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Pharmacology 101 > Lecture 5 Nursing 100 > Flashcards

Lecture 5 Nursing 100 Flashcards

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1
Q

Antitubercular Agents

A 
Screen with PPD
\+means exposed; treat 6-12 months
INH Isoniazid
Rifampin
Ethambutol
Streptomycin
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2
Q

INH Nursing Considerations

A 
po 1 hr ac or 2 hr pc
Do not take with antacids
Assess peripheral neuritis (Numbness, ataxia, stupor)
Give vit b6 if symptoms
Can cause hepatitis
assess liver (f) test
assess for seizures
assess AFB sputum culture
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3
Q

Rifampin Nursing implications

A 
Assess jt pain, muscle cramps
Assess liver (f)
Discolors urine, feces, tears (orange)
give on empty stomach
decreases effectiveness of oral contraceptives
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4
Q

Antifungal Agents (2)

A

mild: athletes foot, thrush

severe systemic infections: lungs, meninges, coccidiomycosis, valley fever

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5
Q

Amphotericin B (Fungizone)

A 
Severe side effects: 
chills, fever, vomitting
jt and abdominal pain
nephrotoxicity
hypokalemia, hypomagnesemia
Premedicate with tylenol &/or Demerol
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6
Q

Amphotericin B (Fungizone) Nursing implications

A 
Not compatible with electrolyte solns
Monitor BUN/Cr
Evaluate VS before and after infusion
Inform pt of side effects
Monitor IV for phlebitis
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7
Q

Nystatin (mycostatin) oral thrush

A

similar chem structure to Amphotericin B
Topically or Orally
oral suspension or troches (football shaped pills you chew on)
swish and swallow

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8
Q

Antiviral Agents (3)

A

Acyclovir (Zovirax)
Zidovudine (AZT, Retrovir)
Ribavirin

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9
Q

Acyclovir (Zovirax)

A

treats herpes virus 1 and 2
antimetabolite- puts virus dormant until next stress
Side effects: N/V/D
Adverse Effects: Nephrotoxicity, bone marrow suppression, seizures

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10
Q

Zidovudine (AZT, Retrovir)

A

treatment for AIDs, ARC (aids related complex), and HIV
limits number of virus present
Monitor blood counts
Prolongs life expectancy

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11
Q

Ribavirin

A

Treatment for Respiratory Syncytial Virus (RSV)
Given by aerosol in tent or ET tube
tetrogenic effects in fetus
Caution pregnant women not to come in contact
babies <1yr: airway gets really small, fluid loss can lead to hypotension

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12
Q

Precautions with all antiviral agents

A 
Keep pt well hydrated
check BP, maybe hypotensive, esp orthostatic
check urine output and renal function
monitor neuro signs (HA)
Monitor WBC and platelet counts
MOST antivirals are VERY TOXIC
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13
Q

Corticosteroids

A

end in sone
synthetic or natural (made in adrenal glands) steroids
classified by biological activities:
glucocorticoids- effect CHO and protein metabolism
Mineralcorticoids- regulate fluid and electrolyte balance
primary use as antiinflammatory and immunosuppressant
may also be used for replacement therapy

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14
Q

Systemic Glucocorticoids

A

absorbed well- po, IM, and IV
distribution- bound to proteins
metabolized in liver
excreted by kidneys

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15
Q

Corticosteroids mechanism of action

A

influences lipid, protein, and CHO metabolism
suppresses hypersensitivity and immune response
masks s/sx serious infection
suppresses inflammatory process
decreases antibody formation
disrupts histamine synthesis

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16
Q

Corticosteroids Therapeuti uses

A

Tx hypercalcemia in bone CA, breat CA
rheumatoid arthritis
nephrotic syndrome, inflammatory bowel syndrome
hypersensitivity reactions (asthma, bee sting, dermatitis, Rx)
antilymphocytic effects- leukemia, lymphoma
cerebral edema- brain swells
COPD- inflammation of resp track

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17
Q

Corticosteroids Drug interactions

A 
many Rx interactions
barbiturates
Lasix
Erythromyci
Aspirin, NSAID- GI problems
vaccines & toxoids
Warfarin- protein binding
Estrogens- cause fluid retention
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18
Q

Corticosteroids Adverse reactions

A 
occur in every systemi
CNS- psychosis, suicidal
Fluid and electrolyte- Na retention, K lose
edema, moon-face, Cushing's Syndrome
GI irriatation, ulceration
osteoporosis, muscle wasting, hunch back, weakness
hyperglycemia- DM and non-diabetics
Immune system- masks infection
cardiovascular- HTN
19
Q

Corticosteroids Nursing Implications

A

Monitor when long term use
avoid in pregnancy, lactating, children
baseline EKG, CXR, electrolytes, liver, kidney (f)
observe wound healing
adminster early in day to stimulate circadian rhythm\
Avoid ETOH and cigarettes, caffeine, and ASA
Do NOT stop abruptly- drop BP and shock

20
Q

Immunosuppressants

A

used in allograft transplants
multisystem toxic effects- most prevent infections
teach pr to report any changes

21
Q

Integumentary agents

A

Kill the lice!
Antibacterial- topical little systemic effect
used for superficial wounds, burns, clean wound first and remove crust
Scabicides/pediculicides forlice- Kwell, scabene, RID, apply then reapply to kill eggs
wash all linen and combs

22
Q

Types of solns (2)

A

antiseptics- used on living tissue: alcohol, iodine, betadine, phisohex
Disinfectants: applied to inanimate objects: Zephiran, bleach

23
Q

Type 1 diabetes

A 
Insulin dependent
thin body type
no insulin produced
<20 yrs old
autoimmune/genetics
3 Ps and prone to ketosis
24
Q

Type 2 diabetes

A 
obese
some insulin produced/high resistance
>40 yrs old
high incidence in families
used no ketosis
25
Q

Hypoglycemic Agents- Insulin

A

beef and pork
humulin from DNA process
or from enzyme of pork
Concentrations: U100 = 100 units per mL

26
Q

Types of Insulin (3)

A 
Regular: 
Humulin N (NPH) Intermediate Acting
27
Q

Regular Insulin

A

rapid acting- clear; onset 1/2-1hr peak 2-4 hrs; duration approx 6 hrs

28
Q

Humulin

A

cloudy

Onset 1-2 hrs, Peak 8-12 hrs, duration approx 24 hrs

29
Q

Long acting Insulin

A

24-36 hrs

30
Q

Insulin Mechanism of Action

A

facilitates uptake and metabolism of glucose

Effect is to lower blood glucose lvls

31
Q

Indications for Insulin Use

A

Type 1 diabetes, DKA, Stimulate uptake of K in hyperkalemia, pt on TPN

32
Q

Insulin Drug Interactions

A

Cause low blood glucose: ETOH, anabolic steroids, ASA sulfonamides, tetracycline
Cause High blood gluc: corticosteroids, glucagon, oral contraceptives, thiazide diuretics, beta blockers

33
Q

Insulin Predictable Adverse Reactions

A

Hpoglycemia: nervous, shaky, diaphoretic, light headed, visual changes, weak, dizzy, stupor, coma, death
Somogyi Phenomenon- hypoglycemia followed by rebound high BG, if more insulin perpetuates the other roller more common at night

34
Q

Somogyi phenomenon

A

hypoglycemia followed by rebound high BG

If more insulin is given- perpetuates the roller coaster; more common at night

35
Q

Insulin Unpredictable Adverse Reactions

A

allergic reactions
lipodystrophy- loss of fat tissue- atrophy
lipohypertrophy-thickening of subcutaneous fat, must rotate injection sites, use at a room T not cold

36
Q

Insulin Nursing Implications

A

teach pt types, dose, syringe, injection technique
observe for high and low BG- teach pt to check
regular meals and exercise
source of quick sugar
store at room temp, do not freeze
rotate vials of cloud- never shake
insulin pump use

37
Q

Oral Hypoglycemic Agents

A 
Sulfonylureas- stim beta cells to produce insulin
used in Type 2 diabetes
1st gen- orinase take BID or TID
2nd gen- micronase take QD
1/2 hr before meal
38
Q

Hypoglycemic interactions

A

raise BG- steroids, lower BG- insulin, ETOH

39
Q

Adverse Reactions hypoglycemic agents

A

allergies, hypoglycemia

40
Q

Hypoglycemic agents nursing implications

A 
observe for sx/s hi or low BG
check renal and liver (f)s
wear ID, have quick sugar
take 1/2 hr before meals
may need more during stress/infections
41
Q

Thyroid Agents

A

Natural or synthetic
used for replacement therapy
increases metabolic rate
interacts with oral anticoagulants and dilantin

42
Q

Thyroid Agents Adverse Reactions

A 
overdose- weight lose
increased appetite
tachycardia
nervousness
perspiration
exophthalmia (large eyes)
43
Q

Thyroid Nursing Implications

A 
Not to pt with MI (myocardial infarction)
caution in angina, HTN
Not if sensitive to pork ASA
Check T3 and T4 tests
do not mix with other IVs

Pharmacology 101 (15 decks)

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