Exam 3 study guide Flashcards
If a patient has an infection what should you do first?
Obtain a culture
Rimantadine
antiviral
Isoniazid
Route: Oral, IM
Inhibits bacterial cell wall synthesis
Side effects/adverse reactions
Dry mouth, GI distress, constipation
Blurred vision, photosensitivity, tinnitus
Drowsiness, dizziness, peripheral neuropathy
Psychotic behavior, tremors, seizures
Hyperglycemia, hepatotoxicity
Thrombocytopenia, agranulocytosis
give with vitamin b6
Rifampin
antitubercular
turns body fluids orange
1 hour before or two hours after meals
report numbness or tingling
eye examinations- drugs may cause visual disturbances
Pyrazinzmide
antitubercular drug
Ethambutol
antitubercular drug
morphine
monitor patient closely when administered intravenously - may cause bradypnea and
NSAIDS
Take with food
inhibit prostaglandins
Analgesic effect
Tylenol
analgesic - safer in children and does not directly influence inflammation
aspirin
anti-inflammatory, anti platelet, antipyretic effect
15- 30 mg/dL
allupurinol
antigout drug
Action
Blocks reabsorption of uric acid which promotes its excretion
Side effects
Flushed skin, headache, sore gums
GI distress, kidney stones
Severe blood dyscrasias (rare)
avoid organ meats, sardines, salmon, gravy, herring, liver, meat soups, and alcohol (especially beer)
Pyridostigmine
myasthenia gravis
Neostigmine
short-acting acetylcholinesterase inhibitor - used for myasthenic crisis
Common side effects of antipsychotics typical and atypical
extrapyramidal symptoms (EPS) of parkinsonism, Neuroleptic malignant syndrome
atypical antipsychotics are less likely to cause EPS or tar dive dyskinesia
Chlorpromazine
antipsychotic
Aliphatic
Side effects
Strong sedation, orthostatic hypotension, moderate Extrapyramidal syndrome
Reddish-brown urine
St johns wort and antidepressants
increase chance of serotonin syndrome
MAO Inhibitors interact with what foods
Tyramine -
Some cheeses, cream, yogurt, coffee, chocolate, bananas, raisins, Italian green beans, liver, pickled foods, sausage, soy sauce, yeast, beer, and red wines can cause a hypertensive crisis.
What type of disease is arthritis?
inflammatory - rheumatoid arthritis is an autoimmune disease
What are the complications of herpes virus and what can it cause later on?
eye infection is a complication? characterized by cold sores or lesions
DUMBBBELS (cholinergic crisis)
Diarrhea Urination Miosis(pupil constriction) Bradycardia Bronchorrhea Bronchospasm Emesis Lacrimation Salivation
what is the antidote for a cholinergic crisis?
atropine
Tuberculosis treatment
Multidrug therapy 6-9m
how do we test for tuberculosis?
sputum sample, blood, skin
Why we treat prophylactically?
To be proactive and address the possibility of infection in at risk groups
What is bacterial resistance and superinfection signs?
?
What are the types of resistance?
acquired
cross
transferred
why don’t we give kids aspirin?
adverse reaction seen in kids coinciding with viruses
SSRI side effects and patient education
No grapefruit juice, venlafaxine and St johns wort may increase the risk of serotonin syndrome
headache, nervousness, blurred vision, insomnia, dry mouth, sexual dysfunction, suicidal ideation
How long before anti depressant / anxiety meds become effective?
2-6 weeks
What is the difference between daily and weekly dosing?
?
Why would a depressed patient take more than one drug?
combination therapy may increase the chance of effectiveness and remission
Ativan
Chronic anxiety
what does st johns wart interact with?
ssri’s
Symptoms of myasthenia gravis
ineffective muscle contraction and muscle weakness
Leads to weakness of respiratory, facial, and extremity muscles
Edrophonium
Acetylcholinesterase inhibitor
ultrashort-acting for diagnosing
most commonly used to differentiate between myasthenic crisis and cholinergic crisis
Pyridostigmine—intermediate-acting
Adverse effects?
A/E: severe muscle weakness, excessive salivation, pupil constriction, fasciculations of facia; muscles (cholinergic crisis)
The patient is admitted to the emergency department with cholinergic crisis. The nurse anticipates administration of…
A. atropine
B. baclofen.
C. edrophonium.
D. neostigmine
A atropine
A patient with myasthenia gravis comes to the emergency department in respiratory distress with a drooping eyelid. To determine if the patient is in myasthenic crisis or cholinergic crisis, the nurse anticipates administration of which drug?
A. Diazepam
B. Baclofen
C. Edrophonium.
D. Neostigmine
C. Edrophonium.
Extrapyramidal syndrome
adverse antipsychotic effect
Stooped posture, masklike facies, rigidity, tremors at rest
Shuffling gait, pill-rolling motion of hands, bradykinesia
Acute dystonia, akathisia, tardive dyskinesia
Neuroleptic malignant syndrome
adverse antipsychotic effect
Excess agitation, altered mental status
Exhaustion, dehydration
Muscle rigidity, hyperthermia, profuse diaphoresis
Blood pressure fluctuations, tachycardia, dysrhythmias
Seizures, rhabdomyolysis
Respiratory and renal failure, coma
Give muscle relaxant Dantroline
Tardive Dyskinesia
Protrusion and tongue rolling
Lip smacking
Involuntary movement of extremitie
Fluphenazine
Action
Blocks dopamine receptors in brain
Use
Manages symptoms of schizophrenia and psychosis
side effects: GI distress, peripheral edema, tachycardia, EPS, acute dystonia
Haloperidol
antipsychotic
Contraindicated in Narrow-angle glaucoma
IM Z track injection
Risperidone
antipsychotic
Side effects/adverse reactions
Sedation, headaches, photosensitivity, Dry mouth, weight gain
Lorazepam
Anxiolytic
Inhibits GABA neurotransmission by binding to specific benzodiazepine receptors
Limit use to 2-4 months
Tricyclic Antidepressants side effects
dry mouth and eyes, GI distress, orthostatic hypotension
Lithium
1.0-1.5
mood stabilizer
when are TCAs such as amitriptyline (Elavil) given?
at night to minimize problems caused by sedative effects
A patient with myasthenia gravis comes to the emergency department in respiratory distress. He has been diagnosed with myasthenic crisis. The nurse anticipates administration of which drug?
neostigmine
infliximab
immunomodulator
administered intravenously
rheumatoid arthritis / crohns disease etc…
A 65-year-old man has been diagnosed with chronic gout. The nurse anticipates that the patient will be treated with
A. allopurinol
B. colchicine.
C. adalimumab.
D. infliximab.
A. allopurinol
Antifungals
Amphotericin B, nystatin, flucoconazole, flucytosine, caspofungin
normal creatinine clearance range?
Male: 97 to 137 mL/min (1.65 to 2.33 mL/s). Female: 88 to 128 mL/min (14.96 to 2.18 mL/s).
