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Pharmacology > Exam 3 blueprint > Flashcards

Exam 3 blueprint Flashcards

1
Q

how do we diagnose TB

A

acid fast sputum test

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2
Q

general patient teaching for tuberculosis treatment

A

avoid alcohol, take meds as prescribed to prevent resistance

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3
Q

general adverse effects of tuberculosis drugs

A

hepatotoxicity

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4
Q

What does INH (isoniazid) treat

A

tuberculosis

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5
Q

Drug-food interactions of INH?

A

tyramine foods, oral contraceptives, antacids decrease absorption

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6
Q

examples of tyramine foods

A

soups, soy sauce, aged cheese, aged meats, fermented foods (wine and some beers), kimchi, figs, avocado

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7
Q

Patient teaching for isoniazid?

A

take B6/pyridoxine to decrease neuropathy, avoid tyramine, avoid alcohol, report symptoms of hepatitis (jaundice, anorexia, abdominal pain, fatigue, nausea), use condoms, take on empty stomach

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8
Q

What does rifampin treat?

A

TB

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9
Q

Side effects of rifampin?

A

will turn body fluids orange-red, hepatotoxicity

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10
Q

What is the polyene anti-fungal drug we discussed? (treats disseminated yeast)

A

amphotericin B (systemic and very toxic drug)

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11
Q

Adverse effects of amphotericin B?

A

nephrotoxicity, thrombophlebitis, bone marrow suppression, hypokalemia, infusion reactions

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12
Q

If a patient on amphoterecin B experiences an infusion reaction, what will their symptoms be? What do we do as a nurse?

A

fever, chills, tachypnea; IV drip very slowly, give test dose and pretreat with acetaminophen and diphenhydramine

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13
Q

How can we prevent nephrotoxicity in our patients taking amphotericin B?

A

keep very hydrated with 1 L NS on day of IV

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14
Q

Can we give amphotericin B with ahminoglycosides?

A

NO ; both produce nephrotoxicity

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15
Q

How to recognize azole anti-fungals?

A

end in azole

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16
Q

Adverse effects of azole anti-fungals?

A

hepatotoxicity, burning with topical administration, nausea, vomiting

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17
Q

Patient teaching for azole anti-fungals?

A

monitor S/S of hepatotoxicity (dark urine and tarry stools), monitor S/S of liver failure (abdominal pain, nausea, anorexia, fatigue, jaundice), fluconazole is a pregnancy category D (use barrier method)

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18
Q

How to recognize anti-virals

A

end in -vir

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19
Q

The antiviral used to treat shingles/herpes?

A

acyclovir

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20
Q

Nursing interventions for acyclovir?

A

rotate IV site and give over 60 minutes, monitor for phlebitis, increase hydration to decrease risk of nephrotoxicity, monitor kidney function and I&O

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21
Q

what does bactericidal mean?

A

kills bacteria

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22
Q

what does bacteriostatic mean

A

inhibits bacterial growth

23
Q

what is culture and sensitivity (C&S)

A

causative microorganism ; vulnerability to specific ABX (what kills it)

24
Q

What causes antibacterial resistance?

A

overuse of antibiotics, not taking full dose regimen

25
Q

What is a superinfection?

A

patient taking antibiotics gets a different infection

26
Q

What are the three general adverse reactions for antibiotics?

A

hypersensitivity/anaphylaxis, superinfection, organ toxicity

27
Q

What are the symptoms of mild and severe hypersensitivity reactions?

A

mild: pruritus, rash, hives
severe: anaphylaxis, SOB, bronchospasms

28
Q

What are the 3 most common superinfections we get from antibiotics?

A

candidiasis as vaginal yeast/ oral thrush, C-Diff/pseudomembraneous colitis, and stomatitis

29
Q

What organs do we primarily see toxicity in when administering antibiotics

A

ototoxicity (ears ringing, loss of balance) , hepatotoxicity (dark urine, abdominal pain, anorexia, fatigue, nausea, vomiting) nephrotoxicity (low output, increased RFTs, differences in urine)

30
Q

General patient teaching for antibiotics?

A

take to completion, use barrier method of birth control, report diarrhea, report allergic reactions, take probiotic, superinfections

31
Q

General nursing interventions for antibiotics?

A

monitor RFTs and LFTs, increase fluids, monitor for superinfections

32
Q

What antibiotic classes inhibit synthesis of bacterial cell wall (contain betalactam ring)

A

penicillins, cephalosporins, vancomycin

33
Q

How to recognize penicillins?

A

end in -cillin

34
Q

Mechanism of action for penicillins?

A

beta lactam ring inhibits synthesis of bacterial cell wall and division from enzymes

35
Q

What drug interactions do we see with penicillins?

A

aminoglycosides are incompatible (require second tubing), oral contraceptives decrease effectiveness, antacids decrease absorption

36
Q

Patient teaching for penicillins?

A

wear medic alert bracelet if allergic, take with food, take full regimen, increase fluids, use backup birth control, monitor s/s of allergic reactions

37
Q

Nursing interventions of penicillins

A

monitor diligently for allergic reaction, get C&S before administering, monitor for superinfection, RFT, LFT, bleeding tests, check compatibility of other meds (ahminoglycosides), report abnormals, dosage calculations

38
Q

What are abnormal lab results we should report to the provider if taking penicillin?

A

allergic reactions, BUN, creatinine, PT, INR, aPTT, platelets, hyperkalemia, hypernatremia

39
Q

How can we recognize cephalosporin antibiotics?

A

begin with ceph- or cef-

40
Q

contraindications of cephalosporins?

A

allergic to penicillin / cephalosporins

41
Q

Adverse reactions of cephalosporins?

A

superinfection, bleeding, hypersensitivity reactions

42
Q

Patient teaching for cephalosporins

A

avoid alcohol (produces disulfiram like reaction), take with food, take probiotic, increase fluids, notify diarrhea, extra birth control

43
Q

Nursing interventions of cephalosporins?

A

monitor for hypersensitivity reactions, use ventrogluteal for IM injections, infuse IV over 30 minutes, get C&S before therapy, RFT, LFT, report diarrhea, report abnormals, report bleeding s/s

44
Q

If someone is allergic to penicillin but not cephalosporins, this is called?

A

true penicillin allergy

45
Q

If someone is allergic to cephalosporins and penicillin, this can mean?

A

allergy to beta-lactam ring

46
Q

What type of antibiotic is vancomycin?

A

glycopeptide

47
Q

Indications for vancomycin?

A

IV is MRSA (can be given oral for pseudomembranous colitis)

48
Q

Adverse effects of vancomycin?

A

red man syndrome, ototoxicity, nephrotoxicity, Steven-johnson syndrome, thrombophlebitis

49
Q

Symptoms of red man syndrome? What causes this?

A

flushing, hypotension, tachycardia ; IV infused too quickly

50
Q

What should we do if our patient has red man syndrome?

A

give diphenhydramine, restart infusion at slower rate

51
Q

Aminoglycosides should be used with caution alongside vancomycin because of what reactions?

A

ototoxicity and nephrotoxicity

52
Q

Nursing interventions for vancomycin?

A

obtain peak and trough levels, infuse over 60 minutes, monitor red man syndrome, monitor hearing changes, monitor infusion site, RFTs, monitor superinfection, obtain C&S first

53
Q
A

Pharmacology (12 decks)

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