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Pharmacology > Quiz 5 > Flashcards

Quiz 5 Flashcards

1
Q

Vascular stage of infective inflammation

A

Prostaglandins are released
Vasoconstriction–>vasodilation–>exudation
(Exudate: wound damage)

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2
Q

Cellular stage of infective inflammation

A

Neutrophils: fight infection
Edema = build up of fluid in interstitial space

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3
Q

Opsonization stage for infective inflammation

A

Pathogens are tagged for removal

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4
Q

Contributing factors for antibiotic resistant microorganisms

A

Skipping doses
Inappropriately using antibiotics
Stopping antibiotic
Giving too small dose of antibiotic
Frequently taking antibiotics as prescribed
Antibiotics for influenza infection

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5
Q

How long does a culture and sensitivity take?

A

48-72 hours

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6
Q

Antimicrobrial vs antibacterial vs antifungal vs antiviral

A

anti-infective
Harmless, some are pathogenic
Yeasts, filamentous, and dermatophytes
Viruses replicate only inside the living cell

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7
Q

Narrow-spectrum vs broad-spectrum antibiotics

A

Narrow: 1 specific bacteria
Broad: everything is targeted

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8
Q

Gram negative vs gram positive

A

+ = normal and simple
- = extra wall, complicated. Harder to treat due to extra shield

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9
Q

Bacteriostatic vs bactericidal

A

Static: inhibits growth
Cidal: Kills bacteria

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10
Q

Causes of opportunistic infection

A

Genetic predisposition
Chemotherapy for cancer
HIV/AIDS infection
Bone marrow disease
Pregnancy

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11
Q

What is empiric therapy

A

treatment of an infection before specific culture information has been reported or obtained

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12
Q

Caution: Salicylates

A

Teratogenic
Do not give to children = reye syndrome (potentially lethal encephalopathy)

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13
Q

Oxicams
Medication name
Action
use

A

Meloxicam
Action: inhibits prostaglandin synthesis
Use: osteoarthritis, rheumatoid arthritis
Requires prescription. Preferred for long term use, generally well tolerated

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14
Q

Acetic acid derivative: indomethacin
Action
Use

A

Strong anti-inflammatory
Gout attacks, rheumatoid arthritis, tendonitis
Benefits outweigh risks

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15
Q

Acetic acid derivatives: indomethacin
Severe adverse effects
Contraindication

A

GI issues, renal impairment, and bleeding
Hx of GI bleeds

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16
Q

Acetic acid derivative: Ketorolac
Risk

A

No antipyretic effect
Greater risk for bleeding and ulcer

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17
Q

Selective Cox-2 Inhibitor
Adverse effects
Contraindication

A

GI distress/ulceration and bleeding
Increased cardiovascular and cerebrovascular risks
Contraindication: renal dysfunction

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18
Q

Anti gout drugs
Colchicine. What is it
Action
Use
Side effects
administration

A

Anti-inflammatory gout drug
Inhibits migration of leukocytes to inflamed sites
Alleviates and prevents gout symptoms
GI distress, N/V/D
PRN for flaring pain due to gout

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19
Q

Action of probenecid
Administration
Adverse effects

A

Blocks re absorption of uric acid which promotes its excretion
Taken daily for prevention
Adverse effects: kidney stones

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20
Q

How are prostaglandins formed?

A

Arachidonic acid: building block + Cyclooxygenase enzyme: turns arachidonic acid into prostaglandins

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21
Q

Function of COX-1

A

Platelets: proper adhesion, ensure clotting, stop bleeding
GI tract: mucous secretion and protects GI lining
Kidneys: maintain blood flow and function, perfuses kidneys

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22
Q

Function of COX-2

A

Numerous tissues. Inactivates
Pain and inflammation

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23
Q

NSAID
Action

A

Inhibit COX enzyme
Inhibit synthesis of prostaglandins: Analgesic effect, antipyretic effect, inhibit platelet aggregation

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24
Q

Salicylates
Medication name
Action
Adverse effects

A

Aspirin
Action: inflammatory, antiplatelet, antipyretic effects
Adverse effects: tinnitus

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25
Q

Propionic acid derivatives
Medication name
Action
Use

A

Ibuprofen
Action: inhibits prostaglandin synthesis
Use: OTC pain, osteoarthritis, fever, dysmenorrhea

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26
Q

Acetic acid derivatives: Ketorolac
Use
Recommendation

A

Exceptional pain relief
Short-term management of pain (<5 days). After 5 days risks outweigh benefits

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27
Q

Selective COX-2 Inhibitor
Prototype
Action
Benefits

A

Celecoxib (celebrex)
Selectively inhibits COX-2 enzyme without inhibition of COX-1
Benefits: inhibits pain and inflammation, less adverse effects

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28
Q

NSAIDs in older adults

A

> drug interactions
incidence of GI distress, ulceration
Encourage > fluid intake: reduce nephrotoxicity

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29
Q

Non-opioid analgesic antipyretics
Medication name
Action
Use
Max dose

A

Acetaminophen
Inhibits prostaglandin synthesis
Use for muscular aches and pain, fever
Max dose: 4 g/day. Give less Tylenol for those with liver failure

30
Q

Gout pathophysiology

A

inflammatory disease of joints, tendons, and other tissues
Uric acid solidifies in the joints

31
Q

Causes of gout

A

uric acid accumulation
Defect in purine metabolism

32
Q

Purine-containing foods

A

organ meats, sardines, salmon, gravy, herring, liver, meat, soups, and alcohol

33
Q

How is uric acid made

A

Purine becomes uric acid by the kidneys

34
Q

Action of allopurinol

A

Decreases uric acid synthesis

35
Q

Glucocorticoids/Corticosteroids
Protype
Use

A

Prednisone
Correct Addison’s disease, decrease inflammation, weakens immune response, inhibit tissue repair

36
Q

Specific uses of glucocorticoids/corticosteroids

A

Inflammatory bowel problems, rheumatoid arthritis, asthma, dermatitis
Preferred short-term: adverse effects get worse over time

37
Q

Adverse effects of glucocorticoids/corticosteroids

A

Moon face, hypertension, > risk of infection, diabetes mellitus, hyperglycemia, fluid retention, hypokalemia, mood swings, appetite changes, blurry vision

38
Q

When would you want to weaken the immune system

A

Organ transplant, autoimmune disorder

39
Q

How do you discontinue glucocortoicoids/corticosteroids

A

tapering

40
Q

S&S of corticoids/glucocorticoids

A

fatigue, weakness, body aches and joint pain, nausea, loss of appetite, mood swings

41
Q

Nursing interventions for corticosteroids/glucocorticosteroids

A

Monitor vital signs and lab values
Watch for evidence of hypokalemia: Heart dysrhythmias, muscles feel weird
Assess for side effects of corticosteroids
Advise pts to eat foods high in potassium

42
Q

General adverse reactions of Beta-lactam antibacterials

A

N/V/D
Allergic reaction: hypersensitivity, rash, pruritus, hives, anaphylactic shock
Superinfection

43
Q

What is a superinfection
usual sites of superinfection

A

Secondary infection when normal flora killed
Usual sites: Mouth: thrush, fungal
Genitourinary tract- yeast infection
Intestines: C-Diff

44
Q

Penicilins
Side effects/adverse reactions

A

Hypersensitivity, anaphylaxis, superinfection, GI distress, clostridium difficile (associated diarrhea)

45
Q

Broad-spectrum penicillins
vs
Extended- spectrum penicillins

A

Ampicillin
Piperacillin

46
Q

Beta-lactamase inhibitors
Action

A

Inhibit bacterial beta-lactamases extending

47
Q

Beta-lactamase inhibitor
Administration

A

Combined with penicilinase-sensitive pencilin
Tazobactam+piperacilin

48
Q

What is beta lactamase

A

Enzyme produced by bacteria to destroy B-lactam ring thus destroying pencillin

49
Q

Cephalosporins
Adverse effects

A

Dysgeusia (weird taste in mouth), GI distress, headache, nephrotoxicity

50
Q

Cephalosporins
Drug interactions and symptoms

A

Alcohol: flushing, dizziness, headache, nausea, vomiting, and muscular cramps

51
Q

What is cross sensitivity

A

If you have an allergy to some substance, then you are much likely to have an allergy to similar substances.

52
Q

What is cross resistance

A

Resistance to one antimicrobial agent may confer resistance to similar drugs.

53
Q

Aminoglycosides
Prototype
Use
Administration
Adverse effects

A

Gentamicin
Treats serious infection
Combination with other antibiotics
Ototoxic and nephrotoxic

54
Q

Aminoglycoside dosing

A

Extended-interval dosing Concentration-dependent on effects
Postantibiotic effect
Loading dose

55
Q

What is a loading dose

A

initial higher dose of a drug that may be given at the beginning of treatment to RAPIDLY achieve a therapeutic level

56
Q

Extended-interval dosing

A

once daily; higher doses initially to get concentration of drug

57
Q

Post-antibiotic effect

A

organisms do not grow for several hours even after discontinuation of medication

58
Q

Fluoroquines
Prototype
Effective against
Side effects

A

Ciprofloxacin
Gram negative
Photosensitivity, eye damage, tendonitis, tendon rupture
(More likely to get sunburned when taking this)

59
Q

Tetracycline
Prototype
Adverse effects
Administration

A

Tetracycline hydrochloride
GI upset, superinfection, photosensitivity, renal and hepatic impairment, permanent tooth discoloration
> 8y/o

60
Q

Sulfonamides
Prototype
Use
Action

A

trimethoprim-sulfamethoxazole
Prevents further growth and replication
Inhibit bacterial synthesis of folic acid

61
Q

Adverse effects of sulfonamides

A

GI upset
Superinfection
Renal: acute renal failure, crystalluria, hyperkalemia
(stay hydrated to flush crystals out)

62
Q

Urinary antiseptics
Prototype
Use
Adminstration consideration
Adverse effects

A

Nitrofurantoin
used only for UTIs. Relief of inflammation, hypermotility, and pain
Give with food
Hepatotoxic and nephrotoxic

63
Q

Urinary analgesic
Prototype
Function

A

Phenazopyridine (pyridium)
Helps with burning, urgency, and frequency with UTI
NOT AN ANTIBIOTIC

64
Q

Macrolides
Prototype
Function
Contraindication

A

Erythomycin
Stops growth of bacteria. Prevent and treat infections in many different parts of the body
Hepatotoxic: existing hepatic injury

65
Q

When to take tetracyclines

A

Empty stomach
1 hour before or 2 hours after eating

66
Q

Food and drug interactions of tetracyclines

A

Dairy-calcium
Antacids-calcium carbonate
Iron supplements
Calcium and iron + tetracycline disrupts chemical structure = prevent absorption

67
Q

Vancomycin
Use for
Adverse effects

A

MRSA
C-Diff
Drug resistant organisms
Red man syndrome

68
Q

What is red man syndrome

A

Can occur if Vancomycin is given IV too fast
Histamine release

69
Q

clinical manifestation of red man syndrome

A

flushing, erythema, pruritus, affecting upper body, neck and face > lower body, myalgia, dyspnea, and hypotension

70
Q

Nursing interventions of red man syndrome

A

stop infusion, administer antihistamine, can restart at a slower rate once symptoms resolve

Pharmacology (10 decks)

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