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PHARM #3
| Term | Definition |
|---|---|
| Which labs should the nurse assess prior to the administration of aztreonam (Azactam)? | BUN, Creatnine, & Liver Function levels |
| Accidental IV administration of which drug can lead to cardiopulmonary arrest and death? | Penicillin G; benzathine, procaine, potassium |
| What category of drugs are drugs of choice (DOC) in treating or preventing skin/skin structure infections? | Cephalosporin |
| A patient allergic to penicillins should not receive which other category of antibiotics? | Cephalosporin |
| How should oral penicillins be administered? | At least 6 ounces of water on an empty stomach |
| What is the purpose of a beta lactamase inhibitor? | protects penicillin from destruction and extends the effectiveness |
| Which drug is the drug of choice for surgical prophylaxis? When/how should it be administered? | Cefazolin (Ancef) Preoperative: 1 hour before surgery, IV/IM Postoperative 500-2000 mg every 8 hours, IV/IM |
| Concurrent use of fluoroquinolones & which category of drugs increases the risk of tendinitis/tendon rupture? | Glucocorticoids |
| What is the major advantage of using fluoroquinolones over aminoglycosides? | aminoglycosides have potentially more seriously toxicities |
| Peak gentamycin levels should be drawn how many minutes after the medication is finished infusing? | 30 min |
| Aminoglycosides should be used with caution in patients with what disease process? | renal disease and neuromuscular disease |
| If a patient exhibits any s/s of an allergic reaction what should the nurse do? | S- stop C- call A- assess P- prepare |
| Why should patients on tetracycline avoid sun and tanning beds? | medication makes skin more sensitive to light (photosensitivity) |
| Why should tetracyclines not be used in children < 8 years old or in pregnant women? | discoloration of the permanent teeth and tooth enamel hypoplasia in both fetuses and children and possibly retard fetal skeletal development |
| What should the nurse inspect the stool for if the patient develops diarrhea? | blood, mucus, pus |
| What are some important drug-drug and drug-food interactions the nurse should educate the patient taking a tetracycline on? | -antacids, antidiarrheal drugs, dairy products, calcium, enteral feedings, or iron preparations can decrease effectiveness -can antagonize the effects of bactericidal antibiotics and oral contraceptives. -potentiate the effects of oral antico-agulants |
| What is the DOC for anthrax and chlamydia? | ciprofloxacin |
| What drug(s) can cause crystalluria? How can the nurse help the patient prevent this? | S-sulfonamides I- indinavir G- gancylovir M- metronidazole A- acyclovir assess urine PH, administer with full glass of water and administer I&O |
| What is the DOC for Lyme disease? | doxyclyine |
| What topical drug is used for burns? | silver sulfadiazine |
| What are the s/s of “red man syndrome”? | (hypotension, flushing, skin rash). This reaction is caused by a release of histamine. |
| The nurse should consider pre-treatment with _____ prior to administration of vancomycin if pt. has had reactions previously. | Diphenhydramine (Benadryl) |
| What drug has a BBW as it is known to cause pseudomembranous colitis? | clindamycin (Cleocin) |
| What drug is associated with a risk of myelosuppression? | Linezolid (Zyvox) |
| What labs should be monitored in patients on azithromycin (Zithromax)? | ALT, AST and CBC |
| What drug can be used topically for the treatment of acne? | clindamycin (Cleocin) |
| Patients on linezolid (Zyvox) should avoid what foods? Why? | Aged cheese or wine, soy sauce, smoked meats or fish and sauerkraut. raises BP |
| There is a drug-drug interaction between Rifadin & what type of medications? | Hepatotoxic drugs, HIV treatment drugs, oral contraceptives, Warfarin |
| Which drugs are the primary drugs used to treat TB? | Isoniazid (INH) Rifampin (Rifadin) Pyrazinamide Ethambutol (Myambutol) |
| Which drug should be dc’d if any s/s liver failure (jaundice, increased LFTs, clay colored stools, etc.)? | isoniazid |
| Which drug can cause red-orange discoloration of body fluids? | Rifampin |
| Which drug can be used for monotherapy to treat latent TB? | Isoniazid |
| What type of therapy for TB is necessary to slow bacterial resistance? | multi drug regimen with extended therapy |
| The ______ phase of TB occurs when an un-infected person inhales airborne particles from an infected person | TRANSMISSION |
| TB requires drug therapy for up to _____ months. | 6-12 |
| Patients on which drug should increase vitamin B6 intake? | isoniazid |
| Peripheral neuropathy could indicate toxicity of which drug? | isoniazid |
| Which drug can cause optic neuritis? | Ethambutol |
| By which route is ribavirin (Virazole) administered? | aerosol |
| Which drug is used to prevent maternal-fetal transmission of HIV? | zidovudine (aka AZT) |
| Which drug is contraindicated in patients with a hx of lactic acidosis? | zidovudine |
| What is the goal of drug therapy for HIV? | Decreasing viral load and help decrease mortality rates |
| Which drug lessens the severity of herpes outbreaks? Is this course of therapy curative? | acyclovir, not curative |
| Which viral infections can be prevented through vaccination? | Chicken Pox Hep B Influenza A & B Rubella Polio Yellow Fever |
| Why are patients with influenza, a viral infection, sometimes prescribed an antibiotic? | to adress possible bacterial complications (pneumonia) |
| What are the priority assessments in a child receiving ribavirin (Virazole)? | Respiratory functions |
| Which drug can be prescribed in a single dose to treat candida infections? | fluconazole |
| How does amphotericin B exert its therapeutic effect? | it combines and interests with other drugs to attach to the well walls to increase permeability to allow secretion of the cell wall |
| If a patient who is using a product for the treatment of vaginal yeast infection does not experience relief of s/s, what should she do? | contact prescriber, and quit taking medication |
| Which lab(s) should be assessed in elderly patients prior to administering “azoles”? | ALT and AST for liver function levels |
| Which lab(s) should be assessed in patients on terbinafine (Lamisil)? | Urinalysis for protein to creatinine ratios, LFT and LST screening |
| Patients on which drug may need replacement of magnesium & potassium? | amphotericin B |
| Concurrent use of which category of drugs with amphotericin B increases potassium depletion leading to hypokalemia & potential cardiac dysrhythmias? | -Corticosteroids - digoxin - muscle relaxers - thiazides |
| What is the usual length of therapy with amphotericin B? | 4weeks - 3months |
| For parasitic infections how therapeutic effect determined? | clean stool samples |
| What category of medications are used to treat malaria? | anti- parasitic |
| Patients should not consume alcohol while on which medication due to a risk of disulfiram reaction? | Amebicides, antimalarials, Anthelmintics |
| Patient education for patients being treated for ___________ should include information on safe sex practices. | trichomoniasis, gonorrhea, and chlamydia |
| How does albendazole exert its therapeutic effect? | -larva cells are selectively destroyed -glycogen is depleted - ATP production increased while energy is depleted - immobilizes worm resulting in death |
| What is the purpose of obtaining the trough level? | to identify toxic levels of medication as soon as possible |
| What trough level would be considered a normal concentration for our 20yr old patient with bacterial meningitis? | below 1 mcg/mL |
| Aminoglycosides should be used with caution in patients with what disease process? | renal disease and pregnancy -renal toxicity and birth defects of deafness |
| By which route should the nurse anticipate administering the vancomycin? | IVPB |
| What trough level would be considered a normal concentration for our patient with MRSA in her wound culture? | through concentration 10-20 mcg/mL |
| Trough levels should be drawn how many minutes after the medication is finished infusing? Are peak levels measured? | immediately before next dose -peak levels are no longer recommended to be monitored |
| What is "red man syndrome"? What are the s/s of "red man syndrome"? | Red man syndrome is a common adverse effect associated with IV vancomycin. -The symptoms are: flushing, rash, itching (pruritus) urticaria, tachycardia, hypotension. |
| The nurse should consider obtaining an order for pre-treatment with what medication prior to administration of vancomycin if pt. has had reaction previously? | diphenhydramine (Benedryl) |
| The patient asks the nurse why she has developed shingles. How will the nurse respond? | if she had chicken pox as a child that the virus can cause singles later inlife due to the virus being dormant for many years within her body. |
| S.C. asks if her shingles could have been prevented. How should the nurse respond? | could have prevented by having a vaccine called Zostavax or Shingrix after she turned 50 to help prevent shingles |
| What other conditions can acyclovir be used for? Does acyclovir cure any of these conditions? | -to decrease pain and sores in people with chicken pox or shingles -first time or repeated outbreaks of genital herpes |
| S.C. asks if she will suffer from any long term effects from the shingles. How should the nurse respond? | possible long term nerve pain from blisters /wounds |
| What is the cause of the orange urine in a patient with active TB and prescribed Rifampin , and should K.R. be concerned? | the drug reaches it effective concentration in the bodily fluids. Since the drug itself if red it makes the bodily fluids red/orange as well. No need to be concerned |
| K.R. read that antibiotics may cause birth control pills to be ineffective, and she asks the nurse if this is the case with rifampin. Should K.R. be concerned about the effectiveness of her birth control pills? | this drug can reduce the effectiveness of birth control and a secondary prevention for contraception should be used if a patient is sexually active. |
| What are the major adverse effects associated with Isoniazid? What signs & symptoms should the nurse monitor for? | -sudden weakness or illness, or fever lasting longer than 3 days -upper stomach pain, nausea, loss of appetite -dark urine, clay colored stool, jaundice -vison changes and pain behind eyes |
| What are the major adverse effects associated with ethambutol? What signs & symptoms would the nurse need to be aware of? | vision problems -blurred vision -loss of vision -loss of red/green color vision -eye pain |
| Which drugs can be used as monotherapy to treat latent TB? | -isoniazid INH -rifapentine RPT -rifampin RIF |
| K.R. asks why her father has to take 3 different medications to treat his TB? How should the nurse respond? | multiple drugs are used to treat TB because the virus is highly resistant and using multiple drugs helps to fight the virus better. |
| Infusion reactions are common with the administration of amphotericin B. What reactions should the nurse assess for? How can they be prevented/managed? | -infuse slowly looking for any side effects. and flush iv line before infusion -fever - shaking chills - hypotension -N/V |
| Which NSAID can be used to manage pre-term labor? | indomethacin (indocin) |
| What are the signs & symptoms of salicylate toxicity? | Cardiovascular: Increased heart rate Central Nervous: hearing loss, dimness of vision, headache, dizziness, mental confusion, drowsiness Gastrointestinal: N/V/D Metabolic: Sweating, thirst, hyperventilation, hypoglycemia or hyperglycemia |
| Which NSAID can be administered IV and is used for its powerful analgesic effects? | ketorolac |
| Why do we use aspirin prophylactically in patients with coronary heart disease? | Prevent blood clots forming in arteries and may lower risk for a stroke or heart attack |
| What is the mechanism of action for the drug colchicine? | thought to inhibit the metabolism, mobility, and chemotaxis of polymorphonuclear leukocytes-used for acute gout attacks and pain/inflammation |
| What adverse effects are associated with colchicine? | Bleeding into the GI or urinary tract |
| What precautions and contraindications should the nurse be aware of for colchicine? | Hypersensitivity to drug Severe renal, GI, hepatic, or cardiac disorders Blood dyscrasias |
| How is colchicine administered? | oral |
| What should the nurse teach the patient with regards to the use of colchicine? | Take on an empty stomach for complete absorption, but best tolerated if taken with food Increase fluid intake of up to 3 L/day Avoid alcohol, OTC cold relief products that contain alcohol |
| What is the mechanism of action for the drug allopurinol? | Inhibits the enzyme xanthine oxidase, which prevents uric acid production |
| What is allopurinol used for? | Reduce the production of uric acid Treats gout and kidney stones |
| What adverse effects are associated with allopurinol ? | agranulocytosis, aplastic anemia, and serious and potentially fatal skin conditions such as exfoliative dermatitis, Stevens-Johnson syndrome, and toxic epidermal necrolysis. |
| What precautions and contraindications should the nurse be aware of with allopurinol ? | Hypersensitivity to the drug |
| How is allopurinol administered? | oral |
| What should the nurse teach the patient with regards to the use of allopurinol ? | Give medication with meals to minimize nausea Avoid hazardous activities if dizziness or drowsiness occurs Avoid alcohol and caffeine |
| What are the contraindications for aspirin? What lifespan considerations are important to know? | alcohol abuse, hypersensitivity, GI or bleeding dis, impaired renal function.Not to be used in children and adolescents due to risk for Reye’s Syndrome |
| What are the adverse effects associated with the use of NSAIDs? | Nausea, dyspepsia, heartburn, epigastric discomfort, bruising, Salicylism |
| What are the differences between NSAIDs and acetaminophen? | only NSAIDs can reduce inflammation |
| What contraindications are important to consider related to NSAID use? | -hypersensitivity -salicylate sensitivity -coronary bypass surgeries -3rd trimester of pregnancy -bleeding disorders |
| What are the therapeutic effects associated with NSAIDs? | decreasing pain and inflammation |
| broad spectrum antibiotics have what suffix ? | -oaxcin |
| tetracylines have what suffix ? | -cylcine |
| how do you recognize a drug is a sulfonamide ? | sulf- |
| what prefix and suffix helps you recognize cephalosporins ? | cef- or ceph |
| what is the suffix that helps you recognize penicillin? | -cillin |
| aminoglycosides and macrolides are recognized by this suffix: | -mycin |
| Floroquinolones (aka quinolones) are recognized in drug names by this suffix: | -floaxin |
| antivirals that are HIV protease inhibitors are recognized in drug names by this suffix: | -navir |
| antiviral drugs that are used for HIV or AIDS have the suffix: | -vudine |
| Anti-fungal drugs can be recognized by this suffix: | -azole |
| Antitubercular (TB) drugs can be recognized by this prefix : | rifa- |
| Retinoid (ANTI ACNE) drug names can be recognized by this prefix: | tretin- |
| NASIDs (anti-inflammatory) drug names can be recognized by these suffix: | -olac or -profen |
| What is the antidote for warfarin? | vitamin K |
| What is the antidote for heparin? | protamine sulfate |
| what is the antidote for aspirin? | sodium bicarbonate |
Created by:
chloemoyer
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