Test 2 Flashcards by Rio Rodriguez

What are the drugs for flu?

Oseltamivir (Tamiflu)
Don’t substitute for flu vaccination

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Oseltamivir facts

Must be taken within 48 hours of flu like symptoms
Take amount prescribed without stopping
Is a neuradaminase inhibitor which stops the spread or replication of the flu virus
Is given orally

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What is olseltamivir contraindicated in?

Renal Dysfunction
Pregnancy or breastfeeding
May need to adjust dosage
Should not be taken if the pt has had nasal influenza vaccine and if pt is taking other neuraminadase inhibitors

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What should you monitor when pt is taking oseltamivir?

Neuropsychiatric symptoms like hallucinations, delirium, and confusion
NVD
Affects may be related to effects on dopamine like lightheadness, dizziness, insomnia, ortho hypotension

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What are some nursing interventions to be sure of when giving oseltamavir?

Get baseline vitals
Ask about current symptoms and when they first started having symtpoms

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What are some patient education you should give when giving oseltamivir?

Oseltamivir is used to reduce severity of symptoms and duration
Does not prevent the spread to others

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What is Acyclovir used for?

Herpes simplex 1 (oral) and 2 (genital)
Treats varicella zoster (chicken pox)

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What are some side effects of Acyclovir?

NEPHROTOXICITY
Malaise, seizures, confusion
Hematuria

Increased liver enzymes

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What are the labs to evaluate when pt is taking Acyclovir?

Increased creatine, BUN, bilirubin, Hb
Decreased ANC, WBC
Increased/ Decreased platelets

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What should you educate pt about when taking Acyclovir?

Stay away from sexual intercourse because drug does not cure virus or prevent spread
Should not be taken with other nephrotoxic drugs
It should be given at a slow rate and drink plenty of fluids

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What are the HIV and AIDS meds?

NNRTI’s
NRTI’s
PI’s
INSTI’s

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What is a common drug of NNRTI’s?

Delavirdine
These drugs are absorbed from GI tract

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What are some complications and side effects of NNRTI’s?

Rash which can lead to steven johson syndrome
Flu like manifestations (headache, fatigue)
CNS: Dizziness, drowsiness, insomnia, nightmares
Nausea and diarrhea

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What should you do as the nurse when dealing with NNRTI complication?

Monitor for rash and notify provider for fever or blistering
Flu: Monitor for adverse reactions and encourage rest and fluid intake
CNS: Should decrease after first few weeks. Don’t perform activities that require alertness
Nausea and Diarrhea: Take at night on empty stomach

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What are some contraindications for NNRTI’s?

Use only during pregnancy only if other options are considered
Reproduction: Use nonhormonal form for atleast 12 weeks after therapy
Severe liver disease: Contraindicated

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What are the drug to drug interactions of NNRTI’s?

Can increase effects of benzodiazepines, antihistamines, calcium channel blockers, warfarin: Monitor for med toxicity
Do NOT use with rifampin and phenytoin: Can cause decreased levels of delavirdine
DO NOT USE W/ St. John wart

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What are NRTI facts?

Rapidly absorbed in GI tract (EXCEPT DIDANOSINE)
Ex drug: Zidovudine
Can be given oral or IV

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What are some complications of NRTI’s?

Suppressed bone marrow: Anemia, neutropenia, thrombocytopenia,
Lactic Acidosis:Hyperventilation, nausea, abdominal pain. Pregnancy increases risk
NVD

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What should you do as the nurse when it comes to the complications of NRTI’s?

Suppressed bone marrow: Monitor CBC and platelets. Educate pt to monitor bleeding, easy bruising, sore throat, and fatigue

NVD: Take w/ food. Monitor fluid and electrolytes

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What are some contraindications for NRTI’s?

Contraindicated in pt’s with medication hypersensitivity
Caution w/ liver disease and bone marrow suppression
Probenecid, valproic acid, and increase zidovudine: Reduce dosage

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What re some interventions for NRTI’s?

Treat anemia w/ epoetin alfa
Treat neutropenia w/ colony stimulating factors

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What are Protease Inhibitors?

Used to treat HIV
Ex drug: Ritonavir
Is taken Oral
Usually is combined with transcriptase inhibitors
Ritonavir is given with other PI’s to increase their effect

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What are some complications of PI’s?

Study These Flashcards

Osteoperosis
Hyperglycemia
Hypersensitivity Reaction
Elevated Blood lipids
Can decrease effectiveness of oral contraceptives

What are the interventions of PI’s?

Study These Flashcards

Osteoperosis: Educate client to eat diet high in calcium and Vitamin D
Hyperglycemia: Monitor for blood glucose. Adjust diet and administer antidiabetic as prescribed. Monitor for increased thirst and urine output
Hypersensitivity reaction: Monitor for rash and notify providor if it develops
Elevated Blood Lipids: Monitor for hyperlipidemia and adjust diet
Oral contraceptives: Should be encouraged to use additional nonhormonal contraceptives

What are some interactions of PI's?

Cause multiple meds to raise to toxic levels AVOID GRAPEFRUIT juice Take medication w/ food to increase absorption EXCEPT INDINAVIR

What are Integrase Strand Transfer Inhibitors?

Treat HIV Oral Ex drug: Raltegravir Is a first line treatment for HIV combined with 2/3 other antiretroviral meds

What are some complications of Integrase Strand Transfer Inhibitors?

Headache and diff breathing: Notify provider Skin Rash Liver Injury: Anorexia, nausea, right upper quadrant pain, jaundice Renal Failure: Monitor for hematuria SUICIDAL IDEATION: Notify provider of suicidal thoughts

What are the interactions of INSTI's?

Raltegravir can be decreased w/ concurrent use of rifampin or tipranavir/ ritonavir: Increase raltegravir dose if needed Monitor baseline and periodic liver function tests

What are some anti Hep C meds?

Elbasvir/Grazoprevir Glecaprevir/Pibrentasvir Sofosbuvir/Ledipasvir Sofosbuvir/Velpatasvir Sofosbuvir/Velpatasvir/ Voxelaprevir Ribavirin (Copegus, Rebetol, Ribasphere) Peginterferon alfa 2a

What are some facts about Hep C meds?

Treatment is usually 8-12 weeks but may be up to 16 weeks Treatment is successful when viral load drops to undetectable levels Treatment is tailored to the patients genotype, previous HVC treatment, and other factors DONT TAKE WITH ST JOHNS WORT

What should you monitor when giving antihep C Drugs?

Monitor for adverse events, med adherence, and drug interactions Monitor blood test results, including hypoglycemia and INR levels (clotting times_

What's something important that you should do before giving an antifungal?

You should obtain a culture

What do all Azoles end in?

-conazole

What are azoles contraindicated in?

Pregnant Breastfeeding Renal Dysfunction Hypersensitivity Hepatic dysfunction Some endocrine problems

What drugs are azoles usually contraindacted with?

Blood thinners like warfarin because it can increase risk of bleeding Erythromycin can increase risk of heart complications

What's the action of azoles?W

They bind to sterols and can cause cell death or interfere with cell replication

Which azole is absolutely contraindicated in fertility problems?

Ketoconazole

What are some side effects of azoles?

GI upset Hepatotoxicity (elevation in liver enzymes, jaundice) Headaches

What is amphoteracin B used in?

Systemic fungal infections Only available via IV

Amphoteracin B is used for only life threatening infections because of what reason?

It is very toxic to the liver Hepatotoxic

What are some side effects of Amphoteracin B?

Hepatotoxicity Phlebitis Infusion reaction (fever, chills): Pretreat with acetaminophen N & V Bone marrow suppression: Obtain baseline CBC and hematacrit Severe renal impairment

True or false: You should do a test dose of Amphoteracin B at first?

TRUEEEE

True or false: Amphoteracin B is safe in pregnant women?

TRUEEE

True or false: Amphoteracin B is safe in breastfeeding

FALSEEEEE

What are some drug to drug interactions of patients taking Amphoteracin B?

Should not take with other nephrotoxic drugs such as antineoplastics or cyclosporine

True or false: Nystatin is good for systemic fungal infections

False

How does nystatin work?

Creates pores that cause cell leakage

When taking oral nystatin, what should you instruct the patient to do?

Swish in mouth for several minutes before swallowing

How is nystatin excreted?

In the feces as unchanged

What are the side effects of nystatin?

Hypotension Tachycardia NVD Topical: Skin irritaiton

What are the drugs used for tuberculosis?

Rifampin Isoniazid Pyrazinamide Ethambutol

What side effect is common for all tuberculosis drugs?

Hepatotoxicity: Advise patients not to drink alcohol and monitor for liver enzymes

What is a side effect of Rifampin?

Orange secretions GI upset Decreased effectiveness of oral contraceptives: Advise pt to use alternative form of birth control

What's a common side effect of Isoniazid?

Neuropathy: Pain, tingling, numbness, burning Observe for manifestations and notify provider

What's a common side effect of Pyrazinamide?

Joint pain

What's a common side effect of Etambutol?

Vision problems (Think E for Eyes) Advise patient to report any issues w/ vision and to get screened regularly

Test 2 Flashcards

(56 cards)