Classification of Meds
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| cross-sensitivity | meds that share common actions and common adverse effects
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| anaphylactic reaction | severe, total-body life-threatening adverse reactions that may result from the admin of any drug
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| FDA Preg Cat A | a risk has not been doc during preg
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| FDA Preg Cat B | animal studies have not shown a risk, but there is inadequate doc in humans, or animal studies have shown adverse effects, but this has not been demo. in humans
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| FDA Preg Cat C | animal studies have shown adverse effects, but there are no adequate studies in humans, or the benefits to the preg woman may outweigh potential risks, or there are no adequate studies in humans or animals
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| FDA Preg Cat D | there is evidence of human fetal risks, but the benefits may outweigh potential risks
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| FDA Preg Cat X | abnormalities have been doc., the risk of use in preg women precludes the use of this med
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| True or False:A person can be allergic to a medicine at any time | True, always look for signs of allergic reactions, including anaphylactic, life threatening situations. Also determine if they are taking OTC meds or herbal supp b/c many of these in combo with prescribed meds can cause serious undesired effects
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| certain meds, if taken with grapefruit juice can cause: | toxicity,some should be taken with food or on an empty stomach
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| Drug-Drug interactions | care must be taken when using two or more drugs:OTC, vitamins, & herbal supp.; variations from decreased effectiveness to overdose
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| Angelica and Chinese angelica (dong quai), cat’s claw, chamomile, chondroitin, feverfew, garlic, ginger, ginkgo, ginseng, goldenseal, grape seed extract, green tea leaf, horse chestnut seed, ledum tincture, turmeric | May contribute to bleeding tendencies, particularly
if combined with oral anticoagulants
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| Bee pollen, celery, coriander, dandelion root, fenugreek, garlic, ginseng, juniper berries, ma huang, Momordica charantia (Karela), xuan shen | May cause problems in persons with diabetes
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| Ashwagandha, barberry, black cohosh root, burdock, cat’s claw, chamomile, dandelion root, false unicorn root, ginger, ginseng, licorice, nettle, octacosanol, schisandra, went rice | May cause problems in pregnancy and/or lactation
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| Black cohosh root, chaste-tree berry, Chinese angelica (dong quai), ginseng, licorice, saw palmetto, St. John’s wort | May have adverse reaction if taken with hormone
replacements or hormonal contraceptives
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| Allspice, evening primrose | May exacerbate seizure disorders
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| Chamomile, evening primrose, fish oil, ginkgo, ginseng, kava, ma huang, passionflower vine, psyllium (may block lithium), St. John’s wort, thyme, valerian, yohimbe | May interact or cause overdose with antidepressants or
other psychiatric medications
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| antibiotic | is one type of anti-infective, is a
chemical compound used specifically to treat bacterial infections.
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| antibiotic | It is a product of living cells formed naturally by other
living cells (e.g., bacteria, yeasts, or molds) or is produced semisynthetically in a laboratory.
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| antibiotic | Although living cells produce
antibiotics, the term “antibiotic” may also be used to mean any
medication that acts as an antimicrobial agent.
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| Antibiotics are classified as: | broad-spectrum: if they are effective against many
organisms
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| Antibiotics are classified as: | narrow-spectrum: or specific if they are effective
against only a few microorganisms
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| bacteriostatic | Antibiotics that retard the
growth of bacteria are called
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| bactericidal | Antibiotics that kill bacteria
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| Controlled release (CR): | drug slowly released over a
period of time
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| Delayed release (DR): | medication will begin to take
effect after a period of time
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| Extended release (ER): | drug released over a longer
period of time
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| Immediate release (IR): | drug released immediately after
being taken
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| Sustained release (SR): | drug released over a period of
time
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| factors must be considered for an antibiotic to be effective | soluble in water & diffuse readily into the body tissues, shouldn't cause an adverse/allergic reaction, shouldn't affect the normal flora, and well absorbed by the GI tract, and should not be an antagonist to other antibiotics
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| If an antibiotic is used indiscriminately, particularly for minor ailments, or is administered improperly: | certain
pathogens may mutate or build a tolerance to it. Eventually,
the antibiotic’s action is rendered ineffective against that
particular microorganism and the microorganism is termed
resistant to the antibiotic.
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| Some clients, who have a particular problem with frequent “strep” infections or a history of rheumatic fever | take a small daily prophylactic (preventive) dose
of oral penicillin,dosage schedule generally
does not build up resistant strains of streptococcus and
generally does not have side effects
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| culture and sensitivity (C&S) | test to
determine the specific microorganism causing an infection
and the medication to which the organism is most sensitive
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| Cultures may be obtained from: | blood, stool, sputum, pus,
wound drainage (exudate), urine, or drainage from mucous
membranes
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| To ensure the accuracy of test results, antibiotic therapy should not start until after the specimen for C&S is obtained and forwarded to the laboratory for analysis. | Rationale: If antibiotic therapy begins before the specimen
is secured, the numbers and types of bacteria present in the specimen
could be reduced, which may result in inappropriate, and perhaps
ineffective, antibiotic selection.
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| most effective and widely used antibiotics | penicillins, cephalosporins, tetracyclines, aminoglycosides,
macrolides, and sulfonamides
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| Penicillin (PCN) | derived from a specific mold, inhibits the
growth of susceptible bacteria. It is also bactericidal in sufficiently high concentrations or blood levels, most effective against gram-positive organisms:
streptococci, staphylococci, and pneumococci, also
a
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| PCN | excreted rapidly in
the urine and is remarkably free of toxic effects
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| PCN | is
ineffective against the tubercle bacillus, all viruses, and the
organisms causing typhoid fever and, therefore, is a fairly
narrow-spectrum antibiotic
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| PCN | The oral route is the easiest and safest way to
administer PCN and is usually effective for all but the most
severe infections
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| PCN | The oral route is the easiest and safest way to
administer PCN and is usually effective for all but the most
severe infections
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| PCN | pregnancy category B
drug
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| PCN | serious
adverse effects, such as hives, a skin rash, fever, dyspnea, or
unusual bleeding, in milder PCN reactions,
symptoms may be delayed and may occur 5 to 14 days after admin
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| Cephalosporins | originally derived from a mold.
Because cephalosporins are structurally similar to PCN, clients
receiving cephalosporin therapy should be asked about previous
sensitivity to PCN
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| cephalosporins are divided into three groups: | first, second,
and third generations
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| wide spectrum | effective
against more pathogens
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| Cephalosporins | bactericidal.
They are produced semisynthetically and are
active against gram-positive cocci, including PCN-resistant
staphylococci, and gram-negative bacteria, including
Escherichia coli, Proteus mirabilis, and Klebsiella species.
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| Cephalosporins | Adverse effects include GI symptoms such as flatulence (excessive intestinal
gas) and diarrhea. Some cephalosporins can cause more
serious adverse effects, such as bone marrow depression. As
with any drug, allergic reactions are possible
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| Cephalosporins | preg cat b,If the client drinks alcohol while
taking a cephalosporin, severe nausea and vomiting are likely.
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| Tetracyclines (TCN) | broad-spectrum antibiotics effective
against a wide variety of organisms, including Rickettsia,
Chlamydia, and Mycoplasma. They are sometimes used in
clients who are allergic to penicillin
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| TCN | are well absorbed
orally,the presence
of food and some dairy products (especially milk) in the
stomach decreases oral absorption.
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| TCN | To promote GI absorption,
clients should receive tetracyclines on an empty stomach
at least 1 hour before or 2 to 3 hours after eating.
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| TCN | The presence of iron, calcium,
magnesium, or aluminum in the stomach influences tetracycline
absorption,shouldn't take
antacids such as Gelusil, Maalox, Mylanta, Tums, or Milk of Magnesia.
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| TCN | Oral calcium supplements will also inhibit absorption and should be
taken at least 1 hour before or 3 hours after taking tetracyclines
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| TCN | Side effects
usually involve the GI system—nausea, vomiting, or diarrhea.
Intestinal infections or digestive difficulties are possible
because tetracyclines also may kill the normal flora
found in the digestive tract
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| TCN | Photosensitivity (sensitivity to
light) may develop. Adverse reactions include skin rash,
burning eyes, and vaginal or anal itching.
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| TCN | pregnancy category D, cause a brownish discoloration of the
enamel in developing teeth and are contraindicated for pregnant
women and for children who do not yet have their
permanent teeth
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| Aminoglycosides | potent bactericidal antibiotics. They
are active against many aerobic gram-negative organisms,
particularly those causing urinary tract infections, meningitis,
and life-threatening septicemias (generalized sepsis or
infection throughout the body)
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| Aminoglycosides | the medication of choice for hospital-acquired
(nosocomial) gram-negative infections,also used
pre-op in some clients who are scheduled for surgery
of the GI tract, b/c the action of these meds
reduces the number of normal bacterial flora found there.
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| Aminoglycosides | can have toxic effects, namely ototoxicity
and nephrotoxicity. Preg cat c
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| Ototoxicity | caused by damage to the
eighth cranial nerve, is manifested by dizziness, tinnitus,
and gradual hearing loss that can occur even several days
after the medication has been stopped.
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| Nephrotoxicity | (kidney
damage) is manifested by blood and protein in the urine
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| Macrolide antibiotics | narrow-spectrum bacteriostatic
agents. Macrolides include azithromycin (Zithromax,
“Z-Pack”), clarithromycin (Biaxin), dirithromycin (Dynabac),
and erythromycin (Erythrocin)
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| Macrolide antibiotics | effective against
most microorganisms that are sensitive to PCN and are used
to treat respiratory tract infections in clients who are allergic
to PCN
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| Macrolide antibiotics | usually administered orally; erythromycin
also may be administered parenterally. Adverse
reactions include skin rashes, abdominal pain, nausea, and
cramping. Macrolides are pregnancy category B agents
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| Macrolide antibiotics | Azithromycin oral suspension
and erythromycin should be given 1 hour before or 2 to 3
hours after a meal. Clarithromycin and dirithromycin should be
taken with food.
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| Sulfonamides | sulfa drugs) are used as
antimicrobial agents, chiefly because of their low cost and
effectiveness in treating common bacterial infections. They
are bacteriostatic agents, requiring normal body processes to
eradicate infection
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| Sulfonamides | use of specific sulfonamides often indicated in the following conditions:chancroid, trachoma,
toxoplasmosis, uncomplicated urinary tract infections,specific cases of malaria, meningococcal meningitis,
Haemophilus influenzae infections of the middle ear
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| Sulfonamides | an alternative to PCN for PCN-sensitive clients with rheumatic
fever
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| Sulfonamides | prescribed with PCN or
erythromycin in conditions such as otitis media. Other sulfonamides
are specific for other disorders. In other words,
not all sulfonamides are appropriate for all disorders
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| Encourage clients taking sulfonamides to drink large amounts of fluids, to dilute the urine | Rationale: Sulfa drugs
are excreted via the kidneys and tend to form crystals in the
urine, which causes kidney irritation and possible kidney stone
formation. The intake of large amounts of fluid will minimize the
possibility of crystal formation.
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| Sulfonamides | adverse reactions including nausea,
vomiting, diarrhea,electrolyte imbalance, cyanosis, or
jaundice
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| Sulfamethoxazole/trimethoprim (Bactrim, Bactrim DS) | a combination drug often considered the medication of
choice for urinary tract infections. As with all other medications
of this type, Bactrim should not be given to infants
younger than 2 months.
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| Sulfamethoxazole/trimethoprim | This medication is not the medication
of choice for streptococcal infections or infections of
the upper respiratory tract.
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| Symptoms of a serious reaction to clindamycin (Cleocin) | include diarrhea with liquid feces
and shreds of intestinal lining. Although rare, this reaction can be
fatal, especially in children or older adults. Therefore, a client who
is receiving clindamycin must report any diarrhea at once
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