Medication Exam - Immunology Drugs Flashcards
Corticosteroids - Dexamethasone - long acting
Anti-inflammatory and Immunosuppressive
Severe inflammation
Short term use whenever possible
Screen for contraindications -kidney or liver disease, GI disease, CV, active infection
LABS - CBC, liver and kidney fxn
Monitor AE - hyperglycemia, hypertension, nausea, insomnia, psychosis
Take with food
Do not stop abruptly - withdrawal (for long term)
Teach how to reduce secondary infections
Adherence of dosing regimens
Enforcing education HPA axis suppression
Antihistamine 1st Generation - Diphenhydramine
Anticholinergic
Significant sedation - sleep aid
Shorter acting, more drowsiness and work faster
Monitor anticholinergic effects, sedation, change in VS, urinary retention, effectiveness of product
Sleep hygiene assess - sleep aids
Antibiotics - Penicillin - Bactericidal
Pen G - Narrow spectrum
Ampicillin - Broad spectrum
Tazocin - Extended spectrum
Pen G - streptococci, pneumococci, staphylococci, gonorrhoea and syphilis
Given IM or IV
AE: Anaphylaxis Diarrhea Nausea Vomiting Pain at injection site Superinfection Some minor drug interaction
Assess for Penicillin Allergy
Monitor electrolyte levels Na and K
Monitor response to therapy
Monitor for signs of superinfection - diarrhea, UTI
If IV, always check med compatibility
Ampicillin
Need back up contraceptive because there are reports of failure
Antibiotics -Cephalosorins - Bactericidal
1st Gen - Cefazolin IV
3rd Gen - Cefotaxime and Ceftriaxone
Cefotaxime - broad spectrum against gram negative
For serious infections of LRT, CNS, GU, bones, blood and joints
AE: Hypersensitivity Rash Itching Anaphylaxis Diarrhea Vomiting Nausea Pain at injection site Some minor drug interactions
Given IM or IV
Less chance of cross sensitivity with higher gen cephalosporins - less similarities to penicillin
Assess allergy to penicillin - know what type of reaction patient had to make a decision
If IV, always check med compatibility
Antibiotics - Aminoglycosides - bactericidal-
Vancomycin IV
Very effective
Usually reserved for serious infections or resistant to anything else
Only used in hospital
Injection or topical
Requires therapeutic drug monitoring
Assess for nephrotoxicity and ototoxicity - remove drug immediately
Lab values - elevated BUN, presence of blood and protein in urine, increased SCr, no or excessive urine output, edema, confusion, delirium —> stop drug admin and start hemodialysis
If IV, always check med compatibility
If IV given too quickly —> Red Man Syndrome - have to slow down infusion
Antibiotics - Fluoroquinolones - Ciprofloxacin
High usage in out patient
Resp, GU, ophtha, GI and Gyne infections
AE:
Nausea
Diarrhea
Photosensitivity
Take with food
Separate from minerals like Ca, Fe, Mg, Al and supplements and antacids by 2h
Metronizadole - bactericidal antibiotic
For anaerobic
No alcohol use
Watch for disulfiram reaction - flushing, tachycardia, SOB, severe nausea and vomiting, throbbing headache, visual disturbance, confusion and dizziness
Antibiotic - Carbapenems - Meropenem
Relatively new
Broad spectrum and very effective
AE: Skin reactions Inflammations at injection site Diarrhea Nausea Vomiting
More for resistant infections like MRSA
Pts receiving carbapenems are severely ill
Serotonin antagonist -Ondansetron
Chemo-induce nausea and vomiting
Dimenhydrinate
Useful after chemo when travelling
Only effective for motion sickness
Nurse’s Role - Antibiotics
Importance of C and S and continuing antibiotics
Assess for baseline infection status - temp, site of infection
Monitor kidney and liver fxn - can alter choice of antibiotic
If IV, always check med compatibility before administering
Watch for anaphylaxis and look for signs of superinfection
Dose around the clock if ordered to maintain appropriate drug levels and avoid resistance
Watch for interactions with dosing
Encourage adherence and finishing course of treatment
