Podcast
Questions and Answers
Which mechanism of action (MOA) is characteristic of Penicillin G and Penicillin VK?
Which mechanism of action (MOA) is characteristic of Penicillin G and Penicillin VK?
- Disrupting the bacterial cell membrane, leading to increased permeability.
- Inhibiting bacterial protein synthesis by binding to the 30S ribosomal subunit.
- Binding to penicillin-binding proteins, inhibiting cell wall synthesis, and causing cell wall lysis. (correct)
- Binding to the bacterial cell wall and inhibiting peptidoglycan synthesis.
A patient with a known allergy to Penicillin is prescribed Cephalexin (Keflex). What is the primary concern?
A patient with a known allergy to Penicillin is prescribed Cephalexin (Keflex). What is the primary concern?
- Cephalexin is safe to administer as it belongs to a different class of antibiotics.
- The patient will experience mild gastrointestinal discomfort.
- There is a potential cross-reactivity between penicillins and cephalosporins. (correct)
- Cephalexin will be ineffective due to the pre-existing penicillin allergy.
Imipenem is prescribed for a patient. The nurse should be aware of which of the following drug interactions?
Imipenem is prescribed for a patient. The nurse should be aware of which of the following drug interactions?
- Increased absorption of oral contraceptives.
- Reduced risk of seizure activity.
- Significantly decreased valproic acid levels. (correct)
- Increased effectiveness of aminoglycosides.
Vancomycin is ordered for a patient with suspected MRSA. What is an important nursing consideration related to its administration?
Vancomycin is ordered for a patient with suspected MRSA. What is an important nursing consideration related to its administration?
A patient is prescribed tetracycline for acne. What education should the healthcare provider give to the patient?
A patient is prescribed tetracycline for acne. What education should the healthcare provider give to the patient?
Which antibiotic is typically the DOC (Drug of Choice) for syphilis?
Which antibiotic is typically the DOC (Drug of Choice) for syphilis?
A patient is receiving IV Vancomycin and begins to experience flushing, rash, and hypotension. Which of the following is the most likely cause?
A patient is receiving IV Vancomycin and begins to experience flushing, rash, and hypotension. Which of the following is the most likely cause?
What is the primary mechanism of action of tetracycline antibiotics?
What is the primary mechanism of action of tetracycline antibiotics?
Which of the following antibiotics is contraindicated in children under 8 years old due to the risk of dental effects?
Which of the following antibiotics is contraindicated in children under 8 years old due to the risk of dental effects?
A patient on Cefazolin is also taking a medication that can increase the risk of bleeding. Which medication is most concerning?
A patient on Cefazolin is also taking a medication that can increase the risk of bleeding. Which medication is most concerning?
A patient is prescribed tetracycline. What advice should the patient receive regarding taking the medication with antacids?
A patient is prescribed tetracycline. What advice should the patient receive regarding taking the medication with antacids?
Which of the following is a common adverse effect associated with tetracycline use?
Which of the following is a common adverse effect associated with tetracycline use?
A patient is prescribed Penicillin G. Which of the following pre-existing conditions should the healthcare provider be most concerned about?
A patient is prescribed Penicillin G. Which of the following pre-existing conditions should the healthcare provider be most concerned about?
A patient develops profuse diarrhea while on Cephalexin. What should the nurse instruct the patient to do first?
A patient develops profuse diarrhea while on Cephalexin. What should the nurse instruct the patient to do first?
Why is oral Vancomycin used to treat Clostridium difficile infections, despite Vancomycin not being absorbed orally?
Why is oral Vancomycin used to treat Clostridium difficile infections, despite Vancomycin not being absorbed orally?
A patient is prescribed tetracycline for the treatment of acne. Besides avoiding sun exposure, what other dietary consideration is important?
A patient is prescribed tetracycline for the treatment of acne. Besides avoiding sun exposure, what other dietary consideration is important?
Which of the following beta-lactam antibiotics is administered only intravenously (IV)?
Which of the following beta-lactam antibiotics is administered only intravenously (IV)?
A nurse is preparing to administer Penicillin G intravenously. What is a critical action to perform after administering the medication?
A nurse is preparing to administer Penicillin G intravenously. What is a critical action to perform after administering the medication?
Which of the following is a potential adverse effect of high doses of Penicillin G, particularly in patients with renal impairment?
Which of the following is a potential adverse effect of high doses of Penicillin G, particularly in patients with renal impairment?
A patient taking Minocycline reports experiencing dizziness and vertigo. What is the most appropriate nursing intervention?
A patient taking Minocycline reports experiencing dizziness and vertigo. What is the most appropriate nursing intervention?
Which of the following adverse effects is most closely associated with aminoglycoside-induced neuro-muscular blockade?
Which of the following adverse effects is most closely associated with aminoglycoside-induced neuro-muscular blockade?
A patient taking erythromycin develops jaundice and abdominal pain. Which hepatic effect is most likely causing these symptoms?
A patient taking erythromycin develops jaundice and abdominal pain. Which hepatic effect is most likely causing these symptoms?
A patient is prescribed ciprofloxacin for a complicated UTI. What potential adverse effect should the patient be LEAST concerned about while taking this medication?
A patient is prescribed ciprofloxacin for a complicated UTI. What potential adverse effect should the patient be LEAST concerned about while taking this medication?
Which antibiotic requires monitoring of both peak and trough levels to ensure efficacy and minimize the risk of toxicity?
Which antibiotic requires monitoring of both peak and trough levels to ensure efficacy and minimize the risk of toxicity?
What is the primary reason for the disulfiram-like reaction associated with metronidazole?
What is the primary reason for the disulfiram-like reaction associated with metronidazole?
A patient receiving intravenous gentamicin develops tinnitus and experiences a gradual decline in hearing acuity. Which action is most important for the nurse?
A patient receiving intravenous gentamicin develops tinnitus and experiences a gradual decline in hearing acuity. Which action is most important for the nurse?
Trimethoprim/sulfamethoxazole (TMP/SMX) is prescribed for a patient with a UTI. Why is it important to monitor potassium levels in these patients?
Trimethoprim/sulfamethoxazole (TMP/SMX) is prescribed for a patient with a UTI. Why is it important to monitor potassium levels in these patients?
Which of the following antibiotics is LEAST likely to be associated with causing Clostridioides difficile-associated diarrhea (CDAD)?
Which of the following antibiotics is LEAST likely to be associated with causing Clostridioides difficile-associated diarrhea (CDAD)?
A patient is prescribed ciprofloxacin and reports pain and swelling in their Achilles tendon after a week of treatment. What is the most appropriate initial action?
A patient is prescribed ciprofloxacin and reports pain and swelling in their Achilles tendon after a week of treatment. What is the most appropriate initial action?
Why are antacids containing magnesium or aluminum avoided when taking fluoroquinolones like ciprofloxacin?
Why are antacids containing magnesium or aluminum avoided when taking fluoroquinolones like ciprofloxacin?
Which statement accurately describes a drug interaction concern when administering erythromycin to a patient already taking a CYP3A4 substrate?
Which statement accurately describes a drug interaction concern when administering erythromycin to a patient already taking a CYP3A4 substrate?
Following the administration of Metronidazole, which sign or symptom would indicate a potential neurotoxic effect?
Following the administration of Metronidazole, which sign or symptom would indicate a potential neurotoxic effect?
Why is extended-interval dosing (once-daily) of aminoglycosides, like gentamicin, considered beneficial in certain patients?
Why is extended-interval dosing (once-daily) of aminoglycosides, like gentamicin, considered beneficial in certain patients?
Which patient population requires extra caution when administering trimethoprim/sulfamethoxazole (TMP/SMX) due to the risk of kernicterus?
Which patient population requires extra caution when administering trimethoprim/sulfamethoxazole (TMP/SMX) due to the risk of kernicterus?
A patient on Clindamycin therapy reports having 8 episodes of watery diarrhea per day. What is the priority nursing intervention?
A patient on Clindamycin therapy reports having 8 episodes of watery diarrhea per day. What is the priority nursing intervention?
Which of the following antibiotics inhibits nucleic acid synthesis, resulting in cell death?
Which of the following antibiotics inhibits nucleic acid synthesis, resulting in cell death?
A patient is prescribed Trimethoprim/Sulfamethoxazole (TMP/SMX) for a UTI. What instructions should the nurse provide regarding fluid intake?
A patient is prescribed Trimethoprim/Sulfamethoxazole (TMP/SMX) for a UTI. What instructions should the nurse provide regarding fluid intake?
Which of the following antibiotics is most likely to cause QT prolongation, especially when combined with other medications that affect cardiac conduction?
Which of the following antibiotics is most likely to cause QT prolongation, especially when combined with other medications that affect cardiac conduction?
A patient with a known sulfa allergy is prescribed Trimethoprim/Sulfamethoxazole (TMP/SMX). What potential cross-allergy should the healthcare provider be aware of?
A patient with a known sulfa allergy is prescribed Trimethoprim/Sulfamethoxazole (TMP/SMX). What potential cross-allergy should the healthcare provider be aware of?
A patient is prescribed both erythromycin and warfarin concurrently. What potential drug interaction should the healthcare provider monitor for?
A patient is prescribed both erythromycin and warfarin concurrently. What potential drug interaction should the healthcare provider monitor for?
A patient is prescribed Rifampin for tuberculosis. What counseling point is most important to include?
A patient is prescribed Rifampin for tuberculosis. What counseling point is most important to include?
A patient is starting Isoniazid for latent tuberculosis. What should the healthcare provider monitor for?
A patient is starting Isoniazid for latent tuberculosis. What should the healthcare provider monitor for?
A patient taking pyrazinamide reports joint pain. Which laboratory value should the nurse monitor?
A patient taking pyrazinamide reports joint pain. Which laboratory value should the nurse monitor?
A patient is prescribed Ethambutol. What specific instruction should the healthcare provider give regarding potential adverse effects?
A patient is prescribed Ethambutol. What specific instruction should the healthcare provider give regarding potential adverse effects?
Which of the following is the most important assessment prior to initiating ethambutol?
Which of the following is the most important assessment prior to initiating ethambutol?
A patient is prescribed Rifampin. Which medication taken concurrently would be of greatest concern?
A patient is prescribed Rifampin. Which medication taken concurrently would be of greatest concern?
When administering amphotericin B, what premedication is most important to prevent infusion reactions?
When administering amphotericin B, what premedication is most important to prevent infusion reactions?
What is a major advantage of using liposomal amphotericin B compared to conventional amphotericin B?
What is a major advantage of using liposomal amphotericin B compared to conventional amphotericin B?
A patient receiving IV amphotericin B develops rigors. What medication should the nurse administer?
A patient receiving IV amphotericin B develops rigors. What medication should the nurse administer?
Why is it important to administer conventional amphotericin B via a slow infusion rate (4-6 hours)
Why is it important to administer conventional amphotericin B via a slow infusion rate (4-6 hours)
A patient is prescribed isoniazid (INH) as monotherapy for latent TB. Which vitamin supplement is typically recommended alongside INH to prevent a common adverse effect?
A patient is prescribed isoniazid (INH) as monotherapy for latent TB. Which vitamin supplement is typically recommended alongside INH to prevent a common adverse effect?
A patient with active TB is prescribed Rifampin, Isoniazid, Pyrazinamide, and Ethambutol (RIPE). The patient asks why so many medications are needed. What is the best explanation?
A patient with active TB is prescribed Rifampin, Isoniazid, Pyrazinamide, and Ethambutol (RIPE). The patient asks why so many medications are needed. What is the best explanation?
A patient on Rifampin complains that their contact lenses are stained. What is the mechanism by which this occurs?
A patient on Rifampin complains that their contact lenses are stained. What is the mechanism by which this occurs?
Which of the following is the most important nursing intervention for a patient receiving amphotericin B to minimize nephrotoxicity?
Which of the following is the most important nursing intervention for a patient receiving amphotericin B to minimize nephrotoxicity?
A patient taking isoniazid (INH) reports experiencing tingling and numbness in their feet, what is the most appropriate action?
A patient taking isoniazid (INH) reports experiencing tingling and numbness in their feet, what is the most appropriate action?
A patient is starting pyrazinamide therapy. What pre-existing condition would be a contraindication?
A patient is starting pyrazinamide therapy. What pre-existing condition would be a contraindication?
A patient is on Ethambutol therapy. Which assessment finding would warrant immediate discontinuation of the medication?
A patient is on Ethambutol therapy. Which assessment finding would warrant immediate discontinuation of the medication?
A patient is receiving amphotericin B intravenously. What electrolyte imbalance is the patient at greatest risk for?
A patient is receiving amphotericin B intravenously. What electrolyte imbalance is the patient at greatest risk for?
Which of the following medications, if taken concurrently with rifampin, would require a dosage adjustment to maintain its therapeutic effect because rifampin is a CYP450 inducer?
Which of the following medications, if taken concurrently with rifampin, would require a dosage adjustment to maintain its therapeutic effect because rifampin is a CYP450 inducer?
A patient is being treated with IV amphotericin B. Which of the following would be indicative of phlebitis at the IV site?
A patient is being treated with IV amphotericin B. Which of the following would be indicative of phlebitis at the IV site?
Which of the following mechanisms describes how azole antifungals, such as fluconazole and itraconazole, combat fungal infections?
Which of the following mechanisms describes how azole antifungals, such as fluconazole and itraconazole, combat fungal infections?
Why is Nystatin typically administered topically or as an oral 'swish and swallow' rather than intravenously?
Why is Nystatin typically administered topically or as an oral 'swish and swallow' rather than intravenously?
Before starting Abacavir treatment, pharmacogenomic testing for HLA-B*5701 is essential. Why is this testing performed?
Before starting Abacavir treatment, pharmacogenomic testing for HLA-B*5701 is essential. Why is this testing performed?
Efavirenz carries a warning to avoid concurrent use with which substance due to potential additive CNS effects?
Efavirenz carries a warning to avoid concurrent use with which substance due to potential additive CNS effects?
Darunavir is always 'boosted' with ritonavir or cobicistat. What is the primary purpose of this 'boosting'?
Darunavir is always 'boosted' with ritonavir or cobicistat. What is the primary purpose of this 'boosting'?
A patient taking itraconazole develops anorexia, fatigue, nausea and vomiting, right upper quadrant abdominal pain, and jaundice. What is the most likely cause of these symptoms?
A patient taking itraconazole develops anorexia, fatigue, nausea and vomiting, right upper quadrant abdominal pain, and jaundice. What is the most likely cause of these symptoms?
A patient is prescribed nystatin oral suspension for a thrush infection. What instruction should the nurse prioritize when educating the patient on how to administer the medication?
A patient is prescribed nystatin oral suspension for a thrush infection. What instruction should the nurse prioritize when educating the patient on how to administer the medication?
Which baseline laboratory test is MOST important to obtain before initiating abacavir therapy?
Which baseline laboratory test is MOST important to obtain before initiating abacavir therapy?
Why should efavirenz be taken on an empty stomach, preferably at bedtime?
Why should efavirenz be taken on an empty stomach, preferably at bedtime?
A patient on darunavir reports new onset hyperglycemia. What is the most appropriate nursing intervention?
A patient on darunavir reports new onset hyperglycemia. What is the most appropriate nursing intervention?
A patient is prescribed itraconazole capsules for onychomycosis. What administration advice is most appropriate?
A patient is prescribed itraconazole capsules for onychomycosis. What administration advice is most appropriate?
What is the primary reason for monitoring CBC in patients receiving Zidovudine?
What is the primary reason for monitoring CBC in patients receiving Zidovudine?
Which of the following instructions is most crucial when counselling a patient starting efavirenz, especially if there is a possibility of pregnancy?
Which of the following instructions is most crucial when counselling a patient starting efavirenz, especially if there is a possibility of pregnancy?
Why is careful evaluation and education regarding drug-drug interactions (DDIs) particularly important for patients prescribed Darunavir?
Why is careful evaluation and education regarding drug-drug interactions (DDIs) particularly important for patients prescribed Darunavir?
A patient taking itraconazole concurrently with warfarin requires close monitoring of which laboratory value?
A patient taking itraconazole concurrently with warfarin requires close monitoring of which laboratory value?
Why is adherence to antiretroviral therapy, such as abacavir, efavirenz, and darunavir, so critical in managing HIV?
Why is adherence to antiretroviral therapy, such as abacavir, efavirenz, and darunavir, so critical in managing HIV?
Which assessment is MOST important to conduct regularly in a patient taking efavirenz due to its potential CNS side effects?
Which assessment is MOST important to conduct regularly in a patient taking efavirenz due to its potential CNS side effects?
A patient taking darunavir reports new onset lipodystrophy. What is lipodystrophy?
A patient taking darunavir reports new onset lipodystrophy. What is lipodystrophy?
What information is MOST important to give a patient who is about to start taking fluconazole?
What information is MOST important to give a patient who is about to start taking fluconazole?
A patient taking darunavir develops an elevated cholesterol level. What is the most appropriate initial intervention?
A patient taking darunavir develops an elevated cholesterol level. What is the most appropriate initial intervention?
Raltegravir inhibits HIV replication by which mechanism?
Raltegravir inhibits HIV replication by which mechanism?
What is the primary goal of using Tenofovir/Emtricitabine as PrEP?
What is the primary goal of using Tenofovir/Emtricitabine as PrEP?
Which of the following is a key consideration when administering IV acyclovir?
Which of the following is a key consideration when administering IV acyclovir?
Why is Ganciclovir primarily used in immunocompromised patients?
Why is Ganciclovir primarily used in immunocompromised patients?
A patient with influenza-like symptoms for 3 days is asking for Oseltamivir. How should the healthcare provider respond?
A patient with influenza-like symptoms for 3 days is asking for Oseltamivir. How should the healthcare provider respond?
What is the primary mechanism of action of methotrexate in treating rheumatoid arthritis?
What is the primary mechanism of action of methotrexate in treating rheumatoid arthritis?
A patient on raltegravir develops a skin rash. What is the most appropriate initial nursing action?
A patient on raltegravir develops a skin rash. What is the most appropriate initial nursing action?
Why is adherence with tenofovir/emtricitabine essential for individuals taking it as PrEP?
Why is adherence with tenofovir/emtricitabine essential for individuals taking it as PrEP?
A patient receiving IV ganciclovir develops agitation, tremors, and hallucinations. What is the likely cause?
A patient receiving IV ganciclovir develops agitation, tremors, and hallucinations. What is the likely cause?
What teaching should be provided to a patient prescribed Oseltamivir?
What teaching should be provided to a patient prescribed Oseltamivir?
A patient taking methotrexate reports oral ulcers. What action should the nurse take?
A patient taking methotrexate reports oral ulcers. What action should the nurse take?
Which of the following instructions is most important for a patient taking raltegravir?
Which of the following instructions is most important for a patient taking raltegravir?
A patient on tenofovir/emtricitabine should be routinely monitored for which adverse effect?
A patient on tenofovir/emtricitabine should be routinely monitored for which adverse effect?
What is a priority nursing action for a patient receiving IV acyclovir?
What is a priority nursing action for a patient receiving IV acyclovir?
What laboratory values are essential to monitor regularly in patients receiving ganciclovir?
What laboratory values are essential to monitor regularly in patients receiving ganciclovir?
A patient with renal dysfunction may require what change to their Oseltamivir dose?
A patient with renal dysfunction may require what change to their Oseltamivir dose?
What action should the nurse take when preparing methotrexate for a patient?
What action should the nurse take when preparing methotrexate for a patient?
Which of the following is a significant contraindication for methotrexate?
Which of the following is a significant contraindication for methotrexate?
Which of the following is an important drug interaction to consider with raltegravir?
Which of the following is an important drug interaction to consider with raltegravir?
A patient is prescribed methotrexate. What baseline assessments are essential?
A patient is prescribed methotrexate. What baseline assessments are essential?
Etanercept is prescribed for a patient with rheumatoid arthritis. What is the primary mechanism of action of this medication?
Etanercept is prescribed for a patient with rheumatoid arthritis. What is the primary mechanism of action of this medication?
A patient is starting Etanercept therapy. Which pre-existing condition would be a contraindication?
A patient is starting Etanercept therapy. Which pre-existing condition would be a contraindication?
A patient on cyclosporine reports experiencing tremors. Which intervention is most appropriate?
A patient on cyclosporine reports experiencing tremors. Which intervention is most appropriate?
A patient is prescribed cyclosporine following a kidney transplant. The patient is also taking several other medications. Which medication would be of greatest concern?
A patient is prescribed cyclosporine following a kidney transplant. The patient is also taking several other medications. Which medication would be of greatest concern?
A patient is starting cyclosporine therapy. What should the nurse monitor to identify potential adverse effects?
A patient is starting cyclosporine therapy. What should the nurse monitor to identify potential adverse effects?
A patient is to receive the pneumococcal polysaccharide vaccine (PPSV23). Which route and location are most appropriate for administration?
A patient is to receive the pneumococcal polysaccharide vaccine (PPSV23). Which route and location are most appropriate for administration?
A 70-year-old patient is scheduled to receive the influenza vaccine. What is an important consideration regarding vaccine choice?
A 70-year-old patient is scheduled to receive the influenza vaccine. What is an important consideration regarding vaccine choice?
Why is it important to avoid administering live vaccines to patients who are taking Etanercept?
Why is it important to avoid administering live vaccines to patients who are taking Etanercept?
What is the primary reason for mixing oral cyclosporine with a diluent in a glass and drinking it immediately?
What is the primary reason for mixing oral cyclosporine with a diluent in a glass and drinking it immediately?
A patient who is about to receive the influenza vaccine reports an egg allergy. Which action should the healthcare provider take?
A patient who is about to receive the influenza vaccine reports an egg allergy. Which action should the healthcare provider take?
What is the most important counseling point regarding pregnancy for a woman of childbearing potential who is prescribed cyclosporine?
What is the most important counseling point regarding pregnancy for a woman of childbearing potential who is prescribed cyclosporine?
A patient on Etanercept therapy reports new onset of night sweats and a persistent cough. What is the priority nursing intervention?
A patient on Etanercept therapy reports new onset of night sweats and a persistent cough. What is the priority nursing intervention?
A patient is prescribed Cyclosporine after organ transplant. What should the patient be taught regarding grapefruit juice?
A patient is prescribed Cyclosporine after organ transplant. What should the patient be taught regarding grapefruit juice?
A patient asks why they need an annual flu vaccine even though they received one last year. What is the best explanation?
A patient asks why they need an annual flu vaccine even though they received one last year. What is the best explanation?
A patient on cyclosporine has developed hirsutism. What is the best approach the healthcare provider should consider?
A patient on cyclosporine has developed hirsutism. What is the best approach the healthcare provider should consider?
The nurse has completed administering the influenza vaccine to a patient. Which action is most important for the nurse to document?
The nurse has completed administering the influenza vaccine to a patient. Which action is most important for the nurse to document?
A patient with a history of heart failure is prescribed Etanercept. What is an important consideration?
A patient with a history of heart failure is prescribed Etanercept. What is an important consideration?
A patient reports drowsiness after receiving the pneumococcal vaccine. What is the most appropriate instruction?
A patient reports drowsiness after receiving the pneumococcal vaccine. What is the most appropriate instruction?
A patient taking cyclosporine is prescribed a new medication known to be nephrotoxic. What is the most appropriate action?
A patient taking cyclosporine is prescribed a new medication known to be nephrotoxic. What is the most appropriate action?
Why is proper storage of the dosing syringe for cyclosporine important?
Why is proper storage of the dosing syringe for cyclosporine important?
A patient with a history of migraines is prescribed sumatriptan. What condition would be a contraindication or require careful assessment before initiating therapy?
A patient with a history of migraines is prescribed sumatriptan. What condition would be a contraindication or require careful assessment before initiating therapy?
A patient is prescribed allopurinol for chronic gout. What information is most important to emphasize to the patient regarding the timing and management of acute gout flares?
A patient is prescribed allopurinol for chronic gout. What information is most important to emphasize to the patient regarding the timing and management of acute gout flares?
A patient who has been receiving morphine for chronic pain reports new onset constipation. Besides increasing fluid and fiber intake, what pharmacological intervention should be considered?
A patient who has been receiving morphine for chronic pain reports new onset constipation. Besides increasing fluid and fiber intake, what pharmacological intervention should be considered?
A patient is about to receive the rabies vaccine. What information should be given to the patient regarding potential adverse reactions and their management?
A patient is about to receive the rabies vaccine. What information should be given to the patient regarding potential adverse reactions and their management?
A patient with acute gouty arthritis is prescribed colchicine. What counseling point regarding potential adverse effects is most important to emphasize?
A patient with acute gouty arthritis is prescribed colchicine. What counseling point regarding potential adverse effects is most important to emphasize?
A patient taking morphine for chronic pain is scheduled for surgery. How should the nurse and healthcare provider manage the patient's pain medication during the perioperative period?
A patient taking morphine for chronic pain is scheduled for surgery. How should the nurse and healthcare provider manage the patient's pain medication during the perioperative period?
A patient is prescribed a fentanyl transdermal patch for chronic pain. What education should be provided to the patient regarding factors that could affect drug absorption?
A patient is prescribed a fentanyl transdermal patch for chronic pain. What education should be provided to the patient regarding factors that could affect drug absorption?
A patient with a history of gout is prescribed allopurinol. Which laboratory value is most important to monitor regularly during allopurinol therapy?
A patient with a history of gout is prescribed allopurinol. Which laboratory value is most important to monitor regularly during allopurinol therapy?
A patient is being discharged on morphine for pain management. What critical information should the nurse provide to the patient and their family regarding respiratory depression?
A patient is being discharged on morphine for pain management. What critical information should the nurse provide to the patient and their family regarding respiratory depression?
A patient with a migraine is prescribed sumatriptan. Which instruction should the nurse give to the patient regarding administration and what to do if the initial dose is ineffective?
A patient with a migraine is prescribed sumatriptan. Which instruction should the nurse give to the patient regarding administration and what to do if the initial dose is ineffective?
A patient that is started on Allopurinol has the following labs: Uric Acid 9.8 mg/dL, BUN 10 mg/dL, Creatinine 0.9 mg/dL, ALT 19 U/L, AST 22 U/L. Which lab is most important to monitor for efficacy of the Allopurinol?
A patient that is started on Allopurinol has the following labs: Uric Acid 9.8 mg/dL, BUN 10 mg/dL, Creatinine 0.9 mg/dL, ALT 19 U/L, AST 22 U/L. Which lab is most important to monitor for efficacy of the Allopurinol?
A patient reports chest tightness after taking sumatriptan for a migraine. What is the most appropriate initial action?
A patient reports chest tightness after taking sumatriptan for a migraine. What is the most appropriate initial action?
A patient is prescribed the Rabies vaccine post exposure. What is the goal of the Rabies vaccine?
A patient is prescribed the Rabies vaccine post exposure. What is the goal of the Rabies vaccine?
A patient on morphine who also has an enlarged prostate is experiencing difficulty urinating. What is the most likely reason and appropriate intervention?
A patient on morphine who also has an enlarged prostate is experiencing difficulty urinating. What is the most likely reason and appropriate intervention?
What would be the most important teaching point for a patient using a fentanyl patch?
What would be the most important teaching point for a patient using a fentanyl patch?
A patient is being treated for gout with colchicine. Which pre-existing conditions would be most concerning?
A patient is being treated for gout with colchicine. Which pre-existing conditions would be most concerning?
A patient prescribed allopurinol reports a rash. What is the most appropriate action?
A patient prescribed allopurinol reports a rash. What is the most appropriate action?
A patient is prescribed morphine for acute pain. What other effect can morphine cause?
A patient is prescribed morphine for acute pain. What other effect can morphine cause?
A patient with a severe migraine is prescribed Sumatriptan. How does Sumatriptan relieve migraine pain?
A patient with a severe migraine is prescribed Sumatriptan. How does Sumatriptan relieve migraine pain?
Prior to administering Morphine, what assessment is most important to obtain?
Prior to administering Morphine, what assessment is most important to obtain?
Which of the following mechanisms of action (MOA) distinguishes aspirin from other first-generation NSAIDs like ibuprofen?
Which of the following mechanisms of action (MOA) distinguishes aspirin from other first-generation NSAIDs like ibuprofen?
A patient with a history of gastritis is prescribed ibuprofen for pain relief. What potential adverse effect should the healthcare provider be most concerned about?
A patient with a history of gastritis is prescribed ibuprofen for pain relief. What potential adverse effect should the healthcare provider be most concerned about?
Celecoxib is prescribed for a patient with osteoarthritis. What is the key mechanism by which celecoxib reduces inflammation and pain?
Celecoxib is prescribed for a patient with osteoarthritis. What is the key mechanism by which celecoxib reduces inflammation and pain?
A patient is taking acetaminophen for chronic headaches. Which of the following instructions is most important to emphasize regarding the risk of hepatotoxicity?
A patient is taking acetaminophen for chronic headaches. Which of the following instructions is most important to emphasize regarding the risk of hepatotoxicity?
Why is aspirin contraindicated in children and adolescents with viral illnesses?
Why is aspirin contraindicated in children and adolescents with viral illnesses?
A patient on long-term aspirin therapy is scheduled for elective surgery. What is the primary concern related to aspirin in the perioperative period?
A patient on long-term aspirin therapy is scheduled for elective surgery. What is the primary concern related to aspirin in the perioperative period?
A patient taking warfarin is prescribed aspirin. What potential drug-drug interaction (DDI) should the healthcare provider monitor for?
A patient taking warfarin is prescribed aspirin. What potential drug-drug interaction (DDI) should the healthcare provider monitor for?
A patient with known cardiovascular disease is prescribed celecoxib. What potential risk should the healthcare provider consider?
A patient with known cardiovascular disease is prescribed celecoxib. What potential risk should the healthcare provider consider?
A patient presents to the emergency department with tinnitus, sweating, headache, and dizziness. They report regularly taking high doses of aspirin. Which condition is most likely?
A patient presents to the emergency department with tinnitus, sweating, headache, and dizziness. They report regularly taking high doses of aspirin. Which condition is most likely?
Which of the following best describes the treatment approach for aspirin overdose?
Which of the following best describes the treatment approach for aspirin overdose?
A patient with a history of peptic ulcer disease is seeking an over-the-counter analgesic. Which of the following is the safest option, considering their medical history?
A patient with a history of peptic ulcer disease is seeking an over-the-counter analgesic. Which of the following is the safest option, considering their medical history?
A pregnant patient in her third trimester is experiencing musculoskeletal pain. Which of the following analgesics should be avoided?
A pregnant patient in her third trimester is experiencing musculoskeletal pain. Which of the following analgesics should be avoided?
A patient on ibuprofen reports developing symptoms such as blistering and skin peeling. Which severe adverse effect is most likely?
A patient on ibuprofen reports developing symptoms such as blistering and skin peeling. Which severe adverse effect is most likely?
A patient is prescribed acetaminophen for fever. What is the primary mechanism of action by which acetaminophen reduces fever?
A patient is prescribed acetaminophen for fever. What is the primary mechanism of action by which acetaminophen reduces fever?
What information should a nurse provide to a patient who is prescribed celecoxib about potential allergic reactions?
What information should a nurse provide to a patient who is prescribed celecoxib about potential allergic reactions?
Which of the following conditions would warrant cautious use, but not necessarily be a contraindication, for ibuprofen?
Which of the following conditions would warrant cautious use, but not necessarily be a contraindication, for ibuprofen?
A patient regularly takes aspirin for its cardioprotective effects. Which of the following mechanisms explains this benefit?
A patient regularly takes aspirin for its cardioprotective effects. Which of the following mechanisms explains this benefit?
A patient on high-dose aspirin is also taking glucocorticoids. What potential drug-drug interaction (DDI) needs to be monitored?
A patient on high-dose aspirin is also taking glucocorticoids. What potential drug-drug interaction (DDI) needs to be monitored?
A patient is prescribed ibuprofen for pain relief, but reports no improvement after several days. What should the healthcare provider consider?
A patient is prescribed ibuprofen for pain relief, but reports no improvement after several days. What should the healthcare provider consider?
Which statement best describes the difference in gastrointestinal (GI) effects between celecoxib and ibuprofen?
Which statement best describes the difference in gastrointestinal (GI) effects between celecoxib and ibuprofen?
What is the primary difference between the mechanisms of action of aspirin and celecoxib in managing pain?
What is the primary difference between the mechanisms of action of aspirin and celecoxib in managing pain?
A patient with osteoarthritis is prescribed celecoxib. What is the MOST important consideration when evaluating the appropriateness of this medication?
A patient with osteoarthritis is prescribed celecoxib. What is the MOST important consideration when evaluating the appropriateness of this medication?
A patient reports taking acetaminophen regularly for chronic pain. Which of the following statements is the MOST critical for the healthcare provider to emphasize?
A patient reports taking acetaminophen regularly for chronic pain. Which of the following statements is the MOST critical for the healthcare provider to emphasize?
Why should aspirin be avoided in children and adolescents who have viral illnesses, such as the flu or chickenpox?
Why should aspirin be avoided in children and adolescents who have viral illnesses, such as the flu or chickenpox?
A patient on long-term, low-dose aspirin therapy is scheduled for an elective surgery. What is the PRIMARY concern related to aspirin in this situation?
A patient on long-term, low-dose aspirin therapy is scheduled for an elective surgery. What is the PRIMARY concern related to aspirin in this situation?
A patient is taking both warfarin and aspirin. Which of the following is the MOST significant risk associated with the concurrent use of these medications?
A patient is taking both warfarin and aspirin. Which of the following is the MOST significant risk associated with the concurrent use of these medications?
A patient with a history of cardiovascular disease is prescribed celecoxib. Which of the following considerations is MOST pertinent to this patient's care?
A patient with a history of cardiovascular disease is prescribed celecoxib. Which of the following considerations is MOST pertinent to this patient's care?
A patient presents with symptoms of tinnitus, sweating, headache, and dizziness. They report regularly taking high doses of aspirin. What is the MOST likely cause of these symptoms?
A patient presents with symptoms of tinnitus, sweating, headache, and dizziness. They report regularly taking high doses of aspirin. What is the MOST likely cause of these symptoms?
What is the MOST appropriate initial treatment for a patient who has overdosed on aspirin?
What is the MOST appropriate initial treatment for a patient who has overdosed on aspirin?
A patient with a history of peptic ulcer disease requires an analgesic for pain relief. Which of the following is the SAFEST over-the-counter (OTC) option?
A patient with a history of peptic ulcer disease requires an analgesic for pain relief. Which of the following is the SAFEST over-the-counter (OTC) option?
During pregnancy, which trimester is it MOST important to avoid NSAIDs, such as ibuprofen or aspirin, and why?
During pregnancy, which trimester is it MOST important to avoid NSAIDs, such as ibuprofen or aspirin, and why?
A patient taking ibuprofen reports developing a rash with symptoms of blistering and skin peeling. Which severe adverse effect is MOST likely causing these symptoms?
A patient taking ibuprofen reports developing a rash with symptoms of blistering and skin peeling. Which severe adverse effect is MOST likely causing these symptoms?
What is the primary mechanism by which acetaminophen reduces fever?
What is the primary mechanism by which acetaminophen reduces fever?
What information is MOST important to provide to a patient prescribed celecoxib regarding potential allergic reactions?
What information is MOST important to provide to a patient prescribed celecoxib regarding potential allergic reactions?
In which of the following conditions would ibuprofen require CAUTIOUS use, but not necessarily be contraindicated?
In which of the following conditions would ibuprofen require CAUTIOUS use, but not necessarily be contraindicated?
A patient regularly takes low-dose aspirin for its cardioprotective effects. Which mechanism explains this benefit?
A patient regularly takes low-dose aspirin for its cardioprotective effects. Which mechanism explains this benefit?
A patient on high-dose aspirin therapy is also taking glucocorticoids. What drug-drug interaction needs to be monitored?
A patient on high-dose aspirin therapy is also taking glucocorticoids. What drug-drug interaction needs to be monitored?
A patient prescribed ibuprofen for pain relief reports no improvement after several days. What should the healthcare provider consider FIRST?
A patient prescribed ibuprofen for pain relief reports no improvement after several days. What should the healthcare provider consider FIRST?
What MOST accurately describes the GI effects differences between celecoxib and ibuprofen?
What MOST accurately describes the GI effects differences between celecoxib and ibuprofen?
Why is education regarding the risks associated with combination products containing acetaminophen like Tylenol Cold + Flu and Percocet important?
Why is education regarding the risks associated with combination products containing acetaminophen like Tylenol Cold + Flu and Percocet important?
Flashcards
Penicillins MOA
Penicillins MOA
Bind to penicillin-binding proteins, inhibiting cell wall synthesis and causing cell lysis.
Penicillins AEs
Penicillins AEs
Nausea, vomiting, diarrhea, renal impairment, electrolyte imbalances, seizures, and allergic reactions.
Penicillins Nursing Implications
Penicillins Nursing Implications
Assess allergies, monitor for reactions, administer carefully, and complete the full course of therapy.
Cephalosporins MOA
Cephalosporins MOA
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Cephalosporins AEs
Cephalosporins AEs
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Cephalosporins Nursing Implications
Cephalosporins Nursing Implications
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Tetracyclines MOA
Tetracyclines MOA
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Tetracyclines AEs
Tetracyclines AEs
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Tetracyclines Nursing Implications
Tetracyclines Nursing Implications
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Vancomycin Use
Vancomycin Use
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Vancomycin MOA
Vancomycin MOA
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Vancomycin AEs
Vancomycin AEs
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Vancomycin Nursing Implications
Vancomycin Nursing Implications
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Erythromycin Use
Erythromycin Use
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Macrolides MOA
Macrolides MOA
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Macrolides AEs
Macrolides AEs
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Macrolides Nursing implications
Macrolides Nursing implications
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Clindamycin Use
Clindamycin Use
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Clindamycin AEs
Clindamycin AEs
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Gentamicin Use & Monitoring
Gentamicin Use & Monitoring
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Aminoglycosides MOA
Aminoglycosides MOA
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Aminoglycosides AEs
Aminoglycosides AEs
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Aminoglycosides Nursing Implications
Aminoglycosides Nursing Implications
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Trimethoprim/Sulfamethoxazole (TMP/SMX) Use
Trimethoprim/Sulfamethoxazole (TMP/SMX) Use
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Sulfonamides MOA
Sulfonamides MOA
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Sulfonamides AEs
Sulfonamides AEs
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Sulfonamides Nursing Implications
Sulfonamides Nursing Implications
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Ciprofloxacin Use
Ciprofloxacin Use
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Fluoroquinolones MOA
Fluoroquinolones MOA
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Fluoroquinolones AEs
Fluoroquinolones AEs
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Fluoroquinolones Nursing Implications
Fluoroquinolones Nursing Implications
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Metronidazole Use
Metronidazole Use
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Metronidazole MOA
Metronidazole MOA
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Rifampin
Rifampin
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Isoniazid
Isoniazid
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Pyrazinamide
Pyrazinamide
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Ethambutol
Ethambutol
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Amphotericin B
Amphotericin B
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Liposomal Amphotericin B
Liposomal Amphotericin B
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Rifampin MOA
Rifampin MOA
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Isoniazid MOA
Isoniazid MOA
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Pyrazinamide MOA
Pyrazinamide MOA
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Ethambutol MOA
Ethambutol MOA
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Amphotericin B MOA
Amphotericin B MOA
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Rifampin AEs
Rifampin AEs
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Isoniazid AEs
Isoniazid AEs
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Pyrazinamide AEs
Pyrazinamide AEs
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Ethambutol AEs
Ethambutol AEs
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Amphotericin B AEs
Amphotericin B AEs
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Rifampin Implications
Rifampin Implications
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Isoniazid Implications
Isoniazid Implications
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Pyrazinamide Implications
Pyrazinamide Implications
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Ethambutol Implications
Ethambutol Implications
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Azole Antifungals MOA
Azole Antifungals MOA
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Polyenes MOA
Polyenes MOA
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NRTIs MOA
NRTIs MOA
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NNRTIs MOA
NNRTIs MOA
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Protease Inhibitors MOA
Protease Inhibitors MOA
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Azole Antifungals AEs
Azole Antifungals AEs
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Nystatin AEs
Nystatin AEs
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NRTIs AEs
NRTIs AEs
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NNRTIs AEs
NNRTIs AEs
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Protease Inhibitors AEs
Protease Inhibitors AEs
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Itraconazole Implications
Itraconazole Implications
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Nystatin Implications
Nystatin Implications
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NRTIs Implications
NRTIs Implications
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NNRTIs Implications
NNRTIs Implications
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Protease Inhibitors Implications
Protease Inhibitors Implications
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Azole Drug Interactions
Azole Drug Interactions
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Abacavir Contraindications
Abacavir Contraindications
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Efavirenz Contraindications
Efavirenz Contraindications
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Protease Inhibitors PK
Protease Inhibitors PK
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Darunavir Contraindications
Darunavir Contraindications
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Raltegravir (Isentress) MOA
Raltegravir (Isentress) MOA
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Raltegravir (Isentress) AEs
Raltegravir (Isentress) AEs
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Raltegravir (Isentress) Implications
Raltegravir (Isentress) Implications
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Tenofovir/Emtricitabine MOA (Truvada/Descovy)
Tenofovir/Emtricitabine MOA (Truvada/Descovy)
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Tenofovir/Emtricitabine AEs (Truvada/Descovy)
Tenofovir/Emtricitabine AEs (Truvada/Descovy)
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Tenofovir/Emtricitabine Implications (Truvada/Descovy)
Tenofovir/Emtricitabine Implications (Truvada/Descovy)
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Acyclovir (Zovirax) MOA
Acyclovir (Zovirax) MOA
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Acyclovir (Zovirax) AEs
Acyclovir (Zovirax) AEs
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Acyclovir (Zovirax) Implications
Acyclovir (Zovirax) Implications
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Ganciclovir (Cytovene) MOA
Ganciclovir (Cytovene) MOA
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Ganciclovir (Cytovene) AEs
Ganciclovir (Cytovene) AEs
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Ganciclovir (Cytovene) Implications
Ganciclovir (Cytovene) Implications
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Oseltamivir (Tamiflu) MOA
Oseltamivir (Tamiflu) MOA
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Oseltamivir (Tamiflu) AEs
Oseltamivir (Tamiflu) AEs
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Oseltamivir (Tamiflu) Implications
Oseltamivir (Tamiflu) Implications
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Methotrexate (Rheumatrex) MOA
Methotrexate (Rheumatrex) MOA
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Methotrexate (Rheumatrex) AEs
Methotrexate (Rheumatrex) AEs
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Methotrexate (Rheumatrex) Implications
Methotrexate (Rheumatrex) Implications
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Etanercept (Enbrel) MOA
Etanercept (Enbrel) MOA
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Etanercept (Enbrel) Use
Etanercept (Enbrel) Use
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Etanercept (Enbrel) AEs
Etanercept (Enbrel) AEs
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Etanercept (Enbrel) Implications
Etanercept (Enbrel) Implications
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Cyclosporine (Sandimmune) MOA
Cyclosporine (Sandimmune) MOA
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Cyclosporine (Sandimmune) Use
Cyclosporine (Sandimmune) Use
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Cyclosporine (Sandimmune) AEs
Cyclosporine (Sandimmune) AEs
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Cyclosporine (Sandimmune) Monitoring
Cyclosporine (Sandimmune) Monitoring
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Influenza Vaccine MOA
Influenza Vaccine MOA
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Influenza Vaccine Use
Influenza Vaccine Use
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Influenza Vaccine AEs
Influenza Vaccine AEs
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Influenza Vaccine Implications
Influenza Vaccine Implications
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Pneumococcal Vaccine MOA
Pneumococcal Vaccine MOA
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Pneumococcal Vaccine Use
Pneumococcal Vaccine Use
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Pneumococcal Vaccine AEs
Pneumococcal Vaccine AEs
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Pneumococcal Vaccine Implications
Pneumococcal Vaccine Implications
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Rabies Vaccine Use & MOA
Rabies Vaccine Use & MOA
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Morphine Use & MOA
Morphine Use & MOA
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Allopurinol Use & MOA
Allopurinol Use & MOA
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Colchicine Use & MOA
Colchicine Use & MOA
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Sumatriptan Use & MOA
Sumatriptan Use & MOA
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Rabies Vaccine MOA
Rabies Vaccine MOA
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Hydromorphone (Dilaudid) MOA
Hydromorphone (Dilaudid) MOA
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Fentanyl (Duragesic) MOA
Fentanyl (Duragesic) MOA
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Allopurinol (Zyloprim) MOA
Allopurinol (Zyloprim) MOA
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Sumatriptan (Imitrex) MOA
Sumatriptan (Imitrex) MOA
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Morphine AEs
Morphine AEs
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Colchicine AEs
Colchicine AEs
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Sumatriptan AEs
Sumatriptan AEs
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Morphine Nursing Implications
Morphine Nursing Implications
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Fentanyl Patch Implication
Fentanyl Patch Implication
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First Generation NSAIDs Uses
First Generation NSAIDs Uses
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Aspirin (ASA) MOA
Aspirin (ASA) MOA
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Aspirin (ASA) AEs
Aspirin (ASA) AEs
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Aspirin (ASA) Contraindications
Aspirin (ASA) Contraindications
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Aspirin (ASA) DDIs
Aspirin (ASA) DDIs
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Ibuprofen (Motrin®, Advil®) MOA
Ibuprofen (Motrin®, Advil®) MOA
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Ibuprofen (Motrin®, Advil®) AEs
Ibuprofen (Motrin®, Advil®) AEs
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Celecoxib (Celebrex®) MOA
Celecoxib (Celebrex®) MOA
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Acetaminophen (Tylenol®) MOA
Acetaminophen (Tylenol®) MOA
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Acetaminophen (Tylenol®) AEs
Acetaminophen (Tylenol®) AEs
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Pain
Pain
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Pain Assessment: Rating
Pain Assessment: Rating
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Pain Assessment: Experience
Pain Assessment: Experience
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Pain Alphabet: Beginning
Pain Alphabet: Beginning
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Pain Alphabet: End
Pain Alphabet: End
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Stimulation Type
Stimulation Type
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Stimulation Chemicals
Stimulation Chemicals
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Basic Pain Types
Basic Pain Types
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Goals of Therapy (Pain)
Goals of Therapy (Pain)
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WHO Analgesic Ladder
WHO Analgesic Ladder
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WHO Analgesic Ladder STEP 1
WHO Analgesic Ladder STEP 1
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WHO Analgesic Ladder STEP 2
WHO Analgesic Ladder STEP 2
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WHO Analgesic Ladder STEP 3
WHO Analgesic Ladder STEP 3
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Drug Classes
Drug Classes
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Analgesics Examples
Analgesics Examples
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Opioids: Pure Opioid Agon
Opioids: Pure Opioid Agon
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Opioids: Other
Opioids: Other
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Nonopioid Analgesics: Mechanism
Nonopioid Analgesics: Mechanism
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NSAIDS: First Generation
NSAIDS: First Generation
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NSAIDS: Celexicob
NSAIDS: Celexicob
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Study Notes
Pain
- Defined as an unpleasant sensory or emotional experience tied to actual or potential tissue damage.
- Pain is subjective.
- Pain can disrupt sleep, alter thoughts and emotions, and affect daily activities.
- The most common symptom that prompts patients to seek medical care.
Pathophysiology of Pain
- Pain receptors get stimulated by mechanical, thermal, or chemical factors like bradykinin, prostaglandin, leukotriene, histamine, or serotonin.
- Sensory experience results form interpretation in the brain.
- The three basic types include nociceptive, inflammatory, and neuropathic pain.
- Pain is assessed via pain scale rating and experience which include:
- Pain alphabet
- OLDCARTS
- COLDSPA
Pain Alphabet
- Pain is assessed via these qualities:
- Quality
- Region(s)
- Severity
- Timing
- What it is usually associated with
- What gives relief
- What makes it worse
Goals of Pain Therapy
- Aim to relieve, prevent, and make pain tolerable.
- Quickly relieve acute pain.
- Chronic pain treatment includes the patient helping establish the goal.
- Keep expectations realistic because total pain relief may not be possible.
- Aim to restore functionality.
WHO Analgesic Ladder
- Provides a pain management strategy that adjusts analgesic therapy to match a level of pain
- STEP 1: Acetaminophen or NSAIDs used
- STEP 2: Acetaminophen + opioid or ASA + opioid combined
- STEP 3: Increasing doses of potent opioids +/- adjuvant therapy
Drugs to Treat Pain
- Non-opioid analgesics
- Opioids include:
- Methadone
- Meperidine
- Codeine
- Oxycodone
- Agonist-antagonist Opioids
- Pentazocine
- Naloxone
- Miscellaneous Pain Medications include:
- Sumatriptan and ergotamine, for Migraine
- Colchicine and Allupurinol, for AntiGout
Nonopioid Analgesics
- Nonopioid analgesics differ from opioids because they exhibit a ceiling effect.
- They typically don't cause tolerance, physical, or psychological dependence.
- Also possess antipyretic properties.
- They work primarily by inhibiting COX enzymes, preventing prostaglandin formation, with exceptions like tramadol and clonidine.
- Nonopioid analgesics treat mild to moderate pain.
First Generation NSAIDs (Salicylates)
- Includes Aspirin (ASA).
- Used for mild to moderate pain, inflammatory disorders, and fever reduction (antipyretic).
- Aspirin is also used as an anti-platelet.
MOA
- Irreversibly inhibits both COX-1 and COX-2 enzymes.
- Aspirin inhibits thromboxane A2 and prostacyclin-mediated platelet aggregation.
AEs
- GI distress (heartburn, nausea).
- Occult bleeding and bleeding.
- Renal impairment (acute, reversible).
- Reye’s Syndrome.
- Hypersensitivity.
- Salicylism (tinnitus, sweating, headache, dizziness).
- Adverse effects in pregnancy.
Nursing Implications
- Overdose is a common cause of salicylism.
- Symptoms: compensated respiratory alkalosis leading to respiratory depression, acidosis, hyperthermia, sweating, dehydration, electrolyte imbalance, coma, death.
- Treatment: supportive care (pump stomach, charcoal, cooling, fluids, bicarbonate IV).
- Over the counter medication.
- Contraindications: history of GI intolerance/ulcers, renal dysfunction, pregnancy, hypersensitivity to aspirin/any NSAID, bleeding disorders.
- Many drug-drug interactions possible, including Warfarin, heparin, and glucocorticoids.
- Decreases inflammation.
- Blocks prostaglandins responsible for inflammation
- Vasodilation leads to erythema
- Increased vascular permeability leads to edema
- Chemotaxis leads to WBC migration
- Aspirin ONLY
- Aspirin inhibits thromboxane A2 and prostacyclin mediated platelet aggregation
- Used in prevention of MI and stroke
- Thromboxane activity inhibited for life of platelet which is roughly 8 days
- Prostacyclin inhibited for several hours
First Generation NSAIDs
- Includes Ibuprofen (Motrin®, Advil®) which is an analgesic and antipyretic (fever reduction).
MOA
- Reversibly inhibits both COX-1 and COX-2 enzymes.
- Treats inflammatory conditions, causing pain and fever.
AEs
- GI distress (heartburn, nausea).
- Occult bleeding.
- Renal impairment.
- Hypersensitivity to aspirin.
- Adverse effects in pregnancy.
Nursing Implications
- CV risk and Stevens Johnson Syndrome (SJS) possibilities.
- Over the counter medication.
- Maximum dose:
- 1200mg/day (OTC).
- 3200mg/day (prescription).
Second Generation NSAIDs
- Includes Celecoxib (Celebrex®).
MOA
- Reversibly inhibits only COX-2 enzyme.
- Therapeutic Action: Used for osteoarthritis and acute pain.
AEs
- GI distress (heartburn, nausea).
- Occult bleeding.
- CV risk.
- Renal impairment.
- Hypersensitivity to aspirin; sulfonamide allergy.
- Adverse effects in pregnancy.
Nursing Implications
- Prescription only.
- Stop drug immediately if skin reactions occur.
Analgesics & Antipyretics
- Includes Acetaminophen (Tylenol®).
MOA
- Inhibits COX in the CNS only.
- Therapeutic Uses: analgesic, antipyretic
AEs
- Acute hepatotoxicity with doses > 4 g/day.
Nursing Implications
- Available as over the counter medication.
- Dosage: 325mg-1,000mg every 4-6 hours for adults.
- Maximum dose:
- 4,000 mg per day (adult dosing inpatient).
- 3,000 mg/day (adult dosing outpatient).
- Educate patients about symptoms of liver toxicity risk
- Max dose 4,000 mg/day via all sources.
- Avoid drinking alcohol, but if alcohol consumption is unavoidable, limit it to no more than 2,000 mg per day.
- Should be avoided in patients with liver disease.
- Combination product dangers.
- Maryland Poison Control at (800) 222-1222 can be called during an Acetaminophen Overdose
- The Antidote: acetylcysteine (Acetadote® Mucomyst®) should be administered ASAP after overdose is recognized
- It may be considered for administration up to 24 hours after acute ingestion
- Medications containing acetaminophen
- Over the counter meds: Excedrin, Midol, Nyquil.
- Prescription meds: Hydrocodone, Tylox, Percocet.
- Acetaminophen overdose can manifest through these stages:
- Stage 1 (Within 24 h): GI symptoms
- Stage 2 (24-72 h): Initial manifestations of liver toxicity (RUQ pain, increasing bilirubin levels, prothrombin time and liver enzymes)
- Stage 3 (72-96 h): Range depending on amount ingested; asymptomatic to fulminant liver failure
- Stage 4 (14 days post ingestion): Recovery or death
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