Meds 2.0 Flashcards
purpose of vancomycin
treats c.diff, and serious bacterial infections such as staph
classification of vancomycin
antibiotic - glycopeptide
mechanism of action for vancomycin
inhibits bacterial RNA and cell wall synthesis leading to cell death
side effects of vancomycin
ototoxicity
nephrotoxicity
GI upset
red man syndrome (IV infusion rxn): infuse slowly to avoid
phlebitis
interactions with vancomycin
NSAIDs, penicillins, aminoglycosides
contraindications with vancomycin
hypersensitivity to corn when given with dextrose soln
hypersensitivity to vancomycin
what to monitor for vancomycin
Therapeutic drug monitoring (TDM)
renal fxn: BUN, serum creatinine, GFR
CBC: anemia, thrombocytopenia (low platelets), leukopenia
electrolyte level
where is vancomycin cleared
in the kidneys
what is tobramycin used for
cystic fibrosis (respiratory system stuff)
eye infection
etc.
classification of tobramycin
antibiotic - aminoglycoside
mechanism of action for tobramycin
inhibits synthesis of bacterial walls by preventing protein synthesis
side effects for tobramycin
ototoxicity
nephrotoxicity
bronchospasms
GI upset
interactions with tobramycin
NSAIDs
vancomycin
other aminoglycosides
furosemide (loop diuretic)
anesthetics
where is tobramycin cleared
kidneys
what to monitor when taking tobramycin
electrolyte imbalances
nephrotoxicity: BUN, serum creatinine
contraindications for tobramycin
hypersensitivity to tobramycin, aminoglycosides, sodium bisulfate
category for acetaminophen
nonopioid analgesic, antipyretic
mechanism of action for acetaminophen
blocks prostaglandin - interfere with pain impulse & temp regulation in hypothalamus
side effects of acetaminophen
Hepatotoxicity
GI upset
decreased fertility
contraindications for acetaminophen
hypersensitivity
liver dysfxn (i.e. alcoholic)
antidote for acetaminophen
acetylcysteine (mucomyst)
interactions with acetaminophen
alcohol
what to monitor for acetaminophen
liver fxn: AST/ALT ratio (around 1.15), bilirubin (0.1-1.2 mg/dL), creatinine
category class of NSAIDs
nonopioid analgesic: anti-pyretic, antiplatelet, anti-inflammatory
mechanism of action for NSAIDs
inhibits prostaglandin synthesis
uses for NSAIDs
mild to mod pain
fever, inflammatory
contraindications for NSAIDs
pregnancy
bleeding disorder
peptic ulcer disease
active bleeding
interactions with NSAIDs
corticosteroids
alcohol
nursing considerations for NSAIDs
take with food to avoid stomach upset
side effects of NSAIDs
GI upset (most common)
MI, stroke
NSAIDs think Nephrotoxic
ulceration, perforation
opioid class
analgesics: CNS depressant
mechanism of action for opioid
binds to opioid receptors in the brain
opioid uses
decrease anxiety & sedate post-op
decrease anxiety in pt w/ dyspnea
relieve pain
treat diarrhea & intestinal cramping
side effects of opioid - long term (won’t build tolerance)
decreased GI fxn - constipation
side effects of opioid - short term (will build tolerance)
decreased vitals
decreased CNS fxn - sedation, insomnia, weakness, dizziness
pruritus (itching)
nausea
burning sensation IV
nursing considerations for opioids
preventative measures for constipation & falls
watch for low vitals
take PO w/ foods to avoid stomach upset
avoid alcohol
when to stop opioids
bradypnea
unarousable
antidote for opioid
naloxone (Narcan) - may require multiple doses due to short half-life
interactions with opioids
antihistamines
benzodiazepines
antidepressants
other pain meds
normal insulin vs. humalog vs. lantus onset
Humalog (fastest) > regular > Lantus (long lasting)
side effects of insulin
hypoglycemia (especially with Humalog)
lipodystrophy (loss of subq fat) @ inj site
interactions with insulin
beta-blockers
salicylates aspirin
alcohol
blood glucose for diabetic values
fasting: 60-130
after eating: <180mg/dL
a1c: <7%
2 handy dandy things to remember about insulin
Long think lonely -> Lantus don’t mix w/other insulin
Regular goes Right into the vein -> regular goes in IV only
