal, esophageal and system infections
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what is the drug clotrimazole prescribed for?
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superficial mycoses (it's topical)
ringworm tinea pedis -on foot tinea corporis -abdomen tinea cruris - groin, crotch tinea capitis - head |
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clotrimazole
how does this drug affect warfarin? |
increases anti-coagulation which can increase bleeding
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what is the #1 nursing responsibility with pain medication administration?
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patient safety
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Mu receptors
-what do they cause when stimulated |
-constipation
-analgesic - relieves pain -respiratory depression - naturally slows down RR. -euphoria- state of well being that comes from the endorphin transmitter being stimulated -sedation- relaxes muscles which helps reduce pain |
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Kappa receptors
-what do they cause when stimulated |
sedation
analgesia dysphoria diuresis - increased urination (no respiratory depression or euphoria) |
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Dilaudid is __times more potent that morphine sulfate
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8
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Fentanyl is __ times more potent that morphine sulfate
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100
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how does Morphine, Dilaudid, and Fentanyl affect a patient's respiratory status and blood pressure?
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cause respiratory depression and hypotension
respiratory depression can start within 7 minutes of morphine and their RR is less than 12. -Their hypotensive B/P systolic is less than 90. Sa02- less than 94% |
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how does the nurse administer these drugs safely (IV push?)
morphine dilaudid |
longer then 1 minute = morphine
(usually slowly over 4-5 minutes) -4-10mg dilaudid/hydromorphone = 1-4mg every 4-6 hours (onset of action is 15 minutes) |
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what assessment and reassessment pieces does the nurse need to perform with IV push nacrotic meds?
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-follow the 5 rights
-check pt allergies -check vital signs b4 and after -check when last dose of pain medication was given -reassesss patient within 30 minutes |
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contraindications and morphine
people taking what 2 pills people with what 4 problems |
patients taking anti-depressants or MAO inhibitors, hypotensive drugs
people with gallbladder disease head injury- increase ICP from respiratory depression) labor- can cause fetal resp. depression GI- used catiously in patients with ulcerative colitis |
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Depodur- what is the route of administration for this drug?
what is it? what is it given for? |
epidural injection only, NEVR IV
its a suspension of fat soluble particles containing morphine (highy lipophilic) can be given before surgery or after clamping the umbilical cord during c-section delivery |
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Narcan
-what is the generic name? |
Naloxone
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Narcan
-what is it used for? |
block opioid actions so it can reverse most effects of the opiod agonists, including respiratory depression, coma, and analgesia
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Narcan
-how is it administered? -IVpush dose? |
IV
IM SubQ Iv push- 0.4mg |
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Oral narcotic administration
-under the half life affects |
significantly inactivated by the 1st pass metabolism in the liver.
that means that the dosage needs to be increased to equal the effects of IV, IM and SubQ |
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Vicodin
-what is it made up of? |
hydrocodone and hydrocodone contains acetaminophen
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Percocet
-what is it made up of |
oxydodone and acetaminophen (5/325)
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Percodan
-what is it made up of |
oxycodone and aspirin (4.5/325)
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Oxycontin SR
-what is it made up of? |
oxycodone (never crush SR)
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ozole means
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antifungal
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tinea means
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fungal
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three nursing goals of patient medication?
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1. patient safety
2. advocating for the patients needs 3. education the patient about their medication |
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what is the #1 drug administered IV?
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morphine
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Depodur has high lipid particles which makes it very _____
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potent
EPIDURAL |
