Review 2 Flashcards
3 considerations selecting antibiotic treatment
- Bacteria factors
- Host specific factors
- Drug specific factors
How to prevent antibiotic resistance
Discourage antibiotic overuse
Encourage patients to finish full course of antibiotics
Follow infection, prevention, and control protocols
HEP A treatment
Pre: Vaccine, Ig (thrombosis risk)
Acute infection: Rest, hydration, antiemetics, antipyretics (prn), AVOID hepatotoxic drugs
HEP B treatment
Interferon (AE- flu like symptoms)
Nucleotide / Nucleoside analogs: Block DNA synthesis
HEP C treatment
No vaccine
Direct acting analogs. AE- fatigue, weakness, headache
Treatment goals for cancer treatment
Cure: chemotherapy, biotherapy, radiation and/or surgery
Control: Enable extension of life when cure not possible
Palliation: Improve quality of life, relieve pain
DAA MOA
directly stimulate alpha or beta receptors
pseudophedrine- a and b receptors
phenylephrine- a1 receptors
Loop Diuretics MOA and AE
MOA: inhibit reabsorption of NA/K/2Cl. Patients reabsorption of water that follows these electrolytes
AE: Dehydration, hypokalemia, hyponatremia, hypocalcemia, ototoxicity, hyperglycemia, increased LDLs
Thiazide Diuretics MOA and AE
MOA- Inhibits mechanisms that favor NA+ absorption. Results in NA+ and K+ excretion and reabsorption of Ca+
AE: Similar to Loops but no hypercalcemia
Potassium Sparing Diuretics MOA
Inhibits sodium-potassium exchange mechanism. Limits reabsorption of Na+ and excretion of K+
Limits osmotic gradient
Potassium Sparing Diuretics AE
Hyperkalemia, Nausea, lethargy, mental confusion
PT concerns diuretics
- be aware of hyperglycemia signs and glucose level
- increased lipid levels
- hypo/hyperkalemia
- dehydration, OH, arrhythmias, DDI with NSAIDS
Direct Vasodilators MOA and AE
MOA: Directly vasodilate peripheral vasculature, inhibit smooth muscle contraction in arterioles
AE: Dizziness, OH
Calcium Channel Blockers MOA and AE
MOA: Block Ca2+ entrance into vascular smooth muscle, decrease smooth muscle tone, vasodilation
AE: Dizziness, OH
Beta Blockers MOA
Competitive antagonist for B adrenoreceptors
Nonselective- B1 and 2
Selective- B1 only
Beta Blocker AE
Nonselective:
Bronchoconstriction, peripheral vasoconstriction, bradycardia, decreased exercise capacity, arrhythmia/anginia/MI, dizziness, OH, depression, fatigue, sexual dysfunction
Selective: same but no pulmonary effects
Beta Blocker Therapeutic Concerns
Can’t use HR as indicator of patient response to exercise, OH, watch for sign of CHF, masks symptoms of hypoglycemia
a1 blockers MOA and AE
MOA: reduce sympathetic tone of blood vessels - vasodilation - decreased peripheral vascular resistance
AE: OH, nasal stuffiness, reflex tachycardia, arrhythmia
a1 blockers therapeutic concerns
Always take BP and monitor OH. Fall risk. Reflex tachycardia and angina. S/S for CHF
Central acting a2 agonist MOA
a2 receptors primarily on presynaptic neurons - stimulate CNS - decreased NE - decreased sympathetic outflow - decreased PR, renal vascular resistance, HR, and BP
Central acting a2 agonist AE and therapeutic concerns
AE: Dizziness, Drowsiness, Fatigue, HA
Concerns: fall risk ,OH, rebound hypertension
ACEi MOA and AE
MOA: block comversion of angiotensin I to II
AE: dry cough, hypotension, dizziness, hyperkalemia, angioedema, acute renal failure
ARB MOA and AE
MOA: antagonist at AT receptor=blocks binding of angiotension II
AE: similar to ACEi but no dry cough
Angina Pectoris
Blood vessels obstructed by sclerotic plaques
Blood supply to body tissues restricted
Workload exceeds O2 supply to cardiac muscle
Ischemia and pain
Nitrates MOA
- work directly on smooth muscle, no receptor.
- decrease amount of Ca available for contraction.
- decreased preload and afterload=decreased workload=decreased O2 demand
Nitrates AE
Reflex tachycardia, dizziness, OH, weakness
Antiplatelets MOA
Aspirin: inhibit COX 1 and 2 - decreased thromboxane A2 - decreased platelet aggregation
ADP receptor inhibitors: blocks P2Y12 receptors - blocks ADP binding - decreased platelet aggregation
Antiplatelet AE
Bleeding is highest concern
