Exam 2: 35 Questions Flashcards
1
Q
what are Penicillins most common side effect
A
-Most common side effects are GI
2
Q
What is the widest antimicrobial activity medications?
A
Penicillins
3
Q
How long and where do you store penicillin?
A
refrigerator and discard after 14 days
4
Q
Are penicillins given on an empty or full stomach?
A
-Most given on empty stomach (1hrr before or 2hrs after meal)
5
Q
What are the natural penicillins and can they be given for pregnancy?
A
Penicillin G and V and
yes they can be given for pregnancy
6
Q
What is 10% of the population allergic to?
A
Penicillins
7
Q
What are the adverse symptoms of ampicillin?
A
n/v/d, tongue inflammation, hypersensitivity, serum sickness, CNS
reactions
8
Q
Common infections treated with cephalexin (Keflex) include:
A
Middle ear, throat, tonsils, bronchitis, pneumonia, UTIs
8
Q
What does Ampicillin have sensitivity to?
A
Often have sensitivity to other Betalactam Antibiotics (penicillin cousins: cephalosporins, carbapenems, and monobactams)
9
Q
Pre-caution in Cephalosporins for allergy in those who are allergic to what?
A
penicillin
10
Q
What should you eat with Cephalosporins?
A
Eat yogurt, drink buttermilk, or take probiotic supplement to help replace intestinal flora
11
Q
What may interfere with clinitest blood sugar monitoring?
A
Cephalexin (Keflex)
12
Q
What are the Penicillin drug names?
A
-Zosyn
-Timentin
-Augmentin
-Unasyn
-Dynapen
13
Q
Do not drink alcohol within how many hours of dose of Cephalexin (Keflex)?
A
72 hrs
14
Q
Adverse reactions for Cephalosporins?
A
GI, confusion, bleeding, hypersensitivity, serum sickness
15
Q
What is the Monobactam drug?
A
Aztreonam (Azactam)
16
Q
Side/Adverse Effects for monobactams
A
*Thrombophlebitis
–WATCH IV SITE
*watch for Candida albicans
– Prescribe Monistat for vaginal Candida infections
– Prescribe nystatin (Myostatin) for oral Candida infections (thrush)
17
Q
Who can you not give monobactams too?
A
- Do not give to patients who already have a viral infection.
- Contraindicated in lactating mothers
- Pre-caution in those allergic to penicillin or cephalosporin
- Incompatible with most other IV meds
18
Q
What are the Carbapenems drugs?
A
Imipenem/Cilastatin, Meropenem (Merrem)
19
Q
What route can you give monobactams?
A
Only IV and IM injection
20
Q
What are carbapenems used for?
A
Used for life-threatening infections
21
Q
How long should you infuse carbapenems?
A
1 hr
22
Q
What medications should you precaution taking with carbapenems?
A
Pre-caution in those allergic to penicillin or cephalosporin
22
Q
What food can you not give if you’re allergic to it with Vancomycin?
A
corn
22
For vancomycin _____ is best route with the exception of colitis (use _____ for colitis)
IV, oral
23
23
What side effects should you look for with vancomycin? (5 answers)
* Red Person Syndrome
- Hypertension and flushing of the face and trunk
*Ototoxicity
-Hearing loss (can be permanent)
-Determine baseline hearing acuity
*Nephrotoxicity
-Kidney failure
*Very toxic to veins
*administer slowly
24
Tetracycline you can't give with what?
Interact with milk products, antacids, and iron salts
25
Give LOTS of _______ to prevent severe esophageal irritation with tetracycline?
Water
26
what are the side effects of tetracycline? (4 answers)
-GI
- photosensitivity (wear sunscreen/avoid sun)
- hepatic and renal toxicity
- Permanent teeth discoloration (Do not give to those less than 8 years old)
27
does tetracycline have a potential for superinfection?
yes
28
What do you not give for 1 hr before bedtime and cannot lay down for 30mins-1hr after administrations (esophageal reflux)?
tetracycline
29
What drug do you keep away from light?
Tetracycline
30
what are the Macrolides drugs?
Erythromycin, azithromycin, clarithromycin
31
What can you not do with Macrolides? (2 answers)
-Do not crush
-Do not drink with fruit juice
32
Aminoglycosides drug?
Gentamicin
33
How do Aminoglycosides work with pregnancy?
-Crosses the placenta, but not the brain blood barrier
-Do not give if pregnant; can cause congenital total deafness
33
Caution use with aminoglycosides:
-Ototoxicity – can be masked by antiemetics; loop diuretics increase risk
-Peripheral neuropathy – common in diabetics; can’t feel toes, feet, fingers
34
Should you get a peak and trough with aminoglycosides?
Get peak and trough
Peak – draw blood 30 minutes to hour after injection
Trough – draw just before giving next dose
Peak above 12mcg/mL and trough above 2mcg/mL can increase risk of toxicity
35
Fluoroquinolones/Quinolones drugs?
Ciprofloxacin (Cipro) Levofloxacin (Levaquin)
35
What is Fluoroquinolones/Quinolones used for?
Often used in UTIs and URIs (skin, bone, joint infections)
35
Fluoroquinolones/Quinolones adverse effects?
GI, dizziness, photosensitivity (avoid sun)
35
Who is precautioned when taking Fluoroquinolones/Quinolones?
Precaution in older patients and athletes (increased risk of tendinitis or tendon rupture)
36
What 4 things do you need to avoid when taking Fluoroquinolones/Quinolones?
-Wait 6 hours before taking an antacid
-Avoid tasks that require alertness
-Avoid caffeinated products
-Do not breastfeed when taking these medications
37
Sulfonamides drugs?
trimethoprim, Bactrim
38
what is Sulfonamides used for?
UTI's
38
What can Sulfonamides decrease?
Increase hypoglycemic effects of sulfonylureas (can drop blood sugar)
38
What is the alternate for being allergic to penicillin?
Sulfonamides
39
do you need to avoid the sun (Photosensitivity) with Sulfonamides?
Yes
40
Prolonged use of Sulfonamides can lead to
blood disorders such as anemia and low WBC and platelet
40
are Sulfonamides often given topically?
no, (increased hypersensitivity)
40
What turns your urine yellow and permanently stains contact lenses?
Sulfasalazine's
40
Can Sulfasalazine's cause Steven-Johnson syndrome?
yes
41
Antiviral drugs (5 answers)
-Acyclovir (Zovirax) - Treats herpes simplex and herpes zoster
-Ganciclovir (Cytovene) – treats cytomegalovirus (CMV)
-Interferon alfa (Intron A) – treats hepatitis B and C
-Oseltamivir (Tamiflu) – treats influenza
-Ribavirin (Rebetol) – treats RSV
42
Assessment for Anti-Viral (3 answers)
- Baseline vitals and labs (CBC, BUN, serum creatinine, liver enzymes, electrolytes)
- Monitor for superinfection
- May experience gingival hyperplasia (swollen, red gums) and oral hygiene is key
43
What 4 things so you need to know about Acyclovir (Zovirax)?
-IV=hydrate
-oral=vertigo
-Labs: CBC, BUN
-Gingival (swollen gums)
44
-Azoles can cause when in men?
breast in men
45
Antimalarial drugs?
Chloroquine
46
Chloroquine
Side/Adverse Effects:
-Visual symptoms
o Blurred vision, night terrors, photophobia
- N/V/D
47
For travelers how do you take Chloroquine?
take a 500mg tablet once weekly for 1-2 weeks before traveling, during travel,
and for 4 weeks after
48
Acute attacks what dosage do you take Chloroquine?
1g orally and then taper dose at 6 hours, 24 hours, and 48 hours
49
Antiparasitic drug?
Metronidazole
50
Metronidazole side/Adverse Effects (6 answers)?
-N/V/D
-Some patients will have a metallic taste
- Mild to moderate CNS symptoms (headache, vertigo, ataxia)
- Severe CNS symptoms (seizures, peripheral neuropathy)
- Darkening of the urine (harmless)
-Superinfection with Candida
51
Antifungal drugs
Azoles & Polyenes
Amphotericin B (Fungizone), Ketoconazole (Nizoral), Fluconazole (Difulcan)
52
What things do you need to know about Amphotericin B? (4 answers)
-(Fungizone) is known for renal toxicity (very common 80%; can be permanent
or temporary) BUNS AND CREATINE TESTS!
-give test dose
- give up to 8 weeks
-swish and swallow Nystatin
53
Ketoconazole (Nizonal) things you need to know (3 answers)
-decrease in sexual hormone synthesis
- oral= give w/ water, tea, coffee, juice
-Patient w/ chlorhydria give 4ml of HCL through straw
54
oral suspension used for thrush.
Nystatin (Myostatin)
55
Terbinafine is used for
fungal infections of fingernails or
toenails.
56
What is the #1 drug for c-diff?
Metronidazole
57
What can you not give with chloroquine?
lemon juice
58
What vitamin should you take with metronidazole?
B6
59
what disease does chloroquine treat?
Malaria
60
What drug anti fungal can cause gynecomastia (breast development in men)?
Ketoconazole (Nizoral)
61
What labs do you run for Ketoconazole (Nizoral)?
ALT and AST
62
What instructions do you educate a patient with inhalers? (3 answers)
-Wait 1-2 minutes between puffs for same inhaler
-Wait 2-5 minutes between puffs from different inhalers (always take rescue first)
-Rinse mouth after use of nebulizer/inhalers to prevent thrush and help with taste
63
Xanthenes drug?
Theo-24
63
What foods do you minimize when taking Theo-24?
xanthine foods (colas, coffee, chocolate)
63
Theophylline Therapeutic blood level = 5-15mcg/mL. What happens if it is higher?
Adverse cardiac effects frequently seen with levels above 30 mcg/mL
Seizures can be seen with levels above 40 mcg/mL
64
What three things do you need to teach with Advair?
- Oral fungal infections such as thrush, so they need to rinse mouth out after using
- may cause boneless in children
- has a sugar increase
64
Inhaled Corticosteroids is what drug?
Advair
65
What is the drug for Leukotriene Modifiers?
Montelukast (Singulair)
66
Montelukast (Singulair) is used to prevent what?
Asthma attacks
67
does Montelukast (Singulair) start working fast?
no, takes about two weeks to work
68
Why can'tyou take Montelukast (Singulair) if you have an allergy to what?
Lactose
69
Singular has the most common side effect of what?
Heartburn
70
Side effects of singular? (5 answers)
Headache, nausea, diarrhea, suicidal ideation, depression
71
Singular is hard on what organ?
Liver (labs ALT and AST)
72
What are the Antihistamines first gen meds? (3 answers)
Diphenhydramine (Benadryl)
Promethazine (Phenergan)
Dimenhydrinate (Dramamine)
73
What is Diphenhydramine (Benadryl) used for?
Used for anaphylaxis, allergic rhinitis, Parkinson’s, insomnia, itching, hay fever
74
May experience gingival hyperplasia (swollen, red gums) and oral hygiene is key is pertaining to what class of drugs?
Anti-viral
74
What is Promethazine (Phenergan) used for?
More for nausea and vomiting instead of allergies
o Often used as adjuvant with pain med post-op
75
what is Dimenhydrinate (Dramamine) used for?
-Used primarily for motion sickness
-Can cause dry mouth symptom
76
What drug can cause paradoxical excitation in children?
Dimenhydrinate (Dramamine)
76
What drugs do you discontinue 72 hours before a skin test?
Dimenhydrinate (Dramamine) and Benadryl
77
Is Promethazine (Phenergan) given IV?
Not given IV much anymore due to risk of improper dilution and pushed too fast
78
What syndrome are at risk for when you take Promethazine (Phenergan)?
Neuroleptic Malignant Syndrome
78
What are the Second Generation Antihistamines?
Loratadine (Claritin)
Cetirizine (Zyrtec)
78
Is it better to give an elderly person a 1st or 2nd generation antihistamine?
2nd generation because it does not cause as much sedation
79
What would you give a patient with rhinitis?
Zyrtec
80
What are the nasal decongestants?
Phenylephrine (NeoSynephrine, Neofrin), Ephedrine, Pseudoephedrine (Sudafed)
81
How many days can you take Afrin?
Use no more than 3 days at a time to prevent rebound congestion
82
What can Afrin cause?
Can cause nervousness, caution in those with high heart rate or cardiac problems
83
Ipratropium (Atrovent) side effects?
Side effects: sore throat, nasal dryness/irritation
o Can’t see, can’t pee, can’t spit, can’t shit
84
can Ipratropium (Atrovent) be used long term?
Can be used long term; does not cause rebound congestion
85
What do you do with Ipratropium (Atrovent) before using it for the first time?
Prime it by spraying 7 times
86
can Fluticasone (Flonase) be used long term?
Approved for longer period of time; but takes longer to work than Afrin
86
What is the side effect with Fluticasone (Flonase)?
decreased growth in long term use by children (steroid)
86
do you need to drink a lot of liquids with Guaifenesin (Mucinex)?
Yes 2-3L a day
87
Expectorants drug?
Guaifenesin (Mucinex)
87
Guaifenesin (Mucinex) is used for what kind of cough?
productive coughs
88
what is the difference in the liquid and the pill Guaifenesin (Mucinex)?
Liquid has a short half life; repeat dosing
88
Anti-Tussives are used to stop what?
stop a non-productive cough
89
What are the Anti-Tussives? (1 opioid and 3 non-opioids)
opioid= Codeine
non-opioid= Dextromethorphan (Robitussin), Benzonatate (Tessalon Perles), Diphenhydramine
(Benadryl)
89
What anti-tussive causes euphoria in high doses?
Dextromethorphan (Robitussin)
89
What is the antidote for acetaminophen poisoning?
Acetylcysteine (Mucomyst)
89
What do you give 15mins before activity to prevent activity induced asthma?
Cromolyn (Intal)
89
Who can you not give Acetylcysteine (Mucomyst) to?
someone with asthma
90
What smells like rotten eggs other than Braxtons feet?
Acetylcysteine (Mucomyst)
91
What organ is Acetylcysteine (Mucomyst) hard on?
Liver
92
What Increases the effectiveness of Albuterol?
Inhaled Corticosteroids
92
What do mucolytics do?
thins down mucus to get rid of secretions
92
Can you mix gentamicin with other IV drugs?
no
93
What is used for life threatening infections and needs to be infused over an hour?
Carbapenems
94
Tb drugs?
Isoniazed
Rifampin
Ethambutol
95
what are the side effects of Rifampin?
-red/orange body fluids
-oral contraceptives are less effective
96
what are the side effects of Isoniazid? (2 answers)
-Neuropathy
-Liver Toxic (jaundice, give B6 and no alcohol)
97
what is the main side effect of Ethambutol?
Eye issues (get eye exams)
98
what are the signs of COPD Emphysema "pink puffer"?
Dyspnea at rest
weight loss
prolonged expiration
barrel chest
98
What are the signs of Chronic Bronchitis "blue bloater"?
Blue skin
long term cough
crackles and wheezes
edema
99
What precautions is TB?
Airborne
100
What food do you avoid with Isonazid?
Tyramine
101
Side effects of TB?
Night sweats
weight loss
Blood tinged sputum
