Meds

Question 1

Isoniazid (INH)

Answer 1

Tx for TB

Can cause B6 deficiency

Question 2

Corticosteroids

Answer 2

Hyperglycemia

Impairs vit D and Calcium metabolism

Increases risk of metabolic bone disease in SBS pts

Question 3

Amphotericin B

Answer 3

Anti-fungal med used to tx systemic infections

Can cause hypokalemia (in conj with steroids)

Question 4

Acetoacetate

Answer 4

Preserves jejunum with TPN

Question 5

Cyclosporine

Answer 5

Immunosuppressant used to prevent transplant rejection

Side effects:
HYPOmagnesemia
HYPERkalemia
HYPERglycemia
HYPERcholesterolemia

Question 6

Cisplatin

Answer 6

Chemotherapy drug

Hypomagnesemia

Question 7

Adriamycin

Answer 7

Anti-neoplastic/cytotoxic chemo drug

Riboflavin deficiency

Question 8

Aldactone

Answer 8

aldosterone receptor antagonist that causes the kidneys to remove water and sodium

Potassium sparing

Question 9

Foscarnet

Answer 9

Anti-viral med

Can impair renal fx

Question 10

Cimetidine/Ramotidine

Answer 10

H2 blocker added to TPN

May decrease diarrhea by reducing gastric acid hypersecretion

Question 11

Aminophylline

Answer 11

Bronchodilator

L-cysteine compatibility issues

Question 12

Loop diuretics (Lasix)

Answer 12

Hypocalcemia

Hypokalemia

Question 13

Ketoconazole

Answer 13

Anti-fungal med

Cannot place in j-tube – Needs ACID medium

Question 14

Valproic acid

Answer 14

Anti-convulsant and mood-stabilizer

Carnitine deficiency

Question 15

Beta-blockers, neuromuscular blockade agents

Answer 15

Decrease caloric needs in trauma

Question 16

Digoxin

Answer 16

Toxicity enhanced by hypercalcemia, kypokalemia, and hypomag

Question 17

Loperamide

Answer 17

Imodium/anti-motility agent

Question 18

Octreotide

Answer 18

Somatostatin analog used in SBS only with refractory diarrhea that isn’t controlled by standard anti-diarrheal

Reserve for pts with high stool OP

Slows jejunal transit

Question 19

Sulfa

Answer 19

Abx for UTI

Can cause hypercalcemia

Question 20

Ursodiol

Answer 20

Helps to dissolve gallstones

Bile acid, 300 mg BID to improve lipid absorption

Question 21

Calcium gluconate

Answer 21

1-2 g for hyperkalemic emergencies

Question 22

Azathioprine (mercaptopurine)

Answer 22

Used for IBD/Crohns

Dehydration, nausea, metallic taste, tingling

Question 23

Methotrexate

Answer 23

Med that Interferes with folate absorption

Question 24

Pancreatic enzyme dosing for infants, kids, and adult TF

Answer 24

Infants: 400-900 units per g fat/feeding
Kids: 500-2500 units/kg/meal (1800 av)
TF: 1800 units per g fat in formula (1/2 dose initial, half dose end)

Do not exceed 10,000 units/kg

Question 25

Dilantin

Answer 25

Can cause folate and B12 deficiency 90% Albumin bound

Question 26

Metoclopramide

Answer 26

Prokinetic May cause neurologic sequelae

Question 27

Meds that are incompatible with PN

Answer 27

``` Acyclovir Amphotericin ganciclovir Cyclosporine Midazolam ``` Alyssa Arielle Gives Cats Mice

Question 28

Conivaptan and tolvaptan

Answer 28

Vasopressin antagonists Increases excretion of water without losses of serum electrolytes. Restores normal serum sodium concentrations

Question 29

Sirolimus (side effects and NT)

Answer 29

Immunosuppressant drug may cause hyperlipidemia and GI upset/disorders ☑️ limit fat and simple CHO intake ☑️Maintain weight

Question 30

Tacrolimus (side effects)

Answer 30

Immunosuppressant drug ``` Side effects: N/V Abdominal distress Hyperkalemia Hyperglycemia ```

Question 31

Tacrolimus (Suggested NT)

Answer 31

Immunosuppressant ☑️ Anti-emetics ☑️ Consider NS if V doesn't subside ☑️ Avoid high K+ foods ☑️ Monitor need for DM meds and long-term carb controlled diet.

Question 32

Cyclosporine (Nutrition Therapy)

Answer 32

``` ☑️ Restrict high K+ foods ☑️ Avoid high Sodium foods ☑️ Supp with high Mg foods/supps ☑️ Limit fat and simple CHO ☑️ Monitor BG levels ```

Question 33

Proton pump inhibitors

Answer 33

Used to tx gastric hypersecretion Suppress significant more acid than H2 blockers Need 50 cm of jejunum to absorb PPIs