Belmont Pharmacology Test 4 drugs
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| ( -cin ) | narrow spectrum abx, for the very sick, not 1st line, inpatient use | ototoxicity (not w/ Lasix & worse w/ renal failure), nephrotoxicity | monitor 3: N O PT, don't give w/ neuromuscular blockers
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| ( -xacin ) | broad spectrum abx, outpatient use | GI, HA, restlessness, Tendon Rupture is Rare, ( Lome- ) has photosensitivity | don't give w/ milk spinach or Tums, raises theophylline & warfarin levels
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| ( -thromycin ) | good alt. to PCN | N/V, anorexia, liver failure, QT prolongation | baseline liver fxn, raises warfarin & theophylline, take w/ full glass of water and on empty stomach, teach liver failure signs: n/v, abd pain, jaundice
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| ( sulfa- ) | abx used mainly for UTI, not used widely b/c of s/e | hypersensitivity (rash, fever), photosensitive, hemolytic anemia, renal problems, kernicterus in newborns | take on empty stomach, hydration, periodic bl. counts, not w/ warfarin, phenotoin, oral hypoglycemics
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| ( -cycline ) | bacteriostatic abx that treats PUD, acne, rocky mtn fever and others | NVD, discolors teeth, PREG X & young children under 8, AAPMC, hepato & renal toxicity, photosensitivity | not w/ milk, iron, laxatives
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| Vancomycin | treats MRSA | ototoxic, red-man syndrome (from rapid infusion - HoTN, chills, fever, rash on neck and chest), DVT, tissue necrosis w/ extravasation | slow IV over 1 HR
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| Cleocin | like ( -thromycin ) | high incidence of AAPMC | (blank)
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| Zyvox | for VRE & MRSA | GI & myelosuppresion | (blank)
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| Flagyl | for amebiasis, AAPMC, bone/joint/skin infection | (blank) | slow over 1 HR
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| Mandelamine. naldixic acid. nitrofurantoin. | 2ndchoice for UTI prevention & Tx | Mandela - long term not w/ antacids. Dixic - resistance develops quickly Fura - harmless brown urine | take all pills, eat prunes, protein, cranberry juice, no milk or citrus, should improve in 3 days
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| pyridium | pain relief for UTI | hepatoxic w. long use, hypersensitivity, NVD | urine turns orange/red and stains, take WITH FOOD
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| Rifampin | 1st line for Myco- TB/Leprosy/avium | hepatotoxicity, discolored body fluids, flu-like sx | decr birth control, warfarin. monitor liver esp. in alcohoics & elderly. take on empty stomach. Poor compliance.
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| INH | 1st line for TB/Leprosy/Avium (mycobacteria) | tingly/unsteady gait from B6 defeciency, hepatotoxicity | monitor B6, liver (alcoholics and elderly), Must be seen once per month
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| Pyrazina | 1st line for TB/Leprosy/Avium (mycobacteria - spread by droplets) | hepatotoxicity, gouty arthritis | monitor liver fxn
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| Ethambutol HCL | 1st line for TB/Leprosy/Avium (mycobacteria - spread by droplets) | gouty arthritis, dose related blurred vision | monthly eye exams
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| streptomycin | ( -cin ) used 2nd line for resistant mycobacteria (TB/Leprosy) | Renal & ototoxicity | only IM injections
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| ALL Mycobacterial agents | against TB/Leprosy/Avium, froplet precautions, screen w/ skin test, diagnosed only by CXR & culture and sens., tx: ~4 drug therapy, direct observation therapy 2-3x/week, avg tx length 12 mo., target testing for nurses and those exposed | (blank) | teach to promote compliance, give B6 w/ INH, oral contraceptives ineffective, high risk: alcohlics, liver dz, diabetics, elderly
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| flucytosine | for systemic fungal infection | anemia, hepatotoxicity, GI distress | (blank)
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| Ampho B | systemic fungal fxn (always IV) | infusion rxn (fever/chills/HA 1-3 hr after infusion starts - pretreat w Tylenol/benadryl), nephrotoxicity, hypokalemia (need runs of K), anemia | refrigerate, only dilute w/ d5w
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| nystatin | mouth wash for candidiasis | (blank) | half on 1 side, half on the other
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| griseofulvin | skin/nails/hair fungal infxn | HA, allergies | take w/ fatty food
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| ( -AZOLE ) | broad spectrum antifungals | NV, hepatotoxicity, cardiac suppresion, HA, (skin rash w/ itraconazole) | drug intrxns
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| acyclovir | 1st line antiviral for HSV-1&2, vericella zoster | well tolerated; phlebitis w/ IV, nephrotoxicity w/ IV | drug interactions - PPI, antacids, rifampin, hepatic interacctions incr other drug levels
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| ganciclovir | antiviral to treat & prevent CMB retinitis | bone marrow suppression, sterility & preg x | (blank)
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| interferon | antiviral, boosts immune, cancer kill | flu-like sx, depression | (blank)
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| zanamivir | inhaler to decr. flu sx, durations & complications | caution w/ asthma pts | caution w/ asthma, can trigger bronchospasm, take w/in 2 days of onset of flu
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| oseltamivir | oral take w/ food | (blank) | take w/in 2 days of onset of flu
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| DKA | get IV for insulin and NS, give bicarb b/c acidosis, check & replace K | (blank) | (blank)
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| dilantin | for seizures, also antidysrhythmic | sedation, gingival hyperplasia, dysrhythmias & decr. BP (IV), rash, hirsutism | 100mg 2-3/d, many drug intrxn, no alcohol, narrow therapeutic (monitor levels), DO NOT mix w/ other IV drugs
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| phenobarbital | for febrile and alc/drug withdrawal seizures | (blank) | (blank)
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| tegretol | neuralgias, bipolar, and seizures | visual disturbances, ataxia, vertigo, HA, Rash (possible Steven-Johnson Syndr.), blood dyscrasias, PREG X | oral contraceptives and warfarin decreased, not with grapefruit juice
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| ( -AM ) | bezodiazepine for status epilepticus | cns depression, amnesia, abuse | (blank)
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| Depakene | for absence seizures, bipolar, prophelactic for migraines | n/d, indegestion, hepatotoxicity, pancreatitis, PREG X | freq. drug level check
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| ethosuximide | for absence seizures | well tolerated, drowsiness & N/V subsides after a few weeks | (blank)
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| trileptal | for partial seizures | dizziness, drowsiness, HA, visual disturbances, n/v, hyponatremia, rash (Steven Johnson Syndrome) | (blank)
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| baclofen/Soma/Flexeril/Robaxin/Skelaxin | muscle relaxant | sleepiness, n/v, constipation, urinary retention, dependence | w/draw gradually, avoid alcohol
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| ( -AM ) | valium - benzodiazepine - muscle relaxant | cns depression, amnesia, abuse | (blank)
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| Dantrium | acts directly on skeletal muscles, also for alignant hyperthermia | heptotoxicity, muscle weakness, diarrhea | (blank)
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| ( -TAMINE ) | for migraine, promotes vasoconstriction by stimulating seratonin | N/V, weakness in legs, numbness & tingling in fingers and toes | do not take w/ ( -TRIPTAN )
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| ( -TRIPTAN ) | 1st line migraine med, promotes vasoconstriction and decr. inflammation by stimulating seratonin | chest heaviness, angina, PREG X, vertigo, malaise, tingling | take w/ onset of sx, risk of dependence and toxicity, teach triggers, non-pharm approaches
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| Rheumatrex | 1st choice for mod-sev RA | hepatic fibrosis, bone marrow suppresin, GI ulceration, pneumonitis | check liver/kidney/CBC/platelets, 3-6 wks for onset
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| Paquenil | for mild RA | retinal damage | 3-6 wks for onset, eye exam q6 mo
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| sulfasalazine | for RA, sulfa drug | common: GI/rash & itching, Serious: hepatitis & bone marrow suppression | Sulfa alleries
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| Etanercept/infliximab/adalimumab($) | TNF blocker to reduces RA symptoms and slow progression | injection site rxn (itching swelling), risk for infection, risk for heart failure, risk for infection from live virus vaccine | mumab is expensive
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| imuran | 2nd line organ transplant rejection | anorexia, nv, neutropenia, thrombocytopenia, infection, alopecia, PREG X | prevent infection, CBC, effectiveness, w/meals, 5 days prior to transplant
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| sandimmune | prevent organ rejection often w Prednisone | Kidney damage (30%), infection, HTN, hirsutism, tremors, gingival hyperplasia | it does not der. WBC/platelets/rbc, watch BUN/Creat closely
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| muromonab-CD3 | treat acute rejection | mainly for 1st dose: lightheadedness, fever/chills (common), dyspnea, chest pain, tremors | have crash cart available for 1st dose
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