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Pharamacology Flashcards

1
Q

What are some side effects of Tetracyclines?

A

Photosensitivity
*Stains perm. teeth if given to children <8
GI upset
renal/hepatic

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2
Q

what drug classes shoul you avoid milk and antacids?

A

tetracyclines and fluoroquinolones

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3
Q

What 3 things needs to be avoided with Tetracyclines?

A

Milk
Antacids
Iron salts

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4
Q

What are some pt education points for tetracyclines?

A

Avoid milk, iron salts, antacids
Take on an empty stomach
Sit up for 30 mins after taking
Do not take w/in 1 hour of bedtime

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5
Q

What are common suffixes for tetracyclines?

A

-cycline

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6
Q

What are aminoglycosides used to treat?

A

Nosocomial Infections
UTIs
CNS infections
Prevention of Endocarditis

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7
Q

What drugs have ototoxicity as an adverse effect

A

vancomycin
aminoglycosides

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8
Q

What are side effects of
aminoglycosides?

A

ototoxicity (loop diuretics increases risks)
neurologic systems decrease
peripheral neuropathy
nephrotoxity
renal failure

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9
Q

What are the common suffixes of Aminoglycosides?

A

-mycin
-micin

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10
Q

When are carbapenems used?

A

LAST LINE of defense
Life-threatening infections resistant to other meds

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11
Q

Side effects of carbapenems?

A

Hypotension
Hyperkalemia
Resp. distress
Seizures
Death

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12
Q

what can a pt aquire when taking momobactams

A

an oral or vaginal candida infection

prescribe miconazole (monistat) for vag and nytatin (mycostatatin) for oral

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13
Q

What are contraindications of carbapenems/monobactams?

A

Use of aminoglycosides

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14
Q

What do carbapenems end in?

A

-penem

Imipenem Cilastatin
Meropenem (Merrem)

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15
Q

What is do all these drugs have in common: monobactams, penicillin, vancomycin, cephisorn, amphotericin b (fungazone), and acyclovir (zovirax)?

A

IV site thrombophlebitis

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16
Q

what is a strage adverse effect for metronidazole?

A

metsllic taste

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17
Q

what two drug classes have peripheral neuropathy?

A

metronidazole and aminoglycosides

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18
Q

what are the two drugs you need to know for metronidazole?

A

tinidazole
iodoquinol

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19
Q

what are adverse effects of metronidazole?

A

metallic taste
GI
CNS symptoms
darkening of urine
superinfection w/ due to antibacterial and antiprotozoal properties

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20
Q

When should you stop taking metronidazole?

A

sever cns sympotoms of seizure and perpheral neuropathy

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21
Q

what are metronidazole used to treat?

A

antibacterial, antiprotozoal, and anthelmintic

protozoal infections, intrabdominal and gynecologic

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22
Q

What medications are used to treat malaria?

A

QUININES
chloroquine
primaquine

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23
Q

How is antimalarial medication presribed?

A

Begin 2 weeks before your travel (500 mg/wk)
Take 4 weeks after arrival home
1 g orally for an acute attack

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24
Q

What are six things are cephalosporins used for?

A

middle ear
throat
tonsils
bronchitis
pneumonia
UTIs

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25
Q

Are cephalosporins bactericidal or bacteriostatic?

A

bacteriostatic

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26
Q

What do cephalosporins end or start with?

A

ceph-
-cef

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27
Q

Side effects of cephalosporins

7

A

GI upset
liver/kidney issues
serum sickness
blood sugar (hyperglycemia
confusion
bleeding
hypersensitivity

Serum sickness- fever, edema, hives, inflammation of blood vessels and joints

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28
Q

Are penicillins bactericidal or bacteriostatic?

A

bactericidal

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29
Q

what are all the kissing counsins of penicillin?

A

cephalosporins, carbapenems, monobactams

cephalosporins (cephalexin), carbapenems (imipenem/cilastain & meropenem) monobactams (aztreonam),

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30
Q

what drug should you use a different form of birth control?

A

Use an alternate form of birth control for penicillins

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31
Q

Side effects of penicillin

A

Gi issues
Hypersensitivity
CNS reactions
*sensitivity to Betalactams
*serum sickness
*anaphylaxis

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32
Q

Examples of Penicillins

A

Penicillin G
Penicillin V
Zosyn
Unasyn
Timentin
Augmentin

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33
Q

What example do you need to know for sulfonamides?

A

co-trimoxazole

some end in -azole/azine

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34
Q

what should you use sulfonamides for?

A

UTIs
patient allergic to penicillin

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35
Q

what should you do for photosensitivity?

A

use sunblock/avoid sun

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36
Q

what drugs have photosensivtiy as an adverse effect?

A

fluoroquinolones
tetracyclines
sulfonamides

fts

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37
Q

What is a side effect of sulfonamides?

8 things

A

photosensitivity
GI
crystalluria
hematuria
sulfasalazine
hyperglycemia
stevens-jognson sydrome
hemorrhage when given with warfarin

sulfasalazine (neon yellow)

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38
Q

What are side effects of Vancomycin?

A

Red Man Syndrome
Ototoxicity
thrombophelbitis
nephrotoxicity

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39
Q

What are some contraindications of vancomycin?

A

Corn allergy
hearing impairment
use w/ Metformin

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40
Q

What is important for the nurse to monitor in a pt who is taking vancomycin?

A

Peaks and troughs
IV site
kidney levels
*baseline hearing

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41
Q

which drug classes both have crystalluria as a side effect?

A

fluroquinolones and sulfonamides

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42
Q

what should you avoid when taking fluoroquinolones?

A

tasks that require alertness and caffeinated products

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43
Q

what are fluoroquinolones used for?

A

UTIs
URIs
respiratory, skin, GI, and bon and joint infection

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44
Q

what drug examples do you need to know for fluoroquinolones?

A

cirprofloxacin
levofloxacin

end in floxacin

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45
Q

What are some side effects of fluroquinolones?

A

photosensitivty
dizziness
GI
rash
fluoquinolones toxicity*
crystalluria

toxic effect on skeletal, tendons, and cartillage

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46
Q

What is the identifier for macrolides?

A

erythromycin
azithromycin
clarithromycin

-thromycin

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47
Q

What can you not have when talking macrolides?

A

no fruit juice

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48
Q

What are side effects of macrolides?

A

increase in esinophils
increase in theophylline levels
increase risk of toxicity
GI

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49
Q

What are the components of a blood culture?

A

Aerobic and anaerobic cultures
Drawn twice
DRAW B4 GIVING MED

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50
Q

What are peaks and troughs?

A

Peak- highest amount of drug, drawn 30 mins to 1 hour after IV injection
Trough- lowest level of drug, draw just before next dose

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51
Q

What is Stevens-Johnson syndrome?

A

Allergic reaction causing:
reddish-purple rash
skin sloughing
swelling of tongue, face, blisters in mouth
can have fever, sore throat, cough, eye pain prior to rash

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52
Q

What is a superinfection?

A

Infection following a current infection
Normal flora is killed
Resistant bacteria is formed

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53
Q

What are antifungals used for?

A

superficial or systemic fungal infections
treat opportunistic infections that happen when the immune system defense is compromised

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54
Q

what is oral candida also know as?

A

thrush

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55
Q

what should you use nystatin (mycostatin) oral suspension for?

A

candid infection (thrush) “swish and swallow”

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56
Q

What needs to be done before administering amphotericin B

A

give a test dose; think about peaks and troughs

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57
Q

which drug has less adverse effect than amphotericine (fungazone)?

A

the lipid based form of Fungazone, it is much more expensive

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58
Q

what should you give with amphotericin B to minimize uncomfortable reactions?

A

diphenhydramine and acetaminophen

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59
Q

Adverse effects of amphotericin B?

A

Bone marrow suppression
Thrombophlebitis
Renal toxicity
chills/fever/tachycardia/hypotension/headache (go away 1-2 hours after infusion)
hypomagnesemia
hypokalemia
chills
fever
GI
anorexia
muscle & joint pain
hypotension
flushing

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60
Q

What does the oral form of ketoconazole require?

A

Acid medium for absorption

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61
Q

What does. the antiinfective acyclovir (zovirax) treat?

A

herpes simplex and herpes zoster

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62
Q

Side effects of acyclovir?

A

topical-burning, itching @ site
oral- n/v, diarrhea, headache, vertigo
IV- thrombophlebitis, CNS toxicity

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63
Q

How do we care for anaphylaxis?

A

Remove trigger (if known)
position in a way to promote ventilation & circulation
Tube if going south fast
hypotension=trendelenberg position

64
Q

What drug is given for anaphylaxis ?

A

Epinephrine

65
Q

Action of anithistamines?

A

compete with histamine @ receptor sites

66
Q

When do histamines work best?

A

Early in response cycle

67
Q

Second gen compared to first gen?

A

Do not cause as much sedation as 1st generation
Don’t cross blood-brain barrier à “peripherally acting”
Longer acting
don’t cause the CNS depression
taken during the day
don’t cause the drowsiness

68
Q

what are the 2nd gen you need to know?

A

loratadine (claritin)
cetririzine (zyrtec)

Loratadine (Claritin) Decreased symptoms of allergic symptoms (nasal stuffiness, red swollen eyes, itching)
Cetirizine (Zyrtec) - Given for allergic/seasonal rhinitis and urticaria (hives)

69
Q

What are the 1st gen antihistamines?

A

Diphenhydramine (Benadryl), promethazine (Phenegran), dimenhydrinate (Dramamine)

70
Q

What are antihistamines used for?

A

Antihistamine effects
CNS depression
Anticholinergic effect
Not useful in extreme anaphylaxis
Not useful as monotherapy

71
Q

Anticholinergic effects

A

Can’t see
Can’t pee
Can’t spit
Can’t shit

Dimenhydrinate (Dramamine)

Promethazine (Phenergan) – Nausea; Anticholinergic

72
Q

What are the primary uses of antihistamines?

Diphenhydramine, Promethazine, Dimenhydrinate

A

nasal allergies, hay fever, hives, mild blood transfusion reaction

73
Q

What are secondary uses of antihistamines?

Diphenhydramine, Promethazine, Dimenhydrinate

A

motion sickness, vertigo, Parkinson’s, anaphylactic reactions, sleep aid

74
Q

Contraindications of antihistamines?

A

3rd trimester of pregnancy
4 days before allergy testing
clients under 2 years (phenegran only)

75
Q

Major side effects of antihistamines

A

hypotension, syncope, unsteady gait

Phenegran only: resp. depression

76
Q

What are nasal decongestants used for?

A

decreases swollen nasal mucosa and decrease stuffiness

77
Q

what does loratdine do?

A

Decreases symptoms of allergies
Nasal stuffiness
red swollen eyes
itching

78
Q

Cetirizine (Zyrtec) assessment

A

CNS depressants
Pregnancy risk B
Renal/hepatic impairment Geri; lower dose
Children; don’t give to under 6yrs w/ renal/hepatic
impairment

79
Q

Loratdine (Claritin) contraidications

A

CNS depressants
Pregnancy risk B
Sunlight
Geriatric

80
Q

Cetirizine (Zyrtec) adverse reactions

A

Mouth dryness
Dizziness
drowsiness

81
Q

what is cetirizine used for?

A

Allergic/seasonal rhinitis
and urticaria (hives)

82
Q

Loratdine (Claritin) adverse reactions

A

Dry mouth
Photosensitivity

83
Q

t/f adrenergic nasal decongestants can be used for long term use

Oxymetazoline (afrin)

A

Use no more than 3 days
at a time
Not for long term use

84
Q

what does anticholinergic nasal decongestants do?

Ipratroqium (Atrovent)

A

Decreases secretions
Blocks acetylcholine
Does not cause the rebound congestion
Prime by spraying 7 times
before use

Side effects:
-Sore throat, nasal dryness

85
Q

what does adrenergic nasal decongestants do?

Oxymetazoline (afrin)

A

dilated arterioles
in the nose to constrict
decreases blood flow amd
congestion
causes heart rate to go up
Causes vasoconstriction

86
Q

what is the adrenergic nasal decongestants?

A

Oxymetazoline (afrin)

87
Q

what is the anticholinergic nasal decongestants?

A

Ipratroqium (Atrovent)

88
Q

Examples of nasal decongestants

A

Phenylephrine
Ephedrine
Naphazoline
Pseudoephedrine (sudafed)
Oxymetazoline (Afrin)
Ipratropium (Atrovent)
Fluticasone propionate (flonase)

Oxymetazoline (Afrin) adrenergic
Ipratropium (Atrovent) anticholinergics
Fluticasone propionate (flonase) corticosteriods

89
Q

what do do you need to know about corticosteriods nasal spary

Fluticasone propinate
(flonase)

A

Treats allergic rhinitis
caused by airborne allergens
Don’t give to anyone under
4yrs
Can decrease growth in
children
nasal burning

90
Q

when should you avoid adrenergic (Oxymetazoline (afrin))?

A

HTN
cardiovascular disease
dysrhythmia
narrow angle glaucoma
stroke

91
Q

t/f you should take adrenergic longer than 3 days

A

fals; don’t take Oxymetazoline (afrin) longer then 3 days

92
Q

what is the corticosteroids nasal spray?

A

Fluticasone propinate
(flonase)

93
Q

Which nasal decongestant can be used long term?

A

Fluticasone propinate
(flonase)

94
Q

Contraindications of nasal decongestants

A

Hx of: hypertension, uncontrolled cardio disease, dysrhythmia
Narrow angle glaucoma
CVA, TIAs
Chronic Asthma
BPH

95
Q

Side effects of Nasal Decon?

A

HTN, palpitations
rebound congestion
headache

96
Q

What do you switch pt to after 3-5 days of Afrin?

A

Pseudoephedrine
(Sudafed)

97
Q

What do antitussives do?

A

Opioids:
suppress cough reflex
analgesic and drying

Non-opioids: suppress cough reflex (dextromethorphan)
Numb receptor cells that cause cough (Benzonatate)

98
Q

Antitussive Examples?

A

Codiene -opiods

Dextromethorphan (Robitussin) - non-opioid
Benzonatate (Tessalon
Perles) - Non-opioid
Diphenhydramine (Benadryl) -Antihistamine

99
Q

What type of cough are antitussives used for?

A

nonproductive cough

100
Q

Contraindications of antitussives?

A

individuals at high risk for resp. depression, sedation (such as elderly)

101
Q

Adverse effects of anti-tussives?

A

N/O: nausea, dizziness, sedation (bendaryl), euphoria (in high doses)

O: CNS effects, Gi effects, abuse potential

102
Q

How do expectorants work

A

Thin the viscosity thus increasing the amount of secretions to be expelled

103
Q

example of expectorant

A

Guaifenesin (Mucinex)

104
Q

Adverse effects of Mucinex

expectorant

A

GI upset, drowsy/dizzy, rash

105
Q

Nurse notes for Mucinex?

expectorant

A

Make sure pt is hydrated
Watch for Tylenol inclusion
Short half life-repeat dose

106
Q

how do mucolytics work?

A

Stimulate glands in respiratory tract
Breakdown and thin secretions

Muscle relaxant properties

107
Q

what are two lower respiratory tract disorders?

A

Asthma
COPD (chronic obstructive pulmonary disease)

108
Q

Examples of mucolytics?

A

Hypertonic saline
(3-7%NS)
Hypertonic sodium chloride (3-7%NS)
Acetylcysteine (NAC)

109
Q

what kind of smell does mucolytics have

Hypertonic saline
(3-7%NS)
Hypertonic sodium chloride (3-7%NS)
Acetylcysteine (NAC)

A

smells like rotten eggs

110
Q

When are mucolytics used

A

acute and/or chronic pulmonary disorders w/ lots of secretions
Mucomyst is antidote for Tylenol overdose
prevent renal dysfunction

111
Q

When would you not give mucomyst?

A

In pt w/ severe asthma

112
Q

Adverse effects of mucomyst?

A

bronchospasm, sore throat, cough, dizziness, hypotension

113
Q

Education for mucomyst?

A

2-3L fluid / day
Mix w/ fruit juices/sodas/water
Watch for acetaminophen toxicity (ALT, AST)

114
Q

Beta2-Adrenergic Agonists examples

A

Albuterol (Proventil) (short
acting)
Levalbuterol (Xopenex)
(short acting)
Formoterol (Foradil) (long
acting)
Salmeterol (Serevent)
(long acting)
Terbutaline (Brethine)
(short acting)

115
Q

Xathine examples

A

Xathine Derivatives
(methylxanthines)
Theophylline (Theo-24)

116
Q

Theophylline (Theo-24) Therapeutic blood levels

A

5-15 mcg/mL
Adverse effects more common with levels of 20-25
mcg/mL

117
Q

Anticholinergics examples

A

Ipratropium (Atrovent)
Tiotropium (Spiriva)

118
Q

list all the brochodilators

A

beta-adrenergic agonists
anticholinergics
xanthine

**beta-adrenergic agonists
**Albuterol (Proventil) (short
acting)
Levalbuterol (Xopenex)
(short acting)
Formoterol (Foradil) (long
acting)
Salmeterol (Serevent)
(long acting)
Terbutaline (Brethine)
(short acting)
anticholinergics
Ipratropium (Atrovent)
Tiotropium (Spiriva)
xanthine
Xathine Derivatives
(methylxanthines)
Theophylline (Theo-24)

119
Q

What are characteristics of asthma?

A

Inflammation
Bronchoconstriction
Mucosal edema
Viscous mucous

120
Q

What is given for an asthma attack?

A

Albuterol

121
Q

What is important education for pts with asthma?

A

Teach them which inhaler is for attacks and which is for prevention
Teach how to use a spacer

122
Q

Assessment in a pt with asthma?

A

O2, HR, BP (before and after)
skin color/temp
RR, depth, rhythm
breath sounds
s/s of resp. distress

123
Q

Teaching on how to use diff inhalers together?

A

Wait 1-2 mins before giving 2nd puff

If taking 2 diff. inhalers: give SHORT ACTING FIRST, wait. 2-5 mins, then long-acting

124
Q

What to do after using a corticosteroid nebulizer?

A

Rinse out mouth to prevent thrush

125
Q

What is COPD characterized by?

A

chronic bronchitis and emphysema

Destruction of the respiratory walls characterized by
one or both

126
Q

What is the #1 Beta2 Adrenergic agonist?

A

Albuterol

127
Q

How does Albuterol work

A

Reduces airway constriction

128
Q

Why are beta-adrenergic agonists used?

A

long term control of asthma
short term control of asthma attack

129
Q

Contraindications of Beta2 Adrenergic receptors?

A

epinephrine, norepinephrine, and dopamine, or cocaine and methamphetamines
Client who have diabetes
mellitus, hyperthyroidism,
heart disease, hypertension, and angina

130
Q

What does overdose of beta2 AAs look like?

A

N/V, paradoxical bronchospasm, tremors

Use “watch and wait”, treat as symps arise

131
Q

How do inhaled anticholinergics work? Why are they used?

A

Block acetylcholine receptors = indirect bronchodilation (open airways)

Prevention of bronchospasm (not for attacks)

Not a rescue inhaler

132
Q

How do Xanthines work?

A

relax bronchial smooth muscle (allows dilation)

133
Q

Why are Xanthines used?

A

Adjunct med for COPD
mild-mod asthma

134
Q

What is therapeutic range of theophylline (Xanthine)?

A

5-15 mcg/ml

135
Q

Xanthine Toxicity/overdose

A

GI
CNS stimulation
Cardia arrythmias can occur with high dose, chest
pains, flushing

136
Q

Side effects of Xanthine?

A

N/V
Anorexia
gastroesophageal reflux
during sleep
Tachycardia
palpitation
dysrhythmias
temporary hyperglycemia
Increase in urination

137
Q

Non-bronchodilators

A

leukotriene receptor antagonists
corticosteroids
mast cell stabilizers

leukotriene receptor antagonistsMontelukast (Singulair)
Zafirlukast (Accolate)
Zileuton (Zyflo)
**corticosteroids
mast cell stabilizers
Cromolyn (Intal)

138
Q

Examples of Leukotriene Modifiers

A

Montelukast (Singulair)
Zafirlukast (Accolate)
Zileuton (Zyflo)

139
Q

What do luekotriene modifiers do?

A

Dilate & open bronchioles

140
Q

How long does it take to see benefits of leukotrienes?

A

About a week

141
Q

Side effects of leukotriene modifiers?

A

Zafirlukast (Accolate): liver dysfunc.
Zileuton (Zyflo): dizziness, insonia, liver dysfunc.
Montelukast (Singulair): heartburn

142
Q

How do inhaled corticosteroids work?

A

Stabilize cell membranes that release bronchoconstrictors
Restores responsiveness of bronchial smooth muscle

143
Q

Why are inhaled corticosteroids used?

A

status asthmaticus
lung maturity & resp. distress in preterm birth
acute exacerbations of COPD, cystic fibrosis, bronchitis

144
Q

How long does it take to see effects of inhaled corticosteroids

A

A few weeks

145
Q

What can inhaled corticosteroids cause?

A

thrush, stunt bone growth, sore throat, suppression of adrenal gland function, bone loss

146
Q

Example of mast cell stabilizer

A

Cromolyn (Intal)

147
Q

What is Intal used for?

A

long-term treatment of asthma

148
Q

Side effects of intal?

A

dizziness, headache
rash, itchiness,
nasal congestion, nasal irrigation
nausea
paradoxical bronchospasm

149
Q

Pt teaching for Intal?

A

Take 3-5 mins AFTER ALBUTEROL
Rinse mouthpiece frequently
Can take 2-4 WEEKS to see improvement
NOT A RESCUE MED

150
Q

Contraindications of antitussives?

A

individuals at high risk for resp. depression, sedation (such as elderly)

151
Q

which drug classes both have crystalluria as a side effect?

A

fluroquinolones and sulfonamides

152
Q

t/f you should take adrenergic longer than 3 days

A

false; don’t take

153
Q

what are two lower respiratory tract disorders?

A

Asthma
COPD (chronic obstructive pulmonary disease)

154
Q

Anticholinergics examples

A

Ipratropium (Atrovent)
Tiotropium (Spiriva)

155
Q

Xanthine Toxicity/overdose

A

GI
CNS stimulation
Cardia arrythmias can occur with high dose, chest
pains, flushing

Pharm (14 decks)

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