Exam 3 Flashcards

Question

Anti-TB Meds

Answer 1

o Isoniazid o Rifampin o Pyrazinamide

Answer 2

Inhibits mycolic acid synthesis in mycobacteria, preventing cell wall formation - anti TB Adverse effects: Hepatotoxic → HEPATITIS peripheral neuropathy → vit B6 / pyridoxine deficiency (tingling, numb) GI upset, rash contraindication: liver disease Ed: No ETOH, other hepatotoxic rx, and foods high in Tyramine take on empty stomach report jaundice antibiotic ed anti TB X mycolic - cell wall X tyramine Hepatitis! Empty stomach Neuropathy - decreased B6 GI, rash

Answer 3

Inhibits bacterial RNA synthesis by binding to RNA polymerase. Broad-spectrum against mycobacteria - anti TB Adverse effects: * Hepatotoxic * red-orange body fluids (norm) * GI upset * thrombocytopenia Contraindications: protease inhibitors (HIV meds) warfarin Ed: antimicrobial teaching no alcohol anti TB RIF X RNA broad Hepato Orange red fluid Thrombocytopnia Abx teaching GI X protease blocker/HIV, warfarin

Answer 4

Mechanism unclear; disrupts mycobacterial cell membrane function - anti TB Adverse effects: * Hepatotoxic * hyperuricemia → gout (joint pain / swelling) * GI upset, rash Ed: no alcohol, hydrate to prevent hyperuricemia anti TB cell membrane Hepato U- uricemia → gout- hydrate GI, rash

Answer 5

ends in "-vir" o Acyclovir o Remdesivir

Answer 6

Inhibits viral RNA polymerase, preventing replication of COVID - anti viral Adverse effects: * Hepatotoxic * nephrotoxic * nausea, infusion-related rxns Hold if eGFR < 30 = kidney dmg Ed: Report jaundice hydrate monitor for worsening resp sx anti viral COVID H+N- hepato + nephro I, N- infusion, nausea - hydrate eGFR <30 = kidney dmg

Answer 7

Inhibits viral DNA synthesis for herpes, varicella Adverse effects: * Nephrotoxic (IV) * phlebitis (inflam vein) * GI upset, HA Ensure IV hydration (prevent nephrotoxicity) administer IV slowly over 1h Ed: Doesn't cure herpes take full course apply topical form w gloves increase fluids anti viral herpes X DNA Phlebitis IV fluid slowly 1h to stop Nephro GI Topical w/ gloves

Answer 8

o Nystatin o Ketoconazole o Amphotericin B

Answer 9

Binds to ergosterol in fungal cells, increasing permeability ONLY for progressive, life threatening, systemic fungal infections due to toxicity Adverse effects: * extreme NEPHROTOXIC (Flush w NS) * infusion rxns (fever, chills, Rigors, hypotension) * hypokalemia * anemia * Bone Marrow Suppression (baseline labs, CBC, H&H) Give Test Dose Premedicate w antipyretics and antihistamines infuse slowly over 2-6h Ed: Expect flu-like sx Hydrate anti fungal ampho-terrible toxic - SOS only increase perm HypoK+ Infusion rxn Bone marrow supp. → CBC, H+H, baseline Anemia Extreme nephro - NS flush Test dose - antipyretic, antihist Infuse slowly 2-6h Flu sx

Answer 10

Binds to ergosterol in fungal cells → cell leakage anti fungal Adverse effects: GI upset (PO) skin irritation (topical) hypersensitivity Swish and swallow (if oral candidiasis) swish and spit (if oral infections in immunocompromised pts) Ed: NPO or drink for 30 mins after complete full course anti fungal cell leaks Skin irritant - topical NPO 30m Allergy GI - PO swish + swall - oral yeast swish + spit - immunocomp.

Answer 11

Inhibits fungal ergosterol synthesis, disrupting cell membranes - anti fungal Adverse effects: HEPATOTOXIC (use only if no alt) QT prolongation GI distress hormonal (gynecomastia, Irregular periods) Ed: Report jaundice, avoid alcohol, take w food, avoid other QT prolonging meds anti fungal Keto "azole" X ergosterol- cell membrane QT W/ food Irregular period, gynecomastia GI Hepato!

Answer 12

ends in "-floxacin" Ciprofloxacin for UTI Inhibits bacterial DNA gyrase, preventing replication Adverse effects: Achilles TENDON RUPTURE QT prolongation phototoxicity Contraindications: pregnancy, kids < 18y Ed: Wear sun protection, take w water, report tendon pain & stop taking, Antimicrobial Teaching UTI X DNA gyrase QT Photo Abx teaching Tendon rup X preg, < 18y

Answer 13

Trimethoprim-Sulfamethoxazole (TMP-SMZ) Inhibits folic acid synthesis for UTI Adverse effects: Stevens-Johnson Syndrome crystalluria (hydrate) blood dyscrasias (Sore Throat, Unusual Bruising) Kernicterus (avoid preggo, breastfeeding) Hypersensitivity (to many drugs) monitor CBC & K+ contraindications: Sulfa allergy, pregnancy, kidney dmg Ed: Hydrate, Antimicrobial Teaching UTI Sulfa: TMP-SMZ X folic acid Blood dyscrasias (unusual bruising, sore throat) Abx teaching Steven John- rash Kernicterus (X preg) Crystalluria - hydrate CBC, K+

Answer 14

Dmg bacterial DNA; for uncomplicated UTIs Adverse effects: Brown, rust color urine (norm) hepatotoxic peripheral neuropathy pulmonary fibrosis, hypersensitivity (long-term use) (SOB, cough, alveolar infiltrations) Blood Dyscrasias (Sore Throat, Unusual Bruising) contraindications: Pregnancy >38 wks, renal/liver dysfunction Ed: take w food uncomp UTI Rust color pee And hepato Neuropathy To pulmonary Oh blood dyscrasias Intake food No preg > 38wks

Answer 15

Urinary analgesic, relieves dysuria for UTI Treats sx only, not the infection Adverse effects: Orange-red urine (norm) GI upset Ed: Will discolor urine and stain clothes UTI Phenazo GI Orange-red pee Treat sx only PAIN RELIEF

Answer 16

Inhibits DNA synthesis in anaerobic bacteria & protozoa Adverse effects: Disulfiram rxn (severe vomiting w ETOH) metallic taste neuropathy CARCINOGENIC Ed: no ETOH during and 48h after UTI X DNA anarobe, protozoa Cancer Awful metallic taste Neuropathy Disulfiram (vomit w ETOH) You can't drink 48h

Answer 17

caused by Mycobacteria airborne droplets affects lungs but can spread to other organs latent or active * Persistent cough (≥ 3 wks) * Hemoptysis (coughing blood) * Night sweats * Wt. loss * Fever, chills, Fatigue *Tuberculin Skin Test (TST) / Mantoux Test Positive = exposure; not necessarily active *Interferon-Gamma Release Assay (IGRA) Detects TB infection in blood *CXR– Detects granulomas (Ghon complex) in active TB *Sputum Culture & Acid-Fast Bacilli (AFB) Stain Confirms active TB

Answer 18

req host cell to replicate produce viral proteins → cell dmg and immune responses * Fever, Fatigue * Body aches, rash * Sore throat, Cough * N/V Polymerase Chain Reaction (PCR) – Detects viral genetic material Rapid Antigen Testing – flu, RSV, COVID

Answer 19

opportunistic superficial or systemic environment or contact Prolonged Abx use Wearing damp clothes (tinea) Superficial – skin, nails, or mucous (ringworm, athlete’s foot, thrush) *Itching, red, scaling *Thick, discolored nails Systemic – internal organs (histoplasmosis, candidemia, aspergillosis) - life-threatening *Fever, chills *Cough, CP (if pulmonary) *Fatigue, wt. loss *Sepsis Fungal Culture – IDs species of fungi CXR / CT – IDs pulmonary infections

Answer 20

bacteria (E. coli) ascends urinary tract → inflam bladder or kidneys mostly females bc shorter urethra and pregnancy Holding urine for long periods Using diaphragms/spermicides Uncomplicated UTI: lower urinary tract Complicated UTI: structural abnormalities, catheter use, immunosuppression Cystitis (Bladder): o Dysuria o Urgency and frequency o Cloudy, foul-smelling urine o Suprapubic pain Pyelonephritis (Kidney) → sepsis: o Fever, chills, fatigue o Flank pain o N/V UA: Shows WBC, nitrites, bacteria Urine Culture: IDs bacteria Blood Culture (if severe): Checks for sepsis Renal US/CT: Assess kidney in recurrent UTIs

Answer 21

onset childhood (use insulin pump) Autoimmune; destroys pancreatic beta cells → No insulin Req exogenous insulin for life metabolic and vascular

Answer 22

onset > 40y hyperglycemia → insulin resistance can't use insulin efficiently Gradual w less severe sx most common Obesity (Fat cells aren’t as sensitive to insulin as muscle is) HTN metabolic and vascular

Answer 23

A1c = > 7% glucose = > 126 recommended: 80 - 130 before meals and at bedtime (adult) 90 - 150 before meals and at bedtime (kids, teens)

Answer 24

Macrovascular abnormalities HTN MI, Stroke PVD Retinopathy, Blindness CKD Diabetic ketoacidosis (DKA) Hyperosmolar hyperglyc nonketotic coma (HHNC) Hyperglycemia Glycosuria Polydipsia, Polyuria, Polyphagia Dehydration

Answer 25

body naturally makes it lowers blood glucose by regulating insulin secretion major stimulus is Glucose clears from blood in 10 -15 mins major role in metabolism: - carbs → glucose - fats → lipids - protein → amino acids

Answer 26

a protein hormone secreted by beta cells in Pancreas allows rapid entry of glucose into cells diff types of insulins differ from onset and duration

Answer 27

Acarbose Metformin Insulins Degludec Exenatide

Answer 28

Human insulins - only in U.S synthetic identical to endogenous insulin Insulin analogs - made in labs

Answer 29

short acting SubQ / IV onset 30-60min peak 2-4h duration 5-8h always w food

Answer 30

onset <15 min short duration 4-8h

Answer 31

NPH cloudy mixture Slower absorption for prolonged action onset 1-3h peak 4-12h duration 12-18h given once or BID post prandial

Answer 32

ABD Followed by upper arm → thigh → butt

Answer 33

Metformin anti-hyperglycemic for T2DM reduce production of glucose by the liver decrease absorption of glucose to increase insulin sensitivity Does not cause hypoglycemia Adverse effects: lactic acidosis (monitor) anti diabetic decrease gluc, increase sens not hypoglyc LA - lactose acidosis

Answer 34

Acarbose delay digestion of complex carbs decrease postprandial glucose (combined w insulin / oral agent) Adverse effects: hypoglycemia GI upset leukopenia thrombocytopenia anemia contraindications: liver disease inflammatory / malabsorptive disorders anti diabetic Alpha glucosidase blocker Acarbose ↓ post prandial glyc ↓ WBC ↓ platelet ↓ glycemia GI Anemia

Answer 35

Exenatide stimulates pancreas to secrete the right amt of insulin based on food eaten postprandial glucose elevations Adverse effects: hypoglycemia GI distress (N/V/D) ACUTE PANCREATITIS (rare, monitor) anti diabetic Stim pancreas secrete insulin based on food Hypoglycemia Acute pancreatitis! GI

Answer 36

increasing trend in T2DM that can't be controlled by diet, exercise, and single-drug therapy. monitored w periodic fasting plasma glucose and glycosylated hgb levels.

Answer 37

ACE / ARB = protect kidneys ASA/Antiplatelet = prevent MI, stroke Diuretic = decrease heart failure HMG-CoA = prevent high cholesterol

Answer 38

norm blood glucose promote metabolism prevent complications prevent hypoglycemia

Answer 39

* awake but feel funny (shaky, sweaty, clammy) = give 15g carbs (crackers) and check blood sugar in 15 mins * unconscious = check breathing and pulse, give blood sugar = dextrose IV / IM (half syringe)

Answer 40

patient is sick glucose > 250 nocturnal hypoglycemia

Answer 41

MI, stroke blindness leg amputation kidney failure

Answer 42

Thyroxine (T4) Triiodothyronine (T3) calcitonin T3 more potent than T4 and more rapid onset but shorter duration

Answer 43

control metabolism rate and O2 Influence function of every cell Heart, muscle, liver, kidneys = extra responsive Brain, spleen, gonads = less responsive growth/development Dentition

Answer 44

increase metabolism rate & O2 → increase heat production increase HR, contraction, resistance, cardiac output → increase cardiac workload increase CHO, fat metabolism → inhibit pituitary TSH secretion

Answer 45

Iodine it's reabsorbed and used to make more thyroid hormones. Unused iodine are excreted in urine

Answer 46

Excess secretion of thyroid hormones Graves, goiter increase metabolism of meds

Answer 47

Diminished secretion of thyroid hormones Myxedema, goiter Primary and secondary decreases metabolism of meds

Answer 48

for hypothyroidism Thyroid cancer thyrotoxicosis during pregnancy Provide exogenous source of thyroid hormones contraindication: preggo, kids (cancer), anti-coags ed: wait couple hrs to eat Wait few hrs to eat Increase thyroid No preg, kids (cancer), anti coags

Answer 49

initial large dose followed by small doses for 6-12 mo until euthyroid achieved individualized doses

Answer 50

30 days date/time/initial when first open vial

Answer 51

only rotate cloudy/NPH "air is cloudy before it's clear" inject air into cloudy insulin vial before regular remove and inject air into reg vial

Answer 52

degludec for diabetes onset 1h lasts > 42h Adverse Effects: Hypoglycemia Hypokalemia Anaphylaxis Wt. gain Lipoatrophy / lipohypertrophy (fat tissue change at injection site frm repeat use) Nasopharyngitis (cold sx) Ed: Take once daily, at same time every day anti diabetic Degludec long acting insulin onset 1h Take same time Hypoglycemia, K+ Ana Wt. gain Lipoatrophy, hyper Nasopharyngitis → cold sx

Answer 53

a program in healthcare facilities to ensure that antibiotics are used only when necessary and appropriate

Answer 54

inhibiting bacterial protein synthesis Adverse Effects: GI upset (N/V/D) metallic taste anaphylaxis hepatotoxic Thrombocytopenia Ed: antimicrobial teaching take w water

Answer 55

remains in body but is inactive; asymptomatic and not contagious

Answer 56

immune system fails to contain infection → progressive lung dmg and systemic sx; is contagious