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Pharmacology > Protective Function > Flashcards

Protective Function Flashcards

1
Q

one type of immune response

A

fever

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2
Q

purpose of chemo agents

A
  1. immune system is not sufficient to protect the body
  2. destroys organisms that invade the body
  3. destroys abnormal cells within body
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3
Q

Function of the Immune System

A

protect body from invasion by general hazards

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4
Q

action of chemo agents

A

alter cell function or disrupt cell integrity causing cell death
prevent cell reproduction, leading to cell death
may affect normal cells

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5
Q

nucleus function

A

contains genetic material
cell reproduction
regulates production of proteins

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6
Q

function of proteins

A

allows cell to function
maintains homeostasis
promotes cell division

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7
Q

parts of cell membrane

A

lipids
proteins - surface antigens
receptor sites
channels

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8
Q

types of lipids

A

phosphlipids
glycolipids
cholesterol

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9
Q

function of lipid layer of cell membrane

A

provide barrier

maintain homeostasis

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10
Q

where are surface antigens found

A

cell membrane

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11
Q

purpose of surface antigen (histocompatibility proteins)

A

role in cell immunity
allows for self identification
immune system recognizes self from non self

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12
Q

function of receptor sites on membranes

A

allows interaction with various chemicals, agents

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13
Q

function of channels or pores

A

allows for passage of substances in and out of cell

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14
Q

G0 phase of cell cycle

A

resting phase

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15
Q

G1 phase

A

gathering phase

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16
Q

S phase

A

synthesizing phase

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17
Q

G2 phase

A

last substances needed for division are collected and produced

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18
Q

M phase

A

cell division -> 2 identical DAUGHTER cells

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19
Q

what did penicillin come from

A

mold

1920

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20
Q

when were sulfonamides introduced

A

1935

bactin sulfer?

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21
Q

action of anti infective drugs

A

interferes with formation of bacterial cell wall
prevents cell of organism from using substances essential to their growth
interferes with protein synthesis
interferes with DNA synthesis
alters permeability of membrane, lets cell components leak out

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22
Q

define narrow spectrum

A

effective against only few microorganisms with specific metabolic pathway/enzyme

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23
Q

med for neisseria gonorrhea

A

spectinomycin (trobcin)

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24
Q

define broad spectrum

A

useful for treating a wide variety of infections

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25
Q

what is selective toxicity

A

toxicity to the infecting agent without harming the normal cells of host/body.

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26
Q

what procedures use prophylactic drugs

A

dental work

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27
Q

how do microorganisms develop resistance

A
  1. by altering binding sites on membrane or ribosome to prevent drug entering cell
  2. by producing enzymes that is antagonist to drug
  3. by changing their permeability
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28
Q

what is acquired resistance

A

microorganisms that were once sensitive to particular drug are no longer sensitive due to being exposed to the drug

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29
Q

how to prevent acquired resistance

A
  1. only prescribe meds when medically necessary
  2. complete taking all meds and don’t stop because you “feel better”
  3. if duration of the drug use is insufficient
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30
Q

define bacteriocidal

A

kills bacteria

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31
Q

define bacteriostatic

A

SLOWS bacterial growth

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32
Q

factors affecting drug choice

A
  1. immune system status
  2. local conditions at infection site
  3. allergic reactions
  4. age
  5. genetics
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33
Q

significance of age

A

cannot metabolize medications as well

increased sensitivity

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34
Q

common drug allergies

A 
penicillin
sulfa drugs
codeine
aspirin (ASA)
iodine based products (contrast dye)
latex based products
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35
Q

what is the first priority when administering anti infectives

A

monitor for allergies BEFORE giving first dose

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36
Q

what info must you have to administer anti infectives

A
  1. type of pathogen and its sensitivity
  2. monitor WBC, lytes
  3. monitor VS
  4. monitor for s/e, a/r
  5. protect the KD unless c/i due to KD failure - UA
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37
Q

how do you protect the KD

A

encourage fluids

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38
Q

other considerations for administering anti infectives

A
  1. hypersensitive reactions
  2. Kd Lv fn tests
  3. effectiveness of drug
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39
Q

s/s of hypersensitive reactions

A 
Lu symptoms
anaphylaxis
redness
swelling
SOB 
phlebitis
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40
Q

indications of drug effectiveness

A

decrease in:
fever, WBC, clinical manifestations of infection
improved lab and diagnostic testing

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41
Q

define trough

A

lowest point?
how much drug is in the system before administration
drawn 30 min prior to admin of the drug

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42
Q

define peak

A

when the concentration of the drug is expected to be the highest
30 min after IV
60 min after IM
1-2 hours after PO

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43
Q

what to teach patients about infection and anti infectives

A 
take entire Rx
cover nose/mouth
dispose of used tissue
rest/sleep
nutrition/fluids
stress effect on immune system
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44
Q

what is the impact of dehydration

A

can decrease immunity

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45
Q

types of antibiotics

A 
penicillins
cephalosporins
sulfonamides
fluoroquinolones
monobactams
animoglycosides
macrolides
lincosamides
tetracyclines
antimycobacterials
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46
Q

classes of antivirals

A 
anitretrovirals
reverse transcriptase inhibitors
protease inhibitors
antiherpes
nucleosides
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47
Q

what effects to all anti effectives have

A

nausea

diarrhea

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48
Q

s/s of infection

A

fever
lethargy
slow wave sleep induction - not fully rested due to no REM sleep
classic signs of inflammation

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49
Q

goal of antibx

A

decrease the population so immune system can deal with bacteria

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50
Q

gram positive bacteria characteristics

A

retains stain or resists decolorization with alcohol

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51
Q

gram negative characteristics

A

loses the stain (is decolorized by alcohol)

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52
Q

aerobic bacteria characteristic

A

needs O2 to survive

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53
Q

anaerobic characteristic

A

doesn’t use O2

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54
Q

aminoglycosides treat?

A

gram neg aerobic bacilli

bactericidal

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55
Q

examples of aminoglycosides

A 
*gentamicin (garamycin)
amikacin (amikin)
kanamycin (kantrex)
neomycin (mycifradin)
streptomycin 
tobramycin (nebcin, Tobrex)
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56
Q

action of gentamicin

A

inhibit protein synthesis causing cell death

treats serious infections

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57
Q

interactions of gentamicin

A

diuretics

neuromuscular blockers

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58
Q

a/r gentamicin

A

ototoxicity

nephrotoxicity

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59
Q

define ototoxicity

A

tinnitus

pain in the ear

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60
Q

penicillin action

amoxicillin/Amoxil

A

inhibits the synthesis of the cell wall

treats infections caused by streptococcal, pneumococcal, staphylococcal, etc

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61
Q

penicillin c/i and a/r

A

c/i - Kd dz
a/r - GI effect

interacts with tetracycline and aminoglycosides

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62
Q

cephalosporins action

cefaclor (Ceclor)

A

interferes with the cell wall building ability during cell division
treats infection

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63
Q

c/i of Cephalosporins

A

Allergies to cephalosporins or penecillins

interaction with aminoglycosides, anticoagulants and ETOH*

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64
Q

Fluoroquinolones action

Ciprofloxacin (Cipro)

A

Broad spectrum, for gram neg
interferes with DNA replication

for UTI, URTI*, skin infections

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65
Q

c/i a/r for fluoroquinolones

A

c/i - allergy, PREGNANCY, lactation

a/r - h/a, dizzy, GI upset

interactions - antacids, quinidine, theophylline

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66
Q

what biological outbreak can you use Cipro for?

A

anthrax

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67
Q

which drug is prophylactic for meningitis

A

Cipro

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68
Q

which antibiotic is most broad of broad spectrum

A

erythromycin

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69
Q

Macrolides action

Erythromycin (Ery tab)

A

binds to cell membranes. interferes with protein synthesis.
both bactericidal and bacteriostatic

tx resp, skin, urinary, GI infections

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70
Q

interactions of erythromycin

A

DIGOXIN - increases toxicity
oral anticoags
theophylline
corticosteroids - decreases immunity

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71
Q

which drug do you use if you are allergic to penecillin

A
  1. erythromycin or
  2. clindamycin
  3. tetracycline
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72
Q

what is the difference between macrolides and lincosamides

A

lincosamides are more toxic

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73
Q

Lincosamides action

Clindamycin (Cleocin)

A

interferes with protein synthesis by binding to cell membrane

for severe infections (frequent dental/bone infections)

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74
Q

c/i of Clindamycin

A

Lv, Kd impairment

GI reactions - a/r

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75
Q

Monobactams action

Aztreonam (Azactam)

A

Narrow spectrum, unique structure with little cross resistance
disrupts bacteria cell wall synthesis - promotes leakage of cell content

for UTI, skin, intra abd and gyn infections

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76
Q

Aztreonam a/r

A

GI, Lv enzyme elevation

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77
Q

Sulfonamides action

Sulfasalazine (Azulfidine)

A

inhibit folic acid synthesis
interferes with cell wall building ability during division

for both gram neg and gram pos bacteria (UTI and ear infections

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78
Q

a/r and interactions of Sulfasalzine

A

a/r - GI s/s, renal effects due to filtration of drug

interacts with thiazide diuretics, sulfonylurea, sulfonamides (bactrim), COUMADIN

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79
Q

Tetracyclines action

Tetracycline (sumycin)

A

inhibit protein synthesis, prevents cell replication

for acne
can be used in place of penicillin

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80
Q

why is tetracycline not for use in children under 8

A

causes damage to bones and teeth

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81
Q

c/i of tetracycline, a/r

A

c/i - allergy, pregnancy, lactation

a/r - *Photosensitivity, GI effects (take on empty stomach), bone and teeth damage

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82
Q

interactions of tetracycline

A

penicillin G, BC, methoxyflurane, Digoxin

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83
Q

s/s of TB

A

pink frothy sputum
O2 saturation in the 90’s
airborne disease
common in condensed populations

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84
Q

what is a common s/e of all TB 1st line drugs

A

all induce peripheral neuropathy

patient feels like walking on “pins and needles”

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85
Q

what is antidote for “pins and needles”

A

vit B6

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86
Q

what are the 1st line of drugs for TB (4)

A

Rifampin
Isoniazid (INH)
Ethambutol
Streptomycin

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87
Q

TB drugs characteristics

A

both bacteriostatic and bactericidal

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88
Q

2nd line of TB drugs (2)

A

pyrazinamide (PZA)

Amikacin

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89
Q

what do you inform the client taking Rifampin

A

may change the color of all bodily fluids PINK

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90
Q

Antimycobacterial actions

Isoniazid (INH) - Nydrazid

A

act on the DNA of the bacteria, inhibiting growth

treats acid fast bacteria

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91
Q

what is another condition caused by mycobacteria and treated by INH

A

leprosy

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92
Q

a/r and interactions of INH

A

a/r - CNS effects, GI irritation

interactions - Rifampin and INH can cause LV toxicity

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93
Q

what nursing teaching do you inform your patient taking INH or Rifampin

A

NO ALCOHOL due to liver toxicity

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94
Q

define virus

A

NON LIVING intracellular parasite that infects bacteria, plants and animals

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95
Q

how do viruses work

A

take over mechanisms of host cell and use it to replicate their own DNA/RNA/protein

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96
Q

most common treatment for virus

A

most require no pharmacotherapy
rest
fluids
prevent spread of infection

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97
Q

which viruses respond to antiviral therapy

A 
influenza A and some resp viruses
Herpes
CMV - cytomegalovirus
HIV
warts, eye infections
Hep B, C
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98
Q

why are viruses difficult to kill

A

because they live IN our cells - drugs that kill viruses also kill our cells

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99
Q

mechanisms of antiviral drugs

A
  1. enter infected cell
  2. interfere with DNA/RNA synthesis or regulation
  3. interfere with virus binding to cell
  4. stimulate host immune system
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100
Q

characteristic of RSV - resp syncytial virus

A

mostly occurs in children

can cause death

101
Q

s/s of respiratory viruses

A

cough, fever, inflammation of nasal mucosa, inflammation of mucosa of respiratory tract

102
Q

s/s of herpes virus

A

painful vesicles that occur in clusters on skin, cornea, mucous membranes
course of primary disease is 2 weeks
duration of recurrance varies

103
Q

definition of vesicle

A

fluid filled blister

104
Q

s/s of CMV

A 
member of herpes family
may be asymptomatic
fatigue
nausea
jaundice
can result in stillbirth, brain damage, birth defects  during pregnancy
associated with weakened immune system
105
Q

organs affected by CMV

A

brain (encephalitis), eyes (retinitis), Lu, St, Intestine

106
Q

s/s of HIV and AIDS

A

acute infection - fever, rash, myalgia
asymptomatic infection follows acute infection
persistent lymphadenopathy > 3 mo
constitutional sx - fever > 1 mo, weight loss, chron fatigue
dementia

107
Q

what are HIV AIDS secondary infections

A

pneumocystitis carinii

disseminated herpes simplex

108
Q

general s/e of HIV meds

A

flu like symptoms

109
Q

nursing consideration for HIV patients

A

ask CD 4 count

110
Q

mechanism of HIV AIDS

A

virus attaches to helper T cells (CD4) -> decrease in CD 4 cells

111
Q

actions of Flu virus meds

A

prevents shedding of the viral protein coat

112
Q

action for Herpes and CMV meds

A

inhibit DNA replication by competing with viral substrate to form SHORTER non effective DNA chain

113
Q

Hep B agents action

A

inhibits reverse transcriptase, causes DNA chain termination

114
Q

HIV meds

A
    1. Nevirapine (Viramune) - reverse transcriptase inhibitor
    1. Zidovudine ATZ (Retrovir) - nucleoside
      1. Enfuvirtide - fusion inhibitor
      2. Ritonavir (Norvir) - protease inhibitor
115
Q

what is procedure for accidental exposure to HIV

A
  1. Must be given Zidovudine or Ritonavir
  2. Must start within 72 hours
  3. Must be administered for 4 weeks
116
Q

what is the action of fusion inhibitor

A

prevents fusion of virus to cell membrane

117
Q

nucleoside action

A

interferes with replication of HIV by inhibiting cell protein synthesis

118
Q

c/i and a/r for Rimantadine (Flumadine)

A

c/i - allergy, pregnancy, lactation

a/r - dizziness, insomnia, nausea, orthostatic hypotension

interacts with anticholinergic drugs

119
Q

acyclovir (zovirax) c/i, a/r

A

c/i - pregnancy and lactation, pt that presents with neurotoxicity
a/r - n/v, h/a, dizziness RASH, PRURITIS, hair loss

120
Q

what drugs does acyclovir interact with

A

nephrotoxic drugs and zidovudine (Retrovir)

121
Q

s/s of neurotoxicity

A

h/a, acting like hung over or drunk

122
Q

what is procedure for allergic reaction to any medication

A

first stop administration
give normal saline
then call Dr for benedryl

123
Q

define Hep B and characteristics

A

potential fatal viral infection of LV
spread by blood and sexual contact
high mortality -> chronic/cancer
treat with interferons, Adefovir (Hepsera) or entecavir (baraclue)

124
Q

Nevirapine (Viramune) c/i and a/r

A

c/i - pregnancy, lactation

a/r - h/a, n/v, rash, chills fever, diarrhea

125
Q

concerns about antivirals

A

all are LV toxic

126
Q

c/i for Ritonavir, a/r

A

pregnancy, lactation

a/r - hyperglycemia

127
Q

nursing intervention for Ritonavir

A

monitor serum alanine aminotransferase (ALT) and bilirubin

128
Q

all protease inhibitors have what characteristic?

A

they are all teratogenic except for saquinavir

129
Q

zidovudine ATZ (retrovir) a/r

A

h/a insomnia, dizziness, nauasea, diarrhea, fever, rash

130
Q

enfuvirtide - fusion inhibitor pharmacokinetics

A

metabolized in LV and recycled in tissue - NOT EXCRETED

131
Q

a/r for Enfuvirtide

interactions

A

h/a, dizziness, myalgia, n/v, diarrhea

interactions - pimozide, rifampin, triazolam, midazolam, BC

132
Q

which antivirals are locally active

A

vidarabine for CMV

acyclovir

133
Q

c/i for vidarabine, a/r, considerations

A

allergy
a/r - local burning, stinging, discomfort
do not apply to broken skin

134
Q

opportunistic infections (7)

A
  1. PCP - pnuemocystis carinii pneumonia
  2. candida albicans
  3. histoplasmosis
  4. TB
  5. CMV
  6. toxoplasmosis
  7. herpes simplex
135
Q

treatment for PCP

A

pentamidine

bactrim

136
Q

tx for candid albicans

A

mycostatin

nizoral

137
Q

histoplasmosis

A

amph B

Nizoral

138
Q

tx for TB

A

INH
Rifampin
Ethambutol

139
Q

tx for CMV

A

cytovene

vidarabine

140
Q

tx for toxoplasmosis

A

pyrimethamine
cleocin
fansidar

141
Q

tx for herpes simplex

A

acyclovir

142
Q

character of fungus

A

more complex than bacteria
unaffected by antibx
grows slowly, may be months before manifestations
can cause serious problems in immunocompromised pt

143
Q

candida is secondary to what diseases

A

HIV

Cancer

144
Q

intervention for candida in the throat

A

have to scrape it out

145
Q

what is fungal wall composed of

A

chitin
various polysaccharides
cell membrane containing ergosterol

146
Q

why is fungus resistant to antibx

A

protective layers of cell

147
Q

what pt are at risk for fungal infection

A
  1. AIDS and AIDS related complex
  2. pt on immunosuppressant drugs
  3. recent transplant surgery or cancer tx
  4. elderly who are no longer protected from environmental fungi
148
Q

consideration for antifungal pt

A

immunocompromised at onset

149
Q

systemic fungals action

A

alter cell permeability

150
Q

topical fungal action

A

alter cell permeability

151
Q

systemic fungal drug

A

fluconazole (diflucan)

amphotericin B

152
Q

topical fungals

A

clotrimazole (lotrimin, mycelex)

153
Q

what are topical fungals used for

A

jock itch

athletes foot

154
Q

antifungal cautions

A

high toxicity
do not use if allergic
not during pregnancy and lactation (except terbinafine)
NOT WITH KD LV DZ - check function before systemic fungal agents
monitor drug serum levels

155
Q

interactions with Amphoterican B

A

nephrotoxic drugs and corticosteroids

can affect levels of cyclosporine, digoxin, oral hypoglycemic, phenytoin, anticoags

156
Q

patient teaching for antifungals

A

have patient report unusual bruising or bleeding

157
Q

amphtericin B indications

A 
broad spectrum - 
aspergilliosis
leishmaniasis
cryptococcosis - cryptococcal meningitis
blastomycosis
moniliasis
coccidiomycosis
histoplasmosis
mucormycosis
candida infections - topical
158
Q

replacement drug for fluconazole

A

terbinafine (lamisil)

159
Q

c/i for amphotericin B

a/r

A

Kd dz

a/r - Kd failure

160
Q

what values do you check for amphotericin B

A

Na, Cl, Bun, Creatinine

161
Q

Which antifungal is used for aspergilliosis

A

Caspofungin (Cancidas)

162
Q

Why do you use flucytosine (ancobon) oral for systemic Candida or Cryptococcus infections?

A

less toxic

163
Q

which agent do you use for intestinal candidiasis both topically and oral

A

Nystatin (Mycostatin, Nilstat)

swish and spit

164
Q

indication of Voriconazole (Vfend)

A

invasive aspergilliosis and serious infections caused by Scedosporium apiospemum and Fasarium species

165
Q

action of Terbinafine (lamisil)

A

blocks the formation of ergosterol
inhibits a CYP2D6 enzyme system

for onychomycosis of toenail or fingernail

166
Q

Fluconazole (Diflucan) indications

A

candidiasis, cryptococcal meningitis, systemic fungal infections
prophylactic agent for reducing the incidence of candidiasis in bone marrow transplant recipient

167
Q

c/i for Fluconazole

interactions

A

c/i - renal dysfx

inhibits CYP450 and may be associated with drug interactions

168
Q

why are antifungals c/i with Kd Lv dz

A

drug metabolism or excretion may be altered or condition may worsen as a result of actions of drug

169
Q

s/e of systemic antifungals

A 
h/a, dizzy, fever, shaking, chills
n/v, dyspepsia, anorexia
LV dysfx
Rash, PRURITIS assoc with local irritation
KD dysfx
170
Q

tinea infections

A

tinea - ringworm
tinea pedis - athlete’s foot
tinea cruris - jock itch
tx with spectazole

171
Q

topical fungal infections are caused by?

A

dermatophytes

172
Q

candida infection is?

A

yeast infection of mouth and vagina

173
Q

Clotrimazole (lotrimin, mycelex) indication

A

only for local treatment of mycoses, including tinea infection

174
Q

teaching for antifungal medication

A
  1. wash affected area with soap and water. apply topical after.
  2. can use drying agent (baby powder)
  3. for feet, cover with clean white socks
  4. avoid occlusive dressings
  5. for vaginal meds, remain in recumbent for 15 min
  6. troches should be dissolved in mouth slowly
  7. nystatin swish and spit
  8. if patient has mycosis, and rash develops with blisters, STOP meds
175
Q

insect bites can lead to what kind of infection

A

protozoal infections

  1. malaria
  2. trypanosomiasis
  3. leishmaniasis
176
Q

what is vector for malaria

A

mosquito

177
Q

what is vector for trypanosomiasis and leishmaniasis

A

water

178
Q

what protozoa infection is due to ingestion or contact?

A

amebiasis
giardiasis
trichomoniasis

179
Q

malaria character

A

most common protozoa dz
requires multi drug tx
tx acute stage and prevent relapse and infection

180
Q

parasites causing malaria

A 
plasmodiums:
falciparum - the most dangerous
vivax - milder form, rarely results in death
malariae - tropical countries, mild sx
ovale - rarely seen, being eradicated
181
Q

s/s of malaria

A

related to destruction of RBC
toxicity of LV
chills due to rupture of merozoites into RBC

182
Q

tx of malaria

A

attacks parasite at various stages of development

183
Q

antimalarial drugs

A
  1. chloroquine (aralen)
  2. halofantrine (halfan)
  3. hydroxychloroquine (plaquenil)
  4. Mefloquine (lariam)
  5. Primaquine (generic)
  6. Pyrimethamine (Daraprim)
  7. Quinine (generic)
184
Q

chloroquine action

A

prevents, tx, malaria and tx extraintestinal amebiasis
interrupts reproduction of protein synthesis
agents that don’t affect the sporozoites are used for prophylaxis

185
Q

halofantrine action

A

tx malaria in combo with other drugs

186
Q

hydroxychloroquine action

A

tx malaria is combo with others esp primaquine

187
Q

what is teaching for pt of mediterranean descent and antimalarial drugs

A

if G6PO deficient, may experience hemolytic crisis as a result of medication

188
Q

mefloquine action

A

prevent, tx malaria in combo with other drugs

189
Q

c/i of mefloquine

A

avoid during pregnancy - check date of last menses

190
Q

primaquine action

A

prevent relapses of vivax and malaria infections

radical cure of vivax

191
Q

pyrimethamine action

A

prevent malaria in combo with others to suppress transmission
tx toxoplasmosis

192
Q

quinine action

A

tx chloroquine resistant infection

193
Q

recommended tx with chloroquine

A

preventative - take before, during and after trips

194
Q

c/i of antimalarial

A

allergy
LV dz
alcoholism
lactation

caution - retinal disease or damage; psoriasis

195
Q

a/r of antimalarial

A

h/a, fever, chills, malaise, vertigo, n/v, Lv dysfx, disturbed visual perception

196
Q

interactions of quinine and derivatives

A

risk for cardiac toxicity
associated with cinchonism (vomiting, tinnitus, vertigo)
antifolate drugs with pyrimethamine can increase risk of bone marrow suppression

197
Q

what organ affected in giardiasis

A

intestine from contaminated water

diarrhea

198
Q

what is affected with leishmaniasis

A

skin, mucous membranes

199
Q

trypanosomiasis is?

A

african sleeping sickness

chagas disease

200
Q

trichomoniasis is?

A

vaginal infection

201
Q

pneumocystis carinii pneumonia PCP is?

A

disease affecting lungs secondary to AIDS

202
Q

risk factors for protozoal infections

A

unsanitary conditions
poor hygiene practices
weak immune system

203
Q

what is amebic dysentery

A

a severe form of diarrhea

204
Q

metronidazole (flagel) actions

A

inhibits DNA synthesis

for protozoals, pathogens in GI, H pylori. also used as an antibx

205
Q

c/i for metronidazole

A

LV DZ, allergy, pregnancy, CNS DZ

a/r - h/a, dizzy, ataxia, n/v, diarrhea

206
Q

metronidazole interactions

A

ETOH

207
Q

helminth

A

tissue invading parasitic worm

208
Q

trichinosis cause

A

caused by ingestion of the encysted larvae of roundworm (trichinella spiralis) in undercooked pork

209
Q

trichinosis affects?

A

lymphatic tissue, lungs, CNS, heart, liver

210
Q

filariasis

A

infection of the blood and tissue by worm embryos, injected by insects

211
Q

schistosomiasis

A

infection by a fluke that is carried by a snail

212
Q

how to assess for ingested worm infections

A

stool sample

213
Q

nematodes aka roundworms types

A 
pinworms
whipworms
threadworms
ascaris
hook worms
214
Q

platyhelminthes or flatworms

A

cestodes (tapeworms)

flukes (schistosomes)

215
Q

most common helminth infection in children?

A

pinworms

216
Q

transmission of pinworms

A

fecal - oral

217
Q

mebendazole (vermox) action indications

A

affects metabolic process that is different in worms vs humans
interferes with normal fn of the worm
most commonly used
for pinworms, round worms, whipworms, hook worms

218
Q

what is significance of bright spots on CT scan of brain

A

neurocystic sarcosis - aka “worms in the brain”

due to uncooked pork

219
Q

c/i of mebendazole

A

pregnancy

few adverse effects

220
Q

a/r of antihelminthics

A 
abd discomfort
diarrhea
pain
h/a
dizzy
fever,
chills 
loss of hair
221
Q

c/i of antihelminthics

A

allergy to any
lactation and pregnancy
caution - LV KD dz or severe diarrhea and malnourishment

222
Q

teaching for antihelminthics

A 
strict hand washing and hygiene
keep nails short, hands clean
shower in a.m.
change and launder undergarments, bed linens, pjs daily
disinfect toilet seat daily
handwash after using restroom
223
Q

Pyrantel (antiminth, pin rid, pin x, reese’s pinworm)

A 
single dose
for pin and round worms
not for pregnancy, lactation
safety not established for young children
a/r - GI and diarrhea
224
Q

cancer

A

uncontrolled growth of cells that invade normal tissues, often fatal
caused by chem, physical or biological
large # of factors can cause/promote

225
Q

treatment/prognosis of cancer

A

treated through surgery, radiation therapy, and drugs

the growth fraction (% of cancer cell undergoing mitosis) is major factor determining success of chemo

226
Q

anaplasia

A

cancer cells lose cellular differentiation and organization and are unable to function normally

227
Q

autonomy of cancer cells

A

cancer cells grow without usual homeostatic restrictions that regulate cell growth and control.
this allows cells to form a tumor

228
Q

metastasis

A

cancer cells travel from place of origin to develop new tumors in other areas of body

229
Q

angiogenesis of cancel

A

abnormal cells release enzymes to generate blood vessels and supply oxygen and nutrients to the cells generating growth
cancer cells use new blood vessels to multiply
cancerous cells rob the host cells of energy and nutrients and block normal lymph

230
Q

s/e of antineoplastics

A 
neurovascular disease
alopecia (capitus /totalis)
stomatitis
nephrotoxicity /hepatotoxicity
bone marrow suppression
blood dyscrasias - leukopenia, thrombocytopenia, agranuloycytosis
231
Q

nursing considerations for cancer

A 
monitor CBC/WBC
monitor i/o - UA
monitor renal  - BUN, Cr, K
monitor for bleeding - prevent injury
monitor s/s - infection
be aware of herbal interactions with meds - asian/pacific islanders
232
Q

what is the problem with alkylating agents such as cytoxan?

A

lethargy

malnourish

233
Q

what is the problem with antimetabolites (methotrexate) for cancer

A

bone marrow suppression

234
Q

what are other considerations for antineoplastics agents regarding bleeding

A

no IM injections
use a soft toothbrush
no shaving

235
Q

why should you not allow fresh fruit, flowers or plants for a pt taking antineoplastics

A

because patient is immunosuppressed.

236
Q

what type of room should be use for patients taking chemo

A

reverse/protective isolation

237
Q

action of chemo

A

given IV to prevent cell replication in both benign and malignant neoplasms
treats variety of cancer
attacks cancer from several different mechanisms
THE MOST TOXIC MEDS used for pharmacotherapy

238
Q

which chemo is used for management of uric acid levels for ped patients with leukemia

A

rasburicase

239
Q

which drug is used for patients who have received cardiotoxic meds

A

zinecard (cardioprotective)

240
Q

which chemo is used to rescue cells for patients due to bone marrow suppression

A

leucovorian (active form of folic acid)

241
Q

replacements for RBC and WBC caused by bone marrow suppression (3)

A
  1. epogen RBC
  2. neupogen WBC
    3 blood transfusion
242
Q

categories of antineoplastics

A
  1. alkylating agents
  2. antimetabolites
  3. antineoplastic antibiotics
  4. mitotic inhibitors
  5. hormones and hormone modulators
  6. cancer cell specific agents
  7. biological response modifiers
243
Q

alkylating agents and action

A

chlorambudil (leukeran) - boosts WBC
react with portions of RNA, DNA and other cellular proteins - affect synthesis of DNA

other agents -

  1. 5 FU
  2. Cysplatin
  3. Cytoxan
244
Q

antimetabolites and actions

A

Metotrexate (folex)
chem structure is similar to natural metabolites
replaces normal protein required for DNA synthesis, interferes with DNA and RNA synthesis.

245
Q

antineoplastic antibiotics and action

A

doxorubicin (adriamycin)
toxic to human cells - not selective for bacteria only
interferes with DNA and RNA synthesis

246
Q

mitotic inhibitors and actions

A

Vincristine (oncovin)
aka spindle poisons
kills cells as the process of mitosis begins

247
Q

hormone modulators and action

A

tamoxifen (nolvadex)
used in cancers that are sensitive to estrogen stimulation
affects reproductive system

also Megace

248
Q

cancer cell specific agents and action

A
  1. Imatinib Myesylate (Gleeve) - for chron myeloid luekemia & GI stromal tumors
  2. Bortezomib (Velcade) - for multiple myeloma
    tx CML and CD117 + unserectable or metastatic malignant GI stromal tumors (GIST)
249
Q

Biological response modifiers and action

A

Aldesleukins - Interleukins - stim immunity by increasing the activity of natural killer cells.

T & B cell modulators

Pharmacology (8 decks)

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