Exam 2 Pharmacology Review PDF

EXAM 2 PHARMACOLOGY REVIEW CHAPTER 7-13 MATH QUESTIONS 10 Math Questions WHAT IS THE BLACK BOX WARNING FOR FLUROQUINOLONES? Black Box Warning: Tendon Rupture WHAT WOULD YOU DO IF A PERSON RECEIVING IV ANTIBIOTICS STARTS FEEL SHORT OF BREATH? ATI PHARM BOOK CH 44 PG 362 WHAT DO IF SOMEONE...

EXAM 2 PHARMACOLOGY REVIEW CHAPTER 7-13 MATH QUESTIONS 10 Math Questions WHAT IS THE BLACK BOX WARNING FOR FLUROQUINOLONES? Black Box Warning: Tendon Rupture WHAT WOULD YOU DO IF A PERSON RECEIVING IV ANTIBIOTICS STARTS FEEL SHORT OF BREATH? ATI PHARM BOOK CH 44 PG 362 WHAT DO IF SOMEONE HAS DYSPNEA WHEN RECEIVING AN INFUSIONS? Stop Infusion Elevate head of bed Listen to lung sounds Call the Providers A- Airway B- Breathing C- Circulation Arnold says Stop the Infusion if you want them to live WHAT SHOULD THE NURSE DO TO MINIMIZE AMINOGLYCOSIDES RISK OF ADVERSE EFFECTS? What is the Black Box warning of Aminoglycosides? Ototoxic & Nephrotoxic Requires Peak & Trough Aminoglycosides result of elevated trough levels Trough gathered before next dose of medication to prevent overdosing. Monitor serum medication levels ATI PHARM BOOK CH 45 PG 370 KNOW ANTIPROTOZOAL MEDICATIONS ADVERSE EFFECTS Flagly (metronidazole) Metallic taste in the mouth  COMMON ANTIPROTOZOAL AGENTS metronidazole (Flagyl, MetroGel, Noritate) Treats amebiasis, trichomoniasis, and giardiasis Also treats anaerobic bacteria C. diff tinidazole (Tindamax) Treats trichomoniasis, giardiasis, and amebiasis Adverse effects: CNS, headache, dizziness, ataxia, loss of coordination, peripheral neuropathy, GI effects, changes in liver function, superinfections, metallic taste ATI PHARM BOOK CH 47 PG 381 WHAT ARE THE SIGNS AND SYMPTOMS OF GENTAMICIN TOXICITY Tinnitus Dizziness  AMINOGLYCOSID gentamici ES n neomycin Serious infections streptomycin tobramycin Requires Peak & Trough Caution: Pregnancy Kidney dysfunction *AEs: Black Box Warning – Ototoxic & Nephrotoxic Bone marrow depression GI effects ATI PHARM BOOK CH 45 PG 371 ATI PHARM BOOK CH 45 PG 369 & 370 ATI PHARM BOOK CH 45 PG 372 WHICH FINDING IS A PRIORITY? A= Airway B= Breathing C= Circulation UNDERSTAND CEPHALOSPORINS Prefix Cef- Similar to Penicillin Need to take caution tot hose allergic to Penicillin What are the adverse effects? Pseudomembranous colitis GI effects Nephrotoxicity Disulfiram-like reaction  CEPHALOSPO cefazolin (Ancef) cefaclor (Ceclor) cef- RINS ceftriaxone (Rocephin) cefepime (Maxipime) Similar to pcn ceftaroline (Teflaro) 5 generations! Each new gen = more likely to reach CSF, more effective Caution: PC *Allergy to pcn! N Increasing resistance *AEs: Pseudomembranous colitis GI effects Nephrotoxicity Disulfiram-like reaction ATI PHARM BOOK CH 44 PG 362 WHAT WOULD YOU DO IF SOMEONE IS ALLERGIC TO PENICILLIN? Verify medications make sure not allergic to one type of penicillin allergic to all types of penicillin CULTURE AND SENSITIVITY Important to get culture before deciding which antibiotics to give a patient CONSIDERATIONS BEFORE STARTING ANTI-INFECTIVE THERAPY 1) Identify correct pathogen C&S 2) Select correct drug Drug that causes least complications Drug that is most effective ATI PHARM BOOK CH 43 PG 357 ATI PHARM BOOK CH 43 PG 359 ATI PHARM BOOK CH 43 PG 360 ATI PHARM BOOK CH 43 PG 359 ATI PHARM BOOK CH 43 PG 360 SOMEONE IS TAKING CIPROFLOXACIN TO TREAT AN INFECTION. WHAT EDUCATION SHOULD THE NURSE PROVIDE?  FLUROQUINOLO levofloxacin ciprofloxacin NES - UTIs, resp., skin, ophthalmic infections floxacin Prevent anthrax Caution: Pregnancy, lactation *AEs: CNS, GI effects Black Box Warning: Tendon Rupture Bone marrow depression Phototoxicity (sunburn) Special Point: avoid antacids WHAT IS IMPORTANT TO MONITOR WHEN ADMINISTERING IV VANCOMYCIN ABCs Airway Breathing Circulation What will kill them first? WHAT IS VANCOMYCIN USED FOR? VANCOMYCIN *Vancomycin: C. diff, MRSA Highly toxic Renal failure, ototoxicity, superinfections “red man syndrome” Therapeutic Range – Peak & Troughs CLIENT HAS PNEUMONIA WHAT SHOULD WE DO BEFORE WE GIVE ABX? ATI PHARM BOOK CH 43 PG 357 WHAT HAPPENS WHEN YOU TAKE RIFAMPIN? ANTIMYCOBACTE pyrazinamide isoniazid dapsone RIALS ethambutol rifampin Treat TB/leprosy Acid fast Used in combination Caution: T B Renal/hepatic failure Teratogenic *AEs: Hepatotoxic Discolors body fluids Hyperglycemia Pseudomembranous colitis ATI PHARM BOOK CH 47 PG 380 WHAT EDUCATION WOULD YOU PROVIDE TO SOMEONE TAKING AN ORAL ANTIBIOTIC? WHAT PRECAUTIONS DO YOU NEED TO TAKE WHEN TAKING CARE OF A PATIENT WITH C-DIFF WHAT'S THE NAME FOR ATHLETES FOOT? tinea pedis WHAT IS RED MAN SYNDROME? HOW DOES IT HAPPEN? HOW SHOULD NYSTATIN BE STORED? WHAT EDUCATION SHOULD YOU PROVIDE FOR SOMEONE TAKING ORAL NYSTATIN?  ANSWER True Rationale: nystatin (Mycostatin, Nilstat) (Oral) Used for the treatment of intestinal candidiasis; also available as a topical preparation. WHAT ARE THE ALLERGIC REACTIONS TO PENICILLIN? Rashes Hives itching  amoxicillin PENICILLINS penicillin G Resistance Chillin’ Cross-sensitivity w/ cephalosporins Yeast *AEs: GI effects Superinfections Anaphylaxis Take on empty stomach  Identifying Allergic Reaction to Amoxicillin (ATI Pharm book ch 44 pg. 361-362) What would you instruct clients to report as potential signs of an allergic response? How long should you observe a client following parenteral administration? ATI PHARM BOOK CH 44 PG 361 ATI PHARM BOOK CH 44 PG 361 ATI PHARM BOOK CH 44 PG 362 WHAT MEDICATIOSN CAN CAUSE NEPHROTOXICITY? Vancomycin Aminoglycosides Cephalosporins Check labs -BUN -Crt WHAT EDUCATION SHOULD A NURSE PROVIDE TO SOMEONE TAKING TB MEDICATION? Treatment involves 6 to 9 months Used in combination Acid fast Caution: Renal/hepatic failure Teratogenic AEs: Hepatotoxic Discolors body fluids Hyperglycemia Pseudomembranous colitis  ATI PHARM BOOK CH 47 PG 379 How long should someone be on antitubercular medication? HOW LONG SHOULD SOMEONE BE ON ANTITUBERCULAR MEDICATION? WHO SHOULD RECEIVE PROPHYLACTIC ANTIBIOTIC TREATMENT ATI PHARM BOOK CH 43 PG 359 ATI PHARM BOOK CH 43 PG 358 ATI PHARM BOOK CH 43 PG 360 WHAT MEDICATION WOULD YOU GIVE FOR HERPES ZOSTER? Cidofovir Acyclovir (Sitavig, Zovirax) Famciclovir Foscarnet (Foscavir) Ganciclovir (Cytovene) Valacyclovir (Valtrex) Valganciclovir (Valcyte) -Vir PROTOTYPE OF HERPES AND CYTOMEGALOVIRUS AGENTS - Others: cidofovir famciclovir foscarnet ganciclovir v i r valacyclovir valganciclo vir WHAT LAB TEST SHOULD BE DONE ON A PATIENT WHO IS TAKING TUBERCULOSIS MEDICATIONS? AST ALT ANTIMYCOBACTE pyrazinamide isoniazid dapsone RIALS ethambutol rifampin Treat TB/leprosy Acid fast Used in combination T B Caution: Renal/hepatic failure Teratogenic *AEs: Hepatotoxic Discolors body fluids Hyperglycemia Pseudomembranous colitis ATI PHARM BOOK CH 47 PG 380 ATI PHARM BOOK CH 47 PG 380 SOMEONE WHO HAS AIDS IS AT RISK FOR WHAT INFECTIOUS ORAL CONDITION Candidiasis WHAT ARE TYPES OF CONDITIONS THAT A PATIENT WOULD RECEIVE AN ANTI- PROTOZOAL MEDICATION? CAUSES OF PROTOZOAL INFECTIONS Insect Bites Malaria Trypanosomiasis (tsetse or common house fly) Leishmaniasis (sandflies) Ingestion Amebiasis Giardiasis Contact Trichomoniasis (vaginitis) WHAT MEDICATION IS USED TO TREAT THE FLU? -Vir Used to treat viruses ATI PHARM BOOK CH 48 PG 385 WHEN SHOULD YOU TAKE MEDICATION TO PREVENT MALARIA 10 days before leaving on a trip MALARIAL PREVENTION Prevention is key CDC recommends those traveling to risk areas get treated with prophylactic antimalaria drugs chloroquine drug of choice for infections from the U.S 1-2 wk before exposure, during, then 4 wk after chloroquine resistance is becoming a problem Treatment combined w/ abx (doxycycline, tetracycline, clindamycin) WHAT EDUCATION WOULD YOU PROVIDE TO SOMEONE TAKING ORAL AMOXICILLIN? DO ANTIVIRAL DRUGS JUST KILL THE VIRUS?  CHARACTERISTICS OF COMMON VIRUSES A virus cannot replicate on its own It must attach to and enter a host cell It then uses the host cell’s energy to synthesize protein, DNA, and RNA. Viruses are difficult to kill because they live inside our cells. Any drug that kills a virus may also kill our cells. WHEN SHOULD SOMEONE WITH THE FLU START DRUG THERAPY? 2 days of symptom onset SOMEONE TAKING AN ORAL ANTICOAGULANT WILL MONITOR WHAT? Increased effects pf oral anticoagulants WHAT ARE ADVERSE EFFECTS OF ANTIMALARIA DRUG THERAPY? Visual disturbances WHAT SHOULD PATIENTS BE AWARE OF WHILE TAKING ANTITUBERCULAR DRUGS? Oral contraceptives may not work while you are taking these drugs WHAT ARE SIGNS AND SYMPTOMS OF HERPES ZOSTER Painful lesions following a nerve pathway WHAT IS CULTURE AND SENSITIVITY What does Culture mean? What is sensitivity? WHEN WOULD A BROAD-SPECTRUM ANTIBIOTIC BE USED? WHAT ARE MANIFESTATIONS OF SUPERINFECTIONS?