Drug matrix 2 Flashcards
what is the MOA of the BCG vaccine?
stimulates an inflammatory response in the bladder with the goal of recruiting immune system to the area of the bladder to recognize cancerous cells
what is the indication for the BCG vaccine?
stage 1 bladder cancer
what are the major adverse reactions to the BCG vaccine?
bladder irritation and systemic infection
what type of vaccine is the BCG vaccine?
live
how often is the BCG vaccine given?
weekly for 6-12 weeks
what are the instructions to administer the BCG vaccine?
patient must empty bladder, the vaccine must dwell in the bladder for 2 hours, patient is to change position Q15 minutes
who is the BCG vaccine contraindicated in?
immunocompromised patients
how long does the patient / nurse need to disinfect the urine of a patient receiving the BCG vaccine?
6 hours
what is sodium bicarbonate given to do?
treat metabolic acidosis
what is the primary adverse reaction to sodium bicarbonate?
bloating
what is the goal of getting sodium bicarbonate?
to slow to progression of CKD, prevent bone loss, and improve nutritional status
what is the route of sodium bicarbonate?
PO
when do you initiate sodium bicarbonate for a patient?
when their HCO3 level is < 15
what is the goal range for HCO3?
18-20
what is the MOA of calcium carbonate?
binds to phosphate
what is the indication for calcium carbonate?
to treat hyperphosphatemia
what is the primary adverse effect of calcium carbonate?
hypercalcemia
what lab levels are important to monitor while a patient is taking calcium carbonate?
calcium levels
when would you instruct a patient to take calcium carbonate?
with meals
what is the indication for calcitrol?
to treat renal osteodystrophy
how does calcitrol work?
stimulates intestinal absorption of calcium and phosphate to help with mineralization in the bones
what is the class of pancrelipase?
pancreatic lipase replacement
what is the indication of pancrealipase?
for reduced secretion of pancreatic enzymes
are side effects common with pancrealipase?
no, they are rare
when would you instruct a patient to take pancrealipase?
with meals and snacks
what is the class for lactulose?
hyper osmotic laxative
what is the MOA of lactulose?
reduces blood ammonia levels by converting ammonia to ammonium to remove it from the body
what is the indication for lactulose?
reduction of ammonia absorption in hepatic encephalopathy
how is lactulose given?
PO or enema / rectal
how is lactulose sometimes titrated?
based on # of stools
lactulose isn’t only given for high ammonia levels - what must the patient have to be able to take this medication?
symptoms of encephalopathy
what lab values must be checked (not ammonia) in the case of lactulose?
potassium
hypokalemia increases or decreases ammonia production?
increases
what is the MOA of rifaximin?
inhibits bacterial RNA synthesis by binding to bacterial DNA
what are the side effects of rifaximin?
peripheral edema, nausea, ascites, dizziness, fatigue, pruritus, skin rash, abdominal pain, anemia
what is the route of rifaximin?
given PO
what should the nurse monitor for when giving rifaximin?
anything that could indicate the development of c . diff
