proficiency exam Flashcards
vancomycin pharm class____
glycopeptide
vancomycin use___
c Dif, endocarditis, enterocolitis, staphyloccal, streptococcal
vancomycin adverse effects__
hypokalemia, abdominal pain, nausea, nephrotoxicity
vancomycin monitoring parameters___
renal function tests, CBC
vancomycin MOA___
inhibits bacterial cell wall synthesis by blocking glycopeptide polymerization
famotidine pharm class___
histamine H2 antagonist
famotidine use ___
GERD, heartburn, aspiration prophylaxis, stress ulcer prophylaxis
famotidine AE____
agitation
famotidine MP____
CBC, gastric pH, occult blood
famotidine MOA___
inhibition of histamine at H2 receptors of the gastric parietal cells, which inhibits gastric acid secretion
prednisolone pharm class__
adrenal corticosteroid
prednisolone use___
anti-inflammatory, immunosuppressant
prednisolone AE___
osteoporosis (fracture)
prednisolone MP___
BP, wt, electrolytes, glucose, intraocular pressure, suppresses immune system
prednisolone MOA___
decreases inflammation by suppression of migration of polymorphonuclear leukocytes; reducing activity & volume of lymphatic system
piperacillin & tazobactam pharm class___
antibiotic, penicillin
piperacillin & tazobactam use___
intraabdominal/pelvic/skin infections, pneumonia.
bite wound/bloodstream/UT infection, cystic fibrosis, septic shock
piperacillin & tazobactam AE___
diarrhea
piperacillin & tazobactam MP___
creatinine, BUN, CBC w/differential, PT PTT, electrolytes, LFTs, urinalysis, bleeding, anaphylaxis, CNS
piperacillin & tazobactam MOA___
inhibits cell wall synthesis
pancrelipase pharm class___
enzyme
pancrelipase use___
pancreatic insufficiency (exocrine), occluded enteral feeding tubes
pancrelipase AE___
h/a, abdominal pain, lymphadenopathy, streptococcal infection, neck pain, otalgia, nasal congestion
pancrelipase MP___
abdominal symptoms, nutritional, wt, growth (in children), stool character, fecal fat
pancrelipase MOA___
natural product harvested from porcine pancreatic glands dissolve in more basic pH of the duodenum so they may act locally
nystatin pharm class___
anti fungal agent
nystatin use___
(oral) candidiasis
(topical) candida species
peritoneal dialysis-associated infection
nystatin AE___
diarrhea, nausea, stomach pain, vomiting
nystatin MOA___
binds to sterols in fungal cell membrane, changing the cell wall permeability allowing for leakage of cellular contents
morphine pharm class___
opioid analgesic
morphine use___
pain management
critically ill (analgesia/sedation)
dyspnea
morphine AE___
constipation, respiratory depression
pruritus-itchy skin
morphine MP___
pain control, respiratory/mental status, BP, signs of misuse or abuse, addiction, s/s hypogonadism or hypoadrenalism
morphine MOA___
binds to opioid receptors in CNS
montelukast pharm class___
leukotriene receptor antagonist
montelukast use___
allergic rhinitis, asthma (maintenance), exercise-induced bronchoconstriction,
-aspirin-exacerbated respiratory disease, hypersensitivity reaction
montelukast AE___
nervous system disorders, psychiatric/sleep disturbances
montelukast MP___
neuropsychiatric events, suicidal thinking/behavior
montelukast MOA___
selective leukotriene receptor antagonist that inhibits the cysteinyl leukotriene receptor
midazolam pc___
Antiseizure Agent, Benzodiazepine
midazolam use___
General anesthesia, Mechanically ventilated patients in the ICU, sedation, Procedural sedation, outside the operating room, Seizures, intermittent, Status epilepticus: Seizalam
midazolam AE___
Vomiting, apnea, bradypnea, decreased tidal volume, nasal discomfort
midazolam MP___
level of sedation, RR, HR, PB, O2 sat, s/s resp depression
midazolam MOA___
Binds to stereospecific benzodiazepine receptors on the postsynaptic GABA neuron at several sites within the central nervous system, including the limbic system and reticular formation
mesalamine PC___
5-Aminosalicylic Acid Derivate
mesalamine USE___
Oral ulcerative colitis in adults. (remission and active)
mesalamine AE___
abdominal pain, constipation, eructation, h/a, Nasopharyngitis
mesalamine MP___
renal function, CBC, hepatic function, dermatological toxicity, s/s of acute intolerance syndrome
mesalamine MOA___
mesalamine modulates local chemical mediators of the inflammatory response, especially leukotrienes, and is also postulated to be a free radical scavenger or an inhibitor of tumor necrosis factor (TNF)
levetiracetam PC___
antiseizure agent, misc.
levetiracetam USE___
Focal (partial) seizures, tonic-clonic seizures, Juvenile myoclonic epilepsy
levetiracetam AE___
increased BP, vomiting, infection, behavioral problems, drowsiness, fatigue, h/a, irritability, psychotic symptoms, asthenia, nasopharyngitis,
levetiracetam MP___
CNS depression, psychiatric behaviors, diastolic BP in kids 1 month to <4 yrs, CBC
levetiracetam MOA___
inhibition of voltage-dependent N-type calcium channels; facilitation of GABA-ergic inhibitory transmission through displacement of negative modulators
ketorolac PC__
analgesic, nonopioid, NSAID
ketorolac USE___
pain management, acute: short term < 5 days
ketorolac AE___
abdominal pain, dyspepsia, nausea, increased liver enzymes, headache
ketorolac MOA___
Reversibly inhibits cyclooxygenase-1 and 2 (COX-1 and 2) enzymes, which results in decreased formation of prostaglandin precursors
ketorolac MP___
response (pain), inflammation, weight gain, edema, renal function, creatinine, BUN, urine output, CBC, platelets, liver function test, chemistry profile, BP, observe for bleeding, mental status.
ketamine PC___
NMDA receptor antagonist; general anesthetic
ketamine USE___
Anesthesia, depression, pain control,
ketamine AE___
laryngospasm, increased HR, increased BP, cardiac arrythmia, decreased BP, decreased HR (cardiac decompensation), drug dependence, withdrawal syndrome, Prolonged emergence from anesthesia, hallucinations, delirium, dysuria, urinary frequency, urinary urgency, urinary incontinence, hematuria, nocturia, cystitis, hydronephrosis, bladder dysfunction, respiratory depression, apnea
ketamine MP___
HR, BP, RR, O2 sat, cardiac function, LFT’s, alkaline phosphate, gamma glutamyl transferase
ketamine MOA___
Produces a cataleptic-like state in which the patient is dissociated from the surrounding environment by direct action on the cortex and limbic system
Acetylcysteine PC___
mucolytics; L-cysteine derivatives
Acetylcysteine USE___
Acetaminophen overdose, viscid/thickened mucus,
Acetylcysteine AE___
Autoimmune disease, Anaphylactoid reaction, bronchospasm, fever, drowsiness
acetylcysteine MP___
anaphylaxis, serum acetaminophen, AST, ALT, bilirubin, PT, INR, serum creatinine, BUN, serum glucose, hemoglobin, hematocrit, and electrolytes. N/V, skin rash
acetylcysteine MOA___
Acetaminophen overdose: Acetylcysteine acts as a hepatoprotective agent by restoring hepatic glutathione, serving as a glutathione substitute, and enhancing the nontoxic sulfate conjugation of acetaminophen.
Mucolytic: Exerts mucolytic action through its free sulfhydryl group which opens up the disulfide bonds in the mucoproteins thus lowering mucous viscosity.
acyclovir PC___
nucleosides and nucleotides
acyclovir USE___
Herpes simple virus (HSV), Herpes zoster (shingles), Varicella (chickenpox)
acyclovir AE___
decreased hemoglobin, decreased in absolute neutrophil count, malaise
acyclovir MP___
Hydration status, urinalysis, BUN, serum creatinine, urine output, liver enzymes, CBC, s/s of neurotoxicity, neutrophil count at least twice a weekly in neonates receiving 60mg/kg/day IV. Monitor infusion site
acyclovir MOA___
Acyclovir triphosphate inhibits DNA synthesis and viral replication by competing with deoxyguanosine triphosphate for viral DNA polymerase and being incorporated into viral DNA
albuterol (salbutamol) PC___
adrenergic beta-2 agonists
albuterol (salbutamol) USE___
Bronchospasms, exercised-induced bronchospasms; hyperkalemia treatment
albuterol (salbutamol) AE___
excitement, tremor, nervousness, bronchospasm, exacerbation of asthma, pharyngitis, rhinitis, upper respiratory tract infection
albuterol (salbutamol) MP___
FEV1, peak flow, BP, HR, serum glucose, serum K+, serum creatinine, arterial or capillary blood gases, lactate, continuous EKG
albuterol (salbutamol) MOA___
Relaxes bronchial smooth muscle by action on beta2-receptors with little effect on heart rate
amoxicillin PC___
aminopenicillins
amoxicillin USE___
Ear, nose, throat infection,
lower resp infection, Helicobacter pylori eradication, UTI, Rhinosinusitis, acute bacterial, skin and skin structure infections
amoxicillin AE___
Diarrhea, nausea, vomiting, Clostridioides difficile diarrhea/colitis, h/a, vulvovaginal infection
amoxicillin MP___
renal, hepatic, and hematological function, s/s of anaphylaxis
amoxicillin MOA__
Inhibits bacterial cell wall synthesis by binding to one or more of the penicillin-binding proteins (PBPs), inhibiting cell wall biosynthesis
ampicillin PC___
aminopenicillins
ampicillin USE___
GI Tract infections, GU tract infections, respiratory tract infecrtions, bloodstream infections, endocarditis, meningitis, bacterial
ampicillin AE___
brain disease (pcn-induced), glossalgia, seizure, sore mouth, erythema multiforme, exforliative, skin rash, urticaria
ampicillin MP___
renal, hepatic, and hematological function, s/s of anaphalaxis
ampicillin MOA___
Inhibits bacterial cell wall synthesis by binding to one or more of the penicillin-binding proteins (PBPs), inhibiting cell wall biosynthesis
carbamazepine PC___
antimanic, antiseizure
carbamazepine USE__
bipolar disorder
focal/generalized onset seizures
neuropathic pain
carbamazepine AE___
nausea, vomiting, ataxia, drowsiness, dizziness, constipation
carbamazepine MP___
CBC with platelet count and differential, reticulocytes, serum iron, liver and renal function tests, urinalysis, BUN, serum sodium, ophthalmic exam including intraocular pressure
carbamazepine MOA___
—may depress activity in the nucleus ventralis of the thalamus or decrease synaptic transmission or decrease summation of temporal stimulation leading to neural discharge by limiting influx of sodium ions across cell membrane or other unknown mechanisms; —stimulates the release of ADH and potentiates its action in promoting reabsorption of water; chemically related to tricyclic antidepressants
gentamicin PC___
antibiotic, amino glycoside
gentamicin USE___
Treatment of serious infections (eg, sepsis, meningitis, urinary tract infections, respiratory tract infections, peritonitis, bone infections, skin and soft tissue infections)
gentamicin AE___
hypertension, abnormal gait,
confusion, seizure, vertigo,
dyspnea, alopecia,
hypocalcemia, hypomagnesemia, hyponatremia, uticaria, hepatomegaly, Agranulocytosis, muscle cramps, visual disturbance, fever, decreased urine specific gravity, hearing loss
gentamicin MP___
Urinalysis,
urine output,
BUN, serum creatinine, plasma gentamicin levels (before and after third dose).
Hearing should be tested before and after treatment.
gentamicin MOA___
Interferes with bacterial protein synthesis by binding to 30S ribosomal subunit resulting in a defective bacterial cell membrane
dexamethasone PC___
Anti-inflammatory Agent; Antiemetic; Corticosteroid, Systemic
dexamethasone USE___
As adjunctive therapy for short-term administration in synovitis of osteoarthritis, rheumatoid arthritis, acute and subacute bursitis, Intralesional injection: Keloids; localized hypertrophic, infiltrated, inflammatory lesions of lichen planus, psoriatic plaques, granuloma annulare, and lichen simplex chronicus
Acute mountain sickness/high-altitude cerebral edema; Acute respiratory distress syndrome, fetal lung maturation
dexamethasone AE___
GI issues, osteoporosis, myopathy, ocular effects,
dexamethasone MP___
Hb, occult blood loss, BP, serum potassium, blood glucose, creatine kinase (if symptoms of myopathy occur), bone mineral density; intraocular pressure with systemic use >6 weeks; consider routine eye exams with chronic use; weight and height in children; hypothalamic-pituitary-adrenal axis suppression
dexamethasone MOA___
suppression of neutrophil migration, decreased production of inflammatory mediators, and reversal of increased capillary permeability; suppresses normal immune response
fluticasone propionate & salmeterol PC___
Beta2 Agonist; Beta2-Adrenergic Agonist, Long-Acting; Corticosteroid, Inhalant
fluticasone propionate & salmeterol USE___
asthma maintenance/controller
COPD
fluticasone propionate & salmeterol AE___
h/a
upper respiratory tract infection
pneumonia
pharyngitis
fluticasone propionate & salmeterol MP___
FEV1, peak flow, and/or other pulmonary function tests; blood pressure, heart rate; CNS stimulation; glaucoma and cataracts; bone mineral density
serum potassium
glucose
s/s candidiasis
fluticasone propionate & salmeterol MOA___
Fluticasone: The mechanism of action for all topical corticosteroids is believed to be a combination of three important properties: Anti-inflammatory activity, immunosuppressive properties, and antiproliferative actions. Fluticasone has extremely potent vasoconstrictive and anti-inflammatory activity.
Salmeterol: Relaxes bronchial smooth muscle by selective action on beta2-receptors with little effect on heart rate
ceftriaxone PC___
Antibiotic, Cephalosporin (Third Generation)
ceftriaxone USE___
infections:
bloodstream
bone/joint
gonococcal
intra-abdominal
lower respiratory tract
meningitis
skin/soft tissue
UTI
bite wounds (off label)
pelvis inflammatory disease
otitis media (acute)
ceftriaxone AE___
urinary sludge (hypercalciuria)
renal failure
pancreatitis
C Dif
anemia
kernicterus
skin tightness
ceftriaxone MP___
Prothrombin time/INR. Observe for signs and symptoms of anaphylaxis. Test-of-cure 7 to 14 days after initial treatment of pharyngeal gonorrhea
ceftriaxone MOA____
Inhibits bacterial cell wall synthesis by binding to one or more of the penicillin-binding proteins (PBPs) which in turn inhibits the final transpeptidation step of peptidoglycan synthesis in bacterial cell walls, thus inhibiting cell wall biosynthesis
cimetidine PC___
Histamine H2 Antagonist
cimetidine USE___
GERD
heartburn
cimetidine AE___
none
cimetidine MOA___
Competitive inhibition of histamine at H2 receptors of the gastric parietal cells resulting in reduced gastric acid secretion, gastric volume and hydrogen ion concentration reduced
cimetidine MP___
CBC, gastric pH, renal function, occult blood w/GI bleeding, signs of confusion