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NCLEX: Pharmacology > Immune System Medications > Flashcards

Immune System Medications Flashcards

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1
Q

Antimetabolite indicated for immune disorders such as RA, psoriasis, certain cancers, and for the dissolvement of ectopic pregnancies

A

Methotrexate (Rheumatrex)

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2
Q

Methotrexate (Rheumatrex) side effects

A

Infections, hepatotoxicity, bone marrow suppression, stomatitis

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3
Q

Methotrexate (Rheumatrex) black box warning

A

Fetal toxicity/death

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4
Q

Methotrexate (Rheumatrex) nursing care

A

Monitor for S/S of infection, liver function, and CBC

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5
Q

Medication indicated for prevention of organ rejection in transplant patients, UC, and RA

A

Cyclosporine (Sandimmune)

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6
Q

Cyclosporine (Sandimmune) side effects

A

Infections, hepatotoxicity, nephrotoxicity, hirsutism, hypertension, tremor

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7
Q

Cyclosporine (Sandimmune) nursing care

A

Notify provider right away of s/s of infection, monitor liver and renal function

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8
Q

Cyclosporine (Sandimmune) black box warning

A

Development of tumors

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9
Q

Doxorubicin (Adriamycin) is an example of an

A

Antineoplastic agent

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10
Q

Doxorubicin (Adriamycin) side effects

A

GI upset, alopecia, bone marrow suppression (anemia, neutropenia, thrombocytopenia), cardiac toxicity, red discoloration of urine/sweat/tears

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11
Q

Doxorubicin (Adriamycin) black box warning

A

Bone marrow suppression, cardiac toxicity, leukemia

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12
Q

Doxorubicin (Adriamycin) nursing care

A

Monitor for infection, cardiac function, and CBC levels; administer antiemetics for N/V

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13
Q

Vincristine is an example of an

A

Antineoplastic agent

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14
Q

T or F: vincristine causes bone marrow suppression

A

FALSE

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15
Q

Vincristine side effects

A

Peripheral neuropathy, phlebitis (IV site), GI upset, alopecia

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16
Q

Vincristine nursing care

A

Administer antiemetics for N/V, monitor for signs of neuropathy, use central line for infusion

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17
Q

Cyclophosphamide (Cytoxan) is an example of an

A

Antineoplastic agent

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18
Q

Cyclophosphamide (Cytoxan) side effects

A

Bone marrow suppression, GI upset, alopecia, hemorrhagic cystitis (inflammation and bleeding from bladder)

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19
Q

Cyclophosphamide (Cytoxan) nursing care

A
  • encourage patient to increase fluid intake to 2-3 L/day during therapy (to help prevent hemorrhagic cystitis)
  • monitor for blood in urine
  • monitor CBC levels
  • give antiemetics for N/V
  • wear gloves when handling and wash hands IMMEDIATELY after handling
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20
Q

Antineoplastic agent indicated for the prevention and treatment of breast cancer

A

Tamoxifen (Nolvadex)

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21
Q

Tamoxifen (Nolvadex) side effects

A

Hot flashes, vaginal bleeding, increased risk of thromboembolism, Hypercalcemia, bone pain, increased risk of uterine and endometrial cancer

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22
Q

Tamoxifen (Nolvadex) nursing care

A

Monitor CBC and calcium levels during therapy; advise patient to report bone pain

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23
Q

Antineoplastic immune modifier indicated for cancers and viral infections such as hepatitis

A

Interferon alpha-2B

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24
Q

Interferons are proteins that _________ the body’s immune response to tumors/viruses and _________ cancer proliferation

A

Enhance; slow

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25
Q

Interferon side effects

A

Flu-like symptoms (fever, muscle aches, chills, lethargy) bone marrow suppression, cardiotoxicity, hepatotoxicity, dyspnea, alopecia, GI upset, psychiatric disorders

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26
Q

Interferon nursing care

A

Monitor: CBC, cardiac function (EKG), liver function, infection, bleeding

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27
Q

Interferon black box warning

A

Risk for psychiatric, autoimmune, ischemic, and infectious disorders

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28
Q

Azithromycin (Zithromax) and erythromycin (E-Mycin) are examples of

A

Macrolides (anti-infectives)

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29
Q

Macrolides are indicated for

A

Bacterial infections (such as respiratory)

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30
Q

T or F: Macrolides are effective against MRSA

A

FALSE

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31
Q

Macrolides are _________ meaning they work by inhibiting protein synthesis and slowly bacterial growth

A

Bacteriostatic

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32
Q

Macrolides side effects

A

GI upset, dysrhythmias (including torsades de pointe), ototoxicity, rash

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33
Q

Administration of Macrolides

A

Take on empty stomach with a full glass of water

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34
Q

Lincosamide anti-infective indicated for severe bacterial infections

A

Clindamycin (Cleocin)

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35
Q

Clindamycin (Cleocin) inhibits protein synthesis and can be _________ or _________ depending on concentration

A

Bactericidal; bacteriostatic

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36
Q

Clindamycin (Cleocin) side effects

A

GI upset, diarrhea, superinfection (C.diff)

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37
Q

Clindamycin (Cleocin) nursing care

A

Monitor bowel movements

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38
Q

Aminoglycoside indicated for serious bacterial infections

A

Gentamicin (Garamycin)

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39
Q

Gentamicin (Garamycin) works by inhibiting protein synthesis and is _________ (kills bacteria)

A

Bactericidal

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40
Q

Gentamicin (Garamycin) side effects

A

Ototoxicity, nephrotoxicity, vertigo, ataxia

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41
Q

Gentamicin (Garamycin) nursing care

A

Monitor for: tinnitus, hearing loss, kidney function, peak/trough levels (d/t narrow therapeutic range)

42
Q

Route of administration for gentamicin (Garamycin)

A

IM or IV

43
Q

Doxycycline (Vibramycin) and tetracycline (Sumycin) are examples of _________ indicated for a wide variety of bacterial infections including acne, Lyme disease, STDs, Rocky Mountain spotted fever

A

Tetracyclines

44
Q

Tetracyclines work by preventing protein synthesis and inhibiting bacterial growth (____________)

A

Bacteriostatic

45
Q

Side effects of tetracyclines

A

GI upset, tooth discoloration in children (and fetuses), hepatotoxicity, photosensitivity, superinfection (C.diff)

46
Q

Tetracyclines should not be given to

A

Pregnant women or children under 8 years old

47
Q

Tetracyclines patient education

A

Take on empty stomach and with full glass of water; wear sunscreen; use additional form of protection as these meds decrease effectiveness of oral contraceptives

48
Q

What foods/meds decrease absorption of tetracyclines

A

Dairy products, foods high in calcium and iron, antacids

49
Q

Antibiotic indicated for serious bacterial infections and antibiotic-associated C.diff

A

Vancomycin

50
Q

Vancomycin side effects

A

Ototoxicity, nephrotoxicity, infusion reaction (“red man syndrome” — slow the infusion down, diphenhydramine), phlebitis (can be prevented if administered via PICC line)

51
Q

Vancomycin nursing care

A

Monitor peak/trough levels and adjust dose depending on creatinine (kidney function)

52
Q

Vancomycin should be infused over ___ hour(s) or more

A

1

53
Q

Side effects of penicillin G and amoxicillin (Moxatag)

A

GI upset (diarrhea, N/V), allergic reaction (dyspnea, rash), renal toxicity, superinfection (c.diff)

54
Q

Penicillin G and amoxicillin (Moxatag) should not be given to patient with a history of

A

Allergies to penicillin or cephalosporin

55
Q

Penicillin G and amoxicillin (Moxatag) nursing care

A

Monitor for allergic response and bowel function

56
Q

Extended release penicillin indicated for moderate to severe bacterial infections, including many penicillin-resistant bacteria

A

Piperacillin/tazobactam (Zosyn)

57
Q

Side effects of piperacillin/tazobactam (Zosyn)

A

Diarrhea, superinfection (C.diff), allergic reaction, phlebitis (at IV site), hepatotoxicity, nephrotoxicity

58
Q

Piperacillin/tazobactam (Zosyn) should not be given to patients with a history of allergies to

A

Penicillin or cephalosporin

59
Q

Piperacillin/tazobactam (Zosyn) nursing care

A

Monitor for: allergic reactions, bowel function, liver and renal labs

60
Q

Cephalexin (Keflex), ceftriaxone (Rocephin), ceftazidime (Tazicef), and cefepime (Maxipime) are examples of _________ indicated for bacterial infections

A

Cephalosporins

61
Q

Side effects of cephalosporins

A

GI upset, allergic reaction, superinfections (C.diff)

62
Q

Cephalosporins should not be given to patients with a history of allergies to

A

Penicillin

63
Q

Cephalosporins patient education

A

DO NOT consume alcohol during therapy; take with food

64
Q

Imipenem/cilastatin (Primaxin) is an example of a broad spectrum _________ indicated for serious bacterial infections

A

Carbapenem

65
Q

Carbapenems side effects

A

GI upset, rash, superinfection (C.diff), seizures

66
Q

Patients allergic to penicillin and/or cephalosporin may have an allergic reaction to

A

Carbapenems

67
Q

Ciprofloxacin (Cipro) and levofloxacin are examples of __________ antibiotics indicated for bacterial infections including UTIs, bone/joint infections, respiratory infections, and anthrax

A

Fluoroquinolone

68
Q

Side effects of fluoroquinolones

A

Diarrhea, superinfection (C.diff), tendon rupture, photosensitivity

69
Q

Fluoroquinolones nursing care

A

Monitor bowel movements, advise patient to wear sunscreen, monitor liver function (these meds may increase liver lab values)

70
Q

Trimethoprim/sulfamethoxazole (Bactrim) is an example of a _________ antibiotic indicated for bacterial infections including UTIs, bronchitis, pneumonia, and otitis media

A

Sulfonamide

71
Q

Side effects of trimethoprim/sulfamethoxazole (Bactrim)

A

GI upset, blood dycrasias, photosensitivity, crystalluria, rash, Steven’s-Johnson syndrome

72
Q

Trimethoprim/sulfamethoxazole (Bactrim) nursing care

A

Assess for sulfa allergies; monitor CBC; advise patient to wear sunscreen and increase fluid intake (to prevent crystalluria)

73
Q

Antibiotic used to treat UTIs

A

Nitrofurantoin (Macrobid)

74
Q

Side effects of nitrofurantoin (Macrobid)

A

GI upset, hypersensitivity, pulmonary toxicity, peripheral neuropathy, brown discoloration of urine

75
Q

Antibiotic indicated for bacterial and protozoan infections

A

Metronidazole (Flagyl)

76
Q

Metronidazole (Flagyl) side effects

A

GI upset, metallic taste, dark urine, dizziness, headache

77
Q

Metronidazole (Flagyl) patient education

A

DO NOT drink alcohol

78
Q

TB medications (HINT: RIPE)

A

Rifampin, isoniazid, pyrazinamide, ethambutol

79
Q

Key side effect of all TB drugs

A

Hepatotoxicity

80
Q

Rifampin side effects

A

Orange secretions, GI upset, decreased effectiveness of oral contraceptives

81
Q

Isoniazide side effect

A

Neuropathy

82
Q

Pyrazinamide side effect

A

Arthralgia (Joint pain)

83
Q

Ethambutol side effect

A

Changes in vision

84
Q

TB meds patient education

A

NO alcohol; family members will need to be tested for TB; sputum samples needed every 2-4 weeks; patients with active TB will need to wear masks in public

85
Q

Patients are no longer infectious with TB after ___ negative sputum samples

A

3

86
Q

TB meds nursing consideration

A

Monitor for signs of liver damage

87
Q

Amphotericin B (Fungizone), ketoconazole, and fluconazole (Diflucan) are examples of

A

Systemic antifungals

88
Q

Key side effect of all antifungals

A

Hepatotoxicity

89
Q

Side effects of amphotericin B

A

GI upset, nephrotoxicity, bone marrow suppression, phlebitis — HIGHLY toxic (only for life threatening fungal infections)

90
Q

Side effects of ketoconazole

A

GI upset, arrythmias

91
Q

Side effects of fluconazole

A

GI upset, rash

92
Q

Systemic antifungals nursing care

A

Monitor for liver dysfunction (pale stools, dark urine, N/V, fatigue, jaundice)

93
Q

Acyclovir (Zovirax), ganciclovir (Cytovene), oseltamivir (Tamiflu), and zanamivir (Relenza) are examples of

A

Systemic antivirals

94
Q

Antiviral indicated for herpes and varicella-zoster viruses

A

Acyclovir (Zovirax)

95
Q

Acyclovir (Zovirax) side effects

A

Phlebitis, GI upset, nephrotoxicity

96
Q

Systemic antiviral indicated for cytomegalovirus

A

Ganciclovir (Cytovene)

97
Q

Side effects of ganciclovir (Cytovene)

A

Phlebitis, GI upset, nephrotoxicity, bone marrow suppression

98
Q

Antivirals indicated for influenza A and B

A

Oseltamivir (Tamiflu) and zanamivir (Relenza)

99
Q

Systemic antiviral patient education

A

These meds do not CURE conditions

100
Q

Oseltamivir (Tamiflu) and zanamivir (Relenza) should be administered within ___ hrs of influenza symptoms

A

48

NCLEX: Pharmacology (11 decks)

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