Pharmacology Exam 2 Study Guide PDF
Document Details
Uploaded by Deleted User
Tags
Summary
This document is a pharmacology exam study guide, covering various drugs and their properties. It details drug classifications, actions, uses, side effects and nursing implications.
Full Transcript
Pharmacology Exam 2 Study Guide 1) methylphenidate Brand:Ritalin Classification: Amphetamine Category: II Action:Modulates serotonergic pathways by affectingchanges in dopamine transport Uses:...
Pharmacology Exam 2 Study Guide 1) methylphenidate Brand:Ritalin Classification: Amphetamine Category: II Action:Modulates serotonergic pathways by affectingchanges in dopamine transport Uses:ADHD, narcolepsy Side Effects:Tachycardia, palpitations, hypertension,dizziness, heart attack, restlessness, tremors, irritability, seizures, euphoria, confusion, insomnia, anorexia, dry mouth, diarrhea, weight loss Nursing Interventions: Give before breakfast & lunch. Report irregular heartbeat. Record ht, wt, & growth of children. Avoid alcohol & caffeine. Use sugarless gum to relieve dry mouth. Don’t stop abruptly; taper off to avoid withdrawal symptoms. Interactions: Caffeine may increase effects. Decreased effects of antihypertensives May alter insulin effects Therapeutic Effect: Pt’s attention span will increase. Pt will behave in a calm manner. 2) temazepam Brand:Restoril Classification: Benzodiazepine Category: IV Uses: Hypnotic to treat insomnia Action: Interacts with neurotransmitter GABA to reduce neuron excitability Side Effects:Drowsiness, tolerance, dependence, depression, respiratory depression, vivid dreams, nightmares 3)midazolam Brand:Versed Classification: Benzodiazepine Category: IV Use: Prolonged seizures Nursing Interventions: Administer slowly to avoid respiratory depression 4)phenytoin rand:Dilantin B Classification: Hydantoins Category: IV Action: Suppresses sodium influx Therapeutic Serum Level: 10 to 20 mcg/mL Side Effects: Gingival hyperplasia, nystagmus, headache, diplopia, dizziness, slurred speech, decreased coordination, alopecia, thrombocytopenia, Stevens-Johnson syndrome Drug interactions: Increased effects with cimetidine (Tagamet), INH, sulfonamides, anticoagulants, aspirin Decreased effects with antacids, calcium, sucralfate, antineoplastics, primrose, ginkgo, oral contraceptives Contraindications: Pregnancy (teratogenic) Nursing interventions: Shake suspension well for 5 minutes. Monitor serum drug levels. Safety: Protect from environmental hazards, driving. Warn female patients taking oral contraceptives to use additional contraception. Warn patients to avoid certain herbs, alcohol, other CNS depressants. Warn patient not to discontinue abruptly. Patients will need frequent oral hygiene & dental check-ups. Oral hygiene: use soft toothbrush to prevent gum irritation & bleeding Teach patients to report sore throat, bruising, nosebleeds. Diabetics must monitor glucose levels. Tell each patient to take drugs at the same time every day. Warn of harmless pinkish red or brown urine. Encourage patients to wear medical-alert identification. 5)carbidopa levodopa Brand:Sinemet Classification: Dopaminergics Uses: Parkinson’s Action: converts to dopamine to increase mobility Side effects: Nausea, vomiting, Involuntary abnormal movement, psychotic behavior, angioedema, palpitations, orthostatic hypotension, insomnia, blurred vision, dizziness, headache 6)rivastigmine Brand:Exelon Classification: Acetylcholinesterase (AChE) Inhibitor herapeutic Effect: Improve cognitive function and slow disease process T Use: Mild to moderate Alzheimer’s disease with fewer drug interactions than donepezil (Aricept) Action: Increases amountof ACh at cholinergic synapses 7)neostigmine bromide Brand:Prostigmin Classification: Acetylcholinesterase Inhibitor Action: Transmission of neuromuscular impulses by preventing destruction of ACh Cholinesterase inhibitors inhibit action of enzyme, resulting in more acetylcholine being available to activate cholinergic receptors & promote muscle contraction. Use: Control & treat MG Side Effects:GI disturbances, N/V/D, abdominal cramps, increased salivation tearing, miosis, (constricted eye pupil), blurred vision, bradycardia, hypotension Nursing Interventions: Administer doses on time. Take drugs before meals if possible (absorbed best). Monitor drug effectiveness. Have antidotes available for cholinergic crisis (Atropine). Encourage patients to wear medical ID. 8)lithium Brand:Lithobid Classification: Mood Stabilizer Therapeutic Serum Range:0.8 to 1.2 mEq/L Serum levels > 1.5 mEq/L may lead to toxicity Action: Alteration of ion transport in muscle & nerve cells Increased receptor sensitivity to serotonin Use: Treat manic episodes in bipolar psychosis Interactions: Increased lithium level with thiazides, methyldopa, haloperidol, NSAIDs, antidepressants, spironolactone, phenothiazines, ACE inhibitors Decreased level with caffeine, loop diuretics, theophylline Side Effects: Headache, drowsiness, dizziness hypotension, dysrhythmias restlessness, dry mouth, metallic taste, GI distress, tremors, muscle weakness peripheral edema, increased urination, memory impairment Nursing Interventions: Monitor vital signs Monitor sodium levels (Hyponatremia = Na 1.5 mEq/L. Toxic side effects: persistent nausea, vomiting, severe diarrhea, blurred vision, tinnitus, ataxia, increasing tremors, confusion, dysrhythmias, seizures Teach patients to wear medical alert identification. Teach patients to take drugs as prescribed & keep medical appointments. Warn against driving motor vehicles or operating dangerous equipment until the drug effect is known. Advise patients that drug effect may take 1 to 2 weeks. Encourage patients to avoid caffeine, crash diets, NSAIDs, diuretics. Advise patients against getting pregnant because of teratogenic effects. 9)baclofen Brand:Lioresal Classification: Skeletal Muscle Relaxant Uses: Spasticity Action: Centrally acting 10)lorazepam Brand:Ativan Classification: Benzodiazepine (Anxiolytics) Category: IV Action: Inhibits GABA neurotransmission by binding to specific benzodiazepine receptors Use: Anxiolytic, antiseizure, insomnia, status epilepticus, sedation induction Side Effects: Drowsiness, dizziness, confusion, blurred vision, headache, weakness, restlessness, brady/tachycardia, suicidal ideation, erectile dysfunction Interactions: Increases CNS depression with alcohol, other CNS depressants, & cimetidine Increases lorazepam plasma levels Increases phenytoin levels Decreases levodopa effects Smoking decreases anti anxiety effects Kava kava may potentiate sedation Discontinuation: Gradually decrease dose over several days Withdrawal: Develops slowly, in 2 -10 days, and may last several weeks Withdrawal Symptoms: Tremor, agitation, nervousness, sweating, insomnia anorexia, muscle cramps Nursing Interventions: Monitor vital signs. Encourage pt to rise slowly to avoid dizziness. arn pt therapeutic response may take 1 to 2 weeks. W Advise patients not to drive a motor vehicle or operate dangerous equipment. Pt should not use for more than 3 to 4 months as tolerance develops & effectiveness decreases. Monitor pt for “cheeking” of medication. Warn patients not to concurrently take CNS depressants, alcohol, or other anxiolytics. Warn against taking antacids & caffeine at the same time, which delays absorption & decreases effects. Kava kava increases the sedative effects of the drug. Pt should take w/ meals or shortly after to decrease GI discomfort. Warn pt against abrupt discontinuation of drug. 11)alprazolam Brand:Xanax Classification: Benzodiazepine Category: IV 12)diazepam Brand:Valium Classification: Benzodiazepine Category: IV 13) Neuroleptic Malignant Syndrome: Rare, potentially fatal condition Symptoms: Altered mental status (AMS), seizures, muscle rigidity, sudden high fever, BP fluctuations, tachycardia, dysrhythmias, rhabdomyolysis (muscle break down), acute renal failure, respiratory failure, coma Treatment: Immediate withdrawal of antipsychotics Adequate hydration Hypothermic blankets Antipyretics, benzodiazepines, muscle relaxants 14) MAO inhibitors phenelzine sulfate (Nardil) tranylcypromine sulfate (Parnate) isocarboxazid (Marplan) selegiline (Emsam, Eldepryl) Action: Monoamine oxidase enzyme inactivates norepinephrine, dopamine, epinephrine, & serotonin Use: depression not controlled by TCAs & 2nd generation antidepressant Not the antidepressants of choice due to adverse reactions Side Effects: Agitation, restlessness, insomnia, anticholinergic effects, orthostatic hypotension, hypertensive crisis from fatal tyramine interaction Drug Interactions: NS stimulants such as vasoconstrictors & cold medications containing C phenylephrine & pseudoephedrine can cause a hypertensive crisis. Food interactions: Foods that contain tyramine: cheeses (cheddar, Swiss, bleu), cream, yogurt, coffee, chocolate, bananas, raisins, Italian green beans, liver, pickled foods, sausage, soy sauce, yeast, beer, & red wines Nursing Interventions: Monitor vital signs. Monitor mood for drug effectiveness. Monitor for suicidal tendencies, seizures. Warn that foods that contain tyramine can cause a hypertensive crisis with MAOIs. Encourage taking drugs as prescribed. Encourage avoiding alcohol, CNS depressants, & cold medicines. Teach them to take drugs with food if GI distress occurs. Warn pt against driving or using dangerous mechanical equipment until drug the effect is known. Warn patients against abruptly stopping drugs. Instruct pt to take drugs at bedtime. Advise pt that therapeutic response usually occurs in 2-4wks Inform pt that herbs (St. John’s wort, ginseng) may interact with antidepressants. 15)amitriptyline Brand:Elavil Classification: Tricyclic Antidepressant Use: Major depression Action: Blocks uptake of neurotransmitters, norepinephrine & serotonin in brain Blocks histamine receptors which leads to sedation Elevates mood Increases interest in ADLs Decreases insomnia Blocks cholinergic receptors which leads to anticholinergic effects Interactions: Increased CNS effects w/ alcohol & other CNS depressants Increased sedation & anticholinergic effects with phenothiazines, haloperidol MAOIs may lead to toxic psychosis, cardiotoxicity Should be discontinued slowly Side Effects: Drowsiness, dizziness, blurred vision, sedation, dry mouth & eyes, skin rash, pruritus, urinary retention, constipation, wt gain, GI distress sexual dysfunction, orthostatic hypotension, dysrhythmias, cardiotoxicity EPS, blood dyscrasias 16)infliximab rand:Remicade B Classification: Immunomodulators Action: Neutralize tumor necrosis factor Disrupt inflammatory process Delay disease progression Uses: RA, psoriatic arthritis, psoriasis, spondylitis, ulcerative colitis, Crohn disease 17)colchicine Brand:Colcrys Classification: Anti-Gout Action: Inhibit migration of leukocytes to inflamed site Use: Alleviates acute gout attacks Side Effects: GI distress, (N/V/D) Nursing Interventions: Taken with food to avoid GI distress Contraindications: Severe renal, cardiac, GI problem 18)allopurinol Brand:Zyloprim Classification: Anti-Gout (xanthine oxidase inhibitor) Action: Decreases uric acid production Increases uric acid excretion Prevent gout attacks Nursing Interventions: Monitor CBC, liver enzymes, renal function. Get yearly eye exam for visual changes. Avoid alcohol, caffeine, & thiazide diuretics that increase uric acid level. Advise patients to increase fluid intake to increase uric acid excretion. 19)ibuprofen Brand:Motrin Classification: NSAID Action: Inhibit biosynthesis of prostaglandins Inhibit platelet aggregation Mimic effects corticosteroids Inhibit COX enzyme Inhibit prostaglandin synthesis Uses: Reduce inflammation, fever, headaches, & pain Interactions: Increased bleeding with warfarin Increased effects with phenytoin, sulfonamides, warfarin Decreased effect w/ aspirin Side Effects: Gastric distress, tinnitus, dizziness, confusion, edema, blood dyscrasias, dysrhythmias, nephrotoxicity Nursing Interventions: Observe for bleeding gums, petechiae, ecchymoses, or black tarry stools Report GI discomfort Take with meal Avoid alcohol 20)naproxen Brand:Naprosyn Classification: NSAID Uses: Reduce inflammation & pain Interactions: Increased bleeding with warfarin Increased effects with phenytoin, sulfonamides, warfarin Decreased effect w/ aspirin Side Effects: Gastric distress, tinnitus, dizziness, confusion, edema, blood dyscrasias, dysrhythmias, nephrotoxicity Nursing Interventions: Observe for bleeding gums, petechiae, ecchymoses, or black tarry stools Report GI discomfort Take with meal Avoid alcohol 21)aspirin Brand:Acetylsalicylic Acid (ASA) Classification: Salicylates (NSAID) Action: Prostaglandin inhibitor that decrease inflammatory process Anti Inflammatory Antiplatelet for cardiac or cardiovascular disorders Antipyretic effects Therapeutic Serum: Salicylate level 15 to 30 mg/dL Toxic Serum: Salicylate level greater than 30 mg/dL Interactions: Increased bleeding with anticoagulants & other NSAIDs Hypoglycemia w/ oral antidiabetics Increased gastric ulcer risk w/ glucocorticoids Decreased effects of ACE inhibitors, loop diuretics, probenecid Increase PT, bleeding time, INR, uric acid Decrease K+, cholesterol, T3, T4 oods containing salicylates (prunes, raisins, licorice) F Certain spices (curry & paprika) Avoid during 3rd trimester of pregnancy. Don’t give to children w/ flu/virus symptoms Side Effects: Tinnitus, hearing loss, dizziness, confusion, agitation, GI distress, ulceration, bleeding, seizures, thrombocytopenia (low platelets) leukopenia (low WBCs), agranulocytosis (extremely low WBCs),Reye’s syndrome (swelling of liver and brain)hypersensitivity, bronchospasm, drowsiness, thirst, N/V/D, convulsions, cardiovascular collapse, coma Nursing Interventions: Monitor serum salicylate level. Observe for evidence of bleeding. Advise pt not to take aspirin w/ alcohol or warfarin to prevent increased bleeding. Instruct pt to discontinue aspirin about 7 days before surgery to reduce risk of bleeding. Do not give aspirin for virus/flu symptoms to children to avoid risk of Reye syndrome. Inform pt that aspirin tablets can cause GI distress. 22) NSAIDs Inhibit biosynthesis of prostaglandins Analgesic effect Antipyretic effect Inhibit platelet aggregation Mimic effects corticosteroids Action: Inhibit COX enzyme Inhibit prostaglandin synthesis Uses: Reduce inflammation & pain Not recommended for fever or headaches (except for aspirin & ibuprofen) First-Generation NSAIDs: Salicylates Para chlorobenzoic acid Propionic acid derivatives Fenamates Oxicams Second-Generation NSAIDs: Selective COX-2 inhibitors 23) cyclooxygenase enzymes I & II Cyclooxygenase (COX) is an enzyme (protein) that helps create two important chemicals in the body: prostaglandin and thromboxane. OX-1is involved in many protective processes in the body. C COX-2is mostly involved in inflammation. 24)acetaminophen Brand:Tylenol Classification: Analgesic Action: Inhibits prostaglandin synthesis Para aminophenol derivative Uses: Relieves pain, discomfort, fever Maximum Dose: 3g/day Antidote: acetylcysteine (Mucomyst) Side Effects: Rash, low incidence of GI distress, hepatotoxicity hepatic necrosis, thrombocytopenia IV: acetaminophen (Ofirmev) Treat pain & fever IV infusion of 15 min 25)meperidine Brand:Demerol Classification: Opioid (synthetic) Category: II Uses: Primarily effective in GI procedures Contraindications: Preferred to morphine during pregnancy Caution with older adults Neurotoxicity (nervousness, agitation, irritability, tremors, seizures) 26)hydromorphone Brand:Dilaudid Classification: Opioid (synthetic) Category: II Uses: Analgesic effect is 6x more potent than morphine with fewer hypnotic effects & less GI distress. Side Effects: Respiratory depression, orthostatic hypotension, confusion urinary retention, pupillary constriction 27)morphine sulfate Classification: Opioid Category: II Uses: Relieves acute pain from acute MI & CA Relieves dyspnea Antidote: Opioid antagonist naloxone (Narcan) 28)fentanyl Brand:Duragesic Classification: Opioid Category: II Contraindications: More potent than morphine Exercise 29)naloxone Brand:Narcan Classification: Opioid Antagonist Side Effects: Tremors, sweating, HTN, tachycardia, excitement, nausea, vomiting, reversal of analgesia, dysrhythmias, Elevated PTT (partial thromboplastin time); bleeding Nursing Interventions: Monitor VS & bleeding continuously. 30) opioid, nonopioid, adjuvant drugs Opioid: Moderate & severe pain Act on CNS Suppress pain impulses as well as respiration & coughing by acting on respiratory & cough centers in medulla of brainstem Antidiarrheal effects Side Effects:nausea & vomiting (particularly in ambulatory pts), constipation moderate decrease in BP, orthostatic hypotension, respiratory depression urinary retention (usually in older adults), antitussive effects Nonopioid: Less potent than opioid analgesics Used to treat mild to moderate pain Effective for dull, throbbing pain of HA, dysmenorrhea, inflammation, minor abrasions, muscular aches & pain, & mild to moderate arthritis Adjuvant Drugs: Adjuvant therapy is usually used along with a nonopioid & opioid. Effective for pain relief in neuropathy Anticonvulsants Antidepressants Corticosteroids Antidysrhythmics Local Anesthetics 31) controlled substance schedule II-IV Schedule I: Illegal high potential for abuse, high potential for addiction chedule II: Legal, high abuse potential, moderate addiction potential S Schedule III: Legal, moderate abuse potential, moderate addiction potential Schedule IV: Legal, moderate abuse potential, moderate addiction potential Schedule V: Legal, low abuse potential, low addiction potential 32)piperacillin-tazobactam Brand:Zosyn Classification: Antibiotic (Beta Lactamase Inhibitors Penicillin) Nursing Interventions: Before any antibiotic, a C&S should be done. Take the entire prescribed drug to avoid drug resistance. Patients should increase fluid intake. Symptoms of superinfection (stomatitis & vaginitis) should always be monitored for all antibiotics. 33)cephalosporin Beta-lactam structure Semi-synthetic Action: Inhibit bacterial cell-wall synthesis Bactericidal Uses: Pharyngitis, tonsillitis, otitis media Respiratory, skin, intraabdominal, bone & joint, urinary, & gynecologic infections STIs, bacteremia, sepsis Groups: First, second, third, fourth, & fifth generation Side Effects: Pruritus, anaphylaxis, GI distress, C. difficile, increased bleeding seizures, nephrotoxicity Interactions: Alcohol, anticoagulants Nursing Interventions: Assess for allergy. Perform C&S before therapy. Assess renal & liver function. Administer IV over 30 min BID or 4x/day. Monitor for superinfection (mouth ulcers or discharge from anal or genital area). For safety, keep out of reach of children. 34) drugs for MRSA Fifth generation cephalosporins Lincosamides Oxazolidinones Glycopeptides (vancomycin& telavancin) etracyclines T Sulfonamides 35)vancomycin Classification: Antibiotic (Glycopeptides) Side Effects: Redneck or red man syndrome Occurs when IV too rapid Severe hypotension Red blotching of face, neck, chest, extremities Toxic reaction not allergic reaction Ototoxicity (CN VIII) Nephrotoxicity Blood dyscrasias Stevens-Johnson syndrome Nursing Interventions: Check C&S before therapy Monitor vancomycin levels Administer over 1-2 hrs IV Rotate sites. Monitor BP (hypotension & tachycardia). Monitor IV site. Monitor renal function tests & hearing. Monitor patients for superinfection. 36)azithromycin Brand:Zithromax Classification: Antibiotic (Macrolides) Nursing Interventions: Report loose stools or diarrhea because of possible pseudomembranous colitis. Advise patients to take a full regimen. 5 day course of medication long half-life—up to 48 to 68 hours peak level of this drug is decreased by antacids Give azithromycin 1hr before or 2hrs after meals w/ full glass of water. Can be used for pt allergic to PCN. 37)trimethoprim-sulfamethoxazole Brand:TMP-SMZ Classification: Antibiotic (Sulfonamide) Action: Synergistic effect Both drugs together in one compound cause bacterial resistance to develop uch more slowly. m Uses: Urinary, intestinal, & lower respiratory tract infections; otitis media; prostatitis Used to prevent Pneumocystis carinii in pts with AIDS Side Effects: Moderate rashes, anorexia, N/V/D, stomatitis, crystalluria, & photosensitivity, agranulocytosis, aplastic anemia, allergic myocarditis Nursing Interventions: Administer w/ full glass of water 1 hr before meals or 2 hrs after meals Increase fluid intake. Monitor for sore throat, bruising, bleeding. Monitor CBC. Check for superinfection. Advise pt not to take w/ antacids. Tell pt to avoid direct sunlight 38)sulfasalazine Brand:Azulfidine Classification: Antibiotic (Sulfonamide) Use: Treatment of ulcerative colitis, Crohn’s disease, rheumatoid arthritis Used to reduce Clostridium & E. coli in stools Side Effects: GI distress, stomatitis, photosensitivity, HA, edema, crystalluria, renal failure, hematuria, blood dyscrasias, anaphylaxis, Stevens-Johnson syndrome Nursing Interventions: Increase fluid intake to at least 2000 mL/day to prevent crystalluria Monitor CBC & renal function. Monitor for rash & superinfection. With warfarin, the anticoagulant effect is increased With sulfonylureas, the hypoglycemic effect is increased Avoid during the 3rd trimester. Wear sunglasses, avoid direct sunlight, use sun block Avoid antacids which decrease absorption rate of drug 39) sulfonamides Action: Inhibit bacterial synthesis of folic acid essential for bacterial growth Humans do not synthesize folic acid but acquire it through the diet; sulfonamides selectively inhibit bacterial growth w/out affecting normal body cells. Bacteriostatic ights gram-negative bacteria F Proteus, Klebsiella, E. coli, Toxoplasma gondii, Salmonella species Uses: Treats otitis media, meningitis, respiratory infections Treats UTIs, prostatitis, gonorrhea, malaria, MRSA Alternative therapy for PCN allergies. 40)TB meds= INH and Rifampin Rifampin Warn patients that body fluids may be reddish orange. Isoniazid (INH) Action: Inhibits bacterial cell wall synthesis Side Effects: GI distress, constipation, blurred vision, photosensitivity tinnitus, dizziness, peripheral neuropathy, psychotic behavior, seizures blood dyscrasias, hepatotoxicity Interactions: Increases effect of INH (alcohol, rifampin, cycloserine, phenytoin) Decreases phenytoin effect when concurrent Decreases absorption (antacids) Alcohol increases risk of neuropathy, hepatotoxicity Patient Teaching: Take INH 1 hour before meals or 2 hours after meals. Must follow a complete regimen. Collect sputum specimen in early morning. Take pyridoxine (vitamin B6) to prevent peripheral neuropathy. Check liver enzymes, CBC. Need frequent eye examinations Report numbness, tingling, burning. Teach sun precautions. To avoid antacids. 41)nystatin Brand:Mycostatin Classification: Antifungal Methods of Administration: Oral (treats Candida infection in mouth) Topical Action: Increases permeability of fungal cell membrane Fungistatic Fungicidal Patient Teaching: wish and swallow. S Gargle if throat is affected. 42)metronidazole Brand:Flagyl Classification: Antiprotozoals (Nitroimidazoles) Action: Impairing DNA function of susceptible bacteria Uses: Primarily to treat disorders associated with organisms in GI tract Prescribed to treat intestinal amebiasis, IBD, trichomoniasis, anaerobic infections, & bacterial vaginosis, Fights against H. pylori, bacteroides, Clostridium difficile, Gardnerella, Prevotella, Giardia, Peptococcus, Trichomones vaginalis protozoa Used as perioperative prophylaxis (prevention of infection) in colorectal surgery Side Effects: Avoid alcohol Disulfiram-type reaction (facial flushing, sweating, severe H/A, slurred speech, tachycardia, palpitations, hypotension, dyspnea) Dark urine or reddish brown Avoid during 1st trimester pregnancy 43) fluoroquinolones Action: Interfere with enzyme DNA gyrase Fight gram-positive & gram-negative bacteria Broad spectrum: bactericidal Ciprofloxacin (Cipro) UTIs, lower respiratory tract infections, skin, soft-tissue, bone & joint infections Levofloxacin (Levaquin) Community-acquired PNA, chronic bronchitis, acute sinusitis, UTIs, & uncomplicated skin infections Moxifloxacin (Avelox) Once-a-day oral & parenteral dosing Used to treat same infections other fluoroquinolones are effective against Ofloxacin (Ocuflox, Floxin) UTIs Use: Anthrax, sinusitis, typhoid fever, STIs, skin, bone/joint, intraabdominal, urinary, respiratory tract infections,PNA Drug Interactions: Antacids decrease absorption rate. Levofloxacin increases the effect of oral hypoglycemics, theophylline, and caffeine. Nursing Interventions: heck C&S. C Infuse IV over 60-90 min. Increase fluid intake >2000 mL/d. Tell pt to avoid caffeine or sun. Check for superinfection. 44)ciprofloxacin Brand:Cipro Classification: Antibiotic (fluoroquinolones) Use: UTIs, lower respiratory tract, skin, soft-tissue, bone & joint infections 45)acyclovir Brand:Zovirax Classification: Antiviral Side Effect: Gingival hyperplasia 46) PCN and PCN allergy Structure of Penicillins: Beta-lactam ring Action: Inhibit bacterial cell wall synthesis Bacteriostatic & bactericidal Types of Penicillins: Basic penicillins Broad-spectrum penicillins Penicillinase-resistant penicillins Extended-spectrum penicillins Basic PCNs Narrow spectrum Use: Effective against gram-positive & a few gram-negative bacteria Treats anthrax, diphtheria Treats endocarditis, pericarditis Treats skin & respiratory infections, STIs Treats scarlet fever, meningitis Treats gingivitis, otitis media Penicillin Allergy: Azithromycin (Zithromax) Sulfonamides 47)guaifenesin Brand:Robitussin Classification: Expectorants Action: Allows elimination by coughing oosens bronchial secretions by reducing surface tension of secretions L Use: Common cold Side effects: Drowsiness, dizziness, HA, N/V/D Nursing Interventions: Take with glass of water Read labels on OTC drugs Check w/ healthcare provider before taking cold remedies 48)diphenhydramine Brand:Benadryl Classification: Antihistamines Action: Competes w/ histamine for receptor sites preventing histamine response Reduces nasopharyngeal secretions, itching, sneezing Use: Treats acute & allergic rhinitis, antitussive, pruritus, urticaria Prevent motion sickness Contraindications: Severe liver disease Narrow-angle glaucoma Urinary retention Interactions: Increases CNS depression with alcohol & other CNS depressants Avoid use of MAOIs Side Effects: Drowsiness, dry mouth, dizziness, blurred vision, wheezing, photosensitivity, urinary retention, constipation, GI distress, blood dyscrasias Nursing Interventions: Obtain list of environmental exposures, drugs, recent foods eaten, stressors. Give with food to decrease GI distress. Avoid operating motor vehicles if drowsy. Avoid alcohol & CNS depressant. Use sugarless candy, gum, or ice chips for temporary relief of mouth dryness. 49)albuterol Brand:Proventil Classification: Bronchodilators Action: Bronchodilation Rapid onset of action Longer duration of action Few side effects se: U Asthma Acute bronchospasm Bronchospasm prophylaxis 50) leukotriene modifiers(montelukast) Action: Reduce inflammatory process & decrease bronchoconstriction Use: Prophylactic & maintenance for chronic asthma Not recommended for acute asthmatic attacks Therapeutic effects with 2-5 days Side Effects: dizziness, HA, GI distress, weakness, infection 51)ipratropium Brand: Atrovent Classification: Bronchodilators Use: Combination of ipratropium bromide with albuterol sulfate (Combivent)–used to treat chronic bronchitis Action: dilates bronchioles Administration: aerosol inhaler Contraindications: Narrow-angle glaucoma Administration Order: 1. Albuterol 2. Atrovent 3. Glucocorticoid 52)theophylline Brand:Theo-24 Classification: Bronchodilators (Methylxanthines) Action: relaxes smooth muscle of bronchi, bronchioles increasing cAMP, promoting bronchodilation Use: maintenance therapy for chronic stable asthma Therapeutic Range: 5-15 mcg/mL (toxicity greater than 20) Contraindications: Seizure, cardiac, renal, or liver disease Side Effects: Dizziness, HA, irritability, hypotension, dysrhythmias, insomnia, seizures, GI distress, tachycardia, palpitations, restlessness 53) glucocorticoid inhaler Not helpful in treating severe asthma attack May take 1-4 wks for inhaled steroid to reach its full effect Rinse mouth to decrease infection 54) sleep medications (sedative hypnotics) Barbiturates enzodiazepines B Non benzodiazepines Melatonin agonists OTC 55)drug for alcohol withdrawals Benzodiazepines: chlordiazepoxide (Librium) 56) Benzodiazepines:Sedation MAOIs:Anxiety/ Depression Antipsychotics:Hallucinations/ Psychosis
