Exam 2 Review: Goldstein Flashcards
5 non-pharmocological interventions for insomnia
- exercise
- decrease noise
- dim the lights
- decrease temp
- reduce screens
- reduce stim
- reduce caffeine
- reduce alcohol
- reduce nicotine
what are 2 drugs from 2 different classes, used for both depression and insomnia
- doxepin
- trazodone
2 drugs for insomnia and anxiety
- lorazepam
- hydroxyzine
2 OTC medications for insomnia
- benadryl
- melatonin
3 drugs from 3 different classes for insomnia that are controlled substances
- zolpidem
- suvorexant
- lorazepam
what is rebound insomnia
- abruptly stopping insomnia medication/discontinuation of benzodiazepines
s/s: sleeplessness, worsening anxiety
first line treatment for depression and anxiety
SSRI
(selective serotonin reuptake inhibitors)
SSRI drugs
- sertraline
- fluoxetine
- escitalopram
- citalopram
- paroxetine
name 3 PRN (as needed) drugs for anxiety
- beta blockers
- antihistamines
- benzodiazepines
3 classes used for daily anxiety
- SSRI
- SNRI
- TCA
name at least 3 different types of anxiety
- generalized
- social
- OCD
- PTSD
- test anxiety
what is a drug class used for physical symptoms of anxiety
beta blockers
name at least 4 education points for a patient prescribed with SSRIs
- do not stop Rx abruptly
- you may experience weight gain
- wait weeks for Rx benefits
- may have increased appetite
- women may experience sexual dysfunction
- still need therapy when taking
SSRI help men with
premature ejaculation
some side effects of taking tricyclic antidepressants
- ECG changes
- CNS depression
- orthostatic hypotension
what are some patient education points specific to phenelzine (hint: MAOI)
must be educated to avoid foods containing tyramine
what drug class inhibits the uptake of norepinephrine
MAOIs
2 primary neurotransmitters related to depression
- serotonin
- norepinephrine
2 screening tools for depression
- PHQ2 (first step approach)
- PHQ9 (further evaluation for PHQ2 positive results)
2 drug classes that do the same thing and works two different ways
- SNRI
- TCA
what 3 drugs can we use for the treatment of bipolar disorder
- lithium
- valproic acid
- chlorpromazine
what lab values should we monitor for lithium?
what do we need to look out for?
- lithium levels
- thyroid
- sodium level
name at least 4 second gen antipsychotics
- aripiprazole
- lurasidone
- olanzapine
- quetiapine
- risperidone
- ziprasidone
name 2 medications for antipsychosis first and second gen
1st gen: haloperidol
2nd gen: ziprasidone
compare first gen and second gen antipsychotics (second gen advantage)
second gen has less side effects such as EPS (extrapyramidal sxs) and NMS (neuroleptic malignant syndrome)
what drug do we use to treat EPS?
benzitropine
what drug do we use to treat NMS
dantrolene
what are extrapyramidal sxs (EPS)
- dystonia
- parkinsonism
- akathisia
- tardive dyskinesia
what are neuroleptic malignant syndrome (NMS) symptoms
- LIFE THREATENING
- severe muscle rigidity
- confusion
- agitation
- increased temperature, pulse and BP
what is the cause of serotonin syndrome
taking multiple serotonin medications
- too much serotonin in CNS
what are SNRIs used for in addition to mental health disorders
- neuropathic pain
- migraine prevention
what is the most common cause of schizophrenia medication to not work
medication compliance
how to help increase medication compliance
direct observation therapy (DOT)
what is the 1st line agent for ADHD
- methylphenidate or
- amphetamine
what is the treatment of narcolepsy
modafinil
(non-amphetamine stimulant)
what is the best choice treatment for ADHD with history of drug abuse
atomoxetine
effects of amphetamine and amoxitine
- weight loss
- staying awake
BB warning for benzos
- high risk abuse
- dependence
5 uses for benzodiazepines
- muscle relax
- sedation
- seizure
- anxiety
- insomnia
how long should pt expect to continue anti-depression medication
at least 6 months
which insomnia medication is considered safe to take long term
remeltione
what is the BB warning for olanzapine
not use for dementia related to psychosis
what is the BB warning for duloxitine
risk for suicide
name 2 drug classes that work by inhibiting bacterial cell wall synthesis
- penicillin
- cephalosporin
what is an important patient education point for rifampin
it may change bodily fluids orange or red
name two cephalosporins
- cefazolin
- ceftriaxone
- cefepime
drug class antibiotics only used o resistant infection
oxazolidinones
what is pyrethrin used for
- scabies
- lice
what are some patient education points for pyrethrin
scabies:
- the entire body should be covered, excluding mucous membranes, and left covered for 8-4 hours
lice:
- wash hair, apply product and leave on for ten minutes, remove nits with nit comb
what drug class is pyrethrin
pediculossides
what are 2 drugs used for TB not not prophylactic
- pyrazinamide
- ethambutol
how do vaccines work
dead pathogens or antigens are injected into the body
- they do not cause disease
- they do stimulate the production of memory cells
- do not make you sick
name at least 5 diseases we have vaccinations against
- varicella
- hep B
- flu
- covid
- TB
- HPV
- HAV
- pneumonia
- tetanus
- measles
- mumps
- etc.
common place for vaccine administration
IM
(intramuscular)
what medication is used for severe fungal infection
amphotericin
what is interferon used for
severe viral infection
(i.e. hep B virus, certain cancers)
interferon adverse effects
flu like symptoms
what is antibiotic resistance
- the more the antibiotic is used, the less effective it becomes
- antibiotics kill harmful illnesses causing bacteria to the body
- with frequent exposure however, bacteria can build up resistance to antibiotics
- pathogen mutates and becomes resistant
what 2 pathogens are resistant to 2 specific antibiotics
- enterococci: resistant to vancomycin
- staphylococcus aureus: penicillin
what principle combats antibacterial resistance?
what is the global approach to address antibiotic resistance?
antimicrobial stewardship
what is antimicrobial stewardship
- match the drug to the bug
- use narrow spectrum ABX when possible
- educate patient to finish Rx
- advocate for pt
- ask if they need work or school note to prevent infection
name 5 pathogens
- bacteria
- viruses
- fungi
- protozoans
- parasites
- helmetics
patient has mild allergic reaction to amoxicillin
can we prescribe ampicillin
No
what pathogen would be killed off by re-administering tazobactam
none
- beta lactam inhibitor does not kill off pathogen, does not treat disease
what would i be most concerned about with pt taking levofloxacin
tendinitis
what are 2 drugs from two different classes that are teratogenic
- aminoglycosides
- vancomycin
3 drugs from 3 different classes that end in -mycin
- azithromycin
- vancomycin
- tobramycin
common drug class used as alternative for those allergic to penicillin
macrolides
what are 3 classes of antibiotics that are protein synthesis inhibitors
- macrolides
- oxazolidinones
- aminoglycosides
what is one patient education point for tetracyclines
take on empty stomach
what drug should you take with food
penicillin
2 drug classes (abx) that we learned, that are only IV
- carbapenems
- aminoglycosides
3 drug classes that fall under antiretroviral pharmaceuticals
- NRTI
- NNRTI
- protease inhibitors
3 patient education points for someone undergoing antiretroviral therapy
- dont miss dose
- stay on it for the rest of your life
- take as prescribed
- miss 1-2 doses then you will become resistant
- get frequent testing for HIV RN and CO4 count
what 2 drugs are in augmentin
- amoxicillin
- clavulanate
what 2 drugs are in descovy
- emtricitabine
- tenofovir
- alafenamide
what 2 drug classes are considered nephrotoxic
- amphotericin
- aminoglycosides
what test would a provider most likely monitor with a patient taking isoniazid
- CMP (ALT, AST)
- culture and sensitivity
most common concern with patient taking levofloxacin
- tendonitis
- tendon rupture
common side effect with someone taking penicillin
upset stomach
name 4 drug/classes that are used prophylactically
- tenofovir
- antimalarial
- isoniazid
- cipro
first line agent for pt with lower UTI
nitrofurantoin
what medication helps with the outbreak of shingles
acyclovir
- must be taken 72 hours
what would you ask any patient prior to administration
do you have any allergies?
what is “ripe”?
4 drug cocktail for TB
R: rifampin
I: isoniazid
P: pyrazinamide
E: ethambutol
