Exam 4 Flashcards
Penicillins
Tx: UTI, ENT infections
S/S: GI upset
Monitor for allergies (at least 30 min)
Rash/hives = antihistamines
Anaphylaxis = epinephrine
Effects of oral contraceptives reduced
Cephalexin
Tx: UTI and meningitis
DONT GIVE IF ALLERGIC TO PENICILLINS
IM injections can burn; give with lidocaine to dilute
IV = dilute +give over 30 min (watch for thrombophlebitis)
Disulfiram-like rxn w/ alcohol
Monitor PT and INR for bleeding time
Don’t give with LR, only NS
aztreonam
Tx: UTI
DON’T GIVE IF ALLERGIC TO PENICILLINS
Monitor for thrombophlebitis (IV) and site irritation (IM), watch for respiratory dysfunction for inhalation route
GIVE SLOWLY AND DILUTE IT
Imipenem
Tx: serious infections
DON’T GIVE IF ALLERGIC TO PENICILLINS
IV site issues may require injection of neutralizing agent if extravasation occurs
Risk of superinfections
Monitor liver and kidney fxn
Vancomycin
Tx: MRSA and C. Diff
Give if allergic to penicillins
Monitor for red-man syndrome, nephrotoxic, ototoxicity
Obtain peak and trough lvls to determine therapeutic lvls in serum
Dilute and give over at least an hour; always on a pump
What actions should a nurse take for a patient experiences Red-man syndrome?
Slow rate of injection, may need to stop injection
Dilute
Give >1 hr
Tetracycline
Tx: acne vulgaris, mycoplasma infections, rickettsial infections
Discolors baby teeth of fetus and permanent teeth of children
S/S: superinfections, photosensitivity
Erythromycin
Prophylactic protection from eye infections in neonates
Don’t give with ototoxic drugs
Cardiac dysrhythmias may occur if given with antidysrhythmics
Interacts with warfarin, digoxin, theophylline
gentamicin
Tx: ENT infections
Monitor trough lvls – may indicate ototoxicity
Potential for nephrotoxicity (monitor BUN 10-20 and Creatinine lvls)
Teratogenic –> deafness
ciprofloxacin “floxacin”
S/S decreased with adequate intake of water
Don’t give to adolescents unless for E. coli or anthrax
S/S: achilles tendon rupture, seizures/increased ICP, hepatotoxic
SEVERLY INCOMPATIBLE: GIVE SLOWLY, DILUTE, SEPARATE SITES, CHANGE TUBING
trimethoprim-sulfamethoxazole “sulfa”
Check allergies
Tx: UTI
S/S: stevens-johnson’s syndrome - treat like a burn
Kernicterus in the fetus = bilirubin build-up that crosses BBB and causes permanent brain damage
Disulfiram-like rxn w/ alcohol
nitrofurantoin
Tx: UTI
“Nitrates in urine needs nitro”
S/S: Tooth-staining with oral (dilute + rinse mouth after admin)
CI: hx of gallbladder, liver, or kidney disease/dysfunction
phenazopyridine
NOT AN ABX - doesn’t prevent infection
Tx: relieves pain and discomfort of UTI
S/S: orange discoloration, GI upset
Isoniazid
Tx: TB (takes about 6-9 months for latent)
Not a cure for latent but prevents activation of TB
S/S: kidney and liver failure (monitor LFTs, avoid alcohol)
Don’t give with disulfiram = psychosis, ataxia because of toxicity
Warm to room temp
Rifampin
Tx: TB, prevents resistance when given with other TB drugs
S/S: discoloration of urine/tears/sweat/saliva, GI upset
Can also color contacts
Metronidazole
Tx: anaerobic bacterial infections (prophylactic colorectal, abdominal, and vaginal surgeries) AND protozoal infections
S/S: vertigo, ataxia, peripheral neuropathy, darkening of urine, metallic taster
If given with disulfiram = psychotic rxn
Disulfiram-like rxn with alcohol can be more severe than other antimicrobials
Chloroquine
Tx: malaria, rheumatoid arthritis, Lupis
S/S: vision problems – get frequent eye exams
Take 500mg 1-2 weeks before travel and 4 weeks after travel.
amphotericin B
Tx: severe, systemic, and fatal fungal infections (candidiasis)
S/S: Renal toxicity (monitor BUN, creatinine, and K)
If taken PO, swish and swallow to allow for dissemination across mucous membranes and slight systemic absorption
Ketoconazole
Tx: systemic fungal infections (in dandruff shampoos)
S/S: liver toxicity
Requires acid medium for absorption (ex: cola, don’t take antacids)
CI for fungal infections of the nails - onychomycosis
acyclovir
Tx: virus
Infuse slowly and monitor (hydrate the patient before and after therapy)
Should be taken within 48 hrs of onset to be effective
S/S: IV - CNS toxicity, rxn at site within 1 hr, renal toxicity; PO - vertigo
Topical instructions: wear gloves, prevent scratching, avoid spreading to eyes or other sites, hand hygiene
Cyclophosphamide (nitrogen mustard)
Tx: leukemia, lymphomas, tumors in head/ovarian/breast, lung cancer
S/S: ELECTROLYTE IMBALANCES (cardiac dysrhythmias and muscle weakness), N/V, alopecia, Neutropenia, kidney toxicity –> hemorrhagic cystitis (give mesna)
Cycle: antiemetic –> cyclo –> mesna
cisplatin
Tx: metastatic testicular and ovarian cancer
Off-Label: cancer of the head and neck, bladder and uterine lining
S/S: ototoxicity, nephrotoxicity, n/v
IV only
doxorubicin
1st line for breast cancer treatment
FREQUENTLY ADDED TO RADIATION THERAPY AND OTHER CANCER TREATMENTS
S/S: red urine/tears, superinfections, cardiac arrest (watch for pink frothy sputum), hepatoxicity (monitor LFT)
Vincristine
Most common drug for pediatric chemo
s/s: peripheral neuropathy, constipation and impaction common in pediatric patients
IV ONLY, MAY BE FATAL IF GIVEN ANY OTHER ROUTE
Leuprolide
Tx: prostate cancer, endometriosis, and uterine fibroids
S/S: infertility, menopause-like, osteoporosis
Client instruction: weight-bearing exercise
Tamoxifen, raloxifene
Tx: breast cancer, prevention of reoccurrence
S/S: abnormal bleeding in uterine/endometrial, menopause-like symptoms
Flutamide
Tx: early prostate cancer (only for males!!)
S/S: feminizing effects, hepatotoxicity (monitor LFT to baseline, monitor indication of liver failure)
Anastrozole
Tx: estrogen receptor-positive breast cancer ONLY IN POSTMENOPAUSAL WOMEN
S/S: osteoporosis, muscle weakness
May predose with acetaminophen
Trastuzumab
Tx: HER2 breast cancer
S/S: allergic reaction because of cytokine release syndrome (flu-likee s/s, rash, dyspnea), HF (dysrhythmias)
Administration: Weekly IV only, don’t give with doxorubicin
Interferon alfa 2a and 2b
2A treats HBV and HCV
2B only for HBV
Dosage units: million
S/S: flu-like symptoms, bone marrow suppression
Enfuvirtide
Tx: HIV to AIDS
S/S: injection site reaction is common, pneumonia
Administration: SQ BID
zidovudine
1st HIV drug developed
s/s: bone marrow suppression
Follow administration requirements 90% of the time at least
MAKE SURE TO DO HYGIENE
If pregnant: PO 5x a day 14 weeks from gestation until delivery, IV during delivery until cord clamped
What is the protocol for administering a vaccine for a patient with steroid usage?
stop the steroid then give vaccine
What does “cancer” encompass?
cellular transformation
Uncontrolled cellular growth
Invades surrounding tissue
Metastasis to other tissues/organs
No growth control mechanisms
T/F: no antineoplastic drug is effective against all types of cancer
true
What are the 3 types of rapidly dividing human cells
hair follicles
GI tract cells
bone marrow cells
What is carcinoma?
epithelial tissue: skin and mucous membranes that line the lungs and GI tract
What is a sarcoma?
connective tissue, muscle, bone, cartilage
What is leukemia?
blood-forming tissue: bone marrow
What is lymphoma?
immune system
What is “oma”
tumor
What is “emia”?
blood
What can become resistant to drugs due to viral mutation?
HIV
