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209 Cards in this Set

  • Front
  • Back
Describe closed fracture
Simple, no break in skin
Describe open fracture
compound, complicated: trauma to surrounding tissues and break in skin
Define comminuted fractures
produce several breaks in bone, producing splinters and
Describe transverse fractures
break straight across
Describe oblique fractures
break at an angle
Describe greenstick fractures
breaks one side of bone and bends other side
In what situations are spiral fractures most common?
most likely type of fracture in abuse situations
When and for what is Buck’s traction used for?
used preoperatively to reduce muscle spasms
Describe closed reduction (manipulation)
manual realignment of bone fragments, traction & counter traction can be manually applied to restore position, length, & alignment
Describe open reduction
surgical realignment, may use wires, pins, screws,
intramedullary rods, possible complications are infxn & anesthesia complications. Early ROM of joints needed--continuous passive motion (CPM) and early ambulation
What is CPM?
CPM provides continuous passive motion to joints (machine that gently moves
limb in ROM). Prevents intraarticular adhesions, decreased posttraumatic
Why ambulate patients post-surgically?
Ambulate post-surgical pts early to help prevent DVT
Describe skin traction
boots, tape, splints, used until skeletal traction or surgery can be done. Watch for skin breakdown
Describe skeletal traction
aligns bones/joints, tx for contractures and congenital hip dysplasia. Continuous/never interrupted, weights not removed unless traction is prescribed intermittent. pt must be aligned in center of bed, weights must not hang on floor, knots in rope must not touch pulley.
Describe compartment syndrome
compression of structures within close compartment of
upper and lower extremities formed by fascial sheaths or bone. s/s intractable cramping pain, numbness, tingling, decrease or absent pulse, pallor, coolness.
Describe fat embolism s/s
restlessness, confusion, dyspnea, crackles. Respiratory support must be instituted early. Risk greatly increased by fracture or bone surgery.
Legg Calve-Perthes Disease
avascular necrosis (lack of blood flow) of femoral
head, most common in boys 4-8. Insidious onset, limp, ache, sore, stiff. TX, rest, non-weight bearing, braces. self-limiting illness
exaggerated lumbar curve inwards (can also happen in cervical spine (c-spine)
rounded back (outward curve) most common in thoracic and sacral areas
most common spinal deformity, involves three planes, lateral curvature, spinal rotation, and thoracic hypokyphosis.
What is the telltale sign of scoliosis?
Telltale sign is uneven rib cage when bending over
infectious process of bone, most common after a throat infection. S. Aureaus most common organism. s/s severe bone pain, guarding, fever, night sweats, chills, swelling, tenderness, drainage from site. ESR elevated, WBC reveals leukocytes.
How is osteomyelitis treated?
IV antibiotics
low bone mass/bone fragility. estrogen acts against bone loss. Encourage to eat food high in calcium: dairy, salmon, broccoli, rhubarb
degenerative joint disease progressing slowly in articulating joints (esp weight bearing). joint pain, stiffness, decreased ROM
Rheumatoid arthritis
chronic systemic disease characterized by recurrent
inflammation of the joints, frequently accompanied by rheumatoid nodules, neuropathy, pericarditis, lymphadenopathy, splenomegaly. Much more common in women.
How is rheumatoid arthritis treated?
NSAIDS and physical therapy
associated with genetic disorder in purine metabolism. Recurrent attacks of arthritis associated with increased uric acid levels and urate crystal deposits in joints. Secondary gout can result from alcoholism, diabetes mellitus, etc.
S/Sx of Gout
large toe most frequently affected but may occur in other joints. Joints appear cyanotic, very tender, may affect knee, ankle or wrist.
Treatment for gout
Treatments: colchicine, NSAID's, corticosteroids. Push 2-3L water per day, limit foods high in purine (organ meats, anchovies, sardines, shellfish, chocolate), provide bed cradle to keep linens off affected area
Post hip replacement surgery
place supine on unoperative side, *abduction pillow to prevent external rotation*, knees apart at all times, pillow between legs when sleeping, never cross legs when sitting, avoiding bending forward when sitting or to pick things up, use raised toilet seat, do not hop to put on clothes
When should you notify the doctor immediately after hip surgery?
Danger sign is leg shorter and externally rotated—notify MD immediately.
injection of contrast agent into subarachnoid space of spine to detect herniation, tumor, and congenital or degenerative conditions of spine. *Important to push fluids afterwards.*
What is the C-reactive protein test used for?
evaluating severity and course of an inflammatory process such as bacterial infection or rheumatic disease
What does the Rheumatoid factor measure?
Rheumatoid factor measures presence of a macroglobulin type of antibody found in rheumatoid arthritis and other connective tissue diseases
Musculoskeletal injury guidelines
keep affected limb elevated above heart to reduce edema, apply ice to reduce edema and decrease pain
What are the five aspects of a neuro assessment
Focus on LOC, motor function, pupillary function (eye movement), respiratory pattern, vital signs
What are the three items of a Glascow Coma Score?
Eye opening, verbal response, and best motor
response. Best score 15, worst 3
What do you look for in assessing increased ICP?
Look for widening pulse pressure
What are other things to look for in patients with ICP?
Other signs are HA, changes in mental status, pupils nor appropriately responsive (pupil dilated on one side, pinpoint pupils both sides, pupils non-reactive, etc.)
What is the treatment for ICP?
Epidural hematoma
Usually arterial bleed between skull and dura. classic: immediate loss of consciousness followed by lucid period, then deterioration again. Emergency, surgery required.
Subdural hematoma
Usually venous bleed between inner layer of dura matter
and outer layer of arachnoid membrane of meninges. symptoms and interventions directly related to size of hematoma, mortality higher than epidural hematoma.
Intracerebral hematoma
Bleeding directly into brain parenchyma. Focal signs
relative to bleed location. Possible s/s=decreased LOC, contralateral hemiparesis/hemiplegia and ipsilateral dilating pupil. manage as increased ICP.
What drug is often used in spinal injuries?
When using corticosteroids, increased tingling/feeling in
fingers/hands indicates
medication is working
Spinal shock
Temporary loss of reflex activity below level of injury, hypotension and bradycardia
Autonomic Dysreflexia
Massive sympathetic response to stimuli. Medical emergency that occurs in most quadriplegics--results in hypertension, pounding headache, vasodilatation above injury level (facial and truncal flushing), vascular engorgement of head and neck vessels. can result in seizures, stroke, MI, death.
What is the treatment for patients with autonomic dysreflexia?
Keep pt upright position, monitor BP, determine cause, stay w/ pt, tx with apresoline
What are the two classificatons of a Cerebral Vascular Accident (CVA)
ischemic and hemorrhagic
Which type of CVA is most common?
Ischemic most common, results from embolus or thrombotic event--causes infarction and necrosis of involved area. Cerebral edema result and can lead to ICP
Hemorrhagic stroke
Bleeding into intracranial cavity or directly into brain parenchyma. Uncontrolled hypertension can cause this.
Subarachnoid bleed s/s
photophobia, nuchal rigidity (Stiffness of the neck, often associated with meningeal infection), kernig's sign (symptom of meningitis; patient cannot extend the leg at the knee when the thigh is flexed because of stiffness in the hamstrings), brudzinski's sign (lifting of the legs in meningeal irritation when lifting a patient's head).
Kernig's sign
Can't passively extend knee with hip flexed 90 degrees from supine position--leg pain and spasm
Brudzinski's sign
flexion of hips and knees when head and neck passively
flexed onto chest
Broca's area
left side of brain area, affects speech
Right brain damage
left hemiparesis, spatial perceptual deficits, behavior
impulsive, memory deficits, indifference to disability.
Left Brain damage
right hemiparesis, speech/language deficits, behavior slow and cautious, distress/depression related to disability
can't express or understand
Receptive aphasia
(temporal lobe) comprehension deficit
Expressive aphasia
(left frontal lobe) can't express oneself
wrong words, word substitution, grammatical errors
blindness if one half of the field of vision in one or both eyes-- results from stroke/CVA
Idiopathic seizures
Such as epilepsy: no known cause, recurrent and episodic
Acquired seizures
have identifiable cause, may be transient or recurring:
hyperpyrexia, CNS trauma, CVA, tumor, metabolic disturbance, alcohol withdrawal, anaphylaxis
What are the three categories of partial seizures?
1) Simple--no loss of consciousness 2) Complex--aka psychomotor, no loss of consciousness 3) Secondary Generalized Seizure--partial seizure from either simple or complex progressing
into generalized seizure with clonic-tonic activity
Generalized Seizures
loss of consciousness, involve both sides of brain
What are the six categories of generalized seizures?
Tonic-clonic, tonic, clonic, atonic, myoclonic and absence
Tonic-clonic seizure
aka grand-mal, may have aura
Tonic seizure
sustained increase in muscle one, generalized stiffening of all extremities
Clonic seizure
sustained rhythmic contraction and relaxation of skeletal muscles
Atonic seizure
spontaneous loss of pustural control for a few seconds, no loss of consciousness
Myoclonic seizure
involuntary muscle jerks of extremities, usually symmetrical
Absence seizure
aka petit mal, more common in children. brief and frequent staring episodes
What are precautionary measures for seizure patients?
For seizures, place patient in lateral position (on side). Seizure precautions on patient in hospital setting—airway nearby, padded bedrails, no restraints
rapid involuntary oscillatory motion of eyeball
What are the three stages of seizure?
preictal (before, sometimes aura), ictal (during), and
postictal (after—usually disoriented, very tired/hard to rouse)
Todd's Paralysis
weakness of an extremity following focal motor or generalized seizure
Status Epilepticus
no recovery between seizures, can be caused by drug withdrawal or inadequate drug levels
What are the three nursing precaution for status epilepticus patients?
Establish airway, place patient on side, monitor
vitals and O2 blood work
Myasthenia Gravis
Characterized by voluntary muscle weakness and fatigability with activity, affects muscles of face, tongue, neck, throat usually, but can affect any muscle group. may become irreversible (muscle fiber degeneration).
Deficiency of which neurotransmitter is involved with myasthenia gravis?
acetylcholine deficiency involved
How does myasthenia gravis present (4)?
presents with difficluty chewing and swallowing, sleepy mask-like expression, drooping jaw, ptosis
How is myasthenia gravis diagnosed?
Tensilon test--IV injection of edrophonium or neostigmine temporarily improves muscle function
How is myasthenia gravis treated?
Treated with anticholinesterase drugs, neostigmine and pyridostigmiine. Drugs less effective as disease progresses; Steroids sometimes help
Myasthenic crisis
Life threatening, caused by insufficient meds.
Cholinergic crisis
Life threatening, caused by too much meds. Reversed with atropine.
What differentiates a myasthenic crisis from a cholinergic crisis?
Tensilon differentiates: if improves, crisis is myasthenic.
Huntington's chorea
Hereditary, chorea (dance like movements, rapid, often violent and purposeless), progressive mental deterioration ending in dementia. late stages, pt emaciated and exhausted
Guillian-Barre syndrome
Acute widespread inflammation or demyelination of ascending nerves in peripheral system, cause unknown. Onset usually within a few weeks of mild viral infection, surgical procedure, or vaccination. Self-limiting illness.
Multiple Sclerosis
Chronic, progressive dymelination of nerve fibers in brain. peripheral nervous system not affected. Remissions and exacerbations
bacterial or viral inflammation of arachnoid and pia layers of meninges, bacterial most severe. presents with fever, HA, confusion, lethargy, mild to combative behavior, seizures, petechial rash, kernig's, nuchal rigidity and
brudzinski's signs. Isolation for first 24 hours.
Parkinson's disease
Progressive muscle rigidity, akinesia (loss of muscle
movements), involuntary tremors, deteriorates for about 10 years, then dies of aspiration or infxn, cause unknown. Disease of extrapyramidal system (responsible for influencing initiation, modulation and completion of movement).
What is the primary cause of Parkinson's disease?
Dopamine deficiency in basal ganglia.
surgical opening of skull
Lumbar puncture (spinal tap)
To remove CSF for studies. bandage over needle site, bed rest for 1 hour post, push fluids, monitor for leakage.
Done by radiologist, contrast material into spinal canal w/syringe allows radiologist to see spinal columns and surrounding tissue. NPO after midnight before, except clear liquids, takes 1 hour, with 4-6 hours post observation time. CT of spine done post, HA normal, keep head elevated for 8 hours post, bedrest, **push fluids**, tylenol for HA.
What is the vaccination schedule for Hep B?
Birth, 4-6 weeks, 4 months--last dose not given before 24 weeks) (can be 3 or 4 doses)
How is the Hep B vaccination given to a newborn?
Give IM, vastus lateralis in newborn
What is the vaccination schedule for DPT (diphtheria, Tetanus, Pertussis)?
2 months, 4 months, 6 months, 15-18 months
When is the booster given for DPT?
4-6 years
When is the booster given for tetanus?
Tetanus booster every 10 years
What is the vaccination schedule for Hib (haemophilus influenza type B)?
2 months, 4 months, 6 months, 12-15 months
What is the vaccination schedule for IPV (inactivated poliovirus)?
2 months, 4 months, 6-18 months, 4-6 years
What is the vaccination schedule for MMR?
12-15 months, 4-6 years
What is the vaccination schedule for varicella (chickenpox)?
12-18 months
What is the vaccination schedule for PCV (pneumococcal)?
2 months, 4 months, 6 months, 12-15 months
When is the vaccination for HepA given (in certain states)?
24 months
When is the vaccination for influenza given?
annually after 6 months of age
What two types of patients is the vaccination for pertussis NOT given?
Not usually given post 6 years of age (increase in reactions) and not usually given to immune-compromised.
Nosocomial infection
Hospital acquired, E.coli cases most common.
What is the best way to prevent nosocomial infections?
Hand washing is the most important preventative measure
What are the two most common nosocomial infections?
Most common infections are pnenumonia and UTI
What is a common sign of a UTI?
Frequency is hallmark sign of UTI
What drug is most commonly used to treat strep infection?
What is a complication of strep infection?
Complication of strep is
What is the common treatment for rheumatic fever?
Penicillin and aspirin
Rheumatic fever
Acute systemic disease with inflammatory lesions of connective and endothelial tissue, can follow upper respiratory infection (URI), can cause heart damage, endocarditis
Gram negative, causes severe watery and possibly bloody diarrhea. Spread thru fecal-oral route, easily transmitted, requires antimicrobials.
What are the presenting symptoms of shigella?
Diarrhea, fever, and stomach cramps starting a day or two after they are exposed to the bacterium. The diarrhea is often bloody. Shigellosis usually resolves in 5 to 7 days.
Lyme disease
Bull’s-eye rash (ring rash), transmitted by ticks, patient has usually been walking in woods
What are the characteristics of Lyme disease?
Chronic, inflammatory multisystem disorder, rash, flu-like symptoms, progresses to arthritis like pain, stiff neck, fatigue, HA, affects skin integrity
What are the treatments for Lyme disease?
doxycycline, ceftriaxone, azythromax
Common treatment for chicken pox (varicella)
Strict isolation until scabs and vesicles disappear, no ASA
How is Reye's syndrome prevented?
Prevented with herpes zoster (varicella) vaccine
Reye's syndrome
Reye's syndrome damages many parts of the body, especially the brain and the liver. For unknown reasons, the parts of the cells that make energy (mitochondria) stop working correctly, causing severe illness. The most serious problems are swelling of the brain and problems with the breakdown of fat, which causes it to build up in the liver and other organs.
Rubella (German measles)
3 day rash and lymphadenopathy, causes birth defects in first trimester. Rash begins on face and spreads to trunk, communicable 10 days before and 5 days post rash. Rash very similar to measles, but NO KOPLIK’S SPOTS in mouth
Rubeola (measles)
Highly contagious, major cause of death in 3rd world,
transmitted by direct contact or droplets, s/s fever, photophobia, hoarseness hacking cough
What is a primary sign of measles?
KOPLIK SPOTS (hallmark sign): bluish grey specks with red halo in mouth opposite molars.
Treatment for rubeola (measles)?
humidifier, bed rest, antipyretics
What causes mononucleosis?
Epstein Barr virus; Spread thru oral route or blood transfusion
S/sx of mononucleosis?
Fever, sore throat, cervical lymphadenopathy, hepatic dysfunction, splenomegaly. Elevated lymphocytes.
Why should patients with mono avoid strenuous activity?
No strenuous activity due to enlarged spleen
Herpes family, spread by body secretions, sexual activity, mucus membranes. Children and daycare workers most at risk, dangerous in pregnancy. Sore throat and fever most common
Severe inflammation of the brain caused by mosquito-borne virus, may produce permanent damage and is often fatal. s/s fever, HA, N/V, URI, photophobia, restlessness, seizures, coma. dx lumbar puncture, blood cultures
Treatment for encephalitis?
antivirals, antibiotics, anticonvulsants, steroids, analgesics
Bacterial meningitis can be caused by Hib (H.Influenza), also can cause
Epiglotittis. Keep tracheotomy set nearby for epiglotittis patient
Transmitted by expelling mycobacterium tuberculosis while talking, coughing, sneezing. Can move to other parts of the body (meninges, kidneys, bones, lymph nodes). s/s fatigue, anorexia, low grade fever, night sweats, hemoptysis, pleuritic pain, dyspnea
When does a tuberculosis patient become non-infectious?
After 2-4 weeks continuous therapy.
What is used to test for tuberculosis in large populations?
Mantoux test used to test for exposure in large populations
Inflammation of the vagina, results from Candida or trichomonas or other bacteria. tx monistat, lotrimin, diflucan
May cause PID and sterility, most common STD in US. may
have no symptoms. tx w/vibramycin or zithromax
Can be acute or chronic, caused by spirochete treponema pallidum
What is the first stage of syphilis?
Painless chancre on genitalia
What is the secondary stage of syphilis?
When it spreads from original chancre and leads to generalized infection. Rash on trunk, extremities, hands. Contact with lesions will transmit. Other s/s= lymphadenopathy, arthritis, meningitis, hair loss, fever, malaise, weight loss. Latency follows, possibly interrupted by recurrence of secondary syphilis.
What is the tertiary stage of syphilis?
Multi-system organ damage. Aortitis, neurosyphilis (dementia, psychosis, paresis, stroke, meningitis). Syphilis tx=antibiotics (PCN G) or doxycycline is allergic to PCN.
How is tertiary stage syphilis diagnosed?
Blood test
Gonorrhea (neisseria gonorrhoeae)
Gram negative bacteria. In men s/s=urethritis,
epididymitis. In women s/s=more likely to be asymptomatic.
How can gonorrhea cause infertility?
By blocking fallopian tube
Blood/body fluid transmission. Will cross placental barrier. Opportunistic infections common, most common is pneumocystic carinii. Also, oral infections. Kaposi’s sarcoma (skin lesions) and pneumocystic carinii associated w/AIDS.
Flat, circumscribed area resulting in change of color of skin--freckles, flat moles (nevi), petechiae, measles, scarlet fever
Elevated firm circumscribed areas less than 1 cm in diameter--warts, elevated moles
Firm, rough lesions with flat top surface greater than 1 cm diameter--psoriasis, seborrheic keratosis
Elevated irregular area of cutaneous edema, solid, transient--insect bites, urticaria, allergic reaction
Elevated, firm, circumscribed lesion deeper in dermis than papule 1-2 cm diameter--erythema nodosum, lipomas (A benign, soft, rubbery encapsulated tumor of adipose tissue usually composed of mature fat cells).
Elevated, filled with serous fluid, less than one cm diameter--varicella, shingles
Similar to vesicle but filled with purulent fluid--impetigo, acne.
Systemic Lupus Erythematosus (SLE)
Autoimmune disorder with remissions and
exacerbations. Can progress to cardiovascular, renal, and neuro probs and severe bacterial infections. s/s arthralgias/arthritis, morning stiffness, pericarditis, popular, erythematous, and purpuric lesions on fingers, toes, elbows, forearms, and hands, depression, psychosis.
What are the important precautions to take for patients with Systemic Lupus Erythematosus (SLE)?
Maintain skin integrity, protect from sunlight/UV light. Topical corticosteroid creams for dry, itchy skin. No hair dyes. Illness similar to rheumatoid arthritis.
Superficial skin lesions caused by staph or hemolytic strep, more common in children. Commonly occurs midsummer to late fall, higher incidence in hot humid climates, very infectious, tx antibiotics.
Treatment for bee stings?
For mild rxns, elevation, cool compresses, oral antihistamines. Remove rings, watches, etc. For more severe reactions, IM or IV antihistamines, SC
epinephrine, and steroids.
What are three instructions to give to a patient to avoid bee stings?
Instruct pt not to walk outside barefoot, not to wear brightly colored clothes or to wear perfumes (attracts bees).
Rocky mountain spotted fever
Caused by rikettsia rickettsi, incubation 2-14 days. Pink macular rash on palms, soles of feel, ankles, fever, malaise. tx antibiotics.
What is of primary concern in severe burns?
What are the three classifications of smoke inhalation?
Carbon monoxide, inhalation injury above glottis and inhalation injury below glottis
What accounts for a majority of deaths at a fire scene?
Carbon monoxide
What does one look for in an inhalation injury above glottis?
Look for singed nasal hairs, hoarseness, painful swallowing
Inhalation injuries below glottis are ____ and can manifest as ____.
usually chemically produced, can manifest as ARDS.
Partial thickness (1st degree)
Involves only epidermis, no blisters
Partial thickness deep (2nd degree)
Involves destruction of epidermis and portions of dermis--blisters, edema, blanching, skin red and mottled. **Very painful, usually needs more analgesics than other burn patients (including third
Full thickness (3rd degree)
Destruction of epidermis, dermis, and portions of
subcutaneous tissue. Wound dry, waxy, white, leathery or hard, can look charred,
**painless and insensate**.
Greatest initial threat to burn patient is
Hypovolemic shock--can lead to agitation, restlessness, and hostility.
Define escharotomy
Cutting thru burned skin to relieve pressure
Curling ulcer
Stress ulcer that occurs 72 hours after extensive burns and involves stomach or duodenum. s/s black tarry stool.
Why is nutrition important in burn patients?
Severely burned patients are hyper metabolic, nutrition very important. Increase protein.
Inflammatory Bowel Disease (Crohn's & Ulcerative colitis)
chronic recurrent inflammation of intestinal tract
Treatment for ulcerative colitis?
Low roughage diet and no milk products
Treatment for Crohn's disease?
High calorie, high vitamins, high protein, low residue,
milk free diet.
Inflammation of the diverticula; Bland diet best.
Where does the pain usually manifest itself in diverticulosis?
Pain usually manifests in LLQ of abdominal area.
Patients who have had bowel surgery in which some of the bowel has been removed may be at risk for
Pernicious anemia due to decrease in intrinsic
ESR is usually elevated during inflammatory processes such as
Rheumatoid arthritis or Lupus
S/sx of poisonings with corrosive chemicals
Agitation, difficltty swallowing, abdominal pain. Call poison control immediately. NO ipecac.
Ipecac child dose and procedures
Usual child dose is 15 cc. Follow immediately w/tepid water. Have pt bend forward to help induce vomiting
Why wouldn't one give ASA to a child?
Reye's Syndrome risk
Colchicine is a medication for acute gout.
Antigout agent, uricosuric (acting to increase the excretion of uric acid in the urine), for hyperuricemia (A build up in the blood of uric acid)
With what existing condition wold Probenecid be contraindicated?
Uric acid kidney stones
Zidovudine (AZT)
(Antiretroviral): inhibits HIV viral replication. Don't take with APAP or probenecid. Repeated blood transfusions may be necessary. Maintain reverse isolation (granulocytopenia).
Antitubercular: used to tx active TB as well as prophylactic. Side effects: peripheral neuropathy, toxic encephalopathy, convulsions, epigastric distress, agranulocytosis, thrombocytopenia, jaundice. Give 1 hour before antacids (antacids decrease absorption). Monitor for visual disturbance (occular toxicity). No tyramine-containing foods (aged, fermented).
Osmotic diuretic: urogenital irrigant) used to decrease ICP, tx of cerebral edema. Side effects: HA, convulsions, thrombocytopenia, blurred vision, pulmonary congestion, tachycardia.
Phenytoin (dilantin)
Anticonvulsant: abrupt D/C can induce status epilepticus. Side effects: H/A, ataxia, nystagmus, sluured speech, constipation, thrombocytopenia,
lupus, gingival hyperplasia, injection site irritation, skin rash. Take with or immediately after meals. May color urine pink/red/brown.
These five vaccines are given SC
Diphtheria toxoid, measles, mumps, rubella, varicella
MMR combo is given
Parasympathomimetic: cholinergic, muscarinic. Treats glaucoma by producing miosis, decrease of intraoccular pressure, contractions of pupils/ciliary muscles. Side effects: Sweating, N/V, dizziness, chills, urinary frequency.
Carbamazepine (Tegretol)
Anticonvulsant: treats partial seizures, grand
mals, mixed sizures. Side effects: dizziness, drowsiness, peripheral neuritis, paresthesias, nystagmus, N/V/D, dry mouth, hepatocellular jaundice, rashes, erythema multiforme, pneumonitis, pneumonia. Avoid abrupt withdrawal.
Sulfisoxazole (Gantrisin, Bactrim, Septra)
sulfonamide, antibacterial. Treats UTI secondary to e.Coli, s. aureus, etc. NOT recommended for B-hemolytic group A Strep. Take 1 hour before meals or 2 hours after meals with water. Avoid exposure to direct sunlight.
Zyloprim (allopurinol)
Reduces amount of uric acid delivered to kidneys by
inhibiting production. Notify if rash or fever develops, drink at least 2000 ml water per day.
Uricosuric drugs (probenecid, sulfinpyrazone):
Acts on renal tubules to inhibit uric acid reabsorption; excretion of uric acid increased and hyperuricemia reduced. Take with food, increase fluids to 2000ml/day.
Dilantin (phenytoin)
Seizure control. Side effects: gingival hyperplasia (needs good oral care), rash, facial coarsening, fever, leukopenia. Toxic signs: nystagmus, ataxia, tremor, drowsiness, constipation,and nausea.
Seizure control. Side effects: Rash, dependency. Toxic signs: sedation, psychic changes, nystagmus, ataxia.
Mysoline (primidone)
Seizure control. Side effects: Rash, dependency. Toxic signs: sedation, psychic changes, nystagmus, ataxia, GI upset.
Tegretol (carbamazepine)
Seizure control. Side effects: bone marrow depression, lens opacities, lethary. Toxic signs: diplopia, dizziness, N/V, ataxia.
Depakene (valproic acid)
Seizure control: Side effects: thrombocytopenia, transient hairloss, hepatic toxicity, inhibited platelet aggregation, drowsiness, N/V, diarrhea.
Zarontin (ethosuximide)
Seizure control. Side effects: H/A, leukopenia, erythema multiforme, pancytopenia (A decrease below normal in the concentration of the three major blood cell types: red cells, white cells and platelets), N/V, dizziness, anorexia, hiccups.
Klonopin (clonazepam)
Seizure control. Side effects: Rash, thrombocytopenia. Toxic effects: ataxia, dizziness, hypotonia, slurred speech, hyperactvity.
Name and describe nucleoside reverse transcriptase inhibitors
Antiretroviral like AZT and Didanosine. Suppress synthesis of viral DNA by reverse transcriptase. Basically keep virus from maturing. First drugs used against HIV infection, still mainstay drug. Must adhere closely to regimen.
Name and describe non-nucleoside reverse transcriptase inhibitors
Antiretroviral such as Viramune and Rescriptor. Binds to active center of reverse transcriptase causing direct inhibition of HIV. Take 1 hour before or after food or antacids. Notify doc if rash develops.
Name and describe Protease inhibitors
Antiretroviral like indinavir, ritonavir. Causes virus to remain immature and noninfectious—when combined with reverse transcriptase inhibitors viral load is reduced to near non-detectable levels. May cause diabetes.