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old Sophomore cards > Drugs for UTI & Oral Contraceptives > Flashcards

Drugs for UTI & Oral Contraceptives Flashcards

0
Q

Urinary antiinfectives

A

Nitrofurantoin (furadantin, macrodantin)

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1
Q

Bacteriostatic, bactericidal

A 
Urinary antiinfectives
Sulfonamides
Fluoroquinolones
Penicillins
Third generation cephalosporins
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2
Q

Sulfonamides

A

Trimethoprim-sulfamethoxazole (bactrim)

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3
Q

Fluoroquinolones

A

Nalidixic acid (NegGram) ciprofloxacin (cipro)

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4
Q

Third generation cephalosporins

A

Cefixime (maxipime)

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5
Q

Treats gram positive and negative

A

Nitrofurantoin (macrobid)

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6
Q

What does nitrofurantoin (macrobid) inhibit?

A

Bacterial enzymes and metabolism

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7
Q

Side effects of nitrofurantoin (macrobid)

A

Dizziness, HA, drowsiness, rust colored or brown urine, rash, pruritus, GI distress, superinfection, peripheral neuropathy, hepatotoxicity, Steven Johnson syndrome, blood dyscrasias

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8
Q

Nursing interventions for nitrofurantoin (macrobid)

A

Take with food, avoid antacids, don’t crush or open capsules, shake liquid suspension, rinse mouth after taking, don’t drive or operate dangerous equipment, INCREASE Fluids, cranberry juice, plums, protein, and vit C

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9
Q

Urinary antiinfective that treats chronic UTI and is bacteriocidal

A

Methenamine hippurate (hiprex)

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10
Q

What is methenamine hippurate (hiprex) effective for?

A

Pseudomonas and E. coli

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11
Q

Caution for methenamine hippurate (hiprex)

A

Not to be taken with sulfonamides because it may cause crystalluria

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12
Q

Client teaching for methenamine hippurate (hiprex)

A

Consume acidic foods and fluids

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13
Q

Urinary analgesic, relieves pain, burning sensation, frequency, urgency

A

Phenazopyridine (pyridium)

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14
Q

Side effects of phenazopyridine (pyridium)

A

GI upset, red-orange urine, blood dyscrasia, nephrotoxicity, hepatotoxicity

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15
Q

Urinary stimulant / treat hypotonic bladder

A

Bethanechol (urecholine)

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16
Q

Action of bethanechol (urecholine)

A

Increases bladder tone of detrusor muscle

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17
Q

Contraindication of bethanechol (urecholine)

A

Peptic ulcer

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18
Q

Side effect of bethanechol (urecholine)

A

GI distress, dizziness, fainting

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19
Q

Urinary antispasmodic

A

Oxybutynin (ditropan)

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20
Q

Action of oxybutynin (ditropan)

A

Direct action on smooth muscles to relieve spasms

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21
Q

Side effects of oxybutynin (ditropan)

A

Drowsiness, tachycardia, dizziness, fainting, blurred vision, dry mouth, constipation

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22
Q

Caution for oxybutynin (ditropan)

A

Avoid in narrow-angle glaucoma, cardiac, renal, hepatic, prostate problems

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23
Q

Urinary antimuscarinics

A

Tolterodine tartrate (detrol)

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24
Q

Action of tolterodine tartrate (detrol)

A

Control overactive bladder

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25
Q

Side effects of tolterodine tartrate (detrol)

A

Drowsiness, tachycardia, dizziness, fainting, blurred vision, dry mouth, constipation

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26
Q

Caution for tolterodine tartrate (detrol)

A

To be avoided of client has narrow angle glaucoma or cardiac, renal, hepatic, prostate problems

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27
Q

PDE5 inhibitors

A

Levitra, cialis, Viagra

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28
Q

Taken for erectile dysfunction/improves blood flow to penis

A

PDE5 inhibitor

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29
Q

When do you take PDE5 inhibitor

A

30 min prior to sex, lasts several hours

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30
Q

Caution PDE5 inhibitor

A

Not for pts taking nitrates

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31
Q

Side effect of PDE5 inhibitor

A

Stuffy nose and headache

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32
Q

A client with a lower UTI has been prescribed nitrofurantoin. What side effect would nurse teach client to expect?

A

Brown, discolored urine

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33
Q

A client entering the med clinic has been diagnosed with overactive bladder. Which med would nurse expect to be ordered?

A

Tolterodine tartrate (detrol)

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34
Q

Combined hormone contraception

A

Contain a synthetic version of estrogen and a compound known as progestin

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35
Q

Most commonly used estrogen

A

Ethinyl estradiol

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36
Q

Older form of estrogen found in higher dose oral combination products

A

Mestranol

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37
Q

Derivative of the steroid testosterone and have progesterone like effects

A

Progestin

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38
Q

What dose do you use for contraception?

A

The lowest effective dose that successfully prevents conception should be used

39
Q

What is the action of the estrogen component of combined hormone contraceptive?

A

Inhibits ovulation by preventing the formation of a dominant follicle which inhibits stimulation of luiteinizing hormone.

40
Q

Action of progestin component

A

Suppresses LH surge, makes cervical mucus thick and hostile to sperm penetration. Ovulation inhibited, pregnancy does not occur.

41
Q

Oral contraception absorption and metabolized

A

Ingested daily, absorbed by gastrointestinal tract and metabolized by liver

42
Q

Combined oral contraceptive effective rate

A

98% accounting for user error

43
Q

Increased estrogenic activity side effects

A

Cyclic breast changes, dysmenorrhea, menorrhagia (heavy periods), chloasma (hyper pigmentation of skin), and VTE, nausea, vomiting, edema, leg cramps, hypertension

44
Q

Side effects of decreased estrogenic activity

A

Amenorrhea and spotting, dyspareunia (painful sex) and nervousness

45
Q

Side effects of increased progestational activity

A

Breakthrough bleeding (BTB) and headaches, increased appetite, weight gain, oily skin and scalp, acne, excess hair growth, decreased breast size

46
Q

When does Breakthrough bleeding occur?

A

Active pill cycle of combined oral contraceptives (COC). More common at start of COC use and when women changes COC type of pill

47
Q

What do majority of women on COC products experience

A

Shorter, lighter periods, decreased blood loss, decreased uterine cramps, elimination of mittelschmerz, reduces incidence if pelvic inflammatory disease

48
Q

Three types of COC

A

Monophasic, biphasic, and triphasic

49
Q

Fixed ratio of estrogen to progestin throughout cycle

A

Monophasics

50
Q

Amount of estrogen is fixed but amount of progestin varies

51
Q

Reduced in first half to provide proliferation of endometrium and increased in second half to promote secretory development of endometrium.

A

Biphasic, this simulates normal process of menstruation with no ovulation.

52
Q

Newest COC/amount of either estrogen or progesterone varies throughout cycle in different ratios during three stages.

53
Q

How are COC packaged?

A

21 day or 28 day tablet packs

54
Q

21 days of active pill followed by 7 pill free days

A

21 day pack

55
Q

21 days of active pill followed by 7 days of inert or counter pills

A

28 day package

56
Q

When is pseudomenstruation or withdrawal bleeding?

A

During hormone free period while taking counters or during 7 day pill free period

57
Q

What is withdrawal bleeding caused by?

A

Level of estrogen and progestin decreases allowing for breakdown of endometrial lining

58
Q

Continuous dosing COC products

A

91 day regimen/84 days active pill, and 7 days of inert pills

59
Q

For continuous COC how often is there withdrawal bleeding?

A

4 times a year

60
Q

Who may benefit from continuous COC?

A

Women with menstrual disorders such as menorrhagia (heavy period), metrorrhagia (irregular bleeding between periods), endometriosis, dysmenorrhea, PMS, and ovarian cyst formation.

61
Q

What increases the risk of circulatory disorders?

A

Estrogen component

62
Q

First day start method

A

Contraception product initiated first day of menstruation. No backup method needed (condoms or diaphragm)

63
Q

Sunday start method

A

Start contraception on Sunday following first day of menstruation or on Sunday if menstruation starts that day. Use backup if started after day 5 of menstruation.

64
Q

Quick start method

A

Start day receive prescription. Use back up method for 7 days if started after day 5 of menstruation.

65
Q

Miss one tablet of COC product

A

Take tablet as soon as realized

Take next pill as scheduled

66
Q

Miss two tablets of COC

A

Take 2 tabs for 2 days with next tab as scheduled

Use back up method of contraception for rest of cycle

67
Q

Miss 3 tab of COC

A

Discontinue present pack and allow for withdrawal bleeding. Start a new pkg of tablets 7 days after the last tab was taken. Use another form of contraception until tabs have been taken for 7 consecutive days.

68
Q

Miss one or more tabs of progestin only products

A

Take tab as soon as realized and follow with next tablet at regular time, PLUS use backup method for 48 hrs

69
Q

Contraception with no estrogen

A

Progestin-only contraception

70
Q

Advantages of progestin only

A

Safe, ease of use, spontaneity of sexual intercourse and reversibility.

71
Q

Disadvantages to progestin only

A

Higher incidence of irregular bleeding and spotting and possibility of depression, mood changes, and fatigue.

72
Q

Progestin only oral contraceptive pill four mechanisms of action

A

1) alteration in cervical mucus, making thick and viscous, blocking sperm
2) interference with the endometrial lining, making implantation difficult
3) decreased peristalsis in Fallopian tubes, slowing transport of ovum
4) in 50% of cycles, interference with LH surge inhibiting ovulation

73
Q

Side effects of progestin deficiency

A

Dysmenorrhea, bleeding late in cycle, heavy menstrual flow with clots, or amenorrhea

74
Q

How long should a women in transitional period of menopause take contraceptives?

A

Until menstruation has ceased 1 year

75
Q

Natural alternatives for menopause

A

Soy, isoflavones from soy, Actaea racemosa or black cohosh, vitamin E, evening primrose

76
Q

What do natural alternatives treat for menopause?

A

Menopause symptoms especially hot flashes

77
Q

Bioidentical hormone therapy for menopause

A

Estrogen-like compounds that have been derived from plants. Most common is soy and Mexican yam root.

78
Q

What are the most commonly commercially available compounds?

A

Estrone, estradiol, estriol, testosterone, and micronized progesterone

79
Q

Benefits of bioidentical hormones

A

Limited side effects, reduced risk of exacerbating the growth of bread cancer cells, equal osteoporosis prevention benefits, decrease in cardiovascular effects

80
Q

Two commonly prescribed bioidentical products

A

Tri-est and Bi-est

81
Q

What do estrogen and progestin do in hormone therapy

A

Estrogen relieves symptoms of menopause while progestin protects uterine endometrium from hyperplasia

82
Q

What forms are hormone therapy available?

A

Oral preparations, transdermal applications, and vaginal preparations

83
Q

Types of vaginal preparations

A

Creams, suppositories, pellets, or rings. Only secrete estrogen

84
Q

Three types of estrogen used in hormone therapy

A

Natural, conjugated equine estrogens (CEE) and synthetic

85
Q

Where is estrogen absorbed and metabolized?

A

Absorbed in GI tract and metabolized by liver necessitating daily doses when oral products are nonesterified

86
Q

Drug used for benign prostate hyperplasia

A

5-alpha-reductase inhibitors and alpha-adrenergic blocking agents

87
Q

Side effects of 5-alpha-reductase inhibitors

A

Decreased libido and erectile dysfunction

88
Q

Side effects of alpha-adrenergic blocking agents

A

Hypotension, dizziness, fatigue

89
Q

What must you consider before giving an alpha-adrenergic blocking agent to a client?

A

It also is used to control blood pressure, so to prevent hypotension ask client for list of their meds before adding another antihypertensive drug

90
Q

Drug to treat poly cystic ovarian syndrome

A

Metformin. It treats insulin resistance, regulates menstrual period and increases possibility of ovulation

91
Q

Pharmacological management of endometriosis

A

Combined hormone contraceptive products, progestational products, gonadotropin inhibitors and Gn-RH agonists,

92
Q

Herbal treatment of PMS

A

Vitamin B6 and increased calcium and chaste berry

93
Q

Antidepressants and anti anxiety Meds for PMS

A

SSTI Meds: Prozac, Zoloft, Paxil, and celexa

For severe: Xanax, Valium, BuSpar, and Ativan

94
Q

Hormonal therapy for PMS

A

Progesterone, medroxyprogesterone acetate,

Long term: orthoevra and nuvaring

old Sophomore cards (28 decks)

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