325 path 1 drugs mod 5 (E3)

Question 1

sodium bicarbonate MOA

Answer 1

dissociates to provide bicarb ion which neutralizes ion concentration and raises blood and urinary pH

Question 2

sodium bicarb indications

Answer 2

metabolic acidosis

Question 3

sodium bicarb SE

Answer 3

-edema & pulmonary edema
-cerebral hemorrhage
-hypernatremia
-abnormal lytes
-tetany
-metabolic alkalosis
-heart failure
-flatulence w/ long term use

Question 4

sodium bicarb nursing considerations

Answer 4

-monitor lytes, ABGs, and cardiac
PO med, do not give IV for hyponatremia (if given IV monitor patency)
-lots of drug interactions
-give 1 to 3 hrs after meals

Question 5

potassium chloride MOA

Answer 5

giving K+

Question 6

potassium chloride indications

Answer 6

treat/prevent K+ depletions when dietary measures provide inadequate

Question 7

potassium chloride nursing considerations

Answer 7

-bad taste, dilute w/ water or juice if powder
-GI ulcers/bleeding
-IV must always be diluted & never IV push
-cannot give IV if pt is not peeing
-IV might cause pain or phlebitis
-have pt on tele always think heart

Question 8

potassium chloride contraindications

Answer 8

-renal failure (always question order if pt is on dialysis)

Question 9

polystyrene sulfonate MOA

Answer 9

binds to K+ in the digestive tract replacing K+ ions for sodium ions

Question 10

polystyrene sulfonate indications

Answer 10

to treat high levels of potassium in the blood

Question 11

polystyrene sulfonate SE

Answer 11

-constipation
-diarrhea
-N/V
-hypokalemia
-(severe) intestinal obstruction & necrosis

Question 12

polystyrene sulfonate precautions

Answer 12

only use in pts w/ normal bowel functions

Question 13

what drug do you use for an emergent pt that has hyperkalemia

Answer 13

D50/Insullin

Question 14

oral magnesium name

Answer 14

mylanta or magnesium sulfate

Question 15

IV magnesium

Answer 15

(magnesium sulfate) replace over several days & can give push if needed

Question 16

magnesium sulfate MOA

Answer 16

replaces Mg

Question 17

magnesium sulfate indication

Answer 17

hypomag, prevent/treat seizures in pre eclampsia, treat cardiac rhythm disturbances

Question 18

magnesium sulfate SE

Answer 18

-hypermag
-confusion/sluggish
-slow movements
-SOB
-nausea
-dizzy
-abnormal heart rhythm

Question 19

magnesium oxide

Answer 19

antacid, can be given for long term low mag

Question 20

how should you give calcium chloride or gluconate

Answer 20

through a central line

Question 21

when given oral calcium what else might you need

Answer 21

Vitamin D

Question 22

how to give IV phos

Answer 22

over long period of time

Question 23

Phosphorus nursing considerations

Answer 23

take care w/ CKD or hypercalcemia bc of increased risk of calcifications

Question 24

class: polyenes

Answer 24

-nystatin
-amphotericin

Question 25

class: pyrimidine

Answer 25

flucytosine

Question 26

class: azoles

Answer 26

fluconazole

Question 27

class: misc. agents

Answer 27

grisefulvin

Question 28

Nystatin indications

Answer 28

treatment of superficial candida infections of mouth, oral mucosa, vagina, topical, vaginal (**yeast**)

Question 29

Nystatin SE

Answer 29

-mild skin irritation -N/V/D -poor GI absorption

Question 30

Nystatin nursing considerations

Answer 30

-too toxic for parental administration -not for systemic infection

Question 31

amphotericin B MOA

Answer 31

binds to erosterol in fungal cell membranes and causes them to become leaky and destroy cell wall of the fungus

Question 32

amphotericin B indications

Answer 32

-agent of choice for most systemic mycoses (fungal)

Question 33

amphotericin B nursing considerations

Answer 33

-can be given PO or IV -dilute & infuse slowly (every other day for months, possible PICC line) -monitor BUN, creatinine & pt on tele -synergistic effects when given w/ flucytosine so help decrease SE

Question 34

amphotericin B SE

Answer 34

-kidney dysfunction -cardiac dysthymias -fever -pain -nausea -headache

Question 35

what do you give to pre treat amphotericin B

Answer 35

-diphenhydramine -acetaminophen -aspirin

Question 36

flucytosine MOA

Answer 36

inhibits fungal DNA synthesis

Question 37

flucytosine indications

Answer 37

allows for a lower dose of amphotericin B to be used

Question 38

flucytosine nursing considerations

Answer 38

usually never given alone

Question 39

fluconazole (& all other "zoles") MOA

Answer 39

interrupts the integrity of the cell wall by interfering w/ the synthesis of ergosterol

Question 40

fluconazole (& all other "zoles") indications

Answer 40

used for both superficial and less serious systemic fungal infections

Question 41

fluconazole (& all other "zoles") SE

Answer 41

-redness/burning/itching (topical) -severe GI upset (systemic) -liver toxicity (systemic)

Question 42

fluconazole (& all other "zoles") nursing considerations

Answer 42

-take w/ food to minimize SE -if oral, separate at least 2 hr from antacids & drugs that decrease stomach acid

Question 43

just fluconazole nursing considerations

Answer 43

-if giving IV, do not mix with other meds -monitor coags for pt on warfarin -watch for hypogly for pts w/ sulfonylureas

Question 44

fluconazole advantages

Answer 44

rapidly and completely absorbed when given orally - able to reach bones, CNS, eyes, respiratory and urinary tracts (**much less toxic than amphotericin** )

Question 45

fluconazole disadvantages

Answer 45

-narrow spectrum -many drug interactions (CYP450 pathway)

Question 46

grisefulvin MOA

Answer 46

inhibits fungal mitosis -> binds to keratin

Question 47

grisefulvin SE

Answer 47

-bone marrow suppression -rash -CNS changes -N/V/D -anorexia

Question 48

grisefulvin indications

Answer 48

resistant dermatophyte infection of scalp, skin and nails

Question 49

class: granulocyte colony stimulating factors (G-CSF) -> hematopoietic agents

Answer 49

-filgrastim -pegfilgrastim (long acting form)

Question 50

filgrastim MOA

Answer 50

promotes proliferation, differentiation, activation of cells that make granulocytes

Question 51

filgrastim indications

Answer 51

malignancies, chemo induced leukopenia, bone marrow transplant, harvesting of hematopoietic stem cells, chronic neutropenia

Question 52

filgrastim SE

Answer 52

-bone pain -leukocytosis

Question 53

pegfilgrastim MOA

Answer 53

increased production of neutrophils

Question 54

pegfilgrastim SE

Answer 54

bone pain

Question 55

pegfilgrastim nursing considerations

Answer 55

long acting derivative of filgrastim