nursing sdg
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| Names of meds | 1.Sulfonamides: sulfa-
2.Penicillins: -cillin
3.Cephalosporins: cef-
4.Tetracyclines: -cycline
5.Macrolides: -mycin
6.Fluroquinolones: -floxacin
7.Aminoglycosides: -cin
8.Anti-virals: -vir
9.Anti-fungal: -zole
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| What is the action of sulfonamides? | =Bacteriostatic(Capable of inhibiting the growth or reproduction of bacteria).
"inhibits" folic acid-> no cell wall formation.
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| What are the adverse reactions of sulfanomides? | hematologic changes:
1.thrombocytopenia( bleeding)
2.aplastic anemia( bone marrow deficit)
3.leukopenia ( decrease WBC)
4.Steven-Johnson Syndrome
5.Crystalluria (increase fluids)
6.Yellow-orange urine
7.Photosensitivity/skin necrosis(sunscreen).
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| What are the contraindications/interactions for Sulfonamides? | 1. do not use if kidney failure
2.sulfo. will increase anticoagulant action.
3.sulfo. + methotrexate=increase bone marrow suppression
3. take sulfo. on empty stomach.
4. sulfasalazine + food is ok
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| Sulfonamides on burns. | Mafenide or silver sulfadiazine for burns.
clean are first then place med+dressing s/e: stinging/burning sensation temporary.
Watch for skin necrosis.
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| Penicillin action | bactericidal, prophylaxis.
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| Penicillin adverse reactions. | AR: anaphylaxis,
cross sensitivity ( between penicillin and cephalosporin; when you're allergic to one, you're allergic to both), superinfections: bacterial,fungal, GI.
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| Penicillin adverse reactions(hematologic changes) | AR hematologic changes:
thrombocytopenia(bleeding),
aplastic anemia( bone marrow deficit), leukopenia ( decrease WBC), Steven-Johnson Syndrome.
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| Penicillin drug resistance | Bacteria has natural resistance or has acquired resistance (example: MRSA.
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| "secondary"/"superinfection" | 1. pseudomembranous colitis( blood& mucous/bacterial).
-Clostridium difficile : pseudomembranous colitis(diarrhea as a result).
2. Vaginal or anal pain or itching.
3. stomatitis TX: vicous lidocaine ( anesthetic).
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| Penicillin interactions | 1. PCN= BCP= decrease effectiveness of BCP.
2.PCN+tetracycline=decrease effectiveness of tetracycline.
3. PCN+ anticoagulant=increase bleeding risk.
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| penicillins implementation. | 1.Take PCN on empty stomach.
2.Check for fungal & bacterial superinfections.( to decrease risk of fungal & bacterial superinfections, add yogurt , buttermilk & acidophilus in the diet).
3.Give antipyretics , antifungals.
4.Use soft bristled toothbrush.
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| signs & symptoms of anaphylactic shock. | 1. loss of consciousness.
2. difficulty breathing d/t airway constriction.
3. lowered blood pressure.
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| cephalosporins action & uses. | action=bactericidal.
uses: UTI, ear infections.
divided into 1st, 2nd, 3rd, & 4th generation drugs.
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| cephalosporins adverse reactions | AR: N/V, diarrhea, nephrotoxicity, hepatotoxicity.
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| cephalosporins interactions | 1.cephalosporins+ aminoglycoside= nephrotoxicity
2. cephalosporin+alcohol= Disulfiram-like reaction ( makes you nauseated).
3.cephalosporin+anticoagulant=
increase bleeding risk.
C+A=Nephrotoxic
C+Al= Disulfirum-like Rx.
C+ Anti = increase bleeding
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| cephalosporins implementations. | 1.Take cephalosporin on empty stomach. Food ok if upset stomach.
2. Watch for superinfection (fungal & bacterial)
3. Inspect for phlebitis & thrombophlebitis.
-fully reconstitute powder .
- shake oral supensions & keep refridgerated.
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| What is disulfiram ? | Used to produce aversion to alcohol in the treatment of alcoholism because extremely uncomfortable symptoms occur when its administration is followed by ingestion of alcohol.
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| What is superinfection? | Infectious disease An infection that follows a prior infection, which occurs when native regional flora are substantially reduced, often by antibiotics, allowing invasion by opportunistic organisms, as in pseudomembranous colitis or esophageal candidiasis
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| Tetracyclines action. | 1.broad spectrum bacteriostatic.
2.used when cannot use PCN.
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| Tetracycline adverse reactions. | 1. superinfections ( fungal& bacterial).
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| Tetracycline interactions. | 1.TCN+ digoxin level= increase Digoxin level.
2.TCN + oral anti-coagulant= increase bleeding risk.
3.Take TCN on empty stomach.
4.TCN+BCP=decrease effectiveness of BCP.
5. no milk(calcium), no antacids, no laxatives b/c these decreases TCN effectivene
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| Tetracycline adverse reactions. | 1.N/V, diarrhea.
2.epigastric distress.
3. stomatitis ( Inflammation of the mucous membrane of the mouth).
4.photosensitivity
5.yellow teeth stains.
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| Tetracycline contraindications. | -don't give Tetracycline to children younger than 9 years old.
-cautious use in: liver & renal impairment.
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| Macrolide(Erythromycin) | 1. take E-mycin with food.
2. E-mycin+ Theophyliline= increase theophylline level.
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| Lincosamide ( Clindamycin) | 1.Give clindamycin with food or a full glass of water.
2.Do not give lincosamides to someone with a viral infection.
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| Fluroquinolones ( ciprofloxacin) & Aminoglycosides (gentamycin) uses. | - used for resistant bacteria such as pneumonia, UTI, etc.
- this is a broad-spectrum bactericidal.
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| Fluroquinolones ( ciprofloxacin) & Aminoglycosides (gentamycin) adverse reactions | 1.N/V , diarrhea.
2. epigastric distress.
3.stomatitis
4. photosentivity
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| Aminoglycosides adverse reactions | 1. nephrotoxicity (hematuria;check BUN)
2. ototoxicity(tinnitus, vertigo)
3. neurotoxicity ( numbness, pain)
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| Aminoglycosides interactions. | 1. Aminoglycosides + cephalosporins=increase nephrotoxicity.
2.Aminoglycosides + loop diuretics= increase ototoxicity.
3. Aminoglycosides + Pavulon= increase
neuromuscular blockade.
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| Fluroquinolones & Aminoglycoside implementation. | 1. PCN + Aminoglycoside = cancels each other.
2. Fluroquinolones + NSAIDs= risk of seizures.
3.don't open enteric coated tablets/capsules.
4.drink lots of water.
5. photosensitivity
6.diarrhea
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| antiviral uses/info/interactions. | uses:CMV in transplant pts., HSV1&2,herpes zoster,HIV, influenza,Hepatitis B&C
info:-decrease virus'ability to reproduce in a cell.
-toxic to human cells.
-these drugs do not cure!
interaction: anti viral+theophylline= increase theophylline blood leve
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| Vancomycin action/uses/complications. | action: bacteriostatic & bactericidal ( depending on dosage).
used for: health/community-acquired pneumonias, skin infections, clostridium difficle ( pseudomembraneous colitis)
complications: vancomycin-resistant enterococcus (VRE).
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| Vancomycin interaction/adverse reactions. | interaction:linezolid+ chocolate, coffee(tyramine)= HTN
adverse reactions: N/V, diarrhea,photosensitivity, ototoxicity, nephrotoxicity, chills(blankets),stomatitis.
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| anti-fungal: amphotericin B | 1.protect IV solution from exposure to light.
2.admin drug immediately after drug is reconstituted.
3. renal damage (most serious AR), so serum creatinine and BUN levels are checked frequently.
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| amphotericin B adverse reactions/interactions. | 1.renal damage (most serious AR), so serum creatinine and BUN levels are checked frequently.
2.bone marrow depression.
3.chills(blanket)
interaction
amphotericin B: increase risk of Digoxin toxicity.
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| Treating iron deficiency anemia: actions & uses | 1.iron preparations( act by elevating serum iron [] , which replenishes Hg & depleted iron stores).
2.vitamin C : increases absorption of iron.
3.milk & tetracycline decrease absorption of iron.
4.iron may stain skin;mix in water/juice and sip with str
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| parenteral iron | -used when pt. can't take oral drugs or when GI intolerance to oral iron admin.
- treats iron deficiency anemia.
-watch for phlebitis
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| iron adverse reactions/contraindications | AR: GI reactions( GI irritations, vomiting, constipation, diarrhea, dark stools;generalized system reactions).
iron supplements: contraindicated in pts. with known hypersensitivity to drug, or any component of the drug.
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| iron contrainications/precautions | iron compounds: contraindicated in pts with hemochromatosis(A hereditary disorder in which iron salts are deposited in the tissues.) or hemolytic anemia.
used cautiously : in pts. with hypersensitivity to aspirin.
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| iron interactions | 1.antibiotics:decrease GI absorption or the antibiotic;TCN decreases iron absorption).
2.levothyroxine:decrease absorption of levothyroxine.
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| iron interactions (con't) | 3.levodopa, methyldopa:decreased effect of Parkinson's medication.
4.ascorbic acid(vitamin C):increased absorption of iron.
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| iron interactions(con't) | 5.hematochromatosis: a disorder that interferes with iron metabolism which resultes in too much iron in the body. The iron builds up in the liver and leads to hepatomagaly.
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| drugs for anemia assoc. with chronic illness/adverse reactions for both. | 1. Epoetin alfa ( Epogen, Procrit)
2. Darbepoetin alfa
AR: 1. HTN, headache, N/V diarrhea, rashes, fatigue, arthralgia (Pain in a joint), skin reaction @ injection site.
2. polycythemia : increase in RBC count.
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| Epoeitn alfa contraindicaitons/precautions | 1.epoeitn alfa: contraindicated in pts. /w uncontrolled HTN, those needing emergency transfusion, those /w hypersensitivity to human albumin. Used with caution in pts. with HTN; heart disease; CHF; history of seizures.
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| Darbepoeitin alfa contraindications | contraindicated in patients with uncontrolled HTN, those allergic to drug.
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| drugs used in Treating folic acid deficiency anemia: actions&uses | 1.follic acid: used in treating megaloblastic anemia; for woemen of childbearing age to decrease incidence of neural tube defects( ex. anencephaly, meningocele).
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| drugs used in Treating folic acid deficiency anemia: actions&uses | 2. leucovorin: used to diminish hematologic effects or methotrexate (used in treating certain types of cancer) .
-leucovorin"rescues" normal cells from being destroyed by methotrexate/called "folinic acid rescue".
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| folic acid contraindications/precautions/interactions | 1.folic acid leucovorin: contraindicated for Tx. pernicious anemia, other anemias in which vitamin B12 is deficient.
2. pregnant wmeon with folate dificiency are @ increased risk for complications of pregnancy, fetal abnormalities.
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| folic acid contraindications/precautions/interactions (con't) | 3. signs of folate deficiency: occurs when sulfasalazine admin. concurrently.
4. increase in seizure activity: occurs when folic acid is admin. with hydantoins.
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| Why Vitamin B12 is essential? |
-Vitamin B12 is essential to growth, cell reproduction, manufacture of myelin, & blood cell production
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| drugs used in Tx Vitamin B12 deficiency anemia : action/uses/adverse reactions | Vitamin B 12: treat pts. with a viram B12 deficiency; also used to perform the Schilling test.
AR: mild diarrhea, itching; increase in RBCs production, acne, peripheral vascular thrombosis; CHF, pulmonary edema.
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| Vitamin B12 deficiency contraindication/precautions/interactions. | contraindicated: allergic cyanocobalamin.
admin: cautiously during pregnancy, in pts with pulmonary disease, anemia.
alcohol, neomycin, colchine=decrease the absorption of oral vitamin B12.
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