Lecture 5 Nursing 100 Flashcards
Antitubercular Agents
Screen with PPD \+means exposed; treat 6-12 months INH Isoniazid Rifampin Ethambutol Streptomycin
INH Nursing Considerations
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
Rifampin Nursing implications
Assess jt pain, muscle cramps Assess liver (f) Discolors urine, feces, tears (orange) give on empty stomach decreases effectiveness of oral contraceptives
Antifungal Agents (2)
mild: athletes foot, thrush
severe systemic infections: lungs, meninges, coccidiomycosis, valley fever
Amphotericin B (Fungizone)
Severe side effects: chills, fever, vomitting jt and abdominal pain nephrotoxicity hypokalemia, hypomagnesemia Premedicate with tylenol &/or Demerol
Amphotericin B (Fungizone) Nursing implications
Not compatible with electrolyte solns Monitor BUN/Cr Evaluate VS before and after infusion Inform pt of side effects Monitor IV for phlebitis
Nystatin (mycostatin) oral thrush
similar chem structure to Amphotericin B
Topically or Orally
oral suspension or troches (football shaped pills you chew on)
swish and swallow
Antiviral Agents (3)
Acyclovir (Zovirax)
Zidovudine (AZT, Retrovir)
Ribavirin
Acyclovir (Zovirax)
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
Zidovudine (AZT, Retrovir)
treatment for AIDs, ARC (aids related complex), and HIV
limits number of virus present
Monitor blood counts
Prolongs life expectancy
Ribavirin
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
Precautions with all antiviral agents
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
Corticosteroids
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
Systemic Glucocorticoids
absorbed well- po, IM, and IV
distribution- bound to proteins
metabolized in liver
excreted by kidneys
Corticosteroids mechanism of action
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
Corticosteroids Therapeuti uses
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
Corticosteroids Drug interactions
many Rx interactions barbiturates Lasix Erythromyci Aspirin, NSAID- GI problems vaccines & toxoids Warfarin- protein binding Estrogens- cause fluid retention
Corticosteroids Adverse reactions
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
Corticosteroids Nursing Implications
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
Immunosuppressants
used in allograft transplants
multisystem toxic effects- most prevent infections
teach pr to report any changes
Integumentary agents
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
Types of solns (2)
antiseptics- used on living tissue: alcohol, iodine, betadine, phisohex
Disinfectants: applied to inanimate objects: Zephiran, bleach
Type 1 diabetes
Insulin dependent thin body type no insulin produced <20 yrs old autoimmune/genetics 3 Ps and prone to ketosis
Type 2 diabetes
obese some insulin produced/high resistance >40 yrs old high incidence in families used no ketosis
