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NURS 324 Pathophysiology > Antipyretic & Antimicrobial Medications > Flashcards

Antipyretic & Antimicrobial Medications Flashcards

1
Q

NSAID

A

Non steroidal anti inflammatory inhibitors

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2
Q

Aspirin Classification

A

NSAID

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3
Q

Aspirin indication

A

pain, fever, inflammation

reduction of platelet aggregration
reduction of cancer risk

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4
Q

Aspirin MOA

A

inhibits Cyclooxygenase enzyme - both COX 1 and COX 2

to reduce fever, pain and inflammation, Aspirin inhibits COX 2

to to protect against MI and ischemic stroke, Aspirin inhibits COX 1

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5
Q

Aspirin is a __________ _________ of cyclooxygenase.

A

Non selective inhibitor

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6
Q

Side effects of Aspirin

A

GI effects- gastritis, dyspepsia, ulcers

renal impairment

bleeding

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7
Q

Side effects of Aspirin result from its inhibition of

A

COX 1 enzyme

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8
Q

What is unique about Aspirin’s inhibition of cyclooxygenase as compared to other NSAIDS?

A

it is irreversible, meaning that its duration of action depends on how quickly tissues can synthesize new molecules of COX-1 and COX-2

all other NSAIDS are reversible inhibitors and their effects decline as soon as blood levels fall

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9
Q

Nursing Considerations: Aspirin: Antipyretic Dosage

A

*Antipyretic: 325-650mg po every 4 hours

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10
Q

Nursing Considerations: Aspirin: Cardiac Dosage

A

Cardiac: may use 325mg po initially in acute event, then 81 mg/day.

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11
Q

Nursing Considerations: Aspirin

Should it be administered to children ?

A

NO.

*Do not administer to children or adolescents younger than 18 years due to risk of Reyes Syndrome

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12
Q

Nursing Considerations: Aspirin

Will enteric coating prevent GI bleeds?
should it be administered with food? what should be avoided with ingestion?
Some drug to drug interactions to be aware of

A
  • Enteric coating may not prevent GI bleeding.
  • Administer with food
  • Avoid alcohol ingestion with medication as it can increase risk of gastric bleeding

*Drug-drug interactions/contraindications -
can intensify effects of anticoagulants so must be used with caution in combination
- use with caution with ACE inhibitors
-

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13
Q

Ibuprofen classification

A

NSAID

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14
Q

Ibuprofen indication

A

fever
analgesic - pain
anti-inflammation

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15
Q

Ibuprofen MOA

A
  • Non-selective inhibitor of COX (1 and 2)
  • Anti-inflammatory
  • Antipyretic
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16
Q

Side effects of Ibuprofen

A

gastric bleeding (although risk is lower than that of Aspirin’s)

*GI – gastritis, dyspepsia, ulcers
*Bleeding
(Selective COX 2 inhibitors are known to cause an increased risk of thrombotic events; celecoxib (Celebrex))

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17
Q

Nursing Considerations: Ibuprofen

A
  • Many drug-drug interactions/contraindications
  • Administer with food
  • Avoid alcohol ingestion with medication
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18
Q

Acetaminophen Classification

A

Acetaminophen is a Cyclooxygenase inhibitor that lacks any anti inflammatory properties.

It is an antipyretic and analgesic

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19
Q

Acetaminophen Indications

A

Fever

Analgesic

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20
Q

Acetaminophen MOA

A

inhibits cyclooxygenase (and thereby prostaglandin synthesis) within the CNS system, thus reducing fever and pain

No anti-inflammatory effects peripherally because it can’t inhibit prostaglandin synthesis outside the CNS

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21
Q

Acetaminophen Side Effects

A

Few and extremely rare at therapeutic doses.
does not cause gastric ulceration or renal impairment and does not inhibit platelet aggregation

Overdose can cause severe liver injury

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22
Q

How is Acetaminophen different from Aspirin ?

A

Acetaminophen does not have any anti inflammatory effects.
Acetaminophen does not suppress platelet aggregation, does not cause gastric ulceration and does not decrease renal blood flow or cause renal impairment

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23
Q

Nursing Considerations: acetaminophen and liver effects

A

Inform patient of potential for severe liver injury if there is an overdose
also advise patients with liver disease to ask their provider if acetaminophen is safe to take

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24
Q

Nursing considerations: Acetaminophen maximum total dosage a day

A

Advise patients to consume no more than 4000 mg (MAX) of acetaminophen a day, including the amount in combination prescription products (eg, Vicodin, Percocet) as well as OTC products.

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25
Q

Nursing Considerations: Acetaminophen and undernourished patients

A

Advise patients who are undernourished (eg, owing to fasting or illness) to consume no more than 3000 mg of acetaminophen a day.

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26
Q

Nursing Considerations: Acetaminophen and Alcohol

A

Advise patients not to drink alcohol while taking acetaminophen.
• Advise patients who won’t stop drinking alcohol (more than 3 drinks a day) to take no more than 2000 mg of acetaminophen a day.

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27
Q

What is unique about Acetaminophen as a Cyclooxygenase inhibitor?

A

It has no anti inflammatory effects.

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28
Q

What are the names of antibiotics affecting cell wall synthesis ?

A

Beta-lactam antibiotics

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29
Q

When instructing a patient in taking antibiotics, make sure to tell them what regarding taking treatment course?

A

Instruct the patient to complete the prescribed course of treatment, even though symptoms may abate before the full course is over.

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30
Q

Indications of antimicrobial effects

A

reduction in fever, pain, or inflammation; improved appetite or sense of well-being

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31
Q

What is selective toxicity ?

A

The ability of a drug to injure invading microbes without injuring cells of the host

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32
Q

What is a bactericidal drug ?

A

Kills bacteria

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33
Q

What is a bacteriostatic drug ?

A

Suppresses microbe growth

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34
Q

Penicillins Drug class

A

Beta-lactam

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35
Q

beta-lactamases - what are they-

also how does it relate to penicillins ?

A

chemicals manufactured by bacteria that make them resistant to all or most beta-lactam antibiotics, such as penicillin

There are drugs that combine a penicillin and a beta lactamase inhibitor to counteract these defenses

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36
Q

Penicillin Indication

A

both therapeutically and prophylactically

*Therapeutic: used for gram-positive bacteria ex. Strep and Staph & a few gram-negatives such as Neisseria, and syphilis (Treponema).

Some will cover anaerobes such as Enterobacter & also Pseudomonas, and Klebsiella

*Prophylactic: used to prevent bacteremia in selected populations at risk for endocarditis, such as people with artificial or damaged heart valves

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37
Q

Penicillin MOA

A

Affects cell wall synthesis

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38
Q

Penicillin Side Effects

A

Allergy

GI – diarrhea, dyspepsia

Renal impairment can cause penicillins to accumulate to toxic levels

Suprainfections possible

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39
Q

What should patients with a penicillin allergy do ?

A

Advise patients with penicillin allergy to wear some form of identification (eg, Medic Alert bracelet) to alert emergency healthcare personnel

Instruct outpatients to report any signs of an allergic response (eg, skin rash, itching, hives).

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40
Q

Penicillin overdose can cause …….

A

neurologic problems, including seizures

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41
Q

Penicillin is synergistic with aminoglycoside antibiotics, but they cannot be administered in ……

A

the same IV line.

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42
Q

Patients taking penicillin - instructions for taking them

A

Instruct the patient to take oral penicillins with a full glass of water 1 hour before meals or 2 hours after. Penicillin V, amoxicillin, and amoxicillin/clavulanate may be taken with meals.

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43
Q

Amoxicillin + clavulanic acid (these drugs combine a penicillin and a beta-lactamase inhibitor)

A

Augmentin

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44
Q

Ampicillin + sulbactam=

A

= Unasyn

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45
Q

Ticarcillin + clavulanic acid =

A

Timentin

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46
Q

Piperacillin + tazobactam =

A

Zosyn

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47
Q

Cephalosporin Drug Class

A

Beta-lactam antibiotics

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48
Q

Four generations:

*First generation
(eg, cephalexin)

*Second generation
(eg, cefoxitin)

*Third generation
(eg, cefotaxime)

*Fourth generation
(cefepime)

*Fifth generation
(ceftaroline)

With each generation of cephalosporins, what is there?

A

increased activity against gram-negative organisms and increased effectiveness against organisms that produce beta-lactamases

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49
Q

To avoid the development of resistant populations of bacteria, ______ and _______generations of cephalosporins should be reserved for serious infections!

A

third and fourth

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50
Q

Cephalosporins MOA

A

affects cell wall synthesis

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51
Q

Cephalosporins Side Effects

A
  • Risk of increased bleeding with warfarin because of interference with Vitamin K metabolism
  • Allergy

GI upset: diarrhea and pseudomembranous colitis

immune-mediated hemolytic anemia

*can promote clostridium difficile suprainfection

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52
Q

Cephalosporins are contraindicated for those with

A

a history of allergic reactions to cephalosporins or of severe allergic reactions to penicillins.

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53
Q

With cephalosporins, it is especially important to monitor …… and exercise caution in patients with a history of …….

A

the prothrombin time, bleeding time, or both. Parenteral vitamin K can correct abnormal prothrombin time. Observe patients for signs of bleeding and, if bleeding develops, discontinue the drug. Exercise caution in patients with a history of bleeding disorders and in patients receiving drugs that can interfere with hemostasis (anticoagulants; thrombolytics; antiplatelet drugs, including aspirin and other NSAIDs).

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54
Q

Alcohol and cephalosporins: good idea or not ?

A

NOT A GOOD IDEA. Several can trigger a disulfiram-like reaction if used with alcohol.

Advise patients about alcohol intolerance and warn them not to drink alcoholic beverages.

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55
Q

Patient instructions for Cephalosporins

A

Don’t intake with alcohol
make sure to refrigerate an oral suspension
Advise patients to take oral cephalosporins with food if gastric upset occurs.
report any diarrhea

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56
Q

Vancomycin Drug Class

A

Non beta-lactam

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57
Q

Vancomycin indications

A

A potentially toxic antibiotic only used to treat serious infections.

Can be used in treating gram+ infections (in those with PCN allergy)

Oral preparation can be used for bowel infections, particularly Clostridium difficile (a suprainfection) – topical to GI system, not absorbed by the bloodstream

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58
Q

For those allergic to penicillins and having a serious infection, this can be used …..

A

Vancomycins

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59
Q

Vancomycins MOA

A

affects call wall synthesis

60
Q

Major toxicity of Vancomycins

A

renal failure

61
Q

Side effects - Vancomycins

A

Ototoxicity and
dose-related nephrotoxicity

Multiple drug interactions with hyperlipidemic drugs, muscle relaxants, and ototoxic drugs

Irritating to the vein, causing thrombophlebitis (use large vein and change site often

Rapid infusion can cause “red man syndrome”

62
Q

What is “red man syndrome ?”

A

an infusion-related reaction peculiar to vancomycin - It typically consists of pruritus, an erythematous rash that involves the face, neck, and upper torso, flushing, urticaria, tachycardia, hypotension

63
Q

Nursing Considerations of Vancomycin

A

*Measure peak and trough levels

Rapid infusion can cause “red man syndrome,” characterized by flushing, rash, pruritus, urticaria, tachycardia, and hypotension. To minimize risk, infuse vancomycin slowly, over 60 minutes or longer.

64
Q

To minimize risk of “red man syndrome,” what can be done?

A

To minimize risk, infuse vancomycin slowly, over 60 minutes or longer.

65
Q

Tetracyclines are what kind of drug ?

A

bacteriostatic inhibitors of protein synthesis

66
Q

Tetracycline, Demeclocycline, Doxycycline, Minocycline - these are the four __________ available for systematic therapy

A

tetracyclines

67
Q

Tetracycline Indications

A

Agents of choice for Chlamydia and rickettsial diseases (Rocky Mountain spotted fever)

Used in acne, periodontal disease.

68
Q

Tetracycline MOA

A

Bind to the 30S ribosomal subunit, which inhibits the binding of transfer RNA to the messenger RNA-ribosome complex. The addition of amino acids to the growing peptide chain is prevented

Broad spectrum but resistance has developed

69
Q

Tetracycline Side Effects

A
  • Discoloration of developing teeth
  • GI distress (epigastric burning, cramps, nausea, vomiting, diarrhea)
  • Photosensitivity
70
Q

All tetracyclines can increase the __________ of the skin to ultraviolet light

A

sensitivity. This can lead to exaggerated sunburn

71
Q

Tetracycline Nursing Considerations : directions for taking

A

Advise patients to take most oral tetracyclines on an empty stomach (1 hour before meals or 2 hours after) and with a full glass of water. Minocycline may be taken with food

72
Q

This type of Tetracycline medication may be taken with food.

A

Minocycline

73
Q

Tetracycline Nursing Considerations: what kind of foods and supplements should patients allow at least 2 hours between ingestion of tetracycline …….

A

Instruct patients to allow at least 2 hours between ingestion of tetracyclines and these chelators: milk products, calcium supplements, iron supplements, magnesium-containing laxatives, and most antacids.

74
Q

Why should Tetracyclines not be given to pregnant women or children below 8 years ?

A

Tetracyclines bind to calcium in developing teeth and form a discolored area. However use during pregnancy will only affect baby teeth.
Discoloration of permanent teeth occurs when tetracyclines are taken by patients 4 months to 8 years

75
Q

Why is it important for patients to know the symptoms of Candidiasis when taking tetracyclines ?

A

Tetracyclines are a broad spectrum antibiotic and so the risk of suprainfection is greater than with antibiotics that have a more narrow spectrum. Candidiasis is one of the diseases that may occur through overgrowth of fungi (in this case, Candida Albicans)

76
Q

Symptoms of Candidiasis -

A

Candidiasis -Inform patients about symptoms of fungal infection (vaginal or anal itching; inflammatory lesions of the anogenital region; black, furry appearance of the tongue), and advise them to notify the prescriber if these occur.

77
Q

Nursing Considerations: Tetracyclines and Sunlight

A

Advise patients to avoid prolonged exposure to sunlight, wear protective clothing, and apply a sunscreen to exposed skin.

78
Q

Macrolides Drug Class

A

Broad spectrum antibiotics that inhibit protein synthesis

79
Q

Why are macrolides called “Macrolides”?

A

Because they are big

80
Q

Azithromycin (Zithromax)
Erythromycin
Clarithromycin (Biaxin)

These are all ……

A

Macrolides

81
Q

Name at least 2 types of Macrolides

A

Azithromycin (Zithromax)
Erythromycin
Clarithromycin (Biaxin)

82
Q

Macrolides Indications

A

Gram-positive and some gram-negative bacteria.

Legionella and Chlamydia

83
Q

In patients with an allergy to penicillin G, this drug class can be used as an alternative of first choice for several infections ?

A

Macrolides

84
Q

Macrolides MOA

A

Prevents protein synthesis

Inhibit addition of new amino acids to the growing peptide chain by binding to the 50S ribosomal subunit

85
Q

Macrolides Side Effects

A

GI disturbances - epigastric pain, nausea, vomiting, diarrhea

QT prolongation and sudden cardiac death - possibility when combined with drugs that can raise its plasma level

86
Q

Erythromycin and clarithromycin (macrolides) are strong inhibitors of __________________________and hence these should be administered with caution in patients taking these drugs …..

A

cytochrome p450 hepatic drug metabolizing enzymes

administer with caution in patients taking drugs metabolized by these enzymes (statins and warfarin, among others).

Azithromycin is a weaker inhibitor of P450 enzymes, but caution is still advised.

87
Q

When giving Erythromycin via IV, make sure to

A

Dilute in large quantities of fluid and infused slowly into a large vein.

88
Q

Clindamycin Drug Class

A

bacteriostatic inhibitor of protein synthesis

89
Q

Clindamycin Indications

A

Anaerobes and gram-positive aerobes

Reserve for serious infections

Poor penetration of the brain.

90
Q

Like macrolides, Clindamycin has a similar MOA:

A

Inhibits 50S ribosomal subunit

91
Q

Clindamycin Side Effects

A

Suprainfection with Clostridium difficile

92
Q

Clindamycin Nursing Considerations

A

IV infusion must be SLOW (fatalities have occurred from too rapid infusion).

93
Q

Aminoglycosides Drug Class

A

Bactericidal Inhibitor of Protein Synthesis

  • Narrow Spectrum Antibiotics
94
Q

Name most commonly employed aminoglycosides

A

Gentamicin
Tobramycin
Amakacin

95
Q

Aminoglycoside Indications

A

Aerobic gram negative bacilli: Pseudomonas, Klebsiella, and Serratia

no activity against anaerobes

96
Q

Aminoglycoside MOA

A

Bind to the 30S ribosomal subunit
thereby causing
1) Inhibition of protein synthesis
2) premature termination of protein synthesis
3) Production of abnormal proteins (secondary to misreading of the genetic code)

97
Q

Aminoglycosides are bactericidal. Cell kill is _____________

A

concentration dependent: the higher the concentration, the more rapidly the infection will clear

98
Q

Aminoglycosides Side Effects

A

Ototoxic and nephrotoxic— adjust for renal impairment

Aminoglycosides can inhibit neuromuscular transmission, causing potentially fatal respiratory depression.

99
Q

Aminoglycosides Nursing Considerations

A

For many patients, once daily infusion is as good as divided doses because it produces very high levels that kill bacteria even after the blood level declines.

Low levels in between the daily dose allows washout from body cells in between doses and lowers the risk of toxicity. (measure peak and trough levels)

Can be used topically to sterilize the gut or on the skin (neomycin) or eye.

100
Q 
Sulfamethoxazole-
 and Trimethroprim (Bactrim) Drug Class
A

Bactericidal Broad Spectrum Antimicrobials : they disrupt the synthesis of tetrahydrofolic acid

these drugs are marketed together in a fixed-dose combination product

101
Q 
Sulfamethoxazole-
 and Trimethroprim (Bactrim) Indications
A

Broad spectrum, including many gram negative and gram positive

Used extensively for UTI, Pneumocystis jerovici pneumonia

102
Q 
Sulfamethoxazole-
 and Trimethroprim (Bactrim) MOA
A

Blocks bacterial enzymes that are important for the synthesis of the building blocks of DNA, RNA and proteins.

Combination of a sulfa drug (sulfamethoxazole) and an inhibitor of a bacterial enzyme called dihydrofolate reductase (trimethoprim) - are synergistic in their activity.

103
Q 
Sulfamethoxazole-
 and Trimethroprim (Bactrim) Side Effects
A

Hypersensitivity reactions are most concerning:

Rash, including rare Stevens-Johnson syndrome.

Heme: hemolytic anemia and other blood dyscrasias (agranulocytosis, leukopenia, thrombocytopenia, aplastic anemia).

Crystalluria (kidney/bladder stones)

CNS: headache, psychosis

104
Q 
When taking Sulfamethoxazole-
 and Trimethroprim (Bactrim) or other Sulfonamides, the patient should remain well \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ and consume 8-10 \_\_\_\_\_\_\_\_\_\_\_\_\_ per day
A

hydrated; glasses of water

105
Q 
Sulfamethoxazole-
 and Trimethroprim (Bactrim) or other Sulfonamides - Nursing Considerations at the first dose
A

First dose – observe closely for rash. Instruct patients to discontinue drug use at the first sign of hypersensitivity (eg, rash).

106
Q

Sulfanamides Contraindications

A

Sulfonamides are contraindicated for patients with a history of severe hypersensitivity to sulfonamides and chemically related drugs, including thiazide diuretics, loop diuretics, and sulfonylurea-type oral hypoglycemics

107
Q

Sulfanamides Nursing Considerations: Exercise caution in those with

A

renal impairment

108
Q

Sulfanamides Nursing Considerations: signs of hemolysis and blood count

A

Observe patients for signs of hemolysis (fever, pallor, jaundice). When sulfonamide therapy is prolonged, periodic blood cell counts should be made.

109
Q

Sulfanamides Nursikng Considerations: Sun exposure

A

Advise patients to avoid prolonged exposure to sunlight, wear protective clothing, and apply a sunscreen to exposed skin.

110
Q

Fluoroquinolones Drug Class

A

Broad Spectrum antibiotic

111
Q

What types of drugs are these ?
Ciprofloxacin (Cipro)

Levofloxacin
Oxofloxacin

A

Fluoroquinolones

112
Q

Fluoroquinolones Indications

A

Active against aerobic organisms, most gram negative and some gram positive

113
Q

Fluoroquinolones MOA

A

Inhibit an enzyme (DNA gyrase) important in bacterial DNA replication

114
Q

Fluoroquinolones Side Effects

A

Can cause irreversible joint disease in children <18

Rarely, tendon rupture in adults

Photosensitivity

Candida suprainfections, especially of the oropharynx

Infrequent but serious CNS effects.

115
Q

Fluoroquinolones Contraindications

A

contraindicated in patients with a history of myasthenia gravis.

116
Q

Use all fluoroquinolones with caution in patients with ………………………………….

A

Use all fluoroquinolones with caution in patients with renal impairment, and in patients age 60 and older, patients taking glucocorticoids, and patients who have undergone a heart, liver, or kidney transplantation.

117
Q

fluoroquinolones shouldn’t be taken with what kind of supplements ?

A

Shouldn’t be taken with aluminum, iron, calcium, iron or zinc supplements.

118
Q

fluoroquinolones Nursing Considerations: Tendon Damage

A

Inform patients about the risk of tendon damage and instruct them to report early signs of tendon injury (pain, swelling, inflammation), and to refrain from exercise until tendinitis has been ruled out.

119
Q

Fluoroquinolones Nursing Considerations: Sun Exposure

A

Advise patients to avoid sunlamps, and to use a sunscreen and protective clothing when outdoors.

120
Q

Metronidazole (Flagyl) Indications

A

Targets anaerobic organisms, including parasites and bacteria:

C. difficile and others

121
Q

Metronidazole (Flagyl) Indications

A

A prodrug that is activated only in anaerobic cells

122
Q

Metronidazole (Flagyl) Side Effects

A

Cytochrome P450 interactions

Darkening of the urine

CNS adverse effects

Caution during pregnancy, avoid during lactation

123
Q

Metronidazole (Flagyl) routes

A

PO and IV

124
Q

Amphotericin B Drug Class

A

Antifungal

125
Q

Amphotericin B Indications

A

Used for life-threatening systemic fungal infections

126
Q

Amphotericin B MOA

A

Binds to sterols in the fungal membrane and increases permeability – the fungal cell swells and bursts

127
Q

Amphotericin B Side Effects

A

Infusion reactions – phlebitis and systemic symptoms (fever, chills, rigors, nausea and headache)

Nephrotoxic – use with caution with other nephrotoxic drugs (aminoglycosides)

128
Q

This drugs nickname is Amphoterrible …..

A

Amphotericin B

129
Q

Amphotericin B route

A

IV only

130
Q

Amphotericin B Nursing Considerations

Can it be used during pregnancy ?

A

Monitor renal labs, intake and output

NOT teratogenic – can be used in pregnancy. (Minimal data available about use during pregnancy)

131
Q

Fluconazole

Ketoconazole
Iitraconazole

Drug Class ………………….

A

Azole Antifungals

132
Q

Azole Antifungals:

Fluconazole

Ketoconazole
Iitraconazole

Indications …………………………….

A

Oral alternative to amphotericin B for systemic fungal infections

Can be used topically for fungal skin infections

133
Q

Azole Antifungals:

Fluconazole

Ketoconazole
Iitraconazole

MOA ……….

A

Inhibit the synthesis of a sterol component of the fungal cell membrane

134
Q

Azole Antifungals:

Fluconazole

Ketoconazole
Iitraconazole

A

Strong inhibitor of cytochrome P450 enzymes – use with extreme caution in hepatically metabolized drugs

Rare hepatic necrosis

Teratogenic!

135
Q

Azole Antifungals:

Fluconazole

Ketoconazole
Iitraconazole

are they safe during pregnancy ?

A

NO! UNSAFE during pregnancy

136
Q

Acyclovir Drug Class

A

Antiviral

137
Q

Acyclovir Indications

A

Active against all herpes viruses: herpes simplex, herpes zoster, and cytomegalovirus (CMV)— although most strains of CMV are resistant

138
Q

Acyclovir MOA

A

Suppresses synthesis of viral DNA – but must be activated by a viral enzyme, thymidine kinase

139
Q

Acyclovir Side Effects

A

Nephrotoxic – maintain high hydration to dilute drug in renal tubules

140
Q

Acyclovir Routes

A

Oral, IV, topical

141
Q

Does Acyclovir eliminate the Herpes Virus ?

A

No: Inform patients with herpes simplex genitalis that acyclovir only decreases symptoms; it does not eliminate the virus and does not produce cure

Advise patients to cleanse the affected area with soap and water 3 to 4 times a day, drying thoroughly after each wash.

Advise patients to avoid all sexual contact while lesions are present, and to use a condom even when lesions are absent

142
Q

Ganciclovir Drug Class

A

Antiviral

143
Q

Because Ganciclovir is excreted unchanged in the urine, what should be done in those with renal impairment?

A

decrease dose for patients with renal impairment.

144
Q

We should monitor blood counts when taking Ganciclovir because of what prominent two adverse effects

A

Granulocytopenia and thrombocytopenia are prominent adverse effects – monitor blood counts.

145
Q

Can Ganciclovir be used during pregnancy ?

A

NO! Teratogenic and embryotoxic – birth control should be in place.

NURS 324 Pathophysiology (6 decks)

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