Pharmacology Final Review: Antibiotics, Penicillin, Contraceptives
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Questions and Answers

What is a common side effect of antidepressants?

  • Increased appetite
  • Improved vision
  • Enhanced memory
  • Orthostatic hypotension (correct)

Which drug should be monitored for liver function?

  • Clozapine
  • Valproate (valproic acid) (correct)
  • Famotidine
  • Phenazopyridine

What should be done before mixing any drugs together?

  • Check for drug interactions
  • Check their compatibility (correct)
  • Ensure the drugs are of the same color
  • Verify expiry dates

What is the best time to take statins?

<p>At night (D)</p> Signup and view all the answers

What is a common side effect of loop diuretics?

<p>Decreased potassium levels (D)</p> Signup and view all the answers

What should be monitored in patients taking loop diuretics?

<p>Sodium and potassium levels (A)</p> Signup and view all the answers

Which of the following is a common side effect of antipsychotic medications?

<p>Tardive dyskinesia (D)</p> Signup and view all the answers

Which of these medications is used to treat alcohol dependency?

<p>Disulfiram (A)</p> Signup and view all the answers

What is the purpose of monitoring white blood cell (WBC) levels in patients taking clozapine?

<p>To assess the risk of infection (D)</p> Signup and view all the answers

What is the primary purpose of a complete blood count (CBC) with differential?

<p>To break down specific white blood cell levels (C)</p> Signup and view all the answers

What is the recommended practice for administering transdermal patches?

<p>Apply the patch with gloves to avoid absorbing the medication (C)</p> Signup and view all the answers

Which of the following is a common side effect of selective serotonin reuptake inhibitor (SSRI) antidepressants?

<p>Photosensitivity (D)</p> Signup and view all the answers

What is the primary purpose of monitoring sodium and potassium levels in patients taking loop diuretics?

<p>To prevent electrolyte imbalances (B)</p> Signup and view all the answers

What is the recommended timing for taking antacid medications?

<p>After meals (C)</p> Signup and view all the answers

What is the recommended administration route for the medication Reglan (metoclopramide)?

<p>Oral, on an empty stomach (D)</p> Signup and view all the answers

What is the recommended time of day to take statin medications?

<p>At bedtime (D)</p> Signup and view all the answers

What is the minimum systolic blood pressure required before blood pressure medications are given?

<p>100 mmHg (D)</p> Signup and view all the answers

What is the first action a nurse should take if they give a patient the wrong medication?

<p>Assess the patient's condition (A)</p> Signup and view all the answers

Which of the following is an example of a paradoxical reaction to a medication?

<p>Pain caused by a pain relief medication (D)</p> Signup and view all the answers

What should a nurse do before mixing any medications together in a syringe?

<p>Ensure the medications are compatible (B)</p> Signup and view all the answers

What is the purpose of monitoring blood levels of a medication?

<p>All of the above (D)</p> Signup and view all the answers

Which of the following is a common side effect of antidepressant medications?

<p>All of the above (D)</p> Signup and view all the answers

What is the primary purpose of the nursing process known as 'ADPIE'?

<p>To assess, diagnose, plan, implement, and evaluate (D)</p> Signup and view all the answers

What should a nurse do if a patient reports an allergy to an antibiotic?

<p>Hold the antibiotic and notify the provider (D)</p> Signup and view all the answers

What is the recommended practice for a nurse when changing shifts and handling narcotics?

<p>Be present for the narcotic count and do not accept the cart keys without witnessing (C)</p> Signup and view all the answers

What is the main purpose of subjective data in nursing?

<p>To gather information directly from the patient (D)</p> Signup and view all the answers

Which medication is specifically mentioned as being dangerous for young people to take?

<p>Fluoroquinolones (A)</p> Signup and view all the answers

What is the recommended administration route for the EpiPen (epinephrine) medication?

<p>Intramuscular injection in the thigh (D)</p> Signup and view all the answers

What is the primary purpose of monitoring sodium and potassium levels in patients taking loop diuretics?

<p>To prevent electrolyte imbalances (A)</p> Signup and view all the answers

What is the recommended administration route for the medication Reglan (metoclopramide)?

<p>Intravenous (B)</p> Signup and view all the answers

Which laboratory test is mentioned as being used to determine a UTI?

<p>Urinalysis (A)</p> Signup and view all the answers

What is the recommended timing for taking antihistamine medications?

<p>No specific timing mentioned (D)</p> Signup and view all the answers

Which of the following is a common side effect of antidepressant medications?

<p>Drowsiness (B)</p> Signup and view all the answers

What is the primary purpose of monitoring white blood cell (WBC) levels in patients taking clozapine?

<p>To detect agranulocytosis (D)</p> Signup and view all the answers

What is the recommended practice for administering transdermal patches?

<p>Wear gloves and apply to closed wounds only (D)</p> Signup and view all the answers

What is the recommended time of day to take statin medications?

<p>Evening (B)</p> Signup and view all the answers

Which of the following is NOT a common side effect of metoclopramide (Reglan)?

<p>Nausea (D)</p> Signup and view all the answers

What is the primary mechanism of action of lactulose in treating liver disease?

<p>It reduces ammonia levels in the blood (D)</p> Signup and view all the answers

Which of the following is a common side effect of marijuana use?

<p>All of the above (D)</p> Signup and view all the answers

Which of the following statements about synthroid (levothyroxine) is FALSE?

<p>It can be taken while breastfeeding (A)</p> Signup and view all the answers

Which of the following is a common side effect of hormone replacement therapy (HRT) for menopause?

<p>Fluid retention (D)</p> Signup and view all the answers

Which of the following medications is used to treat gout flare-ups?

<p>Colchicine (B)</p> Signup and view all the answers

Which of the following statements about aspirin is TRUE?

<p>It has anticoagulant properties (D)</p> Signup and view all the answers

Which of the following is a common symptom of hypothyroidism?

<p>Fatigue (A)</p> Signup and view all the answers

Which of the following is a high-alert medication that requires extra caution when administering?

<p>Insulin (B)</p> Signup and view all the answers

Which of the following statements about naloxone is FALSE?

<p>It is an opioid agonist (C)</p> Signup and view all the answers

Flashcards

Antibiotic Overuse

Excessive antibiotic use can lead to yeast infections, secondary infections, or superinfections by disrupting the balance of gut flora.

Antibiotics & Antifungals

Antibiotics are often given with antifungals to prevent superinfections.

Penicillin Side Effect

A common side effect of penicillin is diarrhea.

Cephalosporin Allergy

Patients allergic to cephalosporins may also be allergic to penicillin.

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Culture Sensitivity

Identifying the type of bacteria and its susceptibility to various treatments.

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Broad-spectrum vs. Narrow-spectrum

Broad-spectrum antibiotics are used initially, followed by narrow-spectrum antibiotics once the specific bacteria are identified.

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Oral Contraceptives & Antibiotics

Antibiotics can reduce the effectiveness of oral contraceptives.

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Contraindicated in Breastfeeding

Many antibiotics and other drugs are contraindicated for breastfeeding mothers.

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Smoking & Oral Contraceptives

Smoking is contraindicated when taking oral contraceptives.

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Initial Patient Assessment

The nurse's first action when a patient's condition changes is assessment.

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Z-track method

A technique used for IM injections to prevent medication leakage.

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Photosensitivity (Sulfa Drugs)

Patients taking sulfa drugs should avoid sun exposure.

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Fluids (Sulfa Drugs)

Drink plenty of fluids while taking sulfa drugs to prevent crystal formation.

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Blood Sugar & Sulfa Drugs

Sulfa drugs can lower blood sugar.

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Aminoglycosides Monitoring

Monitor BUN and creatinine levels when administering aminoglycoside antibiotics.

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Cipro/Levaquin Caution

Cipro and Levaquin (fluoroquinolones) should not be given together.

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Fluoroquinolones & Tendon Damage

Fluoroquinolones, like Cipro, can cause tendon damage.

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Fluoroquinolone Patient Education

Teach patients to drink plenty of water, avoid dairy and calcium-rich foods, avoid sun exposure, and avoid use in patients under 18.

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TB Treatment Duration

TB treatment is 1 year for active cases and 6 months for exposure, airborne precaution.

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Antifungals Suffix

Antifungal medications usually end in '-azoles'.

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Study Notes

Antibiotics and Infections

  • Too much antibiotic use can cause an overgrowth of flora, leading to yeast infections, secondary infections, or superinfections
  • Antibiotics are often given with antifungals to avoid superinfections, and are contraindicated for breastfeeding mothers

Penicillin

  • Common side effect of penicillin is diarrhea
  • Patients with cephalosporin allergy may also be allergic to penicillin

Culture Sensitivity

  • Taking a culture of a bacteria to determine what type it is and what it reacts to/what can kill it
  • Broad-spectrum medications are given initially, while narrow-spectrum medications are given once the organism is identified

Oral Contraceptives

  • Ineffective if taken while on antibiotic therapy
  • Smoking is contraindicated

Assessment

  • The nurse's FIRST step when there is any change in a patient's status is to ASSESS

Injection Methods

  • Z-track method is used for intramuscular injections

Sulfa Drugs

  • Photosensitivity: stay out of the sun
  • Drink plenty of fluids
  • Lowers blood sugar

Aminoglycosides

  • Monitor BUN and creatinine levels

Fluoroquinolones

  • Also known as Cipro, can cause tendon damage after 18-30 days of use
  • Take with food to reduce stomach discomfort
  • Patient education:
    • Drink plenty of fluids to dilute harmful effects
    • Avoid dairy products and juices containing calcium
    • Avoid sun exposure
    • Not recommended for patients under 18 years old
  • Monitor for numbness, tingling in hands and/or feet, and tendonitis
  • Note: Cipro and Levaquin are both fluoroquinolones and should not be administered together

TB Treatment

  • Treatment duration: 1 year for active TB, 6 months for exposure
  • Monitor for changes in vision

Antifungals

  • Suffix: -azoles

Anti-TB Drugs

  • Isoniazid (INH) is a common drug used for TB treatment

Viral Infections

  • Antivirals are virustatic, but not virucidal, meaning they stop viral reproduction but don't kill viruses
  • Used to treat HIV and prevent viral replication

HIV Infections

  • Instruct patients to continue taking HIV medications even after pregnancy
  • HIV medications affect the liver
  • Monitor for changes in vision

Insulin

  • Regulates sugar, fat, and protein, primarily sugar, at the cellular level
  • Always check blood sugar before insulin administration
  • Regular insulin works fast, NPH insulin works slow, and Lispro insulin works rapidly

Diabetes

  • Signs of undiagnosed diabetes: darkening skin patches, increased thirst, urination, and hunger
  • Complications of poorly managed diabetes: frequent thirst, urination, fruity breath, and increased infections
  • Three P's of diabetes: polydipsia, polyuria, and polyphagia

Antidepressants

  • Take 10-14 days to work
  • Contraindicated in patients with vision problems
  • Monitor for muscle twitching
  • Never abruptly stop taking antidepressants

Bipolar Disorder

  • Lithium is the main drug used for treatment
  • Monitor for weakness, lethargy, and sodium levels
  • Avoid excessive exercise

Antianxiety Medications

  • Buspirone binds to serotonin and dopamine receptors
  • Common benzodiazepines: Xanax, Ativan, Valium, and Klonopin

Sedatives

  • Relax patients to sleep
  • Usually used for insomnia

Anticonvulsants

  • Monitor sodium levels
  • Oxcarbazepine is given in a patch

Analgesics

  • Given to relieve pain
  • Can change patient's perception of pain or reduce painful stimuli

Mental Health

  • Mental health drugs can affect the brain and nervous system
  • Never abruptly stop taking antidepressants
  • Monitor for suicidal thoughts
  • Avoid mixing classes of medications

Pharmacology

  • Always check for allergies before administering medications
  • Rotate injection sites
  • Make sure to check the 9 rights of drug administration
  • Document time and place of administration
  • Drink plenty of water with enteric-coated capsules
  • Vials: push air into before withdrawal
  • EpiPens: teach patients around age 5
  • Injection site for 6-month-old: upper thigh### Infections and Antibiotics
  • Tuberculosis (TB) is transmitted through the air (airborne droplets) and treated for 1 year for active cases and 6 months for exposure.
  • Antifungal medications have the suffix "-azoles".
  • Ringworm treatment involves griseofulvin (generic) or Grifulvin V (Trade), which affects the liver and may cause urine discoloration.
  • Diarrhea is a common side effect of pinworm anthelmintic treatment.

Viral Infections

  • Antivirals are virustatic, not virucidal, meaning they stop viral reproduction but don't kill viruses.
  • Pregnant women should avoid contact with RSV (respiratory syncytial virus).
  • Zorivax (Trade) or acyclovir (generic) should not be taken with dairy products.
  • Tamiflu (Trade) or oseltamivir (generic) can only be taken within 24-48 hours of flu symptom onset.

Diabetes

  • Insulin regulates sugar, fat, and protein, primarily sugar, at the cellular level.
  • Always check blood sugar before insulin administration.
  • The three P's of Diabetes are: Polydipsia (increased thirst), Polyuria (increased urination), and Polyphagia (increased hunger).
  • Regular insulin works fast and is short-acting, while NPH insulin works slow and is long-acting.

Mental Health

  • Antidepressants take 10-14 days to work and are contraindicated in patients with vision problems.
  • Never abruptly stop taking antidepressants, as they affect the brain and nervous system.
  • Benzodiazepines are used for short-term anxiety and have a high addiction potential.
  • Narcan (Trade) or naloxone (generic) is the antidote for narcotics.

Medication Administration

  • Always rotate injection sites.
  • Transdermal patches should be applied with gloves on to prevent skin absorption.
  • Check the 9 rights of drug administration: right patient, right medication, right dose, right route, right time, right reason, right documentation, right response, and right evaluation.
  • High alert drugs are medications that can cause harm if administered in error.

Additional Notes

  • Hormone replacement therapy for menopause can cause breast tenderness, bleeding, fluid retention, headache, weight gain, and acne.
  • Thyroid medications should be taken lifelong, and breastfeeding is not recommended.
  • Anti-thyroid medications require liver function monitoring and eye color checks.
  • Lactulose is used to clear out toxins and reduce ammonia levels in the blood for patients with liver disease.

Nursing Interventions

  • For loop diuretics, give in the AM, administer slowly via IV to prevent hypotension, and monitor sodium and potassium levels.

  • For antacid therapy, take with meals or soon after, and at bedtime.

  • For Reglan (metoclopramide), take on an empty stomach, 30 minutes before meals, and monitor for constipation, diarrhea, hypotension, hypertension, bradycardia, tachycardia, dry mouth, and drowsiness.### Subcutaneous Injections

  • Nitroglycerin is administered through a patch or orally (up to 3 tabs, 5-minute intervals) and should not be stopped abruptly.

Angina

  • Unstable angina occurs when symptoms are present at rest, while stable angina occurs when symptoms are triggered by physical activity.

Transdermal Patch

  • Wear gloves when applying a transdermal patch and only apply to closed wounds.

Parenteral Medication

  • Instruct patients to sit up and rinse their mouth after using a meter dose inhaler to prevent thrush.

IV Drugs

  • IV drugs are administered directly into the vein using a syringe through a needleless port or saline lock.
  • Preparation involves medication reconciliation or dilution.

Medication Administration

  • Do not crush capsules.
  • Stay in the room and observe the patient taking medication.
  • Swallow capsules whole.
  • Administer eyedrops 5 minutes apart, in the conjunctival sac.

Enteric Coated Tablets

  • Teach patients to drink plenty of water, not to crush or chew, and avoid taking antacids with enteric coated tablets.

IM Injections

  • For a 6-month-old, administer IM injections in the thigh (vastus lateralis muscle) using the z-track method.

EpiPen

  • EpiPen can be administered through clothing, in the thigh.

IV Pumps

  • If an IV pump is not flowing correctly, check for clamps, kinks, or site issues.

NG Tubes

  • To prevent harm, elevate the bed, check for placement by testing pH, and drink water when inserting the NG tube.

Infections

  • Secondary infections occur during or after treatment for another infection.
  • Urinalysis is used to determine a UTI.

Antibiotics

  • Penicillin side effects include nausea, vomiting, diarrhea, rash, abdominal pain, and urticaria.
  • Antibiotics can reduce the effectiveness of contraceptives.
  • Cephalosporin should not be given to patients allergic to penicillin.
  • Tetracycline teaching points: avoid sun, no alcohol.
  • Gentamicin is an aminoglycoside antibiotic that kills bacteria or prevents growth.
  • Bactrim (sulfa drug) teaching points: drink water to prevent crystal formation.
  • Fluoroquinolones teaching points: drink 2L of water per day.

TB and HIV

  • TB is an airborne precaution.
  • Patients with HIV must continue taking medications if they become pregnant.

Antihistamines

  • Watch for: BP, bulging eyes.

Inhaled Anti-Inflammatory

  • Side effects: thrush, cough, sore throat.

Cromolyn Sodium

  • Used for exercise-induced inhalation.

Pediatrics

  • Infants are most at risk for overdosing.

Thiazides

  • Reduce blood pressure by increasing fluid loss to urine, leading to decreased extracellular fluid and plasma volume, resulting in diminished venous return, increased renin release, reduced cardiac output, and decreased blood pressure.

Lasix

  • Teaching points: drink water to avoid fluid restriction.

Prostate Health

  • Prosguards help maintain a healthy prostate and relax men's muscles to urinate.
  • Use protection when sexually active.

Statin Drugs

  • Cholesterol drug, take at night, no alcohol, no grapefruit juice.

Loop Diuretics

  • Take potassium with Lasix to prevent loss of potassium.
  • Nursing actions: assess vital signs, watch for decreased blood pressure, signs of dehydration, monitor weight loss, check potassium levels, give in the morning, and teach patient to notify if experiencing signs of weakness, muscle cramping, numbness or tingling, or irregular heartbeat.

Phenazopyridine

  • Check liver (ALT/AST) before administration, and do not give to patients with liver problems.

Antihistamines

  • Treat allergy symptoms by blocking the effects of histamine.

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Prepare for your pharmacology final with this review covering antibiotics, common side effects of penicillin, culture sensitivity, and oral contraceptives. Test your knowledge on medication interactions, superinfections, and medication administration guidelines.

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