Exam 3 study guide Flashcards by Abby Finsten

If a patient has an infection what should you do first?

Obtain a culture

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Rimantadine

antiviral

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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

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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

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Pyrazinzmide

antitubercular drug

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Ethambutol

antitubercular drug

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morphine

monitor patient closely when administered intravenously - may cause bradypnea and

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NSAIDS

Take with food

inhibit prostaglandins
Analgesic effect

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Tylenol

analgesic - safer in children and does not directly influence inflammation

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aspirin

anti-inflammatory, anti platelet, antipyretic effect

15- 30 mg/dL

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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)

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Pyridostigmine

myasthenia gravis

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Neostigmine

short-acting acetylcholinesterase inhibitor - used for myasthenic crisis

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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

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Chlorpromazine

antipsychotic
Aliphatic

Side effects
Strong sedation, orthostatic hypotension, moderate Extrapyramidal syndrome
Reddish-brown urine

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St johns wort and antidepressants

increase chance of serotonin syndrome

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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.

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What type of disease is arthritis?

inflammatory - rheumatoid arthritis is an autoimmune disease

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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

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DUMBBBELS (cholinergic crisis)

Diarrhea
Urination
Miosis(pupil constriction)
Bradycardia
Bronchorrhea
Bronchospasm
Emesis
Lacrimation
Salivation

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what is the antidote for a cholinergic crisis?

atropine

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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).