Pharamacology Flashcards
(155 cards)
1
Q
What are some side effects of Tetracyclines?
A
Photosensitivity
*Stains perm. teeth if given to children <8
GI upset
renal/hepatic
2
Q
what drug classes shoul you avoid milk and antacids?
A
tetracyclines and fluoroquinolones
3
Q
What 3 things needs to be avoided with Tetracyclines?
A
Milk
Antacids
Iron salts
4
Q
What are some pt education points for tetracyclines?
A
Avoid milk, iron salts, antacids
Take on an empty stomach
Sit up for 30 mins after taking
Do not take w/in 1 hour of bedtime
5
Q
What are common suffixes for tetracyclines?
A
-cycline
6
Q
What are aminoglycosides used to treat?
A
Nosocomial Infections
UTIs
CNS infections
Prevention of Endocarditis
7
Q
What drugs have ototoxicity as an adverse effect
A
vancomycin
aminoglycosides
8
Q
What are side effects of
aminoglycosides?
A
ototoxicity (loop diuretics increases risks)
neurologic systems decrease
peripheral neuropathy
nephrotoxity
renal failure
9
Q
What are the common suffixes of Aminoglycosides?
A
-mycin
-micin
10
Q
When are carbapenems used?
A
LAST LINE of defense
Life-threatening infections resistant to other meds
11
Q
Side effects of carbapenems?
A
Hypotension
Hyperkalemia
Resp. distress
Seizures
Death
12
Q
what can a pt aquire when taking momobactams
A
an oral or vaginal candida infection
prescribe miconazole (monistat) for vag and nytatin (mycostatatin) for oral
13
Q
What are contraindications of carbapenems/monobactams?
A
Use of aminoglycosides
14
Q
What do carbapenems end in?
A
-penem
Imipenem Cilastatin
Meropenem (Merrem)
15
Q
What is do all these drugs have in common: monobactams, penicillin, vancomycin, cephisorn, amphotericin b (fungazone), and acyclovir (zovirax)?
A
IV site thrombophlebitis
16
Q
what is a strage adverse effect for metronidazole?
A
metsllic taste
17
Q
what two drug classes have peripheral neuropathy?
A
metronidazole and aminoglycosides
18
Q
what are the two drugs you need to know for metronidazole?
A
tinidazole
iodoquinol
19
Q
what are adverse effects of metronidazole?
A
metallic taste
GI
CNS symptoms
darkening of urine
superinfection w/ due to antibacterial and antiprotozoal properties
20
Q
When should you stop taking metronidazole?
A
sever cns sympotoms of seizure and perpheral neuropathy
21
Q
what are metronidazole used to treat?
A
antibacterial, antiprotozoal, and anthelmintic
protozoal infections, intrabdominal and gynecologic
22
Q
What medications are used to treat malaria?
A
QUININES
chloroquine
primaquine
23
Q
How is antimalarial medication presribed?
A
Begin 2 weeks before your travel (500 mg/wk)
Take 4 weeks after arrival home
1 g orally for an acute attack
24
Q
What are six things are cephalosporins used for?
A
middle ear
throat
tonsils
bronchitis
pneumonia
UTIs
25
Are cephalosporins bactericidal or bacteriostatic?
bacteriostatic
26
What do cephalosporins end or start with?
ceph-
-cef
27
Side effects of cephalosporins
| 7
GI upset
liver/kidney issues
serum sickness
blood sugar (hyperglycemia
confusion
bleeding
hypersensitivity
## Footnote
Serum sickness- fever, edema, hives, inflammation of blood vessels and joints
28
Are penicillins bactericidal or bacteriostatic?
bactericidal
29
what are all the kissing counsins of penicillin?
cephalosporins, carbapenems, monobactams
## Footnote
cephalosporins (cephalexin), carbapenems (imipenem/cilastain & meropenem) monobactams (aztreonam),
30
what drug should you use a different form of birth control?
Use an alternate form of birth control for penicillins
31
Side effects of penicillin
Gi issues
Hypersensitivity
CNS reactions
*sensitivity to Betalactams
*serum sickness
*anaphylaxis
32
Examples of Penicillins
Penicillin G
Penicillin V
Zosyn
Unasyn
Timentin
Augmentin
33
What example do you need to know for sulfonamides?
co-trimoxazole
## Footnote
some end in -azole/azine
34
what should you use sulfonamides for?
UTIs
patient allergic to penicillin
35
what should you do for photosensitivity?
use sunblock/avoid sun
36
what drugs have photosensivtiy as an adverse effect?
fluoroquinolones
tetracyclines
sulfonamides
| fts
37
What is a side effect of sulfonamides?
## Footnote
8 things
photosensitivity
GI
crystalluria
hematuria
sulfasalazine
hyperglycemia
stevens-jognson sydrome
hemorrhage when given with warfarin
## Footnote
sulfasalazine (neon yellow)
38
What are side effects of Vancomycin?
Red Man Syndrome
Ototoxicity
thrombophelbitis
nephrotoxicity
39
What are some contraindications of vancomycin?
Corn allergy
hearing impairment
use w/ Metformin
40
What is important for the nurse to monitor in a pt who is taking vancomycin?
Peaks and troughs
IV site
kidney levels
*baseline hearing
41
which drug classes both have crystalluria as a side effect?
fluroquinolones and sulfonamides
42
what should you avoid when taking fluoroquinolones?
tasks that require alertness and caffeinated products
43
what are fluoroquinolones used for?
UTIs
URIs
respiratory, skin, GI, and bon and joint infection
44
what drug examples do you need to know for fluoroquinolones?
cirprofloxacin
levofloxacin
| end in floxacin
45
What are some side effects of fluroquinolones?
photosensitivty
dizziness
GI
rash
fluoquinolones toxicity*
crystalluria
## Footnote
toxic effect on skeletal, tendons, and cartillage
46
What is the identifier for macrolides?
erythromycin
azithromycin
clarithromycin
| -thromycin
47
What can you not have when talking macrolides?
no fruit juice
48
What are side effects of macrolides?
increase in esinophils
increase in theophylline levels
increase risk of toxicity
GI
49
What are the components of a blood culture?
Aerobic and anaerobic cultures
Drawn twice
DRAW B4 GIVING MED
50
What are peaks and troughs?
Peak- highest amount of drug, drawn 30 mins to 1 hour after IV injection
Trough- lowest level of drug, draw just before next dose
51
What is Stevens-Johnson syndrome?
Allergic reaction causing:
reddish-purple rash
skin sloughing
swelling of tongue, face, blisters in mouth
can have fever, sore throat, cough, eye pain prior to rash
52
What is a superinfection?
Infection following a current infection
Normal flora is killed
Resistant bacteria is formed
53
What are antifungals used for?
superficial or systemic fungal infections
treat opportunistic infections that happen when the immune system defense is compromised
54
what is oral candida also know as?
thrush
55
what should you use nystatin (mycostatin) oral suspension for?
candid infection (thrush) "swish and swallow"
56
What needs to be done before administering amphotericin B
give a test dose; think about peaks and troughs
57
which drug has less adverse effect than amphotericine (fungazone)?
the lipid based form of Fungazone, it is much more expensive
58
what should you give with amphotericin B to minimize uncomfortable reactions?
diphenhydramine and acetaminophen
59
Adverse effects of amphotericin B?
Bone marrow suppression
Thrombophlebitis
Renal toxicity
chills/fever/tachycardia/hypotension/headache (go away 1-2 hours after infusion)
hypomagnesemia
hypokalemia
chills
fever
GI
anorexia
muscle & joint pain
hypotension
flushing
60
What does the oral form of ketoconazole require?
Acid medium for absorption
61
What does. the antiinfective acyclovir (zovirax) treat?
herpes simplex and herpes zoster
62
Side effects of acyclovir?
topical-burning, itching @ site
oral- n/v, diarrhea, headache, vertigo
IV- thrombophlebitis, CNS toxicity
63
How do we care for anaphylaxis?
Remove trigger (if known)
position in a way to promote ventilation & circulation
Tube if going south fast
hypotension=trendelenberg position
64
What drug is given for anaphylaxis ?
Epinephrine
65
Action of anithistamines?
compete with histamine @ receptor sites
66
When do histamines work best?
Early in response cycle
67
Second gen compared to first gen?
Do not cause as much sedation as 1st generation
Don’t cross blood-brain barrier à “peripherally acting”
Longer acting
don’t cause the CNS depression
taken during the day
don’t cause the drowsiness
68
what are the 2nd gen you need to know?
loratadine (claritin)
cetririzine (zyrtec)
## Footnote
Loratadine (Claritin) Decreased symptoms of allergic symptoms (nasal stuffiness, red swollen eyes, itching)
Cetirizine (Zyrtec) - Given for allergic/seasonal rhinitis and urticaria (hives)
69
What are the 1st gen antihistamines?
Diphenhydramine (Benadryl), promethazine (Phenegran), dimenhydrinate (Dramamine)
70
What are antihistamines used for?
Antihistamine effects
CNS depression
Anticholinergic effect
Not useful in extreme anaphylaxis
Not useful as monotherapy
71
Anticholinergic effects
Can't see
Can't pee
Can't spit
Can't shit
## Footnote
Dimenhydrinate (Dramamine)
Promethazine (Phenergan) – Nausea; Anticholinergic
72
What are the primary uses of antihistamines?
| Diphenhydramine, Promethazine, Dimenhydrinate
nasal allergies, hay fever, hives, mild blood transfusion reaction
73
What are secondary uses of antihistamines?
| Diphenhydramine, Promethazine, Dimenhydrinate
motion sickness, vertigo, Parkinson's, anaphylactic reactions, sleep aid
74
Contraindications of antihistamines?
3rd trimester of pregnancy
4 days before allergy testing
clients under 2 years (phenegran only)
75
Major side effects of antihistamines
hypotension, syncope, unsteady gait
Phenegran only: resp. depression
76
What are nasal decongestants used for?
decreases swollen nasal mucosa and decrease stuffiness
77
what does loratdine do?
Decreases symptoms of allergies
Nasal stuffiness
red swollen eyes
itching
78
Cetirizine (Zyrtec) assessment
CNS depressants
Pregnancy risk B
Renal/hepatic impairment Geri; lower dose
Children; don't give to under 6yrs w/ renal/hepatic
impairment
79
Loratdine (Claritin) contraidications
CNS depressants
Pregnancy risk B
Sunlight
Geriatric
80
Cetirizine (Zyrtec) adverse reactions
Mouth dryness
Dizziness
drowsiness
81
what is cetirizine used for?
Allergic/seasonal rhinitis
and urticaria (hives)
82
Loratdine (Claritin) adverse reactions
Dry mouth
Photosensitivity
83
t/f adrenergic nasal decongestants can be used for long term use
| Oxymetazoline (afrin)
Use no more than 3 days
at a time
Not for long term use
84
what does anticholinergic nasal decongestants do?
| Ipratroqium (Atrovent)
Decreases secretions
Blocks acetylcholine
Does not cause the rebound congestion
Prime by spraying 7 times
before use
## Footnote
Side effects:
-Sore throat, nasal dryness
85
what does adrenergic nasal decongestants do?
| Oxymetazoline (afrin)
dilated arterioles
in the nose to constrict
decreases blood flow amd
congestion
causes heart rate to go up
Causes vasoconstriction
86
what is the adrenergic nasal decongestants?
Oxymetazoline (afrin)
87
what is the anticholinergic nasal decongestants?
Ipratroqium (Atrovent)
88
Examples of nasal decongestants
Phenylephrine
Ephedrine
Naphazoline
Pseudoephedrine (sudafed)
Oxymetazoline (Afrin)
Ipratropium (Atrovent)
Fluticasone propionate (flonase)
## Footnote
Oxymetazoline (Afrin) adrenergic
Ipratropium (Atrovent) anticholinergics
Fluticasone propionate (flonase) corticosteriods
89
what do do you need to know about corticosteriods nasal spary
| Fluticasone propinate
(flonase)
Treats allergic rhinitis
caused by airborne allergens
Don't give to anyone under
4yrs
Can decrease growth in
children
nasal burning
90
when should you avoid adrenergic (Oxymetazoline (afrin))?
HTN
cardiovascular disease
dysrhythmia
narrow angle glaucoma
stroke
91
t/f you should take adrenergic longer than 3 days
fals; don't take Oxymetazoline (afrin) longer then 3 days
92
what is the corticosteroids nasal spray?
Fluticasone propinate
(flonase)
93
Which nasal decongestant can be used long term?
Fluticasone propinate
(flonase)
94
Contraindications of nasal decongestants
Hx of: hypertension, uncontrolled cardio disease, dysrhythmia
Narrow angle glaucoma
CVA, TIAs
Chronic Asthma
BPH
95
Side effects of Nasal Decon?
HTN, palpitations
rebound congestion
headache
96
What do you switch pt to after 3-5 days of Afrin?
Pseudoephedrine
(Sudafed)
97
What do antitussives do?
Opioids:
suppress cough reflex
analgesic and drying
## Footnote
Non-opioids: suppress cough reflex (dextromethorphan)
Numb receptor cells that cause cough (Benzonatate)
98
Antitussive Examples?
Codiene -opiods
Dextromethorphan (Robitussin) - non-opioid
Benzonatate (Tessalon
Perles) - Non-opioid
Diphenhydramine (Benadryl) -Antihistamine
99
What type of cough are antitussives used for?
nonproductive cough
100
Contraindications of antitussives?
individuals at high risk for resp. depression, sedation (such as elderly)
101
Adverse effects of anti-tussives?
N/O: nausea, dizziness, sedation (bendaryl), euphoria (in high doses)
O: CNS effects, Gi effects, abuse potential
102
How do expectorants work
Thin the viscosity thus increasing the amount of secretions to be expelled
103
example of expectorant
Guaifenesin (Mucinex)
104
Adverse effects of Mucinex
| expectorant
GI upset, drowsy/dizzy, rash
105
Nurse notes for Mucinex?
| expectorant
Make sure pt is hydrated
Watch for Tylenol inclusion
Short half life-repeat dose
106
how do mucolytics work?
Stimulate glands in respiratory tract
Breakdown and thin secretions
| Muscle relaxant properties
107
what are two lower respiratory tract disorders?
Asthma
COPD (chronic obstructive pulmonary disease)
108
Examples of mucolytics?
Hypertonic saline
(3-7%NS)
Hypertonic sodium chloride (3-7%NS)
Acetylcysteine (NAC)
109
what kind of smell does mucolytics have
## Footnote
Hypertonic saline
(3-7%NS)
Hypertonic sodium chloride (3-7%NS)
Acetylcysteine (NAC)
smells like rotten eggs
110
When are mucolytics used
acute and/or chronic pulmonary disorders w/ lots of secretions
Mucomyst is antidote for Tylenol overdose
prevent renal dysfunction
111
When would you not give mucomyst?
In pt w/ severe asthma
112
Adverse effects of mucomyst?
bronchospasm, sore throat, cough, dizziness, hypotension
113
Education for mucomyst?
2-3L fluid / day
Mix w/ fruit juices/sodas/water
Watch for acetaminophen toxicity (ALT, AST)
114
Beta2-Adrenergic Agonists examples
Albuterol (Proventil) (short
acting)
Levalbuterol (Xopenex)
(short acting)
Formoterol (Foradil) (long
acting)
Salmeterol (Serevent)
(long acting)
Terbutaline (Brethine)
(short acting)
115
Xathine examples
Xathine Derivatives
(methylxanthines)
Theophylline (Theo-24)
116
Theophylline (Theo-24) Therapeutic blood levels
5-15 mcg/mL
Adverse effects more common with levels of 20-25
mcg/mL
117
Anticholinergics examples
Ipratropium (Atrovent)
Tiotropium (Spiriva)
118
list all the brochodilators
beta-adrenergic agonists
anticholinergics
xanthine
## Footnote
**beta-adrenergic agonists
**Albuterol (Proventil) (short
acting)
Levalbuterol (Xopenex)
(short acting)
Formoterol (Foradil) (long
acting)
Salmeterol (Serevent)
(long acting)
Terbutaline (Brethine)
(short acting)
**anticholinergics**
Ipratropium (Atrovent)
Tiotropium (Spiriva)
**xanthine**
Xathine Derivatives
(methylxanthines)
Theophylline (Theo-24)
119
What are characteristics of asthma?
Inflammation
Bronchoconstriction
Mucosal edema
Viscous mucous
120
What is given for an asthma attack?
Albuterol
121
What is important education for pts with asthma?
Teach them which inhaler is for attacks and which is for prevention
Teach how to use a spacer
122
Assessment in a pt with asthma?
O2, HR, BP (before and after)
skin color/temp
RR, depth, rhythm
breath sounds
s/s of resp. distress
123
Teaching on how to use diff inhalers together?
Wait 1-2 mins before giving 2nd puff
If taking 2 diff. inhalers: give SHORT ACTING FIRST, wait. 2-5 mins, then long-acting
124
What to do after using a corticosteroid nebulizer?
Rinse out mouth to prevent thrush
125
What is COPD characterized by?
chronic bronchitis and emphysema
## Footnote
Destruction of the respiratory walls characterized by
one or both
126
What is the #1 Beta2 Adrenergic agonist?
Albuterol
127
How does Albuterol work
Reduces airway constriction
128
Why are beta-adrenergic agonists used?
long term control of asthma
short term control of asthma attack
129
Contraindications of Beta2 Adrenergic receptors?
epinephrine, norepinephrine, and dopamine, or cocaine and methamphetamines
Client who have diabetes
mellitus, hyperthyroidism,
heart disease, hypertension, and angina
130
What does overdose of beta2 AAs look like?
N/V, paradoxical bronchospasm, tremors
Use "watch and wait", treat as symps arise
131
How do inhaled anticholinergics work? Why are they used?
Block acetylcholine receptors = indirect bronchodilation (open airways)
Prevention of bronchospasm (not for attacks)
| Not a rescue inhaler
132
How do Xanthines work?
relax bronchial smooth muscle (allows dilation)
133
Why are Xanthines used?
Adjunct med for COPD
mild-mod asthma
134
What is therapeutic range of theophylline (Xanthine)?
5-15 mcg/ml
135
Xanthine Toxicity/overdose
GI
CNS stimulation
Cardia arrythmias can occur with high dose, chest
pains, flushing
136
Side effects of Xanthine?
N/V
Anorexia
gastroesophageal reflux
during sleep
Tachycardia
palpitation
dysrhythmias
temporary hyperglycemia
Increase in urination
137
Non-bronchodilators
leukotriene receptor antagonists
corticosteroids
mast cell stabilizers
## Footnote
**leukotriene receptor** antagonistsMontelukast (Singulair)
Zafirlukast (Accolate)
Zileuton (Zyflo)
**corticosteroids
mast cell stabilizers
**Cromolyn (Intal)**
138
Examples of Leukotriene Modifiers
Montelukast (Singulair)
Zafirlukast (Accolate)
Zileuton (Zyflo)
139
What do luekotriene modifiers do?
Dilate & open bronchioles
140
How long does it take to see benefits of leukotrienes?
About a week
141
Side effects of leukotriene modifiers?
Zafirlukast (Accolate): liver dysfunc.
Zileuton (Zyflo): dizziness, insonia, liver dysfunc.
Montelukast (Singulair): heartburn
142
How do inhaled corticosteroids work?
Stabilize cell membranes that release bronchoconstrictors
Restores responsiveness of bronchial smooth muscle
143
Why are inhaled corticosteroids used?
status asthmaticus
lung maturity & resp. distress in preterm birth
acute exacerbations of COPD, cystic fibrosis, bronchitis
144
How long does it take to see effects of inhaled corticosteroids
A few weeks
145
What can inhaled corticosteroids cause?
thrush, stunt bone growth, sore throat, suppression of adrenal gland function, bone loss
146
Example of mast cell stabilizer
Cromolyn (Intal)
147
What is Intal used for?
long-term treatment of asthma
148
Side effects of intal?
dizziness, headache
rash, itchiness,
nasal congestion, nasal irrigation
nausea
paradoxical bronchospasm
149
Pt teaching for Intal?
Take 3-5 mins AFTER ALBUTEROL
Rinse mouthpiece frequently
Can take 2-4 WEEKS to see improvement
NOT A RESCUE MED
150
Contraindications of antitussives?
individuals at high risk for resp. depression, sedation (such as elderly)
151
which drug classes both have crystalluria as a side effect?
fluroquinolones and sulfonamides
152
t/f you should take adrenergic longer than 3 days
false; don't take
153
what are two lower respiratory tract disorders?
Asthma
COPD (chronic obstructive pulmonary disease)
154
Anticholinergics examples
Ipratropium (Atrovent)
Tiotropium (Spiriva)
155
Xanthine Toxicity/overdose
GI
CNS stimulation
Cardia arrythmias can occur with high dose, chest
pains, flushing
