second med exam Flashcards
what are the classifications of acyclovir
T: antiviral
P: purine analogues
what is a major side effect of acyclovir
thrombotic thrombocytopenic purpura and hemolytic uremic syndome
what are nursing implications of acyclovir?
assess for lesions
assess for recurrence of symptoms
what is the number one thing patients need to do when taking acyclovir
HYDRATE
Action:
interferes with viral DNA synthesis. inhibits viral replication, decreases viral shedding, and reduces the healing time of lesions
acyclovir
classifications of alendronate
T: bone reabsorption
P: bisphosphonates
side effect of alendronate
esophageal irritation
when is alendronate administered
30 min before other meds w/ 6-8 ounces of water
Action:
inhibits reabsorption of bone inhibiting osteoclast activity
alendronate
amoxicillin classifications
T: anti-infective
P: aminopenicillin
side effects of amoxicillin
diarrhea, rash, anaphylaxis
Action:
binds to bacterial cell wall causing cell death
amoxicillin
what is commonly prescribed for skin infections, otitis media, sinusitis, genitourinary infections
amoxicillin
classifications of azithromycin
T: anti-infective
P: macrolides
what med can have hypersensitivity to erythromycin?
azithromycin
Action:
inhibits protein synthesis at the level of 50S bacterial ribosome
azithromycin
clindamycin classifications:
T: anti-infective
side effects of clindamycin
pseudomembranous colitis and diarrhea
what must the nurse do prior to initiating clindamycin
obtain specimen cultures
what can a patient NOT take when taking clindamycin
antidiarrheals
action:
inhibits protein synthesis in susceptible bacteria
clindamycin
what is active against most gram-positive aerobic cocci
clindamycin
diphenhydramine classifications
T: allergy, cold, and cough remedies, antihistamines, antitussives
what are the possible side effects of diphenhydramine
drowsiness, dizziness, sedation, dry mouth, blurred vision, anorexia, photosensitivity
what needs to be assessed before giving diphenhydramine
BP, pulse, RR
client teaching of diphenhydramine
avoid activities requiring alertness
avoid alcohol and CNS depressants
what may happen to children when taking diphenhydramine
excitation
Action:
antagonizes the effect of histamine at H1-receptor sites, does not bind to or inactivate depressant and anticholinergic properties
diphenhydramine
erythromycin
T: anti-infective
P: macrolide
side effects of erythromycin
N&V, ototoxicity, rash, pseudomembranous colitis,, and phlebitis w/ IV
Action:
suppresses protein synthesis at the level of the 508 bacterial ribosome
erythromycin
what diseases should you use erythromycin cautiously in
renal or liver disease
classifications of estrogen
T: hormones
P: estrogens
side effects of estrogen
blood clots, headaches, hypertension, weight changes, edema, breast tenderness, abnormal bleeding, nausea, erectile dysfunction, testicular atrophy, acne, oily skin, gynecomastia
what are important nursing implications of estrogen
healthy history (blood clots, HTN, cancer)
BP and weight, while taking
should estrogen be taken with or without food?
with food, it may increase HDL and triglycerides
when should a patient report estrogen SE
ACHES
abdominal pain, chest pain, headaches, eye problems, severe leg pain
what should a patient avoid while taking estrogen
smoking and grapefruit
action:
promote growth and development of female sex organs and the maintenance of secondary sex characteristics in females
estrogen
what is estrogen used for
contraception
manage perimenopausal and postmenopausal symptoms
hormone-sensitive tumors
gentamicin classifications
T: anti-infective
P: aminoglycoside
gentamicin side effects
ototoxicity, nephrotoxicity, ataxia, vertigo, N&V
what must be obtained before taking/giving gentamicin
specimens
blood levels
hearing
vestibular dysfunction
action:
inhibits protein synthesis in bacteria, bactericidal action
gentamicin
used in treatment for serious gram-negative staphylococci infections
gentamicin
what needs to be adjusted on basis of blood level monitoring and assessment of renal function
gentamicin
oxybutynin classification
T: urinary tract antispasmodic
P: anticholinergics
SE of oxybutynin
drowsiness, dizziness, dry mouth, urinary retention, constipation, nausea
what needs assessed when a patient is taking oxybutynin
voiding patterns
what needs to be avoided when taking oxybutynin
CNS depressants
action: increases bladder capacity and delays desire to void
oxybutynin
what can happen when a child takes oxybutynin
severe psychosis and aggression in children
oxytocin classifications
T: hormones
P: oxytocics
induction side effects of oxytocin
increased uterine motility (hypercontractility) leading to: placental abruption, rapid labor & birth, and uterine rupture. water intoxication
fetal: rapid labor and birth leading to: fetal hypoxia, trauma to fetal head
post-delivery side effects of oxytocin
afterbirth pains
what does a nurse need to assess when giving oxytocin (induction)
assess fetal maturity, pelvic adequacy, fetal heart rate, frequency and duration of uterine contractions, water intoxications, BP and pulse
what does a nurse need to assess when giving oxytocin (post-delivery)
uterine fundus and flow for response
what should a nurse teach a patient about oxytocin
it is used to control bleeding
action:
stimulates uterine smooth muscle, producing uterine contractions similar to those in spontaneous labor. has a vasopressor and antidiuretic effect
oxytocin
antidote to oxytocin
terbutaline or magnesium sulfate
indications of oxytocin
induction of labor, postpartum contol of bleeding after expulsion of the placenta
classifications of phytonadione
T: vitamins, antidote
P: fat-soluble vitamins
side effects of phytonadione
erythema, pain, and swelling at the site, hyperbilirubinemia, allergic reaction, GI upset, unusual taste
what needs assessed for phytonadione
frank and occult bleeding
prothrombin time
what needs assessed for phytonadione
frank and occult bleeding
prothrombin time
what is phytonadione the antidote to
coumadin
what should a patient not take when taking phytonadione
OTC or herbal products
action:
required for hepatic synthesis of blood coagulation factors II (prothrombin). VII, IX and X
phytonadione
what is phytonadione used for
synthesis of prothrombin and factors VII, IX, X needed for blood coagulation
given for malabsorption diseases, severe diarrhea from antibiotic use or new born deficiency
sildenafil classifications
T: erectile dysfunction agent, vasodilator
P: phosphodiesterase type 5 inhibitor
side effects of sildenafill
headache, dizziness, flushing, hypotension, myocardial infarction, dyspepsia, priapism
nursing implications of sildenafil
BP, exercise tolerance
when should a patient take sidenafil
1 hour before sexual activity
DO NOT take more than once a day
what should you NOT take with sidenafil
alpha-adrenergic blockers or nitrates
when should a patient notify HCP when taking sildenafil
if erection is more than 4 hours
what patients cannot take sildenafil
patients with cardiovascular disease
tamsulosin classification
T: none
P: peripherally acting antiadrenergic
side effects of tamsulosin
headache, dizziness, orthostatic hypotension
what should you assess with tamsulosin
BPH (urinary problems)
dizziness and edema
I/O and daily weight
what should patients avoid when first taking tamsulosin
driving
indicated for the management of urinary urgency, hesitancy, and nocturia of benign prostatic hyperplasia
tamsulosin
trimethoprim/sulfamethoxazole classifications
T: anti-infective, antiprotozoals
P: folate antagonists, sulfonamides
side effects of trimethoprim/sulfamethoxazole
rash, N&V, photosensitivity, pseudomembranous colitis, erythema multiforme
what in contraindicated with patients taking trimethoprim/sulfamethoxazole
allergies to sulfa
how should trimethoprim/sulfamethoxazole be administered
with a full glass of water
what should trimethoprim/sulfamethoxazole patients avoid
direct sun exposure
action: combination inhibits the metabolism of folic acid in bacteria at two different points
trimethoprim/sulfamethoxazole
what is trimethoprim/sulfamethoxazole commonly used for
treatment of lower urinary tract infections
