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Pharmacology-NRSE-3010-001 > Exam 3 > Flashcards

Exam 3 Flashcards

1
Q

What is essential in TB medication administration, regardless of how the patient feels?

A

encourage completion of full course of meds to avoid multi-drug resistant TB, as well as revival of bacteria

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2
Q

What is DOT? Why is it used?

A

DOT: Directly observed therapy (watch pt take meds); it decreases resistance and improves cure rates

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3
Q

What is INH?

A

Isoniazid, an antitubercular drug

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4
Q

A patient receiving INH (isoniazid) for tuberculosis reports anorexia, malaise, fatigue, jaundice, and nausea. What might these indicate?

A

hepatitis

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5
Q

What are the most common adverse effects associated with the use of INH?

A

hepatitis and peripheral neuropathy

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6
Q

Your patient is taking RIPE (Rifampin, Isoniazid, pyrazinamide, ethambutol) for active TB. He comes in today & says “My contact lenses have turned red.” Which med caused it?

A

rifampin

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7
Q

What can be taken with INH (Isoniazid) to prevent peripheral neuropathy?

A

B6 (pyridoxine)

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8
Q

A 32 yo is taking RIPE. In addition to LFT, what else should be done for this patient? Why?

A

Ophthalmology exam
Patients receiving ethambutol should have baseline and periodic eye exams because of the drug’s risk of inducing optic neuritis.

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9
Q

Your patient has been prescribed RIPE. He protests to taking so many meds. What would be the best action for the nurse to take?

A

Explain the rationale for multi-drug therapy.

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10
Q

Patient education about INH should include limiting the intake of what examples of foods?

A

fish, avocados, and chocolate
Avocados and chocolate are high in tyramine and may cause hypertension. Tuna fish is high in histamine and may cause headache, palpitations, hypotension, or other reactions.

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11
Q

What action should be taken to minimize the adverse effects from INH (isoniazid), the nurse should monitor?

A

AST and ALT levels
these are liver enzymes and indicate liver functioning. Because hepatitis and other liver problems frequently are
adverse effects of INH, these enzymes should be monitored closely

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12
Q

What is amphotericin B used in the care of patients for?

A

a serious systemic mycotic disease; fungal infection

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13
Q

What do patients receiving amphotericin B have the greatest risk for the development of?

A

nephrotoxicity

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14
Q

Nystatin, an antifungal drug nearly identical to amphotericin B, is indicated for the treatment of what?

A

oral, cutaneous, mucocutaneous, or vaginal candidiasis

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15
Q

Before initiation of amphotericin B therapy, what patient teaching should you do?

A

“Many pts have a reaction to this med. I will premedicate you to diminish the risk.

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16
Q

You are to admin the 1st dose of amphotericin B for a systemic fungal infection. Before beginning the infusion, you should

A

administer an antipyretic, such as acetaminophen, assess vitals, and administer test dose

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17
Q

Your patient has had several ABX and now has oral thrush. How should you help her take it?

A

have the patient swish the suspension in her mouth before swallowing it

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18
Q

What is expected to occur with body fluids of those taking rifampin?

A

orange color

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19
Q

What is common among all antitubercular medications (Rifampin, Isoniazid, pyrazinamide, ethambutol)?

A

hepatotoxicity, require LFTs (liver function tests), contraindicated in liver disease, and should avoid alcohol

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20
Q

what refers to an antibiotic that affects many microorganisms?

A

broad spectrum

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21
Q

What labs should be taken prior to administering antibiotics?

A

culture and sensitivity

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22
Q

How much fluid intake should patients on sulfonamides maintain? Why?

A

1.5 L/day to prevent crystalluria

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23
Q

What syndrome can occur if vancomycin is infused too rapidly?

A

Red man Syndrome

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24
Q

What are high risk effects that may occur with vancomycin?

A

ototoxicity and nephrotoxicity

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25
Q

What is an adverse effect of tetracyclines?

A

photosensitivity

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26
Q

What is a primary concern of penicillin?

A

allergic reactions

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27
Q

What is the black box warning for lincosamides?

A

severe possible fatal colitis

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28
Q

What effects may occur with fluoroquinolones (ciprofloxacin)?

A

achilles tendon rupture, arthropathy, superinfection, crystalluria, and hypersensitivity reactions

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29
Q

What kind of drugs are macrolides?

A

antibacterials

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30
Q

Why should those on cephalosporins avoid alcohol?

A

disulfiram-like-reaction

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31
Q

What should people allergic to penicillin wear?

A

medical alert ID

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32
Q

What drug may be used to treat UTIs that causes brown urine color?

A

nitrofurantoin

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33
Q

What is the prototype drug for cephalosporins?

A

cefazolin

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34
Q

What is bacteria present in the blood known as?

A

bacteremia

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35
Q

What is fluconazole (a triazole-broad spectrum fungistatic agent) often used to treat?

A

vaginal yeast infections

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36
Q

What may occur with urine while on -azole medications (broad spectrum fungistatic agents)?

A

dark colored

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37
Q

Acyclovir is an anti-viral medication used to treat?

A

chickenpox, shingles, herpes

38
Q

What is an often irreversible adverse effect of ciprofloxacin?

A

arthropathy

39
Q

What pregnancy category is isotretinoin?

A

Category X

40
Q

What TB medication causes orange discoloration of body secretions?

A

rifampin

41
Q

What TB medication may cause visual issues?

A

ethambutol

42
Q

Drugs ending in -thromycin, such as azithromycin are within what class?

A

macrolides

43
Q

A 25 year old female is prescribed isotretinoin for acne, what is a critical patient education point that the nurse should make?

A

avoid pregnancy, as this will cause birth defects. Monthly pregnancy tests. 2 tests before being prescribed.

44
Q

What is tamoxifen used in the treatment of?

A

breast cancer

45
Q

What are adverse effects of tamoxifen?

A

Endometrial cancer/vaginal bleeding, thromboembolisms/blood clots, menopause symptoms(hot flash, decreased libido, vaginal dryness), hypercalcemia, N/V

46
Q

What medication stops growth of breast cancer cells by blocking estrogen?

A

Tamoxifen

47
Q

What are the indications for hydroxyurea?

A

leukemia, ovarian, sickle cell anemia, and squamous cell cancer

48
Q

What are the indications for nitrofurantoin?

A

urinary tract infection (UTI) & cystitis (bladder infection)

49
Q

Bactericidal are drugs that:

A

Kill bacteria

50
Q

How do bacteriostatic drugs work?

A

inhibit bacterial growth

51
Q

What causes drug resistance? What can this lead to?

A

Overuse and not taking full course of prescribed medications. It makes the infection difficult to treat.

52
Q

This is a type of secondary infection that occurs following the disturbance of the body’s normal flora, such as after raking broad spectrum antibiotics.

A

superinfection

53
Q

What is culture? What is sensitivity?

A

defines the type of bacteria. Describes what drugs can treat it

54
Q

What should those with an allergy to penicillin wear?

A

medical allergy alert bracelet

55
Q

What should be assessed before giving cefazolin?

A

allergy to penicillin

56
Q

Fatal colitis is the black box warning for what medication?

A

Clindamycin

57
Q

If a patient were to develop Steven Johnson’s syndrome while taking TMP-SMZ (trimethoprim sulfamethoxazole, a sulfonamide), what may their initial symptoms be?

A

flu-like symptoms (fever, malaise, fatigue, coughing)

58
Q

What patient teaching should be given for a patient on a macrolide, such as fidaxomicin?

A

report diarrhea/hearing changes/superinfection (white-cheesy discharge), take probiotic to prevent C. diff., finish full regimen, 2hr before/after antacids, avoid sun, barrier method for birth control

59
Q

what is pseudomembranous colitis?

A

c. diff

60
Q

Because of their robust nature, what must be received prior to giving clindamycin/lincomycin?

A

sensitivity (it is only given when we know that it is necessary for the specific bacteria)

61
Q

What are the adverse effects of lincosamides (clindamycin)?

A

c.diff (diarrhea), rash, fatal colitis

62
Q

what type of drugs end in -floxacin/-xacin (ex. ciprofloxacin)?

A

fluoroquinolones

63
Q

What are the nursing considerations for ciprofloxacin?

A

teach Pt to: avoid sun, avoid caffeine, avoid strenuous exercise (excess pressure on tendon) ;report superinfection signs, tendon/muscle pain.
monitor kidney function. 2L fluid/day

64
Q

What are the indications for metronidazole?

A

vaginal trichomoniasis, giardiasis (diarrheal disease), H. pylori, and C. diff

65
Q

What is a common effect of metronidazole?

A

dark/red-brown urine

66
Q

Because of its risk for a disulfiram like reaction (facial flushing, nausea, vomiting, sweating), patients taking metronidazole should avoid:

A

alcohol

67
Q

what action should be taken following the administration of liquid nitrofurantoin due to the risk of teeth staining?

A

rinse mouth

68
Q

What must female patients who are of child-bearing age sign prior to being prescribed isotretinoin?

A

I-pledge (a statement of agreement to get pregnancy tests before and during medication, as well as to using 2 forms of contraception)

69
Q

What may be the emotional effect of isotretinoin?

A

depression/suicidal thoughts

70
Q

Why should individuals taking sulfamethoxazole increase their fluid intake?

A

prevent crystalluria

71
Q

What medication may cause patients to experience a metallic taste and discolored urine?

A

metronidazole

72
Q

Metallic taste, brown urine, Steven-Johnson, disulfiram-like reaction, and neuro/CNS toxicity are possible effects of which drug?

A

metronidazole

73
Q

This drug can be used in the treatment of vaginal trichomoniasis, giardiasis, helicobacter pylori and C.diff:

A

metronidazole

74
Q

What drug may be used in the treatment of the following: UTI, pneumocystis carinii pneumonitis/Jiroveci pneumoniae?

A

TMP-SMZ (trimethoprim-sulfamethoxazole)

75
Q

What is the recommended infusion for ciprofloxacin?

A

60 minimum, but 60-90mins

76
Q

Arthropathy and achilles tendon rupture may occur with which medication?

A

ciprofloxacin

77
Q

Why should individuals taking ciprofloxacin avoid strenuous activity?

A

to put let pressure on the legs due to the possibility of achilles tendon rupture

78
Q

Fatal colitis is adverse effect of which antibacterial medication?

A

clindamycin

79
Q

What medication may be utilized in the treatment of bacterial pneumonia, legionnaires disease, chlamydia, and pertussis?

A

azithromycin

80
Q

What can taking a daily probiotic prevent for those taking antibiotics?

A

pseudomembranous colitis

81
Q

What medication may be used to treat Lyme disease?

A

doxycycline

82
Q

Why should doxycycline not be given to children who are younger than 8 yrs old?

A

teeth staining

83
Q

What is a rarely used route for doxycycline?

A

intramuscular

84
Q

What should be taken throughout the course of gentamicin administration?

A

peak and trough

85
Q

Red man syndrome may occur as effect of infusing which medication too quickly?

A

vancomycin

86
Q

What can vancomycin be used to treat?

A

C.diff, MRSA, bacterial bone/skin infections

87
Q

Which tuberculosis medication from RIPE may cause gout? Why?

A

ethambutol because it may increase uric acid levels

88
Q

What are symptoms of liver damage?

A

abdominal pain/swelling, N/V, jaundice, severe fatigue

89
Q

What is amphotericin B?

A

a highly toxic anti-fungal medication only used in the treatment of life-threatening fungal infections

90
Q
A

Pharmacology-NRSE-3010-001 (12 decks)

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