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Advanced Med Surg > Pharm 2: Immune, Endocrine, Renal > Flashcards

Pharm 2: Immune, Endocrine, Renal Flashcards

1
Q

nebulized medication to treat and prevent PCP

A

pentamidine (NebuPent)

30-45 min/dose

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2
Q

Nsg intervention and things to monitor (4) for pt on pentamidine

A

Nsg-frequent movement for distribution

Monitor:

BP (severe HoTN)
EKG
Hypoglycemia
BUN/creatinine (nephrotoxicity)

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3
Q

do not give this with pentamidine and why

A

e-mycin

r/f fatal dysrhythmias

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4
Q

Possible AE of metronidazole (6)

A 
dark urine
nvd/c  -  take with food
oral/vaginal candidiasis
decreased WBCs and plts 
disulfiram-like reaction with alcohol
increased r/f bleeding with coumadin
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5
Q

NNRTI

A

inhibits reverse transcriptase before virus enters nucleus
nevirapine (Viramune)
kills good and bad cells

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6
Q

AE of nevirapine (Viramune)

A

flu-like s/s
abn LFTs
SJS

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7
Q

NRTI

A

zidovudine (AZT)–inhibits reverse transcriptase in nucleus

treat and prevent maternal transmission of HIV

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8
Q

keep pt upright while administering and 30 min after giving

A

AZT

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9
Q

biggest AE of HIV treatment in general

A

leukopenia

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10
Q

biggest AE of AZT

A

macrocytic anemia

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11
Q

when using benadryl avoid

A

alcohol, will increase sedation effect

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12
Q

antihistamines aka

A

H1 blockers–block H1 receptors, which decreases histamine release and results in less mucus production

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13
Q

acyclovir (Zovirax) treats

A

Herpes viruses: HSV, herpes zoster, varicella

AIDS pts more likely to get HSV infection

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14
Q

doxorubicin (Adriamycin) is an antineoplastic that also treats

A

Kaposi’s Sarcoma

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15
Q

doxorubicin admin (2)

A

increase fluids 2000-3000/day

anti-emetic 45 min before dose

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16
Q

gown, gloves, and mask when handling med and urine

for pts on this med

A

doxorubicin

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17
Q

this med can cause red urine, hair loss, cellulitis

A

doxorubicin

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18
Q

antibiotic used to treat/prevent PCP

A

sulfamethoxazole with trimethoprim (SMX-TMP) (Bactrim)

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19
Q

Bactrim admin

A

take with food and full glass of water

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20
Q

AE of Bactrim

A

r/f SJS and hypersensitivity reaction
nephrotoxicity- monitor BUN/creatinine
photosensitivity
crystalluria and stones–increase fluids

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21
Q

cyclosporine (Sandimmune)

action and indications

A

inhibits T cell activation
prevention and treatment of organ transplant rejection (used with steroids)
severe RA
unlabeled–UC

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22
Q

avoid grapefruit/juice with this med because it can increase absorption and lead to toxicity

A

cyclosporine

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23
Q

this med causes increased r/f skin cancer due to decreased immunity and photosensitivity

A

cyclosporine

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24
Q

azathioprine (Imuran)

action and indications

A

blocks T cell proliferation
prevent transplant rejection (in combo with cyclosporine and steroids)
severe RA unresponsive to other meds

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25
Q

watch for this with pt on Imuran

A

bleeding, causes thrombocytopenia

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26
Q

admin of Imuran

A

give with or after meals to decrease nausea

omit missed dose

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27
Q

drug interactions with steroids

A

vaccines
NSAIDS/EtOH (increase r/f gastric bleeding)
coumadin
K-depleting agents (increased K loss)

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28
Q

synthetic ACTH; stimulates release from adrenals of cortisol, aldosterone, androgens

A

Cosyntropin

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29
Q

AE of Cosynropin

A

can cause edema and HTN

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30
Q

meds that mimic GH; indications

A

somatropin and somatrem

hypopituitary dwarfism

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31
Q

AE of somatropin

A

hypothyroidism

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32
Q

fludrocortisone (Florinef) indications

A

adrenocortical insufficiency in Addison’s disease; corticosteroid but used for mineralocorticoid effects, which it also has (Na retention and K excretion)

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33
Q

Florinef AE

A

edema, HTN, HF, hypokalemia

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34
Q

med that inhibits GH release (synthetic somatostatin); indications

A

octreotide (Sandostatin)

treatment of carcinoid tumors/crisis and acromegaly

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35
Q

powerful vasoconstrictor that mimics ADH; used in emergency cardiac arrest

A

vasopressin

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36
Q

with vasopressin, monitor for

A

IV site infiltration, can cause necrosis

37
Q

synthetic ADH; indications

A

desmopressing (DDAVP)

DI; nocturnal enuresis; pt should show decrease in UO

38
Q

synthetic T4 and effects

A

levothyroxine (Synthroid)

treat hypothyroidism and increase force of heart contraction; decreases TSH levels; lifelong therapy

39
Q

most significant AE of Synthroid

A

cardiac dysrhythmia/palpitations, first dose tachycardia

40
Q

treatment for HTN secondary to thyroid storm

A

propanolol (Inderal)

41
Q

AE of Cosynropin

A

can cause edema and HTN

42
Q

meds that mimic GH; indications

A

somatropin and somatrem

hypopituitary dwarfism

43
Q

AE of somatropin

A

hypothyroidism

44
Q

fludrocortisone (Florinef) indications

A

adrenocortical insufficiency in Addison’s disease; corticosteroid but used for mineralocorticoid effects, which it also has (Na retention and K excretion)

45
Q

Florinef AE

A

edema, HTN, HF, hypokalemia

46
Q

med that inhibits GH release (synthetic somatostatin); indications

A

octreotide (Sandostatin)

treatment of carcinoid tumors/crisis and acromegaly

47
Q

powerful vasoconstrictor that mimics ADH; used in emergency cardiac arrest

A

vasopressin

48
Q

with vasopressin, monitor for

A

IV site infiltration, can cause necrosis

49
Q

synthetic ADH; indications

A

desmopressing (DDAVP)

DI; nocturnal enuresis; pt should show decrease in UO

50
Q

synthetic T4 and effects

A

levothyroxine (Synthroid)

treat hypothyroidism and increase force of heart contraction; decreases TSH levels; lifelong therapy

51
Q

most significant AE of Synthroid

A

cardiac dysrhythmia/palpitations, first dose tachycardia

52
Q

treatment for HTN secondary to thyroid storm

A

propanolol (Inderal)

52
Q

Carbonic Anhydrase Inhibitors

A

Diuretics that promote Na, K, and HCO3 excretion by inhibiting carbonic anhydrase

53
Q

Carbonic anhydrase inhibitor suffix and indications

A

-Zolamide

Glaucoma, edema, epilepsy, high altitude sickness

54
Q

AE of carbonic anhydrase inhibitors

A

Metabolic acidosis

55
Q

Block Na and Cl reabsorption in ascending loop of Henle causing extensive diuresis; decrease preload and after load and increase K excretion

A

Furosemide (Lasix)

56
Q

This diuretic can be used in severe renal disease

57
Q

Lasix AE

A

Dehydration, hyponatremia and hypovolemia, leading to HoTN
Metabolic alkalosis
Ototoxicity
Hypokalemia

Increased BG and uric acid, decreased Ca and Mg

58
Q

Increased r/f digoxin toxicity when used with

A

NonK sparing diuretics

S\s: a/n/v, visual halos, bradycardia

59
Q

most water resorption, urine concentration takes place in

A

Loop of Henle

60
Q

Potassium sparing diuretics, AKA

A

Aldosterone receptor antagonists

Block aldosterone receptors in DCT and CD resulting in loss of Na and water and retention of K.

61
Q

Indications for K-sparing diuretics

A

Used with loop diuretics to level out K with diuresis

HF, hyperaldosteronism

62
Q

AE of K-sparing diuretics

A

Hyperkalemia (can lead to bradycardia, 3rd degree HB and cardiac arrest)

Spironolactone–muscle weakness and nausea; impotence in men and irregular menses and breast enlargement in women

63
Q

Interactions with K-sparing diuretics

A

+lithium: increased r/f toxicity

+ ACE inhibitors, or K supplements: increased r/f hyperkalemia

64
Q

Block reabsorption of Na and Cl in DCT; promote diuresis in functioning kidneys

A

Thiazide diuretics

65
Q

AE of Thiazides diuretics includes altered levels of

A

K: decreased

Ca, lipids, glucose, uric acid

66
Q

High K foods

A

Spinach
Tomatoes
Avocado
Cantaloupe

67
Q

Promote diuresis by increasing plasma osmolarity, which increases the volume of fluid in the tubule

A

Osmotic diuretics
Mannitol: IV
Glycerol: PO

68
Q

Xanthines cause diuresis by

A

Cardiotonic and vasopressor effects

69
Q

This type of diuretic is given
in the oliguric phase of renal failure,
To promote excretion of toxins,
And to reduce cerebral edema/IICP

A

Osmotic diuretics

70
Q

Danger of K sparing diuretics and CRF

A

Very high K

71
Q

Therapeutic digoxin level

72
Q

S/s of hypokalemia

A

Anorexia, nausea
Lethargy, muscle weakness
Confusion
Hypotension

73
Q

Effects of hyperkalemia

A

Vfib, cardiac arrest

74
Q

Ways to reduce K level

A

Restrict intake
Insulin and glucose
Kayexalate
Dialysis

75
Q

S/s hypernatremia

A 
Edema, HTN
Red flushed skin; dry mucous membranes 
Fever
Thirst
Decreased urine output
76
Q

Treatment for hypernatremia

A

Restrict Na
Fluids–D5W or D10W
Diuretics

77
Q

Best way to assess for fluid retention

A

Daily weight

78
Q

Treats fungal meningitis in HIV pts

A

Amphotericin B

79
Q

Potentially lethal AE of Amphotericin B

A

Hypokalemia, especially after first dose

80
Q

Treatment for HIV related oral/eso/systemic candidiasis

A

Fluconazole

81
Q

Monitor these labs while on Bactrim

A

Kidney function

82
Q

Signs desmopressin therapy is effective

A

Reduced thirst and reduced urinary output

84
Q

Treatment for hyponatremia

A

Sodium rich foods-tomato juice, beef broth

Free water restriction

85
Q

vasoactive drug used in low doses to treat anaphylactic shock

A

epinephrine

86
Q

prevents/treats CMV in HIV + and immunocompromised patients

A

ganciclovir (Cytovene)

87
Q

Meds on this test that can cause SJS (3)

A

nevirapine (Viramune)=NTRI
Bactrim
fluconazole

88
Q

effective against anaerobic bacteria and protozoa

A

metronidazole (Flagyl)

89
Q

r/f capillary leak syndrome with

A

Interleukins

Advanced Med Surg (6 decks)

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