pathopharm 1 drugs mod 5 Flashcards

1
Q

sodium bicarbonate MOA

A

dissociates to provide bicarb ion which neutralizes ion concentration and raises blood and urinary pH

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2
Q

sodium bicarb indications

A

metabolic acidosis

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3
Q

sodium bicarb SE

A

-edema & pulmonary edema
-cerebral hemorrhage
-hypernatremia
-abnormal lytes
-tetany
-metabolic alkalosis
-heart failure
-flatulence w/ long term use

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4
Q

sodium bicarb nursing considerations

A

-monitor lytes, ABGs, and cardiac
PO med, do not give IV for hyponatremia (if given IV monitor patency)
-lots of drug interactions
-give 1 to 3 hrs after meals

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5
Q

potassium chloride MOA

A

giving K+

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6
Q

potassium chloride indications

A

treat/prevent K+ depletions when dietary measures provide inadequate

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7
Q

potassium chloride nursing considerations

A

-bad taste, dilute w/ water or juice if powder
-GI ulcers/bleeding
-IV must always be diluted & never IV push
-cannot give IV if pt is not peeing
-IV might cause pain or phlebitis
-have pt on tele always think heart

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8
Q

potassium chloride contraindications

A

-renal failure (always question order if pt is on dialysis)

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9
Q

polystyrene sulfonate MOA

A

binds to K+ in the digestive tract replacing K+ ions for sodium ions

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10
Q

polystyrene sulfonate indications

A

to treat high levels of potassium in the blood

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11
Q

polystyrene sulfonate SE

A

-constipation
-diarrhea
-N/V
-hypokalemia
-(severe) intestinal obstruction & necrosis

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12
Q

polystyrene sulfonate precautions

A

only use in pts w/ normal bowel functions

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13
Q

what drug do you use for an emergent pt that has hyperkalemia

A

D50/Insullin

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14
Q

oral magnesium name

A

mylanta or magnesium sulfate

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15
Q

IV magnesium

A

(magnesium sulfate) replace over several days & can give push if needed

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16
Q

magnesium sulfate MOA

A

replaces Mg

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17
Q

magnesium sulfate indication

A

hypomag, prevent/treat seizures in pre eclampsia, treat cardiac rhythm disturbances

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18
Q

magnesium sulfate SE

A

-hypermag
-confusion/sluggish
-slow movements
-SOB
-nausea
-dizzy
-abnormal heart rhythm

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19
Q

magnesium oxide

A

antacid, can be given for long term low mag

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20
Q

how should you give calcium chloride or gluconate

A

through a central line

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21
Q

when given oral calcium what else might you need

A

Vitamin D

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22
Q

how to give IV phos

A

over long period of time

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23
Q

Phosphorus nursing considerations

A

take care w/ CKD or hypercalcemia bc of increased risk of calcifications

24
Q

class: polyenes

A

-nystatin
-amphotericin

25
Q

class: pyrimidine

A

flucytosine

26
Q

class: azoles

A

fluconazole

27
Q

class: misc. agents

A

grisefulvin

28
Q

Nystatin indications

A

treatment of superficial candida infections of mouth, oral mucosa, vagina, topical, vaginal (yeast)

29
Q

Nystatin SE

A

-mild skin irritation
-N/V/D
-poor GI absorption

30
Q

Nystatin nursing considerations

A

-too toxic for parental administration
-not for systemic infection

31
Q

amphotericin B MOA

A

binds to erosterol in fungal cell membranes and causes them to become leaky and destroy cell wall of the fungus

32
Q

amphotericin B indications

A

-agent of choice for most systemic mycoses (fungal)

33
Q

amphotericin B nursing considerations

A

-can be given PO or IV
-dilute & infuse slowly (every other day for months, possible PICC line)
-monitor BUN, creatinine & pt on tele
-synergistic effects when given w/ flucytosine so help decrease SE

34
Q

amphotericin B SE

A

-kidney dysfunction
-cardiac dysthymias
-fever
-pain
-nausea
-headache

35
Q

what do you give to pre treat amphotericin B

A

-diphenhydramine
-acetaminophen
-aspirin

36
Q

flucytosine MOA

A

inhibits fungal DNA synthesis

37
Q

flucytosine indications

A

allows for a lower dose of amphotericin B to be used

38
Q

flucytosine nursing considerations

A

usually never given alone

39
Q

fluconazole (& all other “zoles”) MOA

A

interrupts the integrity of the cell wall by interfering w/ the synthesis of ergosterol

40
Q

fluconazole (& all other “zoles”) indications

A

used for both superficial and less serious systemic fungal infections

41
Q

fluconazole (& all other “zoles”) SE

A

-redness/burning/itching (topical)
-severe GI upset (systemic)
-liver toxicity (systemic)

42
Q

fluconazole (& all other “zoles”) nursing considerations

A

-take w/ food to minimize SE
-if oral, separate at least 2 hr from antacids & drugs that decrease stomach acid

43
Q

just fluconazole nursing considerations

A

-if giving IV, do not mix with other meds
-monitor coags for pt on warfarin
-watch for hypogly for pts w/ sulfonylureas

44
Q

fluconazole advantages

A

rapidly and completely absorbed when given orally - able to reach bones, CNS, eyes, respiratory and urinary tracts (much less toxic than amphotericin )

45
Q

fluconazole disadvantages

A

-narrow spectrum
-many drug interactions (CYP450 pathway)

46
Q

grisefulvin MOA

A

inhibits fungal mitosis -> binds to keratin

47
Q

grisefulvin SE

A

-bone marrow suppression
-rash
-CNS changes
-N/V/D
-anorexia

48
Q

grisefulvin indications

A

resistant dermatophyte infection of scalp, skin and nails

49
Q

class: granulocyte colony stimulating factors (G-CSF) -> hematopoietic agents

A

-filgrastim
-pegfilgrastim (long acting form)

50
Q

filgrastim MOA

A

promotes proliferation, differentiation, activation of cells that make granulocytes

51
Q

filgrastim indications

A

malignancies, chemo induced leukopenia, bone marrow transplant, harvesting of hematopoietic stem cells, chronic neutropenia

52
Q

filgrastim SE

A

-bone pain
-leukocytosis

53
Q

pegfilgrastim MOA

A

increased production of neutrophils

54
Q

pegfilgrastim SE

A

bone pain

55
Q

pegfilgrastim nursing considerations

A

long acting derivative of filgrastim