Exam 4 Pharm Maps Flashcards
1
Q
What 4 things do we assess before and after administering respiratory drugs?
A
Lung sounds
Respiratory rate and effort
For cough
O2 saturation
2
Q
Avoid ____ like (3) (all respiratory drugs)
A
Allergens
- Smoking
- Stress
- Air pollutants (grass, ragweed, pollen)
3
Q
Report ____, or ____ that last longer than one week to your physician. (All respiratory drugs)
A
Fever
Cold-like symptoms
4
Q
Decongestant drug name
A
Oxymetazoline (Afrin)
5
Q
Reasons for taking decongestant (3)
A
Cold
Allergies
Sinusitis
6
Q
Action of decongestant
A
Constrict small blood vessels in the upper respiratory system
7
Q
Decongestant contraindications (2)
A
Pregnancy
Children under 6 years old
8
Q
Decongestant adverse reactions (2)
A
Rebound congestion
Tachycardia (rare)
9
Q
The pt. asks how long they should take oxymetazoline, what do you tell them?
A
No more than 5 days to avoid rebound congestion
10
Q
Pt. on Oxymetazoline should avoid ___, why?
A
Caffeine, can increase side effects
11
Q
How do we instruct the pt. to take Oxymetazoline?
A
Blow nose gently. Tilt head back. Place drops into each nostril & keep the head tilted back to allow the medicine to spread throughout the nose
12
Q
Antitussive drug name
A
Benzonatate (Tessalon Pearls)
13
Q
Reason for taking antitussive
A
Cough that is interfering with rest or comfort
14
Q
Action of antitussive
A
Suppresses cough reflex in the medulla
15
Q
Antitussive contraindications (2)
A
Pt. with respiratory depression
Pt. with opioid dependency
16
Q
Antitussive adverse reaction (4)
A
Dizziness (common)
Headache
Sedation (rare but serious)
Nausea
17
Q
What side effects are you most concerned about with Benzonatate?
A
Sedation
18
Q
So, what should you teach your pt. about benzonatate? (2)
A
Caution when driving or operating machinery
Caution with other CNS depressant medications
19
Q
Expectorant drug name
A
Guaifenesin (Mucinex)
20
Q
Reason for taking Mucinex
A
Non-Productive Cough
21
Q
Action of Mucinex
A
Stimulates cell to secrete watery substance to thin mucus
22
Q
Mucinex adverse reaction
A
All GI side effects
23
Q
Pt. on Mucinex should increase ___ intake unless otherwise contraindicated. Why?
A
Fluid
Helps liquefy secretions
No mucus-producing fluids like milk
24
Q
What type of pt. would Mucinex be contraindicated in?
A
Older pt.
Asthma or respiratory insufficiency
25
Bronchodilator (beta agonist) drug name
Albuterol (Proventil)
26
Reason for taking albuterol
Acute asthma or bronchitis
27
Action of Albuterol
Relaxes bronchial smooth muscle (activates beta receptors = bronchial dilation)
28
Albuterol contraindications (2)
Uncontrolled HTN
Arrythmias
29
Albuterol adverse reaction (4)
Tremors, nervousness
Anxiety
Nausea
Palpations
30
What do we teach albuterol pt. about inhalers?
Use a spacer, hold breath, etc.
31
Albuterol can increase __ & cause the pt. to ____
HR
Feel jittery
32
Use albuterol ___
As only as directed
(Don't over puff)
33
Bronchodilator (Anticholinergic) drug name (oldest & most common)
ipratropium (Atrovent)
34
Reason for taking Atrovent
Manages COPD
35
Action of Atrovent
Relaxes bronchial smooth muscles
By blocking acetylcholine receptors, Acetylcholine causes bronchial constriction
36
Atrovent adverse reactions (5)
Dry mouth & throat
Nasal congestion
Heart palpitations
Coughing
GI distress
37
Atrovent is an anticholinergic, what do you tell your pt.?
Drink plenty of fluids, use gum or candy for dry mouth, do not swallow tablets, and rinse your mouth after each use
38
How do you use an inhaler?
1. Stand up.
2 . Use a full inhaler.
3. Shake the inhaler before you use it.
4. Look straight ahead.
5. Use a spacer if needed
6. One breath per puff.
7. Don't let your tongue or teeth get in the way.
39
Leukotriene inhibitor drug name
Montelukast (singulair)
40
Reason for taking Singulair
Chronic management of asthma
41
Action of singulair
Blocks the release of leukotrienes
42
What are leukotrienes a part of
The inflammatory process
43
Singulair contraindication
Children under 12 years old
44
Singulair adverse reactions (3)
Headaches
Agitation
Mood changes
45
Take Singulair as ___
Directed
Every night on a continuous schedule even if symptoms improves
46
Singulair is NOT a ___
Rescue drug
47
Singulair may take ____ to see improvement
1-2 Weeks
48
Take with a ____ - no ___ (all antibiotics)
Full glass of water
No juice
49
Monitor for allergic reactions for the first ____. 3 examples (All antibiotics)
First 30 minutes
ex: rash, angioedema, & wheezing
50
Obtain ___ prior to first does of all antibiotics
Cultures
51
Report any signs of allergic reaction. Examples (4) (Pt. education, all antibiotics)
Rash, mouth sores, abd cramping, & diarrhea
52
Take all antibiotics as ___
Directed
53
What is something we should tell the pt. about all antibiotics? (2)
Finish all of the medication even when feeling better
Do not take other's antibiotics
54
Broad spectrum antibacterial Penicillin drug names (5)
Penicillin (Pen G)
Ampicillin (Omnipen)
Amoxicillin (Amoxil)
Piperacillin-Tazobactam
(Zosyn)
Amoxicillin-Clavulanic Acid (Augmentin)
(Suffix -cillin)
55
Reason for taking Penicillins
Kills bacteria like staph infections, E. coli, and Pseudomonas
56
Action of Penicillins
Bactericidal - Interferes with cell wall synthesis when dividing
57
Penicillins contraindications
Caution in renal failure patients
58
Penicillins adverse reactions (6)
GI disturbances (N/V, diarrhea, bloating, cramping)
Superinfections (C.diff, yeast)
Nephrotoxicity
Neurotoxicity (Confusion, gait, sz, headaches)
Allergic Reaction (Rash, hives, white patches in mouth
Anaphylactic reactions (Angioedema, Wheezing/Stridor)
59
What should be monitored for with Pen G.?
Hyperkalemia
60
Why should you push IV Pen G slowly
To avoid cardiac arrest
61
Why should Augmentin be taken with meals?
To help absorption
62
What is often used prophylactic for dental procedures?
Augmentin
63
Broad spectrum antibiotic Cephalosporins drug names (3)
Cephalexin (Keflex)
Cefazolin (Ancef)
Ceftriaxone (Rocephin)
Prefix cef- or ceph-
64
Reason for taking cephalosporins
Kills bacteria like staph infections, E. coli, and Pseudomonas
65
Action of cephalosporins
Bactericidal - Interferes with cell wall synthesis when dividing
66
Cephalosporins contraindications
Allergic to PCN
67
Cephalosporins adverse reactions (5)
Diarrhea (most common)
Abd cramps
Rash
Pruritus
Edema
68
Give cephalosporins __ minutes, before the first cut of a surgical procedure to prevent ___
60 minutes
A staph infection
69
Cephalosporins is nephrotoxic if mixed with ____
Vancomycin
70
Broad spectrum antibiotic Carbapenem drug names (2)
Imipenem (Primaxin)
Meropenem (Merrem)
Suffix -penem
71
Reason for taking Carbapenem (5)
Used mostly for serious abd infections, UTI, skin, joint, & GYN infections
72
Action of Carbapenem
Bactericidal - Interferes with cell wall synthesis when dividing
73
Carbapenem contraindications (3)
Pt. w/seizure disorders
Caution in elderly
Caution in pt. w/renal impairment
74
Carbapenem adverse reactions (4)
Phlebitis (restart at a different location)
Nausea/vomiting (call for an antiemetic)
Allergic reaction (stop infusion & notify MD)
C.diff (stop infusion, notify MD, & obtain a specimen)
75
Infuse Carbapenem IV over ___
60 minutes
76
Dilute Carbapenem with ____ if given IM, why?
Lidocaine, because it can hurt
77
Monitor pt. on Carbapenem for ___
Seizure activity
78
Monitor Carbapenem IV site for ____
Phlebitis
79
Broad spectrum antibiotic Macrolides drug names (2)
Azithromycin (Zithromax) or (Zpak)
Clarithromycin (Biaxin)
Suffix -thromycin
80
Reason for taking thromycins (4)
Strep infections
Upper/lower resp infections
STD's
Lyme Disease
81
Action of thromycins
Bacteriostatic- Prevents protein synthesis within the cell
Bactericidal in high dose
82
Thromycins contraindications
Breastfeeding
83
Thromycins adverse reactions & what should you report to your MD (4)
Fewer GI side effects
Report jaundice, hearing loss, chest pain or palpitations to your MD
84
Thromycins are highly ____ bound so caution with _____ & ____ because they are also highly ____ bound
Protein-bound
amiodarone & diltiazem
85
Take thromycins with at least ____
8 ounces of water
86
First does is higher ___ then ___ doses after is lower ___ (Thromycins)
500 mg
4 doses
250 mg
87
Take Zpak liquid __ before meals or ___ after meals
1 hour before
2 hours after
88
Thromycins have better __
Tissue penetration
89
Broad spectrum antibiotic tetracyclines drugs names (2)
Tetracycline (Actisite)
Doxycycline (Doxy)
Suffix -cycline
90
Reason for taking cyclines (3)
STD's, Lyme disease, & acne
91
Action of cyclines
Bacteriostatic- inhibits protein growth
92
Cyclines contraindications
Pregnant or breastfeeding
93
Cyclines adverse reaction
Photosensitivity
94
Pt.s on cyclines should avoid ___ and ___
Sun exposure & tanning beds
95
Cyclines can cause damage to the ___ on children's teeth
Enamel
96
Cyclines slows fetal ___
Skeletal growth and are teratogenic
97
What is teratogenic?
Substances or factors that can cause developmental abnormalities in a fetus.
98
Take cyclines __ before or ___ after a meal
1 hour before
2 hours after
99
Pts. on cyclines should avoid ___ products such as ____
Dairy products
Milk, cheese, yogurt, ect.
100
Aminoglycosides drug names (3)
Tobramycin
Gentamycin
Neomycin
Suffix -micin or -mycin
101
Reason for taking mycins (3)
Pseudomonas, E. coli, & Proteus Klebsiella
102
Action of mycins
Bactericidal - Inhibits protein synthesis in gram-negative strains
103
Mycins contraindications (2)
Caution in renal pt. and hearing impaired
104
Mycins adverse reactions (4)
Most nephrotoxic & ototoxic antibiotic
Report any tinnitus & hearing loss
Dizziness (vertigo)
Gait disturbance due to inner ear problems
105
What is tinnitus?
Ringing in the ears
106
Assess ___, ___, & ____ with mycins
BUN >20 hold & call MD
Creatine >1.3 hold & call MD
UOP <30mL/hr hold & call MD
107
Monitor ___ & ___ levels with mycins
PEAK & TROUGH
108
Pt.s should consult MD if they have ___ or ___ problems (mycins)
Kidney or hearing problems
109
Mycins work on what type of bacteria
Gram-negative aerobic bacilli (need oxygen)
110
Broad spectrum antibiotics Quinolones drug names (2)
Ciprofloxacin (Cipro)
Levofloxacin (Levaquin)
Suffix -floxacin
111
Reason for taking floxacins (3)
UTI, respiratory tract, & skin infections
112
Action of floxacin
Bactericidal -interferes with DNA replication - cell dies
113
Floxacins contraindication
Liver problems (rare)
114
Floxacins adverse reactions (2)
Rupture tendon & long-term nerve damage
115
Do not take ___ or ___ with floxacins
Vitamins or minerals (Zinc, calcium, magnesium)
116
Take floxacins with __
Food
117
Avoid ___ with floxacins
Dairy products
118
Restrict ____ with floxacins, why?
Caffeine
Increases jitteriness
119
Report ___ with floxacins
Tendon pain
120
Floxacins are the common drug to treat ___ & ____
Anthrax & urinary infections
121
Glycopeptides drug name
Vancomycin
122
Reason for taking vancomycin
Treatment of choice for MRSA
123
Action of vancomycin
Bactericidal
Interferes with DNA – kills bacteria
124
Vancomycin contraindications (2)
Renal or hearing impaired
125
Vancomycin adverse reactions (2)
Nephrotoxic (causes kidney damage) & Ototoxic (causes tinnitus & deafness)
126
Infuse vancomycin IV over ___, why?
60 minutes, rapid can cause hypotension
127
What should the trough levels be for vancomycin?
10-20mcg/mL
Hold >20 mcg/mL & call MD
128
Pt.s on vancomycin should report ___ or ___
Ringing in the ears or loss of balance
129
Monitor for ____- oral vancomycin only
Superinfection (C-diff)
130
Monitor for ____ (Vancomycin) - Usually happens w/in the first 10 min b/c infusing too fast
Vancomycin flushing syndrome (vfs)
131
Vancomycin flushing syndrome symptoms (4)
Hypertension
Flushing & pruritis
Red rash on face, neck, chest, & extremities
132
What should you do if the pt. is experiencing Vancomycin Flushing Syndrome?
Stop treatment immediately
Administer an antihistamine (Benadryl)
Wait until symptoms resolve - usually about 20 minutes
Restart rate at half the dose - usually over 2 hours
