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Pharmacology 101 > Lecture 4 Nursing 100 > Flashcards

Lecture 4 Nursing 100 Flashcards

1
Q

Penicillins

A

first Antibiotic in WW2

lots of diff reasons to use: inhibits bact cell wall; STD’s; ear infections

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2
Q

Four groups of Penicillins

A

Natural
Penicillinase resistant
amino-penicillin
Extended spectrum penicillin

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3
Q

Penicillin Absorption

A

oral dose varies- empty stomach best
IM for noncompliant/inconvenient
IV immediate dist

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4
Q

Penicillin Guide

A

classified according to action
food slows absorption
2 hr apart from aminoglycosides
not good for high BP
could be prob for renal pt
platelets clot- dysfunction: bleeding, bruising
monitor for freq headaches, SOB (shortness of breath)

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5
Q

Penicillin Distribution

A

wide throughout body

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6
Q

Penicillin Metabolism

A

limited extent in liver

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7
Q

Penicillin Excretion

A

60% unchanged by kidneys

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8
Q

Penicillin Mechanism of action

A

Bactericidal- destroys the bact
inhibits cell wall synthesis
cell lysis

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9
Q

Penicillin- Therapeutic use

A

Wide spectrum of antimicrobial action; gram + and gram - bacteria; common infections: syphillis, GC, URL, Otitis media; endocarditis

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10
Q

Penicillin Drug intereactions

A

Extended spectrum- inactivates aminoglycosides

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11
Q

Penicillin- Adverse Reactions

A

Low incidence of serious toxicity
Predictable: adminstered as disodium salts; may increase; hepatotoxicity; GI- glossitis, N/V/D; colitis; superimposed infection; CNS irritability- colitis; superimposed infection; CNS irritability

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12
Q

Penicillins- Unpredictable Reactions

A

Allergic (3-10% of pop)
anaphylactic- SOB, hypotensive TX Epine
Serum Sickness 7-10 days p tx» fever, hives, joint pain
Renal Failure

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13
Q

TX

A

Treatment

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14
Q

Hematuria

A

blood in urine

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15
Q

Proteinuria

A

protein in urine

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16
Q

Penicillin Nursing Implications

A 
Assess pt HX
Check allergies
assess GI symptoms
Check electrolyte lvls
Administer 1 hr ac or 2 hr pc
advise pt to complete full course
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17
Q

Cephalosporins

A

Categorized by generations- first through third- build up resistantce
have beta lactum structure similar to PCN
Cross sensitivity occurs
Used for anaerobic bact- don’t need O2 to live

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18
Q

Cephalosporin Pharmacokinetics

A

absorptions poor po, IM painful, better IV
dist wide except CNS
metabolized diff by each generation
excreted- unchanged by kidneys

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19
Q

Cephalosporin mechanism of action

A

bacterialcidial

inhibits cell wall synthesis

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20
Q

Cephalosporin therapeutic use

A

Gm+ and gm-; some anaerobic
Surgical prophylaxis (before surgery)
resp infection, skin, soft tissue
bones, joints, UTI

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21
Q

Cephalosporin Drug interactions

A

alcohol- antibuse effect: HA, dizziness, N/v, cramps

Impenem, cilastatin

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22
Q

Antibuse

A

type of drug taken to stop alcoholism b/c sideffects that occur when taking with alcohol

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23
Q

Cephalosporin Predictable Adverse Reactions

A

IM painful; colitis- can lead to diarrhea; thrombophelibitis- swell blood vessel and become hardened where IV goes; renal insufficiency; bleeding disorders; GI= NVD, super infection

24
Q

Cephalosporin Unpredictable Adverse Reactions

A

Hypersensitivity; mild to severe; 5-10% reactivity with PCN

25
Q

Cephalosporin Nursing Implications

A

Check for allergies to PCN; Give IM diluted with lidocaines; monitor for superinfection; avoid alcohol (ETOH)

26
Q

Tetracycline

A

Rarely Rx of choice

Classified: short, intermediate, long-acting

27
Q

Tetracycline Pharmacokinetics

A

Absorption- po several food and RX interfere; poor IM
Distributed- widely
Excreted primarily by kidneys

28
Q

Tetracycline Mechanism of Action

A

Bacteriostatic
Inhibits growth and multiplication
Interferes with protein synthesis

29
Q

Tetracycline Therapeutic uses

A

Broad spectrum Gm+ and Gm-; Rock Mtn Fever; Lyme disease; acne in low doses

30
Q

Tetracycline Food and drug interactions

A

Antacids, iron, ETOH, milk products

31
Q

Tetracycline Predictable Adverse reactions

A 
Poor tooth enamel development < 8 yrs old
GI distress
Photosensitivity skin and eyes
altered bone growth
hepatotoxic- fatty infilitrates
nephrotoxic- renal failure
CNS toxic- dizzy
32
Q

Tetracycline Unpredictable Adverse Reactions

A

Hypersensitivity; anaphylaxis

33
Q

Tetracycline Nursing Implications

A 
Not in children < 8 yrs old
assess hypersensitivity
check renal function
check if pregnant or lactating
take po with 8 oz of fluid
not with milk: Ca, Mg, Fe
take on empty stomach
avoid direct sunlight
contains tartrazine (dye)
34
Q

Chloramphenicol Pharmacokinetics

A

Absorbed- po or IV
Distributed- widely
Metabolized in liver by special enzyme (may not be present)
Excreted as metabolite by kidneys

35
Q

Chloramphenicol Mechanism of Action

A

Bacteriostatic- inhibits multiplication; cell wall synthesis

maybe bactericidal

36
Q

Chloramphenicol Therapeutic use

A 
Gm+ and gm-
anaerobic bact
meningitis in brain
typhoid fever
salmonella
hemopilus influenza meningitis
37
Q

Chloramphenicol Drug interactions

A

Inhibits metabolism of hypoglycemia agents= low blood glucose
inhibits anticonvulsant= dilantin toxicity
dilantin: highly pro bound- binds w/ everything
alters potential of anticoagulants= bleeding

38
Q

Chloramphenicol Predictable Adverse Reactions

A

GI- N/V, glossitis diarrhea
gray syndrome- neonates maybe fatal: ashen color, circulatory collapse, death
bone marrow suppression (reversible)- leukocytes, erythrocytes, platelets- may look anemic

39
Q

Chloramphenicol Unpredictable Adverse Reactions

A

Aplastic Anemia- irreversible, pancytopenia

Hypersensitivity

40
Q

Chloramphenicol Nursing Implications

A

screen for sensitivity
assess liver (f)
monitor for bone marrow suppression (labs)
Tell MD if fever, sore throat, fatigue, bruising (signs of liver disease)

41
Q

Clindamycin & Lincomycin

A

Inhibit protein synthesis

use limited to serious infections- intrabdominal, pleuropulmonary

42
Q

Clindamycin & Lincomycin Drug Interactions

A

with erythromycin and neuromuscle blocking agents

43
Q

Clindamycin & Lincomycin Predictable Adverse Reactions

A

80% diarrhea

pseudomembranous Colitis- maybe fatal

44
Q

Clindamycin & Lincomycin Unpredictable Adverse reactions

A

hypersensitivity

45
Q

Clindamycin & Lincomycin Nursing implications

A 
Used for nosocomial infections
screen pt for intestinal diseases- esp colitis
monitor liver (f) tests
46
Q

Erythromycin

A

TX common infections
Highly effective
Safe
can be used in pts allergic to PCN

47
Q

Erythromycin Mechanism of Action

A

Bacteriostatic

inhibits protein synthesis

48
Q

Erythromycin Therapeutic Uses

A

Broad spectrum gm+/gm-
Legionaries (drug of choice for this disease)
GC/syphilis if PCN sensitive

49
Q

Erythromycin Drug Interactions

A

Decreased theophylline excretion- increase toxicity

50
Q

Erythromycin Adverse Reactions

A 
Few
Only with high doses
more likely if renal failure
allergic reactions
hepatitis
51
Q

Erythromycin Nursing Implications

A 
Assess allergies (cross sensitivity to ASA)
assess liver (f)
check incompatibilities in IV soln- MANY
52
Q

Sulfonamides (Sulfa)

A

First effective systemic antibiotic

many resistant bacteria

53
Q

Sulfonamides (Sulfa) M of A

A

Bacteriostatic

inhibits production of folic acid

54
Q

Sulfonamides (Sulfa) Therapeutic Use

A

Use in UTI, colitis,pneumocyctis pneumonia (AIDS)- prevents reoccurrence of rheumatic fever group A beta hemolytic strep

55
Q

Sulfonamides (Sulfa) Drug Interactions

A

PABA (para-aminobenzoic acid) sun screens

Digoxin- reduces dig bioavailability

56
Q

Sulfonamides (Sulfa) Adverse Reactions

A

High dose- crystaluria
N/V/D common
Hypersensitive
Photosensitivity

57
Q

Sulfonamides (Sulfa) Nursing Implciations

A 
pt HX- skin rash, 
low urine output
pregnancy, lactation, 
recent use of PABA, 
po with ample fluids
avoid direct sunlight

call MD for sx hematologic reaction: sore throat, pallor, jaundice, weakness

Pharmacology 101 (15 decks)

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