Nurs572 Exam 2 part1 Word Scramble
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Question | Answer |
Four live attenuated vaccines | LAIV, MMR, Varicella, Rotavirus |
contraindications live attenuated virus vaccine | pregnancy, immmunocomp, HIG / whole blood recipient |
LAIV | live attenuated influenza virus |
which influenza vaccine is live attenuated? | LAIV - nasal admin |
which influenza vaccine is inactivated | TIV - IM, ID admin |
MMR | live attenuated measles, mumps, rubella |
which vaccine is most likely to cause anaphylaxis | MMR |
varicella | live attenuated varicella virus |
which immunization is contraindicated for ASA/salicylates that can lead to Reyes | Varicella vaccine |
Rotavirus-1 | live, attenuated, ORAL admin (1), pentavalent |
Rotavirus-2 | live, attenuated ORAL admin (2 dose), monovalent |
Which vaccines are conjugated? | HIB, PCV, MCV4 |
HIB | hemophilus influenza type b |
PCV | pneumoccoal conjugate vaccine |
MCV4 | meningococcal conjugate vaccine - tetravalent |
Example of toxoid vaccine | DTaP |
DTaP | Diptheria, Tetanus, Acellular Pertussis |
Which is adult toxoid immunization | TDap = tetanus toxoid, diptheria toxoid, acellular pertussis |
What is DTwP? | Diptheria, tetanus and WHOLE CELL Bordatella Pertussis - -which leads to more serious ADRs |
What are the 4 inactivated vaccines | IPV, Hep A, Hep B, TIV (inactivated influenza) |
IPV | inactivated poliovirus |
Does IPV cause poliovirus? | No, it is inactivated. Only the previous oral poliovirus vaccine was active, no longer available |
HepB | has HepB surface antigen |
How do we administer HepB to newborns? | If mom is HepB+ then newborn gets both HBIGs and vaccine. If mom is HepB- then newborn gets vaccine only |
HepA | inactivated HepA virus |
Who do we administer HepA to? | In Arizona, a high risk region, it is recommended routinely for kids |
TIV | inactivated influenza, given IM, ID |
What vaccine is inactive virus-like particles? | HPV |
HPV recommended age admin | 9-26, ideally start 3 IM doses at 11-12 yo |
mild allergic response mediated by | histamine |
anaphylaxis mediated by | leukotrienes, prostaglandins |
Which antihistamine generation has fewest side effects | 2nd generation antihistamines |
Do H1 antagonists bind at H2 receptors? | No, they only bind H1 receptors |
What is the MOA of H1 antagonists? | selective binding to H1 receptor preventing them from activation; also anticholinergic in CNS and PNS |
How do some antihistamines treat for motion sickness? | the anticholinergic effects in the vomit center of medulla, CN VIII vestibular apparatus |
Besides allergic related disorders, what are other uses for antihistamines? | transfusion reactions, motion sickness, insomnia, URIs |
How does antihistamine help in treatment of common cold? | anticholinergic effect prevents secrtions which leads to drying of mucous membranes |
What is the most common compliance related side effect | sedation |
Antihistamine drug interaction with this class of drugs | CNS depressants, has additive effect |
Which generation of anthistamines has the greates anticholinergic effect | first generation anthistamine |
Side effects of antihistamines | CNS - sedation, dizzy, confusion. GI - A,N,V,D,C. anticholinergic, cardiac dysrhythmias |
Four First Generation H1 antagonists | diphenydramine, chlorpheniramine, cyproheptadine, promethazine (antipsychotic) |
one of the first antihistamines | diphenhydramine(1st gen) |
antihistamine that is less sedating, better tolerated | chloropheniramine (1st gen) |
antihistamine that adds appetite stimulation action | cyproheptadine (1st gen) |
Antihistamine that is also anti-nausea, antipsychotic class | promethazine (1st gen) |
Which class of antihistamines is less effective for URI? | Second generation less effective because of lower anticholinergic effects |
which class of antihistamines should not be used for insomnia | second generation less effective because they are less sedating |
what are the 7 second generation antihistamines | certirizine, levocertirizine, fexofenadine, loratadine, desloratidine, azelastine, olopatadine |
2nd generation racemic mixture antihistamines | certirizine, levocertirizine |
2nd generation metabolite of terfenandine, no indication of torsade de pointes | fexofenadine |
2nd generation antihistamine that I take | loratadine |
2nd generation antihistamine that is longer acting metabolite of loratadine | desloratadine |
2nd generation antihistamines (2) nasal sprays | azelastine, olopatadine |
side effect of calcium, Vit D products | constipation |
What class of drugs cause decreased absorption of Vit D and calcium products | corticosteroids |
Oral forms of calcium | calcium salts, usually calcium carbonate, which has highest percent calcium, cheapest |
other forms of calcium salts | calcium -- chloride, gluconate, glucepate, acetate, lactate, citrate |
what is the oral form of calcium | calcium glubionate |
what is the inactive form of vitamin D | cholecalciferol |
Which activated form of Vitamin D is given either po or injection | calcitriol |
what form of activated vitamin D is given ONLY po and is synthetic | doxercalciferol |
what form of activated Vitamin D is given ONLY INJECTION and is synthetic | paricalcitol |
What is the MOA of bisphosphonates | poorest bioavailability absorbs into bone to inhibit osteoclasts |
What are bisphosphonates used for | prevention and treatment of osteoporosis in periomenopausal, osteoporosis in males, anyone with corticosteroid induced osteoporosis |
what is a dangerous ADR with bisphosphonates | esophagitis |
special admin instructions for bisphosphonates | first thing in AM before food, with full glass of water, stay upright with no food for at least 30 minutes |
name 3 bisphosphonates | alendronate, risedronate, ibandronate |
Which bisphosphonates are given daily or weekly | alendronate, risedronate |
Which bisphosphonate is given daily or monthly | ibandronate |
What SERM is commonly used for osteoporosis and may also protect against estrogen-receptor-positive breat cancer | raloxifine |
what is the MOA of calcitonin | major role to inhibit osteoclasts --> decreased bone resorption |
what is the minor role of calcitonin | inhibits renal reabsorption of calcium --> decreased serum calcium levels |
what is an unusual ADR for some calcitonin long-term patients | they can develop antibodies to this product |
What is the only drug to increase bone formation | teriparatide |
how does teriparatide increase bone formation | it is a recombinant form of PTH that increases osteoblast activity > it increases osteoclast activity. Net effect is more bone formation than reabsorption |
what drug is a calcimemetic | cinacalcet |
What is cinacalcet's MOA | increases sensitivity of calcium sensing cells in parathyroid --> negative feedback to decrease PTH secretion at lower levels of calcium than usual |
what is cinacalcet given for | hypercalcemia - by keeping calcium on the bone by increasing PTH receptor sensitivity |
most common type of glaucoma | primary open angle glaucoma (POAG) |
What are two mechanisms to treat glaucoma | Decreased aqueous production (ABC) and Increased outflow (PP) |
The classes of drugs that decrease aqueous humor production | Alpha-2 agonists, Beta Blockers, Carbonic Anhydrase Inhibitors |
Classes of drugs that increase aqueous outflow | prostaglandins, parasympathomimetics |
Drug in Alpha 2 agonist glaucoma | brimonidine |
Which Beta blocker drugs are more effective in treating glaucoma | non-selective B1B2 are more effective, thought to be Beta-2 receptor that mediates aqueous production |
What are the non-selective beta blockers for glaucoma | timolol, carteolol, levobunolol, metipranolol |
What is the selective Beta-1 blocker for glaucoms | betaxolol |
What class is the first line agents in glaucoma treatment | Beta Blockers used first |
What are general side effects for ABC drugs | Occular: burn, sting, hyperemia Systemic: HA, fatigue, xerostomia, cross BBB |
What are general ADRs for CAIs | occular: burt, sting, allergy, dry Systemic: metallic taste, asthenia, paresthesias |
CAIs - topical admin | dorzolamide, brinzolamide |
CAIs - systemic admin | acetazolamide, methazolamide, dichlorphenamide |
What class of drugs that increase outflow of aqueous humor are also considered by many to be a first-line treatment along with Beta Blockers? | prostaglandins also considered this |
Advantages of prostaglandin admin | daily dosing, equally effective to beta blockers |
What are most common occular s/e of prostaglandins | racoon pigmentation around iris, eyelids, skin near eye. eylash growth, and the usual others |
Name 3 prostaglandins | latanoprost, travoprost, bimatroprost |
prostaglandin 1 of 3 | latanoprost |
prostaglandin 2 of 3 | travoprost |
prostaglandin 3 of 3 | bimatroprost |
What is MOA of parasympathomimetic for glaucoma | miosis pulls iris away from lining of sclera, opening the drain |
What class is considered SECOND TO LAST resort for glaucoma | parasympathomimetics |
What two classes of parasympathomimetics for glaucoma | direct acting cholinergics, indirect action AChE inhibitors |
What are unusual occular s/e of parasympathomimetics | brow ache, ciliary muscle spasm, miosis, iris pigmentation, cataracts |
Name 2 direct acting parasympathomimetic drugs for glaucoma | pilocarpine, carbachol |
Name 1 indirect acting parasympathomimetic drug for glaucoma | echothiophate |
name 1 non-selective adrenergic hardly ever used for glaucoma | dipivefrin |
What are the general MOAs of antibiotics | cell wall synthesis, membrane permeability, protein/nucleic acid synthesis, antimetabolites, viral enzyme inhibitors |
the term chemotherapy, in general | traditionally applies to cancer therapy, but applies equally to therapy of infectous disease |
narrow spectrum vs. broad spectrum | narrow targets a few microbes, broad targets many microbes |
bactericidal vs. bacteriostatic | cidal kills the bug, static slows its growth, giving immune system better odds to overcome |
mechanisms microbial resistance | resistance to drug metabolizing enzymes, drugs ability to penetrate cell, microbial receptor alteration, efflux pumps remove drug from cell, synthesis of antagonistic substances |
slogan for antimicrobial resistance | cure the patient today; protect the community tomorrow . . .and . . .don't medicate instead of educate |
selection of antibiotic - triad concept | bug-drug-patient |
selection of antibiotic - factors | identify likely organism, its susceptibility, host factors, drug factors |
special circumstances where broad spectrum may be advisable | fever unknown origin, surgical drainage/prophylactic tx, immunosuppressed host, difficult locale of pathogen (CSF, endocardum, osteomyelitis) |
prophylactic antibiotics administered when | first dose before incision of clean and clean/microbial contaminated surgery. agent must cover spectrum of usual etiological agents. |
who long do we admin prophylactic antibiotics | intra-op doses only if duration of procedure > serum level of agent used. RARELY are post-op doses necessary, may be counterproductive |
classes of cancer drug therapies | cytotoxic agents, hormones, biologic response modifiers |
chemotherapy drugs more toxic to tissue with | more toxic to tissues with high growth factors-> act more on actively growing cells |
Types of fast-growing cells targeted by chemorx | tumor cells, bone marrow, GI tract, skin/hair follicles, sperm |
types of chemorx strategies | intermittent chemo, combination chemo, optimizing dosage schedules, regional drug delivery |
intermittent chemo objective | results in regrowth of normal cells faster than regrowth of tumor cells |
chemo side effects- bone marrow suppression | neutropenia, thrombocytopenia, anemia (least significant) |
chemo side effects - GI | stromatitis (ulcers), n/v some d |
chemo side effects - hair | alopecia |
chemo side effects - hyperuricemia | cell death increases byproducts resulting in increased uric acid |
chemo side effects - extravasation | admin needle exits vessel--> toxic chemo into tissues |
chemo side effects- reproductive | fetotoxic (inhibits embryogenesis), some irreversible sterility in males |
chemo side effects - carcinogenesis | many agents cause other cancers long-term |
chemo side effects - unique toxicities | cardiotoxicity, nephrotoxicity, neuropathy |
Created by:
lorrelaws
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