- HIV in adults and children - Prophylaxis in preventing transmission to fetus - Epstein-Barr

- Treat HIV 1 infection in combination with other antivirals - Not effective in HIV 2 infection

Unit 11 and 12 Flashcards by Ashlee Thornton

Zidovudine (AZT) Use

HIV in adults and children
Prophylaxis in preventing transmission to fetus
Epstein-Barr

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Nucleoside/Nucleotide reverse trascriptase Inhibitors (NRTT’s)

Zidovudine (AZT)

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Nonnucleoside reverse transcriptase inhibitors (NNRTT’s)

Efavirenz (EFV)

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Efavirenz (EFV) Use

Treat HIV 1 infection in combination with other antivirals

- Not effective in HIV 2 infection

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what combined with Efavirenz (EFV) increases CNS effect?

Use of alcohol or pyschoactive drug

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Efavirenz (EFV) serious effects

Stevens Johnsons syndrome
Lipodystrophy
hepatotoxicity
seizures and severe depression, paranoid or manic reactions

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Efavirenz (EFV) labs

Liver function (before and during therapy)

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S/S of liver toxicity

fatigue, jaundice, N/V

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what are food teachings for zidovudine/AZT

take 1 hour before meals

pt on low fat diet

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how is AZT given

3 divided doses

never IM!

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what needs special monitoring with use of AZT

monitor cbc, liver enzymes
report sore throat, bleeding, bruising, fatigue-these are indicators for blood dyscrasias, bone marrow suppression and possible lactic acidosis

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what common side effect of AZT is treated with NSAIDS

headache

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physical changes r/t lipodystrophy

fat redistribution
Fat loss:
-Arms and legs (veins tend to show up more)
-Face (sunken cheeks, temples, or eyes)
-Buttocks
Fat buildup:
- Abdomen (central obesity)
- Breasts (occurs in both men and women)
- Back of neck and shoulders (sometimes called a “buffalo hump”)
- Fatty growths in different parts of the body (called lipomas)

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Protease inhibitors

Saquinavir (Invirase)

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Saquinavir (Invirase) contraindications

hypersensitivity
under age 16
liver impairment
pts with diabetes-causes hyperglycemia

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Entry Inhibitors

Enfuvirtide (Fuzeon)

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Enfuvirtide/Fuzeon use

HIV/Aids drug is used to tx pts who experience treatment failure or don’t tolerate other antivirals

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Enfuvirtide is given subq only, how long does it take to reach its peak

8 hours

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What drug is given only SQ

Enfuvirtide/Fuzeon

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which drug is used for acute attacks of malaria, but not relapses

chloroquine/aralen

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which malarial patients would not be given chloroquine/aralen

patients with pre-existing eye disease since this drug can cause opacity of the eye

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in which patients should chloroquine/aralen be used with great caution

those with:
hepatic disorders
blood dyscrasias
dental disease
GI disorders
neurologic disorders

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teaching for proper dosing of chloroquine/aralen includes includes what 3 items

take as scheduled on a weekly basis
take with meals to decrease GI symptoms
take prophylactially 2 weeks prior to travel in malaria zones

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what adverse effects do patients need to know about chloroquine/aralen

turns urine red or brown
have periodic eye and ear exams r/t vision and hearing effects
avoid alchol
use oatmeal baths for itchy skin

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when should you notify your physician if you are taking chloroquine/aralen

if you experience a sore throat, bruising, fever, unusual fatigue

Antiprotozoan drugs

Flagyl/metronidazole

what is Flagyl/metronidazole used for

tx of parasites: trichomoniasis amebiasis giardiasis

what are off label uses of flagyl

Crohns disease anaerobic infections antibiotic for diarrhea

should Flagyl be used during pregnancy

no. it crosses the placenta and breast milk

can you drink the same day you take Flagyl

no. alcohol should be separated in use by at least a day to prevent disulfiram-like interactions (n/v, flushing, tachycardia, SOB) very unpleasant.

FLagyl/metronidazole has GI effects and causes dry mouth, what can be done to help with this

suck on ice chips or hard candies | take with meals

if Flagyl is being used for tx of an STI, what needs to be done

treat both partners in the relationship

what is the time frame for IV infusion of Metronidazole/Flagyl

infuse slowly over an hour

which drug is used to treat PCP (pneumocystis carinii pneumonia)

pentanidine isethionate/Pentam 300

what position should the pt receiving Pentam 300 be in

the pt should be lying down, recusitation equipment should be nearby. monitor vs before, during, and for 2 hrs after admin.

can a patient on Pentam 300 be given other IM injections

no. can cause bleeding, bruising, hematomas. | this drug can induce thrombocytopenia

what are some nursing interventions for use of Pentam 300

don't give at hs, can cause hypoglycemia ingest small frequent meals even when nauseated protect drug from light, use w/in 24 hr don't mix with other drugs

what is good patient teaching for Pentam 300

call physician for non-subsiding N/V use a bronchodilator 1st if using Pentam 300 in an inhaler may experience hypotension-change positions slowly

which labs are needed for the patient on Pentam 300

needed labs are liver enzymes, CBC, occasional EKG

which drug is an antiviral

acyclovir/Zovirax

what is zovirax/acyclovir used for

tx of oral/parenteral/ topical herpes infections | antiviral for herpes only

what are serious side effects of acyclovir/zovirax

confusion, tremors, hallucinations, seizures, coma, nephrotoxicity

if giving acyclovir/zovirax IV, how long should it be infused

over 60 min

what are the main nursing interventions for zovirax

give drug with a full glass of water | can be given w/ or w/o food

which drug is an anti-helminthic (worm)

Mebendazole/Vermox

what is Mebendazole/vermox used for

tx of nematodes, pinworms, hookworms, giant roundworms

when should mebendazole/vermox not be given

to a pt who has hypersensitivity IBD or hepatic disease pregnant or breastfeeding

what labs are needed with vermox

CBC and liver enzymes

patient teaching for vermox should include what

monitor for sore throat, fever, fatigue itching may be relieved with oatmeal baths wash your fruits and veggies thoroughly

which 2 drugs are anti-fungals

amphotericin B/fungizone | fluconazole/diflucan

what are contraindications for amphotericin

hypokalemia hypomagnesemia anemia

what are the side effects of amphotericin

electrolyte imbalances=common | nephrotoxicity, azotemia, renal failure,renal tubular acidosis=serious

nursing interventions for amphotericin/fungizone

don't give w/other nephrotoxic drugs keep pt well hydrated monitor electrolytes, CBC, Renal, hematopoietics

when should the client on diflucan call the dr.

call physician if jaundice, excessive diarrhea and N/V | especially if skin becomes red, irritated, peely (stevens-johnsons)

what are teaching for the pt on diflucan

take with food, avoid alcohol, use aspirin, not acetominophen to avoid liver damage

which drug is a non-depolarizing neuro-muscular blocking agent

turbcurarine/tubarine

what is the reason for using turbocurarine/tubarine

it is a skeletal muscle relaxant that is used in conjunction with general anesthetics.

how does turbcurarine help pts in the ICU

how does turbcurarine help pts in the ICUit minimizes their movements to conserve energy and prevent agitation. This helps prevent ICP in these patients.

what is an off label use for turbocurarine

it is also used to diagnose myasthenia gravis

turbocurarine/tubarine has several serious side effects. what are they

prolonged paralysis apnea malignant hyperthermia

which drug is a depolarizing neuromuscular blocking agent

succinylcholine/anectine

when should succinylcholine not be used

it should not be used in pts with acute narrow angle glaucoma.

a patient has been ordered to receive succinylcholine. Their labs show hyperkalemia. what should be done 1st

fix hyperkalemia before giving succinylcholine/anectine

what drug is used for parkinson's disease

carbidopa-levodopa/sinemet

how does carbidopa-levodopa/sinemet work

dopamine cannot cross the BBB so its precursor-levodopa-is used.

why is carbidopa added to the levodopa

because there is such a high level of destruction before the levodopa is actually absorbed

what are common side effects of carbidopa-levodopa/sinemet

abnormal movements orthostatic hypertension GI effects

which patients should not receive carbidopa-levodopa/sinemet

those who are: hypersensitive have closed angle glaucoma are on MAOI's

what cancer form can carbidopa-levodopa/sinemet trigger

it can activate malignant melanoma

which patients need close monitoring while on carbidopa-levodopa/sinemet

those with cardiac disease, peptic ulcer disease, and diabetes

which drug is used for ALS

Riluzole/rilutek. it slows the disease's progression

which common side effects of riluzole/rilutek can be confused with s/s of ALS

muscle fatigue n/v anorexia vertigo and somnolence

what does a patient on riluzole/rilutek need to report to their physician

s/s of neutropenia-sore throat, fever, other signs of infection

which drug is used for multiple sclerosis

glatiramer/copaxone

which movement disorder drug should never be given IV

glatiramer/copaxone should only be given SQ

what are good SQ injection sites

back of upper arm, lower abdomen-inch away from the navel, mid thigh

what is glatirame/copaxone mixed with

sterile water. keep refrigerated

which drug is a respiratory stimulant

caffeine.

what increases the effect of caffeine?

Grapefruit juice

what centrally acting stimulant is used for ADHD and narcolepsy

dextroamphetamine/dexadrine. aka speed!

what is the supply limit on dexadrine

a 30 day supply is given r/t abuse potential/class II drug

Unit 11 and 12 Flashcards

(81 cards)