c13 Flashcards
(105 cards)
1
Q
Phenylephrine (Neo-Synephrine) therapeutic class and pharmacologic class
A
Therapeutic Class: Nasal decongestant; mydriatic drug; antihypotensive
Pharmacologic Class: Adrenergic drug (sympathomimetic)
2
Q
Prazosin (Minipress) therapeutic class and pharmacologic class
A
Therapeutic Class: Antihypertensive
Pharmacologic Class: Adrenergic-blocking drug
3
Q
mechanism of action of Phenylephrine (Neo-Synephrine)
A
stimulate the sympathetic nervous system directly/indirectly
4
Q
uses Phenylephrine (Neo-Synephrine)
A
produces many of the same responses as anticholinergics
- constricts blood vessels –> BP goes up and treats nasocongestion
5
Q
severe reactions of Phenylephrine (Neo-Synephrine)
A
- death –> restrict IV use USE SMALL DOSES
6
Q
MOA Prazosin (Minipress)
A
inhibit sympathetic nervous system
7
Q
uses of Prazosin (Minipress)
A
- hypertension
- dysrhytmias
- angina
- heart failure
- benign prostatic hypertrophy BPH
- narrow-angle glaucoma
8
Q
primary use of adrenergic-blocking drugs
A
hypertension
9
Q
therapetuic and pharmacologic class of ibuprofen (advil, motrin)
A
Therapeutic Class: analgesic, anti-inflammatory drug, antipyretic
Pharmacologic Class: NSAID
10
Q
ibuprofen (advil, motrin) uses
A
- mild to moderate pain
- fever
- inflammation
11
Q
ibuprofen (advil, motrin) actions are due to what?
A
inhibition of prostaglandin synthesis
12
Q
common indications of ibuprofen (advil, motrin)
A
- pain associated w/ chronic musculoskeletal disorders
- RA + osteoarthritis - headache
- dental pain
- dysmenoorhea
13
Q
administration alerts of ibuprofen (advil, motrin
A
give the drug on an empty stomach
if nausea, vomiting, or abdominal pain occurs, give w/ food
14
Q
adverse effects of ibuprofen (advil, motrin)
A
- nausea
- heartburn
- epigastric pain
- dizziness
- GI ulceration w/ occult or gross bleed MAY occur w/ high doses for prolonged periods
- renal impairment due to chronic use
15
Q
black box warning for ibuprofen (advil, motrin)
A
- increased risk of serious thrombotic events
- MI
- stroke –> fatal
- increased risk of GI events including bleeding, ulceration, perforation of the stomach or intestines
- occurs more frequently in older adults
16
Q
contraindications of ibuprofen (advil, motrin)
A
- pt w/ active peptic ulcers
- significant renal or hepatic impairment
- HF
- serious HTN
- stroke or MI
17
Q
drug-drug interactions of ibuprofen (advil, motrin)
A
- anticoagulants and other coagulation modifiers
- aspirin –> decreases anti-inflammatory action
- antihypertensive action of diuretics, beta blockers, ACE inhibitors
18
Q
treatment of overdose of ibuprofen (advil, motrin)
A
alkaline drug
19
Q
therapetuic and pharmacologic class of prednisone
A
therapeutic class: anti-inflammatory drug
pharmacologic class: corticosteroid
20
Q
uses of prednisone
A
- synthetic corticosteroid –> actions are the result of being metabolized to an active form
- duration = 4-10 days
- acute brochopasm
- antineoplastic agent
21
Q
administration alerts of prednisone
A
- do not use if signs of system infection are present
2. slowly decrease dose if using more than 10 days
22
Q
adverse effects of prednisone
A
- long-term therapy –> Cushing’s syndrome
23
Q
contraindications of prednisone
A
active viral, bacterial, fungal, or protozoan infections
24
Q
drug-drug interactions of prednisone
A
- concurrent use w/ amphotericin B or diuretics increases potassium loss
- can raise blood glucose levels –> pt with diabetes need insulin dose adjusted
25
therapetuic and phamacologic class of acetaminophen (tylenol)
therapeutic class: antipyretic and analgesic
pharmacologic class, centrally acting COX inhibitor
26
uses of acetaminophen (tylenol)
has no anti-inflmamtory properties --> ineffective in treating arthritis or pain caused by tissue swelling following injury
1. TREATS FEVER
2. relieves mild-moderate pain
3. severe pain --> combined w/ opioids
27
action of acetaminophen (tylenol)
reduces fever by direct action at the level of hypothalamus and dilation of peripheral blood vessels, which enables sweating and dissipation of heat
does not cause GI bleeding or ulcers, like NSAIDS
28
administration alert of acetaminophen (tylenol)
1. regular consumption of alcohol --> drug-induced hepatoxicity
destroys liver if overdose --> die
29
adverse effects of acetaminophen (tylenol)
liver + hypothalamus
1. malnoursihed --> acut toxicity --> renal failure --> fatal
2. acute toxicity: nausea, vomitting, chills, abdominal discomfort, and fatal hepatic necrosis
2. liver damage risk
30
black box warning of acetaminophen (tylenol)
1. potential to cause severe and fatal LIVER INJURY
| 2. serious allergic reactions w/ symptoms of angioedema, difficulty breathing, itching, or rash
31
contraindications of acetaminophen (tylenol)
chronic alcoholism
32
drug-drug interactions of acetaminophen (tylenol)
1. inhibits warfarin metabolism
| 2. high dose or long term use --> elevated warfarin levels + bleeding
33
hepatitis B vaccine classes
vaccine
34
uses of hepatitis B vaccine
ppl at risk for exposre to hepatitis virus
1. infants born to HBV-positive mothers
2. HPV-infected blood exposure
3. High-risk sexual practices (multiple partners)
4. ppl who contract STIs repeatedly
5. healthcare workers
6. dialysis pt
7. prisoners
8. HBV areas of travel
35
how is Hep B vaccine produced and how many injections are needed?
recombinant DNA technology using yeast cells
3 IM injections; second dose is given 1 month after first, and third dose 6 months after first dose
36
contraindications of Hep B vaccine
hypersensitivity to yeast or HBV vaccine
1. fever or active infections
2. compromised cardiopulmonary status
37
drug-drug interaction of hep b
immunosuppresants will decrease effectiveness
38
classes of Interferon alfa-2b (intron-A)
therapeutic class: immunostimulant
pharmacologic class: interferon, biologic response modifier
39
actions/uses of Interferon alfa-2b (intron-A)
biologic response modifier prepared by recombinant DNA technology --> treat cancers and viral infections
available for IV, IM, and subcutaneous administration
40
administration alerts of Interferon alfa-2b (intron-A)
1. provider experienced with its use
| 2. subcutaneous administration is recommended for pt at risk for bleeding
41
adverse effects of Interferon alfa-2b (intron-A)
flulike syndrome of fever, chills, dizziness, fatigue
headache, nausea, vomiting, diarrhea, and anorexia, depression, suicidal ideation
serious toxicity --> immunosuppression, hepatotoxicity, neurotoxicity
42
black box warning of Interferon alfa-2b (intron-A)
cause aggravate fatal or life-threaning neuropsychiatric, autoimmune, ischemic, or infectious disorders
43
contraindications of Interferon alfa-2b (intron-A)
hypersenstivity to IFNs, autoimmune hepatitis, and hepatic decompensation
neonates and infants
44
cyclosporine (gengraf, neoral, sandimmune) classes
therapeutic: immunosuppressant
pharmacologic: calcineurin inhibitor
45
actions and uses of cyclosporine (gengraf, neoral, sandimmune)
1. obtained from a soil fungus that inhibits helper T cells
2. less toxic to bone marrow cells
3. used in combo w/ high doses of corticosteroid
4. approved for prophylaxis of kidney, heart, liver transplant reject; psoriasis, xerophthalmia
46
adverse effects of cyclosporine (gengraf, neoral, sandimmune)
1. kidneys
- reduced urine output
2. hypertension and tremor
3. headache, gingival hyperplasia, elevated hepatic enzymes
47
black box warning of cyclosporine (gengraf, neoral, sandimmune)
only adminstered by healthcare providers experienced
serious infections and possible malignancies
monitor renal function
48
penicillin G classes
therapetuic: antibacterial
pharacologic: cell wall inhibitor, natural penicillin
49
penicillin G uses + actions
1. drug of choice against streptococci, pneumococci, and staphylococci organisms that do not produce penicillinase and are shown to be susceptible by C&S testing
2. gonorrhea and syphilis
3. given by IV + IM
4. pencilin V and amoxicillin --> oral penicillin therapy is desired
50
adverse effects of penicillin G
diarrhea, nausea, and vomiting
anaphylaxis
late hypersenetivity
51
contraindications of penicillin G
pt with severe renal disease
52
cefazolin (ancef, kefzol) classes
therapeutic class: antibacterial
pharmacologic class: cell wall inhibitor: 1st generation cephalosporin
53
actions and uses of cefazolin (ancef, kefzol)
1. beta-lactam antibiotic used for treatment and prophylaxis of bacterial --> susceptible gram-positive organisms
2. respiratory tract, urinary tract, skin structures, biliary tract, bones, joints
NOT effective against MRSA
longer half-life --> less frequent dosing
54
adverse effects of cefazolin (ancef, kefzol)
rash + diarrhea
pain + phlebitis can occur at IM injection sites
seizures are rare
55
contraindications of cefazolin (ancef, kefzol)
extensively excreted by kidneys --> pt w/ severe renal disease
56
Tetracycline (sumycin, others) classes
therapeutic: antibacterial
pharmacologic: tetracycline; protein synthesis inhibitor
57
actions/uses of Tetracycline (sumycin, others)
broad range of gram-positive + gram-negative, including chlmaydia, rickettsiae, mycoplasma
effective aggainst H. pylori
given pO
topical + oral preparations treat acne
58
adverse effects of Tetracycline (sumycin, others)
tendency to affect vaginal, oral, and intestinal flora --> superinfection
nausea, vomiting, epigastric burning, diarrhea
teeth discoloration
photosensitivity
59
contraindications of Tetracycline (sumycin, others)
severe renal or hepatic impairment
60
Erythromycin (Eryc, Erythrocin, others) classes
therapeutic: antibacterial
pharmacologic: macrolide; protein synthesis inhibitor
61
actions/uses of Erythromycin (Eryc, Erythrocin, others)
- inactivated by stomach acid --> coated, acid-resistant tablets or capsules that dissolve in small intestine
- pt who are unable to tolerate penicillins or have pencillin-resistnat infection
- effective against most gram-positive bacteria
62
adverse effects of Erythromycin (Eryc, Erythrocin, others)
nausea, abdominal cramping, vomitting
hearing loss, vertigo, dizziness
cardiotoxic and pose a risk for potentially fatal dysrhythmias
63
Gentamicin (Garamycin, others) classes
therapeutic: antibacteriall
pharmacologic: aminoglycoside; protein synthesis inhibitor
64
uses/actions of Gentamicin (Garamycin, others)
broad-specturm bactericidal antibiotic usually prescribed for serious urinary, respiratory, nervous, or GI infections when less toxic antibiotics are contraindicated
not absorbed by the oral route
65
how to monitor therapeutic range of Gentamicin (Garamycin, others)
check serum drug levels
66
adverse effects of Gentamicin (Garamycin, others)
rash, nausea, vomitting, fatigue
67
black box warnings of Gentamicin (Garamycin, others)
neurotoxicity may manifest as ototoxicity and produce a loss of hearing or balance
tinnitus, vertigo, persistant headaches --> signs of ototoxicity
neuromuscluar blockade and respiratory paralysis
severe neuromscular weakness
signs of reduced kidney function include oliguria, proteinuria, and elevated BUN and creatinine levels
68
contraindicaitons of Gentamicin (Garamycin, others)
pt w/ impaired renal function or those w/ hearing loss
69
Ciprofloxacin (Cipro) classes
therapeutic: antibacterial
pharmacologic: fluoroquinolone; bacterial DNA synthesis inhibitor
70
actions/uses of Ciprofloxacin (Cipro)
inhibiting bacterial DNA gyrase, affects bacterial replication and DNA repair
more effective against gram-negative
UTI, sinusitis, pneumonia, skin, bone and joint infections, infectious diarrhea, and certain eye infections
71
adverse effects of Ciprofloxacin (Cipro)
nausea, vomitting, diarrhea
dont take w/ antacids or mineral supplements bc drug absorption will be diminshed
72
black box warning of Ciprofloxacin (Cipro)
tendinitis and tendon rupture
73
contraindications of Ciprofloxacin (Cipro)
pt experiences pain or inflammation of tendon
74
trimethoprim-sulfamethoxazole (bactrim, septra) classes
therapeutic: antibacterial
pharmacologic: sulfonamide; folic acid inhibitor
75
actions/uses of trimethoprim-sulfamethoxazole (bactrim, septra)
UTIs
inhibits bacterial metabolism of folic acid
both SMZ and TMP are synergestic
-development of resistnace is lower
76
adverse effects of trimethoprim-sulfamethoxazole (bactrim, septra)
nausea and vomiting
pt w/ pre-existing kidney disease --> crystalluria, oliguria, renal failure
avoid direct sunlight
77
contraindications of trimethoprim-sulfamethoxazole (bactrim, septra)
documented megaloblastic anemia due to folate defiiency should not receive this drug
78
Isoniazid (INH) classes
therapetuic: antituberculosis drug
pharmacologic: mycolic acid inhibitor
79
Isoniazid (INH) uses/actions
first-line drug for TB
inhibit synthesis of mycolic acids, which are essential components of mycobacterial cell walls
bactericidal for actively growing organsims but bacteriostatic for dorman mycobacteria
may be used alone for chemoprophylaxis, or in combo w/ other antituberculosis drugs for treating active disease
80
adverse effects of Isoniazid (INH)
numbness of hands/feet, rash, fever
neurotoxicity, convulsions, optic neuritis, dizziness, coma, memory loss, psychoses
81
black box warning of Isoniazid (INH)
hepatoxociity
jaundince, fatigue, elevated hepatic enzymes, loss of appetite
82
contraindications of Isoniazid (INH)
severe hepatic impairment
83
mechanism of action of pencillin
kill bacteria by disrupting cell walls
most effective on gram-positive bacteria
84
primary use of pencillin
meninigtis; skin bone and joint infections; stomach infections; blood and valve infections; gas gangrene; tetanus; anthrax; sickle-cell anemia in infants
staph, strep, pneumonia
85
adverse effects of penicilin
safest class of antibiotics
bacteria can become resisitnat
allergy is possible
lowered red/ whtie blood cell and platelet levels
86
cephalosporins action
bind to bacterial cell wall, inhibit cell-wall synthesis
act w/ broad-spectrum activity against gram-negative organisms
5 generations w/ increased extent of activity
87
primary use of cephalosporins
serious infections of lower respiratory tract, central nervous system genitourinary system, nbones bloods and joints
88
adverse effects of cephalosporins
safe drugs
adverse effects similar to penicllins
89
MOA tetracycline
effective agianst broad range of gram-positive + gram-negative organisms
90
primary use of tetracycline
Rocky Mountain spotted fever
typhus, cholera, Lyme disease, peptic ulcers, and Chlamydia; newer ones for drug-resistnat intra-abdominal infections + complicated skin-structure infections, especially those caused by MRSA
91
adverse effects of tetracycline
superinfections, nausea, vomiting, diarrhea, teeth discoloration, photsensitivey; drug resistance
92
MOA macrolides
inhibits protein synthesis by binding to bacterial ribosome
effective against most gram-positivie and many gram-negative bacteria
93
primary use of macrolides
1. whooping cough
2. legionnaire's disease
3. streptococcus
4. H. influenzae
5. Mycoplasma pneumonia
94
adverse effects of macrolides
nausea, abdominal cramping and vomiting, diarrhea, superinfections, concern about resistant bacterial strains
95
aminoglycosides MOA
inhibit bacterial protein synthesis
96
primary uses of aminoglycosides
serious systemic infections caused by aerobic gram-negative bacteria, myobacteria, and some protozoans
97
adverse effects of aminoglycosides
more toxic than other antibacterial classes, with serious systemic adverse effects
98
MOA fluoroquinolones
inhibit bacterial DNA synthesis by inhibiting DNA gyrase + topoisomerase IV
99
primary use of fluoroquinolones
respiratory infections, GI, and genitourinary tract infections
skin + soft tissue infections
UTIs
prophylaxis of anthrax infection
100
adverse effects of fluroquinolones
nausea, vomiting, diarrhea, sleep disturbances, headche, dizziness,
most serious: dysrhythmias, hepatotoxicity
101
MOA sulfonamides
suppress bacterial growth by inhibitng bacterial synthesis of folic acid
102
sulfonamides primary use
UTI, pneumocystis carinii pneumonia, shigella infections of small bowel
103
adverse effects of sulfonamides
formulation of crystals in the urine, hypersnsitivty reacitons, nausea, vomiting,
serious adverse effects: agranulocytoiss, acute hemolytics anemia, and aplastic anemia
104
first-line drugs of TB
initial phase: 2months daily therapy with :
1. isoniazid
2. rifampin
3. ethambutol
continuation phase: 2 months isoniazid and rifampin 2-3x per week
105
chemoprophylaxis for TB
anti-tubercular drugs used to prevent disease in high-risk populations
- patients w/ aids
- close contacts + family members of recently infected tuberculosis patients
- patients who are HIV positive and are receiving immunosuppressant drugs
