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PharmTest1 Flashcards

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1
Q

Penicillin-G

A

-Narrow Spectrum ABT - B Lactam

TX: PNA/URI Contraindications: Renal patient, pregnant, lactating

Adverse RX: allergy, N&V, Diarrhea, super infections

Interactions: Beta Blockers (increase anaphylaxis) Contraceptives

Nursing Implications: Watch for loose stools, keep epi-pen ready, watch BUN/Creat, keep refrigerated, C&S before administration

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2
Q

Is Penicillin G appropriate for a pregnant woman

A

No. What’s wrong with you? Preg Cat. C

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3
Q

Penicillin G ________ may be given IV

A

Aqueous. Other forms lead to cardiac arrest

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4
Q

Cefazolin

A

Cefazolin (Ancef, Kefzol)

Treats skin, bone, GI, GU infections. Pre-op Prophylaxis

Contraindications: Use caution with PCN allergies due to cross sensitivities

Adverse effects: GI issues, Pseudomembranous Colitis, nephrotoxicities, superinfection

Nursing: Stop alcohol usage, including OTC medications

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5
Q

“Disulfram” reaction

A

A response brought on by alcohol usage with some medications -

  • N/V
  • Chest pain/palpitations
  • SOB,
  • respiratory depression
  • Flushing of the skin,
  • diaphoresis
  • confusion
  • Cephalosporins/Cefazolin
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6
Q

Vancomycin

A

-Only drug in class -

Toxic -

Effective on Gram (+) infections -Oral form is effective on Pseudomembranous colitis, Septicemia, endocarditis, bone and joint infections -

Contraindications: Pregnancy, hypersensitivity -

Adverse Effects: Ototoxicity, Nephrotoxicity, Red man syndrome -

Drug interactions: Statins

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7
Q

Red Man Syndrome

A

S/e of running Vancomycin too fast.

Excess histamine release:

  • flushing of head and neck,
  • hypotension,
  • diaphoresis,
  • vascular collapse.

SLOW DOWN INFUSION

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8
Q

Is Vanco appropriate for pregnancy?

A

Nope.

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9
Q

Gentamycin

A

-Amninoglycoside -

Bactericidal, inhibits protein synth Tx: serious infections, Pelvic inflammatory disease, surgical prophylaxis

Adverse Rx: nephrotoxicity, “all of the penia’s”, apnea, ototoxicity

Black Box warnings: do not give with any medication which is also ototoxic, or nephrotoxic

NEUROTOXIC, NEPHROTOXIC, OTOTOXIC, NO BABIES

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10
Q

Ototoxic Medications causing hearing issues

A

Gentamycin,

Vancomycin,

MY FUCKING EARS

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11
Q

Clindamycin

A
  • Gram - and gram +
  • NO BABIES

**Adverse rx- **C-diff (fatal)

**Nursing implications- **give with food

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12
Q

Erythromycin

A

Tx: PID (gonorrhoeae), Legionnaires disease, Chlamydia, Pertussis

Incompatible with dextrose IV solutions.

Adverse Reactions: arrhythmia, pseudomembranous colitis, anaphylaxis Interactions: Increases serum levels of many medications. NO GRAPEFRUIT

Nursing considerations: monitor hepatic function, overgrowth of other bacteria and fungi

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13
Q

Tetracycline

A

Tx: Gonorrhea, syphilis, acne (topical), Helicopacter pyloir

Adverse Reactions: “all of the penia’s”, tooth discoloration in young children, superinfection of other bacteria, N/V/D, photosensitivity, and rash, Candida

Interactions: antacids/laxatives/antidiarrheals/iron (reduce abt absorption) Digoxin (monitor for dig toxicicty), NO MILK.

DISCOLORS TEETH. BINDS TO CALCIUM

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14
Q

Drinking milk on the beach is to be avoided with:

A

Tetracycline.

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15
Q

Grapefruit is to be avoided with:

A

Erythromycin

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16
Q

Expired ______ is toxic

A

Tetracycline

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17
Q

Chloramphenicol

A

**Class: **Man made ABT

Broad spectrum abt- harsh abt

Influenza, brain abcesses, acute typhoid fever

Adverse Effects (AE): HA, N/V/D Blindness, HA, anemias due to bone marrow suppression

Bacterostatic/bacterocidal

Decreases clearance of many drugs, and many drugs decrease its clearance. Use caution.

PEAK AND TROUGH

GRAY BABY SYNDROME

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18
Q

Gray Baby Syndrome

A
  • Vomiting
  • Ashen gray color of the skin
  • Limp body tone
  • Hypotension (low blood pressure)
  • Cyanosis blue discolouration of lips and skin.
  • Hypothermia
  • Cardiovascular collapse

CHLORAMPHENICOL

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19
Q

Ciprofloxacin

A

(Cipro)

**Classification: **Quinolones/ Fluoroquinolones

**Use: **Bone, joint, URI, skin, UTI, ANTHRAX, PLAGUE, Aerobic only

**Contraindications: **Younger than 18, Pregnancy

**Adverse Reactions: **Seizure, SJS, TENS, “Penia’s” Cdiff, Tendon rupture

**Interactions: **antacids, iron, Steroids

**Nursing: **Monitor for crystaluria, rash

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20
Q

Can cipro be given to pregnant women

A

No

Pregnancy Category C

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21
Q

UA is required before treatment, for

A
  • Pregnant women
  • women over the age of 55
  • Men
  • Patients with reoccuring symptoms
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22
Q

SMZ-TMP

Suflamethoxazole-Trimethoprim

A

(Bactrim/Septra/Sulfatrim)

Classification: Sulfonomide

Use: Ear infx, URI, PNA, Shigellosis

Contraindications: Sensitivites, Pregnancy, infants yonguer than 2m, Hepatic injury

Adverse Reactions: Seizures, CDiff, N/v/d, “Penias” rashes

Interactions: Increases concentrations of dig, coumadin, dilantin,

Nursing: Double check dosage, Renal and liver test, excess caution in patients with HIV. Increase fluids

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23
Q

Is Bactrim DS appropriate for pregnant women?

Study These Flashcards
A

Nope, not for late term

24
Q

INH

Study These Flashcards
A

(Isoniazide)

Use: Treatment or prevention of TB,

Contraindications: Liver patient

Adverse Reactions:Hepatoxoxicity, Peripheral neuropathy, encephalopathy

Interactions: Seizure meds, ETOH, antacids, benzos, disulfram, tordolol, coumadin

Nursing: Monitor s/s liver damage, very toxic, NO BOOZE

25
When undergoing tx for TB, what should patient avoid?
**Alcohol**, fish, cheese, beer, chocolate
26
Rimfampin
Use: FDA approved: TB, mengiococcal infx Offlabel: Leprosy, MRSA, osteomylitis Contraindications: Hypersensitive, hepatic issues Adverse Reactions: Discolored urine, sweat, saliva, N/V/D Interactions: Increases EXCRETION of other drugs Nursing: Monitor hep function, oral contraceptives, Give Rimfampin over 3 hours EMPTY STOMACH
27
Can Rifampin be given to pregnant women
Only if benefits outweigh risk. Monitor closely.
28
Amphotericin B
"Amphoterrible" ## Footnote Use: Tretment of systemic, life threatening, fungal or protazoal infections Contraindications: Anemia, HYPOCALCEMIA/MAGNESIA, VERY NEPHROTOXIC Adverse Reactions:Hundreds. Chills, fever, HA, hypotension, v-fib Interactions: Antinoplastic agents, cyclosporine, aminogycloosides Nursing: Monitor s/s liver damage, very toxic
29
Diflucan
(Fluconazole) ## Footnote **Overview:** Used to treat candidiasis and prophylaxis for fungal diseases in immunocompromised patients. Used for candidiasis and cryptococcal meningitis Widely distributed, **Contraindications/Precautions:** No absolute contraindications exist to fluconazole. **Adverse Effects (AE):** Diarrhea, nausea, vomiting, abdominal pain, headache, rash, and dizziness Alopecia, Most serious AE: Stevens-Johnson syndrome **Drug Interactions:** Many drug–drug interactions are possible due to P-450 system Teratogenic effects with higher doses in animal studies
30
Chloroquine
**Therapeutic** Class: Anti-Infective **Pharm**. Class: Antimalarial **Action**: Interferes w/ DNA & protein synthesis **Overview**: Used primarily for malaria: secondarily for amebiasis, rheumatoid arthritis, and lupus **Contraindications/Precautions**: Hypersensitivity, pre-existing eye disease A**dverse Effects (AE):** Common- EKG changes, n&v, abd pain, hypotension Serious- vision hearing issues, toxicity occurs quickly- arrest, retinopathy and aplastic anemia Prophylactic Tx mostly – 1/week beginning 2 weeks before trip, and continue 4-6 weeks after. Stop too soon and could develop malaria. Mosquitoes carry virus, also could get from contaminated blood.H - Chloroquine - blurred vision, retinopathy, GI upset, headaches, hair loss, can’t take with Alcohol, can’t take if lack G6P6 enzyme (some Middle Easterns), makes urine/sweat/tears red-brown.
31
Acyclovir
**Overview**: Used for the management of herpes simplex virus, herpes zoster virus, Epstein-Barr virus, and cytomegalovirus Drug treats the symptoms it is **not a cure** **Tx-** Herpes viruses/Epstein-Barr/CMV/Varicella 70% excreted unchanged in urine Contraindications/Precautions: Hypersensitive and elderly (renal issues), cross-sensitivity to ganciclovir **Adverse Effects (AE):** Often well tolerated Common AE- light-headed, N&V, anorexia, abd pain, HA Serious AE- confusion, tremors, seizure, coma, renal dysfunction **Drug Interactions:** Theophylline's and probenecid (less renal excretion thus more acyclovir in blood- more AE from acyclovir) **Nursing Implications/Patient Education:** Advise the patient to drink at least **8-oz glasses of water** a day. Administer IV acyclovir over 60 minutes. Acyclovir treats the symptoms of the disease Emphasize that acyclovir does not prevent the transmission of infection to another person and does not cure the infection. Maximizing therapeutic effects: Admin the drug at regular intervals Minimizing AE: **Ensure hydration to avoid nephrotoxicity** Anti-virals are for Non-HIV viruses. Agents act against a narrow spectrum of viruses, & hence their utility is limited to a few types of infections Development of anti-virals is new. About 20 available in the US. Herpes Simplex and Varicella Zoster (Shingles) Routes: IV, oral and topical forms Hand washing after topical applications AE seizures Patients with renal impairment need to stay hydrated Nephrotoxicity and CNS toxicity. Patient educ: Acyclovir treats the symptoms of the disease, it does not cure the disease or prevent transmission.
32
Zidovudine
(Retrovir) ## Footnote **Class: **Antiretroviral **Treats: **HIV, along with a coctail of other drugs. Also used to prevent HIV from passing from mother to infant **Considerations:** Take on empty stomach with fluids, sitting up. Take on a rigid schedule. May lead to liver and bone marrow damage **Adverse Rx:** Lactic acidosis, seizures, gum bleeding, pancreatitis, penias.
33
Use backup birth control with:
Ciprofloxacin
34
You should do what to prevent the primary complication of Acyclovir?
HYDRATE to avoid Kidney damage
35
Ciprofloxacin is appropriate for Gram _____ organisms
Negative
36
Ciprofloxacin's greatest adverse reaction is
Tendinitis and tendon rupture
37
C-Diff is a serious complication of -
Erythromycin Clindomycin Erythromycin
38
Give ________ 2 hours before or after Penicillin
Gentamycin
39
\_\_\_\_\_\_\_ Should be administered cautiously in patients over the age of 35, due to risk of ______ injury
Isoniazid, Liver
40
If patient is on MetoproLOL, you would question which order?
Penicillin
41
When administering Penicillin, and this other antibiotic, give them at least two hours apart \_\_\_\_\_\_\_\_\_\_\_\_\_
Gentamycin and Penicillin should not be given together
42
People allergic to PCN should also avoid
Cephalosporins - Cefazolin - Keflex Imipenem
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