Test 2 Flashcards
What are the drugs for flu?
Oseltamivir (Tamiflu)
Don’t substitute for flu vaccination
Oseltamivir facts
Must be taken within 48 hours of flu like symptoms
Take amount prescribed without stopping
Is a neuradaminase inhibitor which stops the spread or replication of the flu virus
Is given orally
What is olseltamivir contraindicated in?
Renal Dysfunction
Pregnancy or breastfeeding
May need to adjust dosage
Should not be taken if the pt has had nasal influenza vaccine and if pt is taking other neuraminadase inhibitors
What should you monitor when pt is taking oseltamivir?
Neuropsychiatric symptoms like hallucinations, delirium, and confusion
NVD
Affects may be related to effects on dopamine like lightheadness, dizziness, insomnia, ortho hypotension
What are some nursing interventions to be sure of when giving oseltamavir?
Get baseline vitals
Ask about current symptoms and when they first started having symtpoms
What are some patient education you should give when giving oseltamivir?
Oseltamivir is used to reduce severity of symptoms and duration
Does not prevent the spread to others
What is Acyclovir used for?
Herpes simplex 1 (oral) and 2 (genital)
Treats varicella zoster (chicken pox)
What are some side effects of Acyclovir?
NEPHROTOXICITY
Malaise, seizures, confusion
Hematuria
Increased liver enzymes
What are the labs to evaluate when pt is taking Acyclovir?
Increased creatine, BUN, bilirubin, Hb
Decreased ANC, WBC
Increased/ Decreased platelets
What should you educate pt about when taking Acyclovir?
Stay away from sexual intercourse because drug does not cure virus or prevent spread
Should not be taken with other nephrotoxic drugs
It should be given at a slow rate and drink plenty of fluids
What are the HIV and AIDS meds?
NNRTI’s
NRTI’s
PI’s
INSTI’s
What is a common drug of NNRTI’s?
Delavirdine
These drugs are absorbed from GI tract
What are some complications and side effects of NNRTI’s?
Rash which can lead to steven johson syndrome
Flu like manifestations (headache, fatigue)
CNS: Dizziness, drowsiness, insomnia, nightmares
Nausea and diarrhea
What should you do as the nurse when dealing with NNRTI complication?
Monitor for rash and notify provider for fever or blistering
Flu: Monitor for adverse reactions and encourage rest and fluid intake
CNS: Should decrease after first few weeks. Don’t perform activities that require alertness
Nausea and Diarrhea: Take at night on empty stomach
What are some contraindications for NNRTI’s?
Use only during pregnancy only if other options are considered
Reproduction: Use nonhormonal form for atleast 12 weeks after therapy
Severe liver disease: Contraindicated
What are the drug to drug interactions of NNRTI’s?
Can increase effects of benzodiazepines, antihistamines, calcium channel blockers, warfarin: Monitor for med toxicity
Do NOT use with rifampin and phenytoin: Can cause decreased levels of delavirdine
DO NOT USE W/ St. John wart
What are NRTI facts?
Rapidly absorbed in GI tract (EXCEPT DIDANOSINE)
Ex drug: Zidovudine
Can be given oral or IV
What are some complications of NRTI’s?
Suppressed bone marrow: Anemia, neutropenia, thrombocytopenia,
Lactic Acidosis:Hyperventilation, nausea, abdominal pain. Pregnancy increases risk
NVD
What should you do as the nurse when it comes to the complications of NRTI’s?
Suppressed bone marrow: Monitor CBC and platelets. Educate pt to monitor bleeding, easy bruising, sore throat, and fatigue
NVD: Take w/ food. Monitor fluid and electrolytes
What are some contraindications for NRTI’s?
Contraindicated in pt’s with medication hypersensitivity
Caution w/ liver disease and bone marrow suppression
Probenecid, valproic acid, and increase zidovudine: Reduce dosage
What re some interventions for NRTI’s?
Treat anemia w/ epoetin alfa
Treat neutropenia w/ colony stimulating factors
What are Protease Inhibitors?
Used to treat HIV
Ex drug: Ritonavir
Is taken Oral
Usually is combined with transcriptase inhibitors
Ritonavir is given with other PI’s to increase their effect
What are some complications of PI’s?
Osteoperosis
Hyperglycemia
Hypersensitivity Reaction
Elevated Blood lipids
Can decrease effectiveness of oral contraceptives
What are the interventions of PI’s?
Osteoperosis: Educate client to eat diet high in calcium and Vitamin D
Hyperglycemia: Monitor for blood glucose. Adjust diet and administer antidiabetic as prescribed. Monitor for increased thirst and urine output
Hypersensitivity reaction: Monitor for rash and notify providor if it develops
Elevated Blood Lipids: Monitor for hyperlipidemia and adjust diet
Oral contraceptives: Should be encouraged to use additional nonhormonal contraceptives
What are some interactions of PI’s?
Cause multiple meds to raise to toxic levels
AVOID GRAPEFRUIT juice
Take medication w/ food to increase absorption EXCEPT INDINAVIR
What are Integrase Strand Transfer Inhibitors?
Treat HIV
Oral
Ex drug: Raltegravir
Is a first line treatment for HIV combined with 2/3 other antiretroviral meds
What are some complications of Integrase Strand Transfer Inhibitors?
Headache and diff breathing: Notify provider
Skin Rash
Liver Injury: Anorexia, nausea, right upper quadrant pain, jaundice
Renal Failure: Monitor for hematuria
SUICIDAL IDEATION: Notify provider of suicidal thoughts
What are the interactions of INSTI’s?
Raltegravir can be decreased w/ concurrent use of rifampin or tipranavir/ ritonavir: Increase raltegravir dose if needed
Monitor baseline and periodic liver function tests
What are some anti Hep C meds?
Elbasvir/Grazoprevir
Glecaprevir/Pibrentasvir
Sofosbuvir/Ledipasvir
Sofosbuvir/Velpatasvir
Sofosbuvir/Velpatasvir/ Voxelaprevir
Ribavirin (Copegus, Rebetol, Ribasphere)
Peginterferon alfa 2a
What are some facts about Hep C meds?
Treatment is usually 8-12 weeks but may be up to 16 weeks
Treatment is successful when viral load drops to undetectable levels
Treatment is tailored to the patients genotype, previous HVC treatment, and other factors
DONT TAKE WITH ST JOHNS WORT
What should you monitor when giving antihep C Drugs?
Monitor for adverse events, med adherence, and drug interactions
Monitor blood test results, including hypoglycemia and INR levels (clotting times_
What’s something important that you should do before giving an antifungal?
You should obtain a culture
What do all Azoles end in?
-conazole
What are azoles contraindicated in?
Pregnant
Breastfeeding
Renal Dysfunction
Hypersensitivity
Hepatic dysfunction
Some endocrine problems
What drugs are azoles usually contraindacted with?
Blood thinners like warfarin because it can increase risk of bleeding
Erythromycin can increase risk of heart complications
What’s the action of azoles?W
They bind to sterols and can cause cell death or interfere with cell replication
Which azole is absolutely contraindicated in fertility problems?
Ketoconazole
What are some side effects of azoles?
GI upset
Hepatotoxicity (elevation in liver enzymes, jaundice)
Headaches
What is amphoteracin B used in?
Systemic fungal infections
Only available via IV
Amphoteracin B is used for only life threatening infections because of what reason?
It is very toxic to the liver
Hepatotoxic
What are some side effects of Amphoteracin B?
Hepatotoxicity
Phlebitis
Infusion reaction (fever, chills): Pretreat with acetaminophen
N & V
Bone marrow suppression: Obtain baseline CBC and hematacrit
Severe renal impairment
True or false: You should do a test dose of Amphoteracin B at first?
TRUEEEE
True or false: Amphoteracin B is safe in pregnant women?
TRUEEE
True or false: Amphoteracin B is safe in breastfeeding
FALSEEEEE
What are some drug to drug interactions of patients taking Amphoteracin B?
Should not take with other nephrotoxic drugs such as antineoplastics or cyclosporine
True or false: Nystatin is good for systemic fungal infections
False
How does nystatin work?
Creates pores that cause cell leakage
When taking oral nystatin, what should you instruct the patient to do?
Swish in mouth for several minutes before swallowing
How is nystatin excreted?
In the feces as unchanged
What are the side effects of nystatin?
Hypotension
Tachycardia
NVD
Topical: Skin irritaiton
What are the drugs used for tuberculosis?
Rifampin
Isoniazid
Pyrazinamide
Ethambutol
What side effect is common for all tuberculosis drugs?
Hepatotoxicity: Advise patients not to drink alcohol and monitor for liver enzymes
What is a side effect of Rifampin?
Orange secretions
GI upset
Decreased effectiveness of oral contraceptives: Advise pt to use alternative form of birth control
What’s a common side effect of Isoniazid?
Neuropathy: Pain, tingling, numbness, burning
Observe for manifestations and notify provider
What’s a common side effect of Pyrazinamide?
Joint pain
What’s a common side effect of Etambutol?
Vision problems (Think E for Eyes)
Advise patient to report any issues w/ vision and to get screened regularly
