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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
Propionic acid derivatives Medication name Action Use
Ibuprofen Action: inhibits prostaglandin synthesis Use: OTC pain, osteoarthritis, fever, dysmenorrhea
26
Acetic acid derivatives: Ketorolac Use Recommendation
Exceptional pain relief Short-term management of pain (<5 days). After 5 days risks outweigh benefits
27
Selective COX-2 Inhibitor Prototype Action Benefits
Celecoxib (celebrex) Selectively inhibits COX-2 enzyme without inhibition of COX-1 Benefits: inhibits pain and inflammation, less adverse effects
28
NSAIDs in older adults
> drug interactions > incidence of GI distress, ulceration Encourage > fluid intake: reduce nephrotoxicity
29
Non-opioid analgesic antipyretics Medication name Action Use Max dose
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
Gout pathophysiology
inflammatory disease of joints, tendons, and other tissues Uric acid solidifies in the joints
31
Causes of gout
uric acid accumulation Defect in purine metabolism
32
Purine-containing foods
organ meats, sardines, salmon, gravy, herring, liver, meat, soups, and alcohol
33
How is uric acid made
Purine becomes uric acid by the kidneys
34
Action of allopurinol
Decreases uric acid synthesis
35
Glucocorticoids/Corticosteroids Protype Use
Prednisone Correct Addison's disease, decrease inflammation, weakens immune response, inhibit tissue repair
36
Specific uses of glucocorticoids/corticosteroids
Inflammatory bowel problems, rheumatoid arthritis, asthma, dermatitis Preferred short-term: adverse effects get worse over time
37
Adverse effects of glucocorticoids/corticosteroids
Moon face, hypertension, > risk of infection, diabetes mellitus, hyperglycemia, fluid retention, hypokalemia, mood swings, appetite changes, blurry vision
38
When would you want to weaken the immune system
Organ transplant, autoimmune disorder
39
How do you discontinue glucocortoicoids/corticosteroids
tapering
40
S&S of corticoids/glucocorticoids
fatigue, weakness, body aches and joint pain, nausea, loss of appetite, mood swings
41
Nursing interventions for corticosteroids/glucocorticosteroids
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
General adverse reactions of Beta-lactam antibacterials
N/V/D Allergic reaction: hypersensitivity, rash, pruritus, hives, anaphylactic shock Superinfection
43
What is a superinfection usual sites of superinfection
Secondary infection when normal flora killed Usual sites: Mouth: thrush, fungal Genitourinary tract- yeast infection Intestines: C-Diff
44
Penicilins Side effects/adverse reactions
Hypersensitivity, anaphylaxis, superinfection, GI distress, clostridium difficile (associated diarrhea)
45
Broad-spectrum penicillins vs Extended- spectrum penicillins
Ampicillin Piperacillin
46
Beta-lactamase inhibitors Action
Inhibit bacterial beta-lactamases extending
47
Beta-lactamase inhibitor Administration
Combined with penicilinase-sensitive pencilin Tazobactam+piperacilin
48
What is beta lactamase
Enzyme produced by bacteria to destroy B-lactam ring thus destroying pencillin
49
Cephalosporins Adverse effects
Dysgeusia (weird taste in mouth), GI distress, headache, nephrotoxicity
50
Cephalosporins Drug interactions and symptoms
Alcohol: flushing, dizziness, headache, nausea, vomiting, and muscular cramps
51
What is cross sensitivity
If you have an allergy to some substance, then you are much likely to have an allergy to similar substances.
52
What is cross resistance
Resistance to one antimicrobial agent may confer resistance to similar drugs.
53
Aminoglycosides Prototype Use Administration Adverse effects
Gentamicin Treats serious infection Combination with other antibiotics Ototoxic and nephrotoxic
54
Aminoglycoside dosing
Extended-interval dosing Concentration-dependent on effects Postantibiotic effect Loading dose
55
What is a loading dose
initial higher dose of a drug that may be given at the beginning of treatment to RAPIDLY achieve a therapeutic level
56
Extended-interval dosing
once daily; higher doses initially to get concentration of drug
57
Post-antibiotic effect
organisms do not grow for several hours even after discontinuation of medication
58
Fluoroquines Prototype Effective against Side effects
Ciprofloxacin Gram negative Photosensitivity, eye damage, tendonitis, tendon rupture (More likely to get sunburned when taking this)
59
Tetracycline Prototype Adverse effects Administration
Tetracycline hydrochloride GI upset, superinfection, photosensitivity, renal and hepatic impairment, permanent tooth discoloration > 8y/o
60
Sulfonamides Prototype Use Action
trimethoprim-sulfamethoxazole Prevents further growth and replication Inhibit bacterial synthesis of folic acid
61
Adverse effects of sulfonamides
GI upset Superinfection Renal: acute renal failure, crystalluria, hyperkalemia (stay hydrated to flush crystals out)
62
Urinary antiseptics Prototype Use Adminstration consideration Adverse effects
Nitrofurantoin used only for UTIs. Relief of inflammation, hypermotility, and pain Give with food Hepatotoxic and nephrotoxic
63
Urinary analgesic Prototype Function
Phenazopyridine (pyridium) Helps with burning, urgency, and frequency with UTI NOT AN ANTIBIOTIC
64
Macrolides Prototype Function Contraindication
Erythomycin Stops growth of bacteria. Prevent and treat infections in many different parts of the body Hepatotoxic: existing hepatic injury
65
When to take tetracyclines
Empty stomach 1 hour before or 2 hours after eating
66
Food and drug interactions of tetracyclines
Dairy-calcium Antacids-calcium carbonate Iron supplements Calcium and iron + tetracycline disrupts chemical structure = prevent absorption
67
Vancomycin Use for Adverse effects
MRSA C-Diff Drug resistant organisms Red man syndrome
68
What is red man syndrome
Can occur if Vancomycin is given IV too fast Histamine release
69
clinical manifestation of red man syndrome
flushing, erythema, pruritus, affecting upper body, neck and face > lower body, myalgia, dyspnea, and hypotension
70
Nursing interventions of red man syndrome
stop infusion, administer antihistamine, can restart at a slower rate once symptoms resolve

Pharmacology (10 decks)

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