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Nursing school level 2 > patho test 2 drugs > Flashcards

patho test 2 drugs Flashcards

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1
Q

bacteriostatic

A

inhibit growth of bacteria

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2
Q

MOA of sulfonamides

A

inhibits bacterial synthesis of folic acid (DNA)

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3
Q

what cells are not affected by sulfonamides

A

cells requiring exogenous b-9

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4
Q

sulfonamides are highly concentrated in the

A

kidneys

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5
Q

example of sulfonamides

A

bactrim (Sulfamethoxazole/trimethoprim)

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6
Q

adverse effect of bactrim

A

integumentary considerations and immune mediated

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7
Q

what drugs/disease process can have potential interactions with sulfanomides

A

DM when taking sulfonylureas which can cause hypoglycemia and epilepsy when taking phenytoin which can cause nystagmus, encephalopathy, dysarthria, and ataxia

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8
Q

examples of sulfonylureas

A

glipizide

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9
Q

MOA of glipizide

A

stimulate beta cells (insulin)

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10
Q

phenytoin does what to clearance

A

reduces it which can increase effects of other drugs

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11
Q

bactericidal

A

enter cell wall and lyse bacteria - work on gram positive bacteria

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12
Q

penicillin is a

A

bactericidal

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13
Q

when is PCN IV used

A

for HF, card dys, FVO, CKD - added to Na and/or K

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14
Q

adverse effects of penicillin

A

urticaria, pruritus, angioedema, rash, anaphylaxis

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15
Q

PCN G

A

IM penicillin - used for uncomplicated syphilis

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16
Q

if patient is allergic to penicillin they could also be allergic to

A

cephalosporins

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17
Q

antibiotic used for meningitis

A

ceftriaxone

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18
Q

phenazopyridine also called

A

pyridium

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19
Q

phenazopyridine for

A

topical analgesic. can buy over the counter. for pain, during, and urgency of urination

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20
Q

bacteria that has evolved with beta lactamase

A

E. coli - has figured out how to break the beta lactam ring so we needed to figure out a way to inhibit that actions

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21
Q

antibiotics that bacteria can’t break the beta-lactam ring

A

ampicillin and pipercillin

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22
Q

beta lactase inhibitors are considered

A

time dependent killers in which we have to meet a minimum inhibitory concentration

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23
Q

cephalosporin beta lactams are similar to

A

penicillins

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24
Q

cephalosporin beta lactams spectrum

A

broad spectrum

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25
Q

how many generations of cephalosporin beta lactams are there

A

5 and gram negative coverage increases with each generation

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26
Q

cefazolin

A

(ancef) - first generation cephalosporin - most gram positive coverage

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27
Q

what is cefazolin used for

A

surgical prophylaxis

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28
Q

ceftriaxone

A

(Rocephin) third generation cephalosporin- can cross the blood brain barrier

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29
Q

how often do you give ceftriaxone

A

long acting (every 24 hr dose)

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30
Q

what is ceftriaxone given for

A

since it can cross the blood brain barrier it is given for meningitis but also broad spectrum so can be given for UTIs

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31
Q

cefepime

A

(Maxipime) 4th generation cephalosporin

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32
Q

what is cefepime used for

A

complicated UTI, skin infections, and community acquired PNA

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33
Q

ceftaroline

A

(Teflaro) 5th generation cephalosporin

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34
Q

what is ceftaroline effective against

A

MRSA and used for C-A PNA

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35
Q

carbapenems MOA

A

inhibits cell wall synthesis

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36
Q

carbapenems spectrum

A

broadest spectrum

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37
Q

carbapenems are used for

A

acutely ill and complicated infection

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38
Q

carbapenems have cross sensitivity with

A

penicillins

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39
Q

carbapenems need to be infused over

A

60 mins

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40
Q

carbapenems can cause drug induced

A

seizure activity that is more likely in geriatrics and those with CKD and is dependent on dosing

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41
Q

carbapenems example

A

imipenem/cilastatin (Primaxin), meropenem (Merrem), Ertapenem (Invanz)

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42
Q

cilastatin inhibits _________ from breaking down ________

A

cilastatin inhibits dehydropeptidase from breaking down imipenem

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43
Q

imipenem/cilastatin (Primaxin) is effective against

A

evolved bacteria

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44
Q

imipenem/cilastatin (Primaxin) indication

A

endocarditis (MRSA), hospital acquired pneumonia, intraabdominal infection, sepsis, UTI

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45
Q

Macrolides MOA

A

antibiotic - bacteriostatic that inhibits RNA protein synthesis

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46
Q

Macrolides indication

A

chlamydia, gonorrhea, syphilis, infection of eye, skin, and respiratory infection

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47
Q

Macrolides example

A

erythromycin and azithromycin

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48
Q

erythromycin side effects

A

it stimulates GI motility so N/V/D

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49
Q

azithromycin dosed

A

every 24 hours

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50
Q

aminoglycocides

A

antibiotic used for virulent gram negative bacteria

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51
Q

aminoglycocides example

A

gentamicin and tobramycin

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52
Q

aminoglycocides has what type of effect

A

synergistic effect

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53
Q

synergistic effect

A

the effect of 2 antibiotics used together is greater than each of them used alone. using beta lactams to break down cell wall makes it easier to get another antibiotic in

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54
Q

aminoglycocides side effects

A

ototoxic, nephrotoxic, and neurotoxic

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55
Q

aminoglycocides ototoxicity can cause

A

damage to CN 8, dizziness, tinnitus, hearing loss that is permanent

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56
Q

aminoglycocides nephrotoxicity can cause

A

proteinuria, urine casts, and reversible abnormal renal labs

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57
Q

aminoglycocides should be dosed based off

A

renal function

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58
Q

aminoglycocides neurotoxicity can cause

A

altered level of conscious to paralysis

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59
Q

clindamycin IND

A

sepsis, PNA, and bone, skin, respiratory, GU infection

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60
Q

clindamycin contraindicated in

A

ulcerative colitis

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61
Q

clindamycin can enhance

A

vecuronium which can lead to respiratory paralysis

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62
Q

linezolid also called

A

Zyvox

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63
Q

zyvox has been created to treat

A

VRE and also affective against MRSA

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64
Q

zyvox indication

A

skin and PNA with resistant bacteria

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65
Q

zyvox availability

A

great oral availability

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66
Q

side effects of zyvox

A

N/V/D, decrease platelets, serotonin toxicity

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67
Q

eating tyramine finds with zyvox can

A

increase blood pressure

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68
Q

zyvox can interact with what drugs

A

it can strengthen vasopressors

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69
Q

vancomycin

A

used to treat MRSA, gram positive, and severe bone/skin infections

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70
Q

oral form of vancomycin used for

A

C. diff

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71
Q

vancomycin side effects

A

ooo-nephron-neuro toxic, can cause additive neuromuscular blockade effects

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72
Q

if vancomycin infused too fast it can cause

A

hypotension or red man syndrome

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73
Q

how fast should vancomycin be administered

A

over more than 60 minutes

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74
Q

corticosteroids example

A

methylprednisolone and prednisone

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75
Q

biologics include

A

anti-cancer and anti-TNF drugs

76
Q

anti-TNF drug

A

adalimumab (Humira) and infliximab (Remicade)

77
Q

TNF is a

A

pro inflammatory cytokine

78
Q

IND for humira

A

RA, psoriasis, inflammatory bowel disease

79
Q

BBW of humira

A

infection and cancer risk

80
Q

infliximab (Remicade)

A

anti-TNF drug contraindicated in HF and has BBW of risk of infection and cancer

81
Q

immunomodulator examples

A

methotrexate and cyclosporine

82
Q

cyclosporine is for

A

organ rejection prevention

83
Q

what antibiotics should you take for inflammatory bowel disease

A

ciprofloxacin or metronidazole (flagyl)

84
Q

ciprofloxacin BBW

A

tendon rupture

85
Q

anticholinergics do what

A

slow peristalsis and have a drying effect on secretions

86
Q

anticholinergics example

A

belladonna alkaloids also called donnatal elixir

87
Q

belladonna alkaloids onset

A

1-2 hours

88
Q

side effect of anticholinergics

A

urinary retention

89
Q

opiates for diarrhea

A

slows peristalsis and has anticholinergic effects

90
Q

example of opiates used for diarrhea

A

diphenoxylate with atropine (Lomotil) and loperamide (Imodium A-D)

91
Q

diphenoxylate with atropine (Lomotil) onset

A

45-60 minutes

92
Q

loperamide (Imodium A-D) onset

A

1-3 hours

93
Q

bulk forming laxatives

A

absorb water into the intestines

94
Q

bulk forming laxatives example

A

psyllium (Metamucil)

95
Q

psyllium (Metamucil) is made from

A

seeds

96
Q

emollient laxatives

A

help water and fat into the the stool to soften it and to lubricate intestinal wall

97
Q

emollient laxatives example

A

decusate (colace) and oil enema

98
Q

decusate (colace) useful for

A

fecal impactions and hemorrhoids

99
Q

hyperosmotic laxative

A

draws water into colon

100
Q

hyperosmotic laxative example

A

lactulose

101
Q

lactulose can be given

A

orally or rectally

102
Q

lactulose does what

A

sugar draws water into bowel, converts ammonia into ammonium which cannot be reabsorb so it leaves with the stool

103
Q

stimulant laxative

A

stimulates nerves that innervate intestines to increase peristalsis and inhibits water reabsorption

104
Q

what laxative is most likely to cause dependence

A

stimulant laxative

105
Q

stimulant laxative example

A

bisacodyl (dulcolax) and Senna (senokot)

106
Q

bisacodyl (dulcolax)is given

A

oral or rectal suppository

107
Q

Senna (senokot) does what

A

causes bowel evacuation within 6-12 hours - may cause abd pain and is used for surgery if they want the bowels completely empty

108
Q

most misused over the counter drugs

A

laxatives

109
Q

laxatives are contraindicated in

A

fecal impaction, intestinal obstruction, and abdominal pain

110
Q

what can restore normal flora balance

A

lactobacillus

111
Q

if patient is on _____ of glucocorticoids they will need____

A

taking 10 mg or more of glucocorticoids daily they will need stress dosing in times of trauma

112
Q

exogenous administration of glucocorticoids causes

A

endogenous secretions to stop

113
Q

glucocorticoids do what

A

control inflammatory response by decreasing capillary permeability, decreases migration of WBC, and stabilizing mast cells. they also promote glycogenesis and stimulate bone demineralization

114
Q

glucocorticoids cause a risk for

A

circulatory collapse

115
Q

increased sodium and water cause K+ and H+ to

A

decrease

116
Q

glucocorticoids examples

A

hydrocortisone, solu-medrol, prednisone, and dexamethasone

117
Q

solu-medrol is for

A

rescue IV drug

118
Q

glucocorticoids IND

A

LUPUS, MS, ulcerative colitis, crohns, skin disorders, asthma, COPD, organ transplant, spinal cord injuries

119
Q

glucocorticoids considerations

A 
HF because of sodium and water retention 
psychosis
poor wound healing
hyperglycemia
osteoporosis
120
Q

mineralocorticoid example

A

fludrocortisone

121
Q

fludrocortisone IND

A

adrenocortical insufficiency (Addison disease)

122
Q

adverse effects of fludrocortisone

A

fluid volume overload, HF, HTN, increased intracranial pressure

123
Q

fludrocortisone dosing

A

PO only, small dose of 0.1 mg

124
Q

hydrocortisone has what type of effect

A

effect on mineralocorticoids because t is most similar to cortisol

125
Q

anti-emetic classes

A

anticholinergics, antihistamines, pro kinetics, anti-dopaminergic, serotonin blockers, tetrahydrocanabinoids

126
Q

anticholinergics do what

A

block ACh receptors, antisecretory, antispasmodic

127
Q

anticholinergics examples

A

scopolamine, dicyclomine, atropine, oxybutynin

128
Q

antihistamines do what

A

H1 blockers and anticholinergic effects

129
Q

examples of antihistamines

A

meclizine, diphenhydramine, hydroxyzine

130
Q

adjunct for antiemetics

A

dexamethasone and lorazepam

131
Q

antidopaminergics

A

block dopamine in the brain

132
Q

antidopaminergics have risk for

A

extrapyramidal effects and CNS depression

133
Q

antidopaminergics adverse effects

A

urinary retention, constipation, dry mouth

134
Q

cardiac considerations for antidopaminergics

A

monitor for prolonged QT

135
Q

example of antidopaminergics

A

promethazine (phenergan) and prochlorperazine (compazine)

136
Q

promethazine (phenergan) considerations

A

extreme care with IV route so dilute it

137
Q

promethazine (phenergan) BBW

A

res depression and tissue necrosis

138
Q

how do you administer promethazine (phenergan)

A

deep IM injection and PR

139
Q

prochlorperazine (compazine) BBW

A

geriatric death

140
Q

prokinetics do what

A

dopamine antagonist at the chemo receptor zone and stimulates peristalsis which enhances gastric motility and emptying

141
Q

example of pro kinetics

A

metoclopromide (reglan)

142
Q

metoclopromide (reglan)

A

is a prokinetic and has extrapyramidal effects with long term use

143
Q

is metoclopromide (reglan) okay with pregnancy

A

yes you can use for N/V in pregnancy

144
Q

metoclopromide (reglan) considerations

A

slow IV push or can cause hypotension or Supraventricular tachycardia

145
Q

metoclopromide (reglan) BBW

A

tardrive dyskinesia

146
Q

serotonin does what

A

stimulates vasodilation in GI, secretion, mobility, and sensation of intestine

147
Q

serotonin (5-HT3) blockers do what

A

block receptors in GI tract and brain

148
Q

serotonin (5-HT3) blockers examples

A

granisetron (kytril) and ondansetron (Zofran)

149
Q

when should you give serotonin (5-HT3) blockers

A

30 minutes before surgery ends and 30-60 minutes prior to chemo receptor

150
Q

adverse effects of serotonin (5-HT3) blockers

A

long QT and cardiac dysrhythmias if pushed too fast and headache

151
Q

what should you check before administering serotonin (5-HT3) blockers

A

liver function test

152
Q

how do you administer serotonin (5-HT3) blockers

A

IV push slow for 2-5 minutes

153
Q

examples of tetrahydrocannabinoid

A

Dronabinol (Marinol)

154
Q

what does tetrahydrocannabinoid do

A

inhibitory effects of cerebral cortex and reticular formation

155
Q

is tetrahydrocannabinoid intoxicating

A

no it is nonintoxicating

156
Q

what can tetrahydrocannabinoid stimulate

A

appetite and weight gain

157
Q

adverse effect of tetrahydrocannabinoid

A

drowsiness, anxiety, dry mouth, and dizziness

158
Q

tetrahydrocannabinoid most commonly used for

A

HIV/AIDs, cancer, and 2nd line when other antiemetics fail

159
Q

when should tetrahydrocannabinoid be given

A

1 hour before therapy

160
Q

proton pump inhibitor example

A

omeprazole and pantoprazole

161
Q

proton pump inhibitor does what

A

inhibits all H+ (HCL) secretion for 24 hour

162
Q

proton pump inhibitor is used for

A

stress ulcer prophylaxis

163
Q

achlorhydria

A

absence of hydrochloric acid

164
Q

what can achlorhydria cause

A

bacterial overgrowth, intestinal metaplasia, and speed up of bone mineral loss

165
Q

intestinal metaplasia

A

change the cells within the stomach lining

166
Q

why do proton pump inhibitors speed up bone mineral loss

A

because calcium is used for digestive process so when there is no acid it starts pulling from bones

167
Q

does proton pump inhibitors effect food absorption

A

no

168
Q

proton pump inhibitors put you at risk for

A

osteoporosis and C. diff

169
Q

omeprazole should be given

A

30-60 minutes before meals to prepare stomach for digestion

170
Q

omeprazole can mask

A

symptoms of serious underlying disease

171
Q

omeprazole and NG tube

A

can block tube so ask for liquid form

172
Q

pantoprazole is given for

A

IV infusion for GI bleeding

173
Q

how is pantoprazole given

A

bolus and continuous

174
Q

antithyroid drugs

A

methimazole (tapazole) and propylthiouracil PTU

175
Q

antithyroid drugs impedes

A

formation of TH but does not act on circulating hormone so can take approximately 2 weeks to work

176
Q

widespread side effects of antithyroid drugs

A

bone marrow and liver toxicity and loss of stamina and weight gain

177
Q

levothyroxine

A

works like thyroid hormone which increases metabolism, increase cardiac output, increase blood flow to kidneys

178
Q

side effect of levothyroxine

A

based on giving too much or too little

179
Q

contraindications for levothyroxine

A

MI, cardiac considerations

180
Q

onset of levothyroxine

A

3-5 days usually oral but IV available for myxedema coma

181
Q

elimination of levothyroxine

A

1/2 life of 6-10 days so risk for toxicity

182
Q

levothyroxine is highly

A

protein bond

183
Q

increased metabolism from levothyroxine does what

A

increase oxygen consumption and overall cell reproduction

184
Q

red man syndrome

A

hypotension and erythema

185
Q

extrapyramidal symptoms

A

twitching

186
Q

tardive dyskinesia

A

permanent twitching

Nursing school level 2 (15 decks)

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