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LINDSAY - PHARM I > TEST 3 > Flashcards

TEST 3 Flashcards

1
Q

DEFINITION: Uncontrolled and rapid cellular growth

A

CANCER

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2
Q

2 ways cancer cells spread in tissue:

A
  1. Grow & invade adjacent tissues

2. Break away from original tumor mass and travel by means of the blood or lymphatic system to distant sites

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3
Q

DEFINITION: is a disease or symptom that is the consequence of the presence of cancer in the body

A

PARANEOPLASTIC SYNDROMES (PNS)

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4
Q

First Signs of Malignancy:

A
  1. Cachexia (most common) – like wasting

2. Fever, fatigue, weight loss

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5
Q

DEFINITION: Pharmacological treatment of cancer

A

CHEMOTHERAPY

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6
Q

2 groups of antineoplastic drugs:

A
  1. Cell cycle-nonspecific (CCNS)

2. Cell cycle-specific (CCS)

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7
Q

TRUE OR FALSE? Antineoplast drugs target healthy and non-cancerous cells in different ways

A

FALSE - DO not differentiate between healthy and non-cancerous cells

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8
Q

DEFINITION: Original site of growth

A

PRIMARY LESION

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9
Q

DEFINITION:
• Uncontrolled cell growth
• Secondary lesion in a new part of the body

A

METASTASIS

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10
Q

DEFINITION: Mass of new cells; tumor

A

NEOPLASM

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11
Q

DEFINITION: can be benign or malignant (cancerous)

A

TUMOR

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12
Q

DEFINITION: cancers of epithelial tissue

A

CARCINOMAS

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13
Q

DEFINITION: cancers of connective tissue

A

SARCOMA

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14
Q

DEFINITION: cancers of bone marrow, lymph tissue

A

LYMPHOMAS

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15
Q

DEFINITION: cancer cancers of blood

A

LEUKEMIAS

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16
Q

DEFINITION: Non-cancerous and not an immediate threat to life.

A

BENIGN

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17
Q

DEFINITION: Leakage of an intravenously or intra-arterially administered drug into the tissue space surrounding the blood vessel.

A

EXTRAVASATION

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18
Q

DEFINITION: The absence of cellular differentiation.

A

ANAPLASIA

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19
Q

DEFINITION: A malignant neoplasm of blood-forming tissues.

A

LEUKEMIA

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20
Q

DEFINITION: A neoplasm of lymphoid tissue that is usually malignant but, in rare cases, may be benign.

A

LYMPHOMA

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21
Q

DEFINITION: The process by which cancer spreads from the original site of growth to a new and remote part of the body.

A

METASTASIS

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22
Q

DEFINITION: Antineoplastic drugs that are cytotoxic in any phase of the cellular growth cycle.

A

CELL-CYCLE NON-SPECIFIC

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23
Q

DEFINITION: A malignant neoplasm of the connective tissue arising in fibrous, fatty, muscular, synovial, vascular, or neural tissue.

A

SARCOMA

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24
Q

DEFINITION: A permanent change in cellular genetic material (DNA).

A

MUTATION

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25
Q

DEFINITION: An alkylating agent.

A

CYCLOPHOSPHAMIDE

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26
Q

DEFINITION: A cytotoxic antibiotic.

A

BLEOMYCIN

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27
Q

DEFINITION: An antimetabolite.

A

METHOTREXATE

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28
Q

DEFINITION: A mitotic inhibitor.

A

VINCRISTINE

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29
Q

DEFINITION: A radiopharmaceutical.

A

SODIUM IODIDE I-131

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30
Q

DEFINITION: The lowest point in a fluctuating value.

A

NADIR

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31
Q

TRUE OR FALSE? SOME ANTI-NEOPLASTIC DRUGS HAVE CHARACTERISTICS OF BOTH OF CCNS & CCS DRUGS

A

TRUE

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32
Q

CELL CYCLE-NONSPECIFIC (CCNS)

_________________ during any phase of the cell cycle

A

Cytotoxic

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33
Q

CELL CYCLE-NONSPECIFIC (CCNS)

More effective against large, slowly growing ______________

A

tumors

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34
Q

2 kinds of CELL CYCLE-NONSPECIFIC (CCNS) drugs:

A
  1. Alkylating drugs

2. Cytotoxic antibiotics

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35
Q

ALKYLATING DRUGS

Are _______________ at any stage in the growth cycle of cancer cells

A

effective

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36
Q

ALKYLATING DRUGS

Prevent cancer cells from _________________ with the process of alkylation

A

reproducing

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37
Q

WHICH CLASS OF ALKYLATING DRUGS?

  • cyclophosphamide (Procytox)
  • mechlorethamine (Mustargen)
A

Classic alkylators (nitrogen mustards)

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38
Q

WHICH CLASS OF ALKYLATING DRUGS?

  • carmustine
  • lomustine
  • streptozocin
A

Nitrosoureas

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39
Q

WHICH CLASS OF ALKYLATING DRUGS?

• Cisplatin

A

Probable alkylators

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40
Q

WHICH PROBABLE ALKYLATOR DRUG?

• For treatment of solid tumors

A

CISPLATIN

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41
Q

2 CONSIDERATIONS FOR USE WITH CISPLATIN:

A
  1. Do not administer AMINOGLYCOSIDES with Cisplatin as it increases risk of nephrotoxicity
  2. Ensure client is adequately hydrated to prevent nephrotoxicity
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42
Q

ADVERSE EFFECTS FOR ALKYLATING DRUGS

A
  1. Nephrotoxicity, peripheral neuropathy, ototoxicity

2. Extravasation causes tissue damage and necrosis

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43
Q

Patients taking alkylating drugs, what can prevent nephrotoxicity?

A

hydration

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44
Q

ALKYLATING DRUGS – NURSING IMPLICATIONS

Monitor for expected effects of __________ _____________ suppression

A

bone marrow

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45
Q

ALKYLATING DRUGS – NURSING IMPLICATIONS

Expect nausea, vomiting, diarrhea, and _____________ (mouth ulcers – very painful)

A

stomatitis

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46
Q

ALKYLATING DRUGS – NURSING IMPLICATIONS

for patients with stomatitis

A

avoid high fiber, spicy, citric acid foods or foods of extreme temperature to decrease discomfort. Use soft bristle toothbrushes, etc…

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47
Q

ALKYLATING DRUGS – NURSING IMPLICATIONS

Report ANY ringing/roaring in the ears—possible __________________

A

ototoxicity

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48
Q

ALKYLATING DRUGS – NURSING IMPLICATIONS

Peripheral __________________ may occur—report tingling, numbness, pain in extremities

A

neuropathies

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49
Q

CYTOTOXIC ANTIBIOTICS

Used to treat cancer – too ____________ to treat infections

A

toxic

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50
Q

CYTOTOXIC ANTIBIOTICS

Can cause ___________ _____________ ___________ – except BLEOMYCIN

A

bone marrow suppression

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51
Q

CYTOTOXIC ANTIBIOTICS

Active in all phases of the __________ ______________

A

cell cycle

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52
Q

CYTOTOXIC ANTIBIOTICS

Act through alkylation & thereby ___________ DNA synthesis

A

block

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53
Q

WHICH CLASS OF CYTOTOXIC ANTIBIOTICS?
• Daunorubicin
• Doxorubicin

A

o Anthracycline antibiotics

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54
Q

WHICH CLASS OF CYTOTOXIC ANTIBIOTICS?

• Bleomycin

A

o Other cytotoxic antibiotics

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55
Q

INDICATIONS FOR WHAT KINDS OF DRUGS?

Used to treat a variety of solid tumors & some hematological malignancies

A

CYTOTOXIC ANTIBIOTICS

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56
Q

INDICATIONS FOR WHAT KINDS OF DRUGS?

Also used to treat AIDS related Kaposi’s sarcoma

A

CYTOTOXIC ANTIBIOTICS

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57
Q

3 ADVERSE EFFECTS FOR CYTOTOXIC ANTIBIOTICS

A
  1. pulmonary toxicity or fibrosis (bleomycin)
  2. heart failure (daunorubicin) or cardio myopathy (doxorubicin)
  3. Liver, kidney & cardiovascular toxicities
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58
Q

CYTOTOXIC ANTIBIOTICS – NURSING IMPLICATIONS

A

Expect bone marrow suppression, nausea, vomiting, diarrhea, stomatitis

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59
Q

CYTOTOXIC ANTIBIOTICS – NURSING IMPLICATIONS

Monitor ______________ status

A

pulmonary

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60
Q

CYTOTOXIC ANTIBIOTICS – NURSING IMPLICATIONS

Monitor for _____________, _____________ toxicity

A

nephrotoxicity

liver

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61
Q

CYTOTOXIC ANTIBIOTICS – NURSING IMPLICATIONS

Monitor __________________ status

A

cardiovascular

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62
Q

CYTOTOXIC ANTIBIOTICS – NURSING IMPLICATIONS

daunorubicin may turn the ____________ a reddish color

A

urine

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63
Q

WHAT KIND OF ANTINEOPLASTIC DRUGS?
• Used to oppose effects of hormone and block sex hormone receptors
• Used as adjuvants & in palliative therapy

A

HORMONAL ANTINEOPLASTIC DRUGS

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64
Q

WHAT TYPE OF NEOPLASM ARE THESE HORMONAL ANTINEOPLASTIC DRUGS USED FOR:
• Tamoxifen
• Medroxyprogesterone

A

FEMALE SPECIFIC NEOPLASMS

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65
Q

WHAT TYPE OF NEOPLASM ARE THESE HORMONAL ANTINEOPLASTIC DRUGS USED FOR:
• Leuprolide

A

MALE SPECIFIC NEOPLAMS

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66
Q

WHAT KIND OF ANTINEOPLASTIC DRUGS?

• Used to treat a variety of cancers or symptoms caused by cancer

A

RADIOPHARMACEUTICALS

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67
Q

CELL CYCLE-NONSPECIFIC – NURSING IMPLICATIONS

Monitor for _______________: REST & ELEVATE AFFECTED LIMB

A

extravasation

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68
Q

CELL CYCLE-NONSPECIFIC – 5 NURSING IMPLICATIONS IF EXTRAVASATION OCCURS?

A
  1. STOP INFUSION. CALL DR.
  2. LEAVE CATHETER IN PLACE
  3. ATTEMPT TO ASPIRATE ANY RESIDUAL DRUG AND BLOOD FROM CATHETER
  4. ADMINISTER ANDIDOTE AS PER PHARMACIST.
  5. USE HOT/COLD PACKS AS INDICATED
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69
Q

CELL CYCLE-NONSPECIFIC – NURSING IMPLICATIONS

______________ is the best approach for extravasation & continuous ____________ of IV site is essential

A

Prevention

monitoring

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70
Q

CELL CYCLE-NONSPECIFIC – NURSING IMPLICATIONS

Assess baseline __________ _____________ before giving ANY antineoplastic drugs (drugs cause bone marrow suppression)

A

blood counts

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71
Q

WBCs NORMAL RANGE

A

5000-15000

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72
Q

TRUE OR FALSE?

If allergic to medication the client should still take the medication.

A

TRUE

Unless anaphylactic.

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73
Q

CELL CYCLE-NONSPECIFIC – NURSING IMPLICATIONS

3 complications associated with bone marrow suppression

A
  1. Anemia
  2. Thrombocytopenia
  3. Neutropenia
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74
Q

CELL CYCLE-NONSPECIFIC – NURSING IMPLICATIONS

Monitor for oncological emergencies

A
  1. Infections
  2. Pulmonary toxicity
  3. Allergic reactions
  4. Stomatitis with severe ulcerations
  5. Bleeding
  6. Metabolic aberrations
  7. Bowel irritability with diarrhea
  8. Renal, liver, cardiac toxicity
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75
Q

CELL CYCLE-NONSPECIFIC – NURSING IMPLICATIONS

Cytoprotective drugs may be used to reduce _____________

A

toxicities

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76
Q

Intravenous (IV) amifostine (Ethyol) to reduce renal toxicity associated with _______________

A

cisplatin

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77
Q

IV or oral allopurinol (Alloprim) to reduce ______________

A

hyperuricemia

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78
Q

CAREFUL WHEN ADMINISTERING ‘_______________’ MEDICATIONS. DO NOT MIX THEM UP AS THEY HAVE DIFFERENT SIDE EFFECTS & INDICATIONS

A

‘RUBICIN’

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79
Q

A fever for a client taking CCNS antineoplastics is above ______________

A

37.8C

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80
Q

CELL CYCLE-SPECIFIC (CCS)

Cytotoxic during a ______________ cell cycle phase

A

specific

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81
Q

CELL CYCLE-SPECIFIC (CCS)

More effective against ______________ growing tumors

A

rapidly

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82
Q

CELL CYCLE-SPECIFIC (CCS)

Used to treat a variety of _________ tumors and some _____________ malignancies

A

solid

hematological

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83
Q 
WHICH KIND OF ANTINEOPLASTIC DRUG INCLUDES THE FOLLOWING?
o	Antimetabolites
o	Mitotic inhibitors
o	Topoisomerase I inhibitors
o	Antineoplastic enzymes
A

CELL CYCLE-SPECIFIC (CCS)

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84
Q

WHICH CLASS OF ANTIMETABOLITES?

Results in nonproduction of DNA & cell death (interferes with the use of folic acid)

A

Folate antagonists

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85
Q

WHICH CLASS OF ANTIMETABOLITES?

methotrexate raltitrexed disodium

A

Folate antagonists

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86
Q

WHICH CLASS OF ANTIMETABOLITES?

Results in the interruption of the synthesis of DNA & RNA (interrupts metabolic pathways of purine nucleotides).

A

Purine antagonists

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87
Q

WHICH CLASS OF ANTIMETABOLITES?

Attacks tumor cells

A

Purine antagonists

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88
Q

WHICH CLASS OF ANTIMETABOLITES?
• cladribine (Leustatin) – not widely used
• fludarabine phosphate
• allopurinol

A

Purine antagonists

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89
Q

WHICH CLASS OF ANTIMETABOLITES?

Results in interruption of synthesis of DNA & RNA (interrupts metabolic pathways of pyrimidine bases)

A

Pyrimidine antagonists

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90
Q

WHICH CLASS OF ANTIMETABOLITES?

o cytarabine fluorouracil

A

Pyrimidine antagonists

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91
Q

INDICATIONS FOR WHAT KINDS OF DRUGS?

  • Used in combination with other drugs
  • Treats solid tumors & hematological malignancies
  • Oral & topical forms are used for lose-dose maintenance and palliative cancer therapy
A

ANTIMETABOLITES

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92
Q

3 ADVERSE EFFECTS FOR ANTIMETABOLITES

A
  • Alopecia (Hair loss)
  • Nausea & vomiting
  • Myelosuppression (Bone Marrow Suppression)
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93
Q

WHICH KIND OF ANTINEOPLASTIC DRUG INCLUDES THE FOLLOWING?

  • Natural products obtained from plants & trees
  • All work before, or during, mitosis
A

MITOTIC INHIBITORS

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94
Q

WHICH CLASS OF MITOTIC INHIBITORS:

o Etoposide

A

Epipodophyllotoxin derivatives

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95
Q

WHICH CLASS OF MITOTIC INHIBITORS:
o Paclitaxel
o Docetaxel

A

Taxanes – ‘taxel’ drugs

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96
Q

WHICH CLASS OF MITOTIC INHIBITORS:

o Vincristine

A

• Vinca alkaloids – ‘vin’ drugs

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97
Q

INDICATIONS FOR MITOTIC INHIBITORS:

• SLOWS ____________ ____________

A

CELL DIVISION

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98
Q

INDICATIONS FOR MITOTIC INHIBITORS:

• USED TO TREAT A VARIETY OF ___________ TUMORS & SOME _______________ MALIGNANCIES

A

SOLID

HEMATOLOGICAL

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99
Q

ADVERSE EFFECTS FOR FOR MITOTIC INHIBITORS:

A
  • Liver, kidney, lung toxicities
  • Convulsions**
  • Extravasation
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100
Q

WHICH KIND OF ANTINEOPLASTIC DRUG INCLUDES THE FOLLOWING?

• Inhibits DNA function & prevent DNA religation

A

TOPOISOMERASE I INHIBITORS

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101
Q

WHICH KIND OF ANTINEOPLASTIC DRUG INCLUDES THE FOLLOWING?

o Irinotecan (Camptosar)

A

TOPOISOMERASE I INHIBITORS

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102
Q

INDICATIONS FOR WHAT KINDS OF DRUGS?
• Ovarian & colorectal cancer
• Small-cell lung cancer & others

A

TOPOISOMERASE I INHIBITORS

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103
Q

ADVERSE EFFECTS FOR TOPOISOMERASE I INHIBITORS

A

Cholinergic diarrhea (delayed, occurring 2 to 10 days after dosage) (irinotecan [Camptosar]) ***

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104
Q

WHICH KIND OF ANTINEOPLASTIC DRUG INCLUDES THE FOLLOWING?

Synthesized using cultures of bacteria and recombinant DNA technology

A

ANTINEOPLASTIC ENZYMES

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105
Q

WHICH KIND OF ANTINEOPLASTIC DRUG INCLUDES THE FOLLOWING?

o Asparaginase
o Pegaspargase (not commonly used
Asparaguses)

A

ANTINEOPLASTIC ENZYMES

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106
Q

INDICATIONS FOR WHAT KINDS OF DRUGS?

• Acute lymphocytic leukemia

A

ANTINEOPLASTIC ENZYMES

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107
Q

ADVERSE EFFECTS FOR ANTINEOPLASTIC ENZYMES

A

• Impaired pancreatic function. Leads to:
o Hyperglycemia
o Severe or fatal pancreatitis

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108
Q

NURSING IMPLICATIONS FOR CELL CYCLE-SPECIFIC (CCS)

Assess baseline blood counts before giving any antineoplastic drugs because of ______________ (bone marrow suppression)

A

myelosuppression

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109
Q

NURSING IMPLICATIONS FOR CELL CYCLE-SPECIFIC (CCS)

Danger of ________________ of vesicants – leads to massive tissue injury or irritants – less damage if infiltrated

A

EXTRAVASATION

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110
Q

NURSING IMPLICATIONS FOR CELL CYCLE-SPECIFIC (CCS)

Given IV – using ____________ venous IV catheters rather than _______________ catheters is recommended

A

central

peripheral

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111
Q

NURSING IMPLICATIONS FOR CELL CYCLE-SPECIFIC (CCS)

Remember rapidly dividing cells (normal & cancer cells) are effected & MONITOR FOR EFFECTS OR COMPLICATIONS ON THE FOLLOWING TISSUES

A

o Mucus membranes
o Hair follicles
o Bone marrow component

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112
Q

NURSING IMPLICATIONS FOR CELL CYCLE-SPECIFIC (CCS)

Monitor for complications WITH GI mucus membranes:

A

Stomatitis (lesions & sores in mouth) – most distressful symptom

Altered bowel function with high risk for poor appetite, nausea, vomiting, diarrhea, and inflammation and possible ulceration of GI mucosa

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113
Q

NURSING IMPLICATIONS FOR CELL CYCLE-SPECIFIC (CCS)

Monitor for complications WITH HAIR FOLLICLES

A

• Loss of hair (alopecia)

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114
Q

NURSING IMPLICATIONS FOR CELL CYCLE-SPECIFIC (CCS)

Monitor for WITH Bone marrow components

A

• Dangerously low blood cell counts (life-threatening)

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115
Q

NURSING IMPLICATIONS FOR CELL CYCLE-SPECIFIC (CCS)

Take measures to monitor for and prevent infection in patients with _____________ or _______________

A

neutropenia

leukopenia

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116
Q

NURSING IMPLICATIONS FOR CELL CYCLE-SPECIFIC (CCS)

Monitor & prevent bleeding in patients with ________________ and __________

A

thrombocytopenia

anemia

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117
Q

NURSING IMPLICATIONS FOR CELL CYCLE-SPECIFIC (CCS)

Anemia may result in severe _______________

A

fatigue

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118
Q

NURSING IMPLICATIONS FOR CELL CYCLE-SPECIFIC (CCS)

Anti-emetics work better if given ______-______ minutes before chemo

A

30-60

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119
Q

NURSING IMPLICATIONS FOR CELL CYCLE-SPECIFIC (CCS)

Women of childbearing age need to use a nondrug form of _____________ (dick sock) during therapy & sometimes for months afterward because chemo is a ______________

A

contraception

teratogen

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120
Q

NURSING IMPLICATIONS FOR CELL CYCLE-SPECIFIC (CCS)

Advise clients to avoid ______________ & persons with ______________

A

crowds

infections

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121
Q

ANTI-TUBERCULOSIS DRUGS

• Treat all forms of __________________

A

Mycobacterium

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122
Q 
•	Common infection sites for what disease?
o	Lung  (primary site)
o	Brain
o	Bone 
o	Liver
o	Kidney
A

TUBERCULOSIS

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123
Q

_______________ is transmitted via droplets expelled by coughing or sneezing. Gains access to the body via inhalation

A

TUBERCULOSIS

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124
Q

_________________ is considered a pandemic

A

TUBERCULOSIS

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125
Q

Anti TB drugs can inhibit protein or cell wall __________________

A

synthesis

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126
Q

ANTI-TUBERCULOSIS DRUGS

• Before the results of susceptibility tests are known, begin a regimen with multiple anti-tuberculosis drugs (this reduces chances of developing _________________)

A

resistance

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127
Q

ANTI-TUBERCULOSIS DRUGS

• Once susceptibility is known, _____________ drug regimen

A

adjust

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128
Q

ANTI-TUBERCULOSIS DRUGS

Monitor adherence closely because non-adherence increases the incidence of _________-_____________ _____________

A

drug-resistant organisms

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129
Q

2 CONTRAINDICATIONS FOR ANTI-TUBERCULOSIS DRUGS

A
  • Major kidney or liver dysfunction

* Chronic alcohol use

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130
Q

WHICH CLASS OF DRUGS?

o	Ethambutol (Etibi)
o	Isoniazid (Isotamine)* AKA INH
o	Rifampin (Rifadin, Rofact)
A

ANTI-TUBERCULOSIS DRUGS

• Cell wall inhibitors

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131
Q

WHICH DRUG?

• Choice drug for TB treatment

A

Isoniazid (Isotamine)* AKA INH

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132
Q

WHICH DRUG?

• Metabolized in the liver through acetylation – watch for slow acetylators

A

Isoniazid (Isotamine)* AKA INH

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133
Q

WHICH DRUG?

• Usually used with rifampin

A

Isoniazid (Isotamine)* AKA INH

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134
Q

WHICH DRUG?

• Can be used alone or in combination with other drugs

A

Isoniazid (Isotamine)* AKA INH

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135
Q

2 ADVERSE EFFECTS – Isoniazid (Isotamine)* AKA INH

A
  • Peripheral neuritis

* Hepatotoxicity

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136
Q

INTERACTIONS – WHICH DRUG
• Reduces absorption of antacids (decreases isoniazid levels)
• Reduces effectiveness of oral contraceptives
• Additive effect with rifampin
o Increases CNS & liver toxicity

A

Isoniazid (Isotamine)* AKA INH

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137
Q

NURSING IMPLICATIONS – Isoniazid (Isotamine)* AKA INH

• Pyridoxine may be needed to combat _______________ adverse effects associated with INH therapy

A

neurological

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138
Q

2 ADVERSE EFFECTS – Rifampin (Rifadin, Rofact)

A
  • Hepatitis
  • Should be told that their urine, stool, saliva, sputum, sweat, or tears may become reddish orange; even contact lenses may be stained
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139
Q

INTERACTIONS – WHICH DRUG?
• Increases metabolism
• Oral contraceptives

A

Rifampin (Rifadin, Rofact)

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140
Q

2 ADVERSE EFFECTS – Ethambutol (Etibi)

A
  • Retrobulbar neuritis

* Blindness

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141
Q

NURSING IMPLICATIONS - ANTI-TUBERCULOSIS DRUGS

Therapy may last for up to _____ months

A

24

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142
Q

NURSING IMPLICATIONS - ANTI-TUBERCULOSIS DRUGS

Meds should be taken at the _________ time every day

A

same

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143
Q

NURSING IMPLICATIONS - ANTI-TUBERCULOSIS DRUGS

Stress importance of strict _______________ to regimen

A

adherence

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144
Q

NURSING IMPLICATIONS - ANTI-TUBERCULOSIS DRUGS

Advise clients they are ______________ during the initial period of their illness

A

contagious

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145
Q

NURSING IMPLICATIONS - ANTI-TUBERCULOSIS DRUGS

Emphasize the importance of adequate ______________ and _____________

A

nutrition

rest

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146
Q

NURSING IMPLICATIONS - ANTI-TUBERCULOSIS DRUGS

Should not consume ______________

A

alcohol

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147
Q

NURSING IMPLICATIONS - ANTI-TUBERCULOSIS DRUGS

Be careful with ___________ drugs

A

OTC

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148
Q

NURSING IMPLICATIONS - ANTI-TUBERCULOSIS DRUGS

Oral preparations may be given with _________ to reduce gastrointestinal (gi) upset, even though patients are recommended to take them 1 hour before or 2 hours after meals

A

meals

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149
Q

NURSING IMPLICATIONS - ANTI-TUBERCULOSIS DRUGS

Watch for lack of clinical response to therapy, indicating possible drug ____________ (not necessarily due to non-compliance)

A

resistance

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150
Q

NURSING IMPLICATIONS - ANTI-TUBERCULOSIS DRUGS

Instruct patients on the adverse effects that should be reported to the physician immediately, SUCH AS:

A

Fatigue, nausea, vomiting, numbness and tingling of the extremities, fever, loss of appetite, depression, jaundice

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151
Q

Purified protein derivative (PPD): ID injection used to detect TB ____________

A

exposure

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152
Q

Purified protein derivative (PPD): Positive Mantoux reaction is indicated by _______________ (not erythema) at the site of injection

A

induration

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153
Q

Bacillus Calmette-Guérin (BCG): Is used worldwide to vaccinate __________ ______________ against TB

A

young children

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154
Q

Bacillus Calmette-Guérin (BCG): _______________ active TB

A

Reduces

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155
Q

ANTI-FUNGAL DRUGS ‘AZOLE’

Treat infections caused by _____________
o Systemic
o Topical

A

fungi

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156
Q

ANTI-FUNGAL DRUGS ‘AZOLE’

Infections caused by fungus are known as ________________

A

mycoses

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157
Q

ANTI-FUNGAL DRUGS ‘AZOLE’

Some ______________ are part of our normal skin, mouth, intestine & vaginal flora

A

fungi

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158
Q

ANTI-FUNGAL DRUGS ‘AZOLE’

Four types of mycotic infections:

A

o Cutaneous
o Subcutaneous
o Superficial
o Systemic – can be life threatening, occurs in the immunocompromised

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159
Q

WHICH TYPE OF DRUG?

  • amphotericin B (Fungizone)
  • caspofungin (Cancidas)
  • fluconazole (Diflucan)
  • ketoconazole
  • griseofulvin
A

SYSTEMIC ANTIFUNGALS

160
Q

WHICH IS THE DRUG OF CHOICE FOR MANY SEVERE FUNGAL INFECTIONS

A

amphotericin B (Fungizone)

161
Q

WHICH TYPE OF DRUG?

  • miconazole
  • nystatin
A

TOPICAL ANTIFUNGALS

162
Q

WHICH DRUG?

Causes terrible adverse effects

A

Amphotericin B (Fungizone)

163
Q

WHICH DRUG?

Main concerns
o Renal toxicity
o Neurotoxicity: seizures and paraesthesias

A

Amphotericin B (Fungizone)

164
Q

WHICH DRUG?

Some side effects are pre-treated so they can receive the antifungal with less adverse effects

A

Amphotericin B (Fungizone)

165
Q

WHICH DRUG?

To reduce the severity of the infusion-related reactions, pretreatment with antipyretics (e.g., acetaminophen), antihistamines, antiemetics, or corticosteroids may be given

A

Amphotericin B (Fungizone)

166
Q

3 CONTRAINDICATIONS – ANTIFUNGALS

A
  • Liver failure
  • Renal failure
  • Porphyria (griseofulvin)
167
Q

INTERACTIONS – ANTIFUNGALS

A

Many antifungal drugs are metabolized by the cytochrome P-450 enzyme system

Drug interactions are significant with azole antifungals.

168
Q

NURSING IMPLICATIONS - ANTI-FUNGAL DRUGS ‘AZOLE’

Patients receiving intravenous (IV) infusions, monitor vital signs every _____ TO _____ minutes

A

15 to 30

169
Q

NURSING IMPLICATIONS - ANTI-FUNGAL DRUGS ‘AZOLE’

During IV infusions, monitor __________ and ___________, urinalysis results, liver and kidney function tests, and __________ _________ _________ to identify adverse effects

A

intake
output
complete blood counts

170
Q

NURSING IMPLICATIONS - ANTI-FUNGAL DRUGS ‘AZOLE’

Some oral forms should be given with __________ to decrease gastrointestinal upset; others require an empty stomach

A

meals

171
Q

NURSING IMPLICATIONS - ANTI-FUNGAL DRUGS ‘AZOLE’

_____________ given as an oral lozenge or troche (lozenge) should be slowly and completely dissolved in the mouth (not chewed or swallowed whole)

A

nystatin

172
Q

NURSING IMPLICATIONS - ANTI-FUNGAL DRUGS ‘AZOLE’

nystatin suspension should be _____________ thoroughly in the mouth as long as possible before _____________

A

swished

swallowing

173
Q

ANTIMALARIALS

More than one drug may be used for synergistic or additive ___________ ____________

A

killing power

174
Q

ANTIMALARIALS

Some drugs are used __________________ against malaria

A

prophylactically

175
Q

3 CONTRAINDICATIONS FOR ANTIMALARIALS

A
  • Tinnitus
  • Pregnancy (quinine)
  • Severe renal, hepatic, or hematological dysfunction
176
Q

1 ADVERSE EFFECTS - ANTIMALARIALS

A

• Primarily GI

177
Q

INTERACTIONS – chloroquine

cimetidine decreases ______________ of chloroquine

A

metabolism

178
Q

INTERACTIONS – chloroquine

Hepatotoxic drugs and alcohol increase chloroquine levels in liver, thereby increasing ______________

A

hepatotoxicity

179
Q

INTERACTIONS – primaquine and other hemolytic drugs

Increase the risk for _______________ effects

A

myelotoxic

180
Q

INTERACTIONS – mefloquine (Lariam)

Increase the risk of ____________, ___________ __________, & __________________

A

dysrhythmia, cardiac arrest, & seizures

181
Q

NURSING IMPLICATIONS – ANTIMALARIALS

When used prophylactically, these drugs should be started ____ TO _____ WEEKS before potential exposure to malaria and continued for ______ weeks after leaving the malaria-endemic area

A

1 to 2 weeks

4

182
Q

NURSING IMPLICATIONS – ANTIMALARIALS

• Taken ___________

A

weekly

183
Q

NURSING IMPLICATIONS – ANTIMALARIALS

Instruct patient to notify physician immediately if any of the following occurs:

A 
o	Ringing in the ears
o	hearing decrease
o	visual difficulties
o	nausea
o	vomiting
o	profuse diarrhea
o	abdominal pain
184
Q

NURSING IMPLICATIONS – ANTIMALARIALS

Alert patients to the possible ______________ of the symptoms of malaria so that they will know to seek immediate treatment

A

recurrence

185
Q

ANTIPROTOZOAL DRUGS

Patients with compromised ____________ __________ are at risk for acquiring protozoal infections which are often ___________ in this case

A

immune systems

fatal

186
Q

WHICH TYPE OF DRUG?

  • atovaquone (Mepron)
  • metronidazole (Flagyl)
  • pentamidine
  • paromomycin (Humatin)
A

ANTIPROTOZOAL DRUGS

187
Q

INDICATIONS - atovaquone (Mepron)

Used to treat mild to moderate _____________ ____________ – infections HIV + people get

A

Pneumocystis jirovecii

188
Q

2 ADVERSE EFFECTS - atovaquone (Mepron)

A
  • Altered liver function

* Leukopenia

189
Q

INDICATIONS - metronidazole (Flagyl)

• Has ______________ activity

A

anthelmintic

190
Q

1 ADVERSE EFFECT - metronidazole (Flagyl)

A

• Metallic taste

191
Q

INDICATIONS - pentamidine

Used to prevent and treat _____________ ____________ pneumonia

A

Pneumocystis jirovecii

192
Q

INDICATIONS - pentamidine

• Treats other _______________ infections

A

protozoal

193
Q

1 ADVERSE EFFECT - pentamidine

A

Bronchospasms

194
Q

INDICATIONS - paromomycin (Humatin)

Used to treat ___________ and ____________ protozoal infections

A

amoebiasis

intestinal

195
Q

ANTI-HELMINTIC

Used to treat parasitic _________ infections

A

worm

196
Q

ANTI-HELMINTIC

Drug treatment is very ___________to the organism

A

specific

197
Q

ANTI-HELMINTIC: mebendazole (Vermox)

  • Used to treat _________ ___________
  • May cause ____________________
A

Pin Worms

myelosuppression

198
Q

ANTI-HELMINTIC: Pyrantel

• Kills _________________ infections

A

roundworm

199
Q

ANTI-HELMINTIC: praziquantel (Biltricide)

_____________ worms’ musculature and ______________ their suckers

A

Paralyzes

immobilizes

200
Q

ANTI-HELMINTIC: praziquantel (Biltricide)

_________ ____________ is a contraindication

A

Liver disease

201
Q

NURSING IMPLICATIONS: ANTIMALARIAL, ANTIPROTOZOAL, AND ANTHELMINTIC DRUGS

Be sure to collect specimens before beginning ___________ _______________

A

drug therapy

202
Q

NURSING IMPLICATIONS: ANTIMALARIAL, ANTIPROTOZOAL, AND ANTHELMINTIC DRUGS

Some drugs may cause the _________ to have an asparagus-like odour or cause an unusual ___________ odour or a __________ ____________

A

urine
skin
metallic taste

203
Q

NURSING IMPLICATIONS: ANTIMALARIAL, ANTIPROTOZOAL, AND ANTHELMINTIC DRUGS

Administer all drugs as ordered and for the ______________ length of time

A

prescribed

204
Q

NURSING IMPLICATIONS: ANTIMALARIAL, ANTIPROTOZOAL, AND ANTHELMINTIC DRUGS

Most drugs should be taken with ________ to reduce GI upset

A

food

205
Q

ANTIBIOTICS

Used to treat _____________ infections

A

bacterial

206
Q

WHICH TYPE OF DRUG?

o	Sulfonamides
o	Penicillins
o	Cephalosporins
o	Macrolides
o	Tetracyclines
o	Aminoglycosides
o	Fluoroquinolones
o	Others: Carbapenems, Monobactams, Ketolides
A

ANTIBIOTICS

207
Q

NURSING IMPLICATIONS - ANTIBIOTICS

The most common adverse effects of antibiotics are nausea, vomiting, and diarrhea
o ESPECIALLY _____________

A

MACROLIDES

208
Q

NURSING IMPLICATIONS - ANTIBIOTICS

All oral antibiotics are absorbed better if taken with at least _________ to ___________ mL of water

A

180 TO 240

209
Q

NURSING IMPLICATIONS - ANTIBIOTICS

Assess for signs and symptoms of ________________: fever, perineal itching, cough, lethargy, or any unusual discharge

A

superinfection

210
Q

NURSING IMPLICATIONS - ANTIBIOTICS

Patients should be instructed to take antibiotics exactly as prescribed and for the ___________ of time prescribed; they should not stop taking the medication early because they feel better – CONTRIBUTES TO _______________

A

length

RESISTANCE

211
Q

NURSING IMPLICATIONS - ANTIBIOTICS

If cultures are ordered, it is essential to obtain them from appropriate sites ______________ beginning antibiotic therapy

A

BEFORE

212
Q

NURSING IMPLICATIONS - ANTIBIOTICS

For safety reasons, check the __________ of the medication carefully because there are many drugs that sound alike or have similar spellings

A

name

213
Q

NURSING IMPLICATIONS - ANTIBIOTICS

4 potential drug interactions

A

COUMANIN,
SULFA DRUGS,
DIURETICS,
BIRTH CONTROL PILLS

214
Q

NURSING IMPLICATIONS - ANTIBIOTICS

Monitor for ______________ effects

A

therapeutic

215
Q

SULFONAMIDES

• Inhibit growth of ______________

A

bacteria

216
Q

SULFONAMIDES

In most cases, sulfonamides are ____________ with another antibiotic:

A

combined

217
Q

INDICATIONS - SULFONAMIDES

Treatment of ________

A

UTIs

218
Q

INDICATIONS - SULFONAMIDES

Prophylaxis and treatment of Pneumocystis jirovecii _____________ (co-trimoxazole)

A

pneumonia

219
Q

CONTRAINDICATIONS - SULFONAMIDES

Known drug allergy to sulfonamides or to chemically related drugs such as (2):

A

o Sulfonylureas

o Thiazide and loop diuretics

220
Q

2 ADVERSE EFFECTS - SULFONAMIDES

A
  • Photosensitivity

* Stevens-Johnson syndrome

221
Q

INTERACTIONS - SULFONAMIDES

Sulfonamides may:
o Potentiate the _______________ effects of sulfonylureas in diabetes
o Reduce the efficacy of ________ _______________

A

hypoglycemic

oral contraceptives

222
Q

NURSING IMPLICATIONS - SULFONAMIDES

Should be taken with at least _________ mL of fluid per day, unless contraindicated

A

2000

223
Q

NURSING IMPLICATIONS - SULFONAMIDES

Oral forms should be taken with food or _______ to reduce GI upset

A

milk

224
Q

β-Lactam Antibiotics

• Broad groups of drugs including these 2:

A

o Penicillins**

o Cephalosporins**

225
Q

INDICATIONS - PENICILLINS

Prevention and treatment of infections caused by susceptible bacteria, such as (3):

A

o Gram-positive bacteria
o Streptococcus spp.
o Staphylococcus spp.

226
Q

ADVERSE EFFECTS - PENICILLINS

A
  • MANY DRUG INTERACTIONS

* Oral contraceptives

227
Q

NURSING IMPLICATIONS – PENICILLINS

Any patient taking a penicillin for the 1st time should be carefully monitored for an __________ _____________ for at least 30 minutes after its administration

A

allergic reaction

228
Q

NURSING IMPLICATIONS – PENICILLINS

The ____________ of oral penicillins is decreased when taken with caffeine, citrus fruit, cola beverages, fruit juices, or tomato juice

A

effectiveness

229
Q

CEPHALOSPORINS

  • 4 _______________ of drugs
  • ________________ a broad spectrum of bacteria
A

generations

Destroys

230
Q

INDICATIONS - First Generation Cephalosporins

Used for ___________ prophylaxis, upper respiratory tract infections, otitis media

A

surgical

231
Q

INDICATIONS - Second Generation Cephalosporins

  • Have ___________ gram-negative coverage than first generation
  • Is used prophylactically for ______________
A

better

surgery

232
Q

Third Generation Cephalosporins

• Most potent group against gram-___________

A

negative

233
Q

WHICH 3RD GENERATION CEPHALOSPORIN?

  • Both IV and IM – no oral form
  • Long half-life
  • Once-a-day dosing
A

o ceftriaxone (Rocephin)

234
Q

WHICH DRUG - Fourth Generation Cephalosporins

Broader spectrum of antibacterial activity than third-generation, especially against gram-positive bacteria

A

o cefepime (Maxipime)

235
Q

ADVERSE EFFECTS - CEPHALOSPORINS

Potential cross-sensitivity with penicillins if ______________ exist

A

allergies

236
Q

NURSING IMPLICATIONS – CEPHALOSPORINS

Some of these drugs may cause a disulfiram-like reaction when taken with _______________**

A

alcohol

237
Q

CARBAPENEMS

• Have very broad-spectrum ____________ action

A

antibacterial

238
Q

CARBAPENEMS

• Are reserved for complicated body cavity and connective tissue ______________

A

infections

239
Q

CARBAPENEMS

• May cause drug-induced _________ activity

A

seizure

240
Q

CARBAPENEMS

• Are all given ________________

A

parenterally

241
Q

MACROLIDES ‘MYCINS’

• Prevent _____________ _____________ within bacterial cells

A

protein synthesis

242
Q

MACROLIDES ‘MYCINS’

o ________________ (hardest on the stomach)

A

Erythromycin

243
Q

4 INDICATIONS - MACROLIDES ‘MYCINS’

A
  • Strep infections
  • Syphilis & Lyme disease
  • Gonorrhea, Chlamydia, Mycoplasma
  • active ulcer disease
244
Q

ADVERSE EFFECTS - MACROLIDES ‘MYCINS’

A

ERYTHROMYCIN PRIMARILY GI EFFECTS ***

azithromycin (Zithromax) and clarithromycin (Biaxin)
Fewer GI adverse effects, longer duration of action, better efficacy, better tissue penetration

245
Q

INTERACTIONS - MACROLIDES ‘MYCINS’

A

Can reduce the efficacy of oral contraceptives

246
Q

TETRACYCLINES

Should not be used in children under age 8 or in pregnant or lactating women because __________ discoloration will occur

A

tooth

247
Q

INDICATIONS - TETRACYCLINES

A

Acne

248
Q

4 ADVERSE EFFECTS - TETRACYCLINES

A

o Discoloration of permanent teeth and tooth
enamel in fetuses and children, or nursing infants

o Superinfection
o Diarrhea
o Pseudomembranous colitis

249
Q

NURSING IMPLICATIONS – TETRACYCLINES

Milk products, iron preparations, antacids, and other dairy products should be ____________

A

avoided

250
Q

NURSING IMPLICATIONS – TETRACYCLINES

• Due to _____________________, avoid sunlight and tanning beds

A

photosensitivity

251
Q

AMINOGLYCOSIDES

• Often used in combination with other antibiotics for ________________ effects

A

synergistic

252
Q

INDICATIONS - AMINOGLYCOSIDES

Used to kill Gram-______________ bacteria

A

negative

253
Q

INDICATIONS - AMINOGLYCOSIDES

• Aminoglycosides are poorly absorbed through the gastrointestinal (GI) tract so are given _____________

A

parenterally

254
Q

INDICATIONS - AMINOGLYCOSIDES
**
neomycin, however, is given orally to decontaminate the GI tract before surgical procedures OR _____________

A

ENEMA

255
Q

CONTRAINDICATIONS - AMINOGLYCOSIDES

• Cause ____________ harm when administered to pregnant women

A

fetal

256
Q

2 ADVERSE EFFECTS - AMINOGLYCOSIDES

A
  • Ototoxicity (Vertigo may occur)

* Nephrotoxicity

257
Q

INTERACTIONS - AMINOGLYCOSIDES

• Aminoglycosides have an increased risk for nephrotoxicity when used with:

A

o vancomycin (Vancocin)
o cyclosporine
o amphotericin B (Fungizone)

258
Q

INTERACTIONS - AMINOGLYCOSIDES

• Use with loop diuretics increases the risk for _________________

A

otoxoticity

259
Q

INTERACTIONS - AMINOGLYCOSIDES

• Warfarin (Coumadin) _____________

A

toxicity

260
Q

NURSING IMPLICATION - AMINOGLYCOSIDES

• Monitor drug levels to prevent _____________

A

toxicity

261
Q

NURSING IMPLICATION - AMINOGLYCOSIDES

Monitor ____________ (LOWEST) levels every 3 days while on therapy or as ordered

A

trough

262
Q

Symptoms of _____________ include dizziness, tinnitus, and hearing loss

A

ototoxicity

263
Q

Symptoms of _________________ include urinary casts, proteinuria, and increased blood urea nitrogen (BUN) and serum creatinine levels, & WEIGHT GAIN

A

nephrotoxicity

264
Q

FLUOROQUINOLONES

• Oral absorption is reduced by _______________**

A

antacids

265
Q 
WHAT KIND OF DRUGS ARE THESE?
o	levofloxacin (Levaquin)
o	ciprofloxacin (Cipro)
A

FLUOROQUINOLONES

266
Q

INDICATIONS - FLUOROQUINOLONES

DRUG OF CHOICE FOR ________________

A

ANTHRAX

267
Q

INDICATIONS - FLUOROQUINOLONES

• Lower respiratory tract infections –___________________***

A

PNEUMONIA

268
Q

CONTRAINDICATIONS - FLUOROQUINOLONES

Avoid in clients taking _________________ drugs such as disopyramide and amiodarone as dangerous cardiac dysrhythmias can occur

A

antiarrhythmic

269
Q

INTERACTIONS - FLUOROQUINOLONES

Concurrent use of the following with quinolones greatly reduces their oral absorption:
o ___________________

A

Antacids

270
Q

clindamycin (Dalacin C)

• May cause pseudomembranous ____________

A

colitis

271
Q

Linezolid

• Used for ______________

A

MRSA

272
Q

metronidazole (Flagyl)

• Used for intra-abdominal and ______________ infections

A

gynecological

273
Q

vancomycin (Vancocin)

• ________ ___________ syndrome may occur – LOOKS LIKE AN ALLERGIC REACTION

A

Red man

274
Q

vancomycin (Vancocin)

• May cause ____________ and _____________

A

ototoxicity

nephrotoxicity

275
Q

vancomycin (Vancocin)

• Should be infused over ______ minutes

A

60

276
Q

vancomycin (Vancocin)

• Ensure adequate ____________ (2 L fluids/24 hr), if not contraindicated, to prevent nephrotoxicity

A

hydration

277
Q

______________ medications kill or suppress viruses by:

  1. Destroying virions or
  2. Inhibiting their ability to replicate
A

Antiviral

278
Q

ANTIVIRAL MEDICATIONS

Drugs that destroy virions include THESE 2:

A
  • Disinfectants

* Immunoglobulins

279
Q

ANTIVIRAL MEDICATIONS

2 Drugs that inhibit viral replications are:

A
  • Nonretroviral drugs

* Antiretroviral drugs

280
Q

ANTIVIRAL DRUGS: Healthy cells are often killed also, resulting in serious ________________

A

toxicities

281
Q

ANTIVIRAL DRUGS: Inhibit viral _______________

A

replication

282
Q

INDICATIONS - ANTIVIRAL DRUGS

• Used to treat infections caused by viruses other than ____________

A

HIV

283
Q

CONTRAINDICATIONS - ANTIVIRAL DRUGS

o Patients with severely compromised ____________ function
o Pre-existing ___________________

A

kidney

hemoglobinopathies

284
Q

amantadine

• Active only against influenza ______

A

A

285
Q

ADVERSE EFFECTS - amantadine

• Central nervous system (CNS): _______________, _______________, ______________

A

insomnia, nervousness, lightheadedness

286
Q

acyclovir (Zovirax)

Used to suppress _______________ of:
o HSV-1, HSV-2, VZV

A

replication

287
Q

ganciclovir (Cytovene)
• Used to treat _____________________ (CMV)
• Used to treat CMV ____________

A

cytomegalovirus

retinitis

288
Q

ribavirin (Virazole)

used for hospitalized ______________ with respiratory syncytial virus (RSV)

A

infants

289
Q

oseltamivir (Tamiflu) and zanamivir (Relenza)

  • These drugs act against _____________ types A and B, reducing the duration of illness
  • Treatment should begin within ______ days of symptom onset
A

influenza

2

290
Q

ANTIRETROVIRAL DRUGS

• Antiretroviral therapy (ART) includes at least ____ medications

A

3

291
Q

ANTIRETROVIRAL DRUGS

• Purpose is to reduce the _________ ___________

A

viral load

292
Q

ADVERSE EFFECTS - ANTIRETROVIRAL DRUGS

• Adverse effects are ______________ and vary with each drug

A

numerous

293
Q

ADVERSE EFFECTS - ANTIRETROVIRAL DRUGS

Goal: to find the regimen that will best __________ the infection with a ___________ adverse-effect profile

A

control

tolerable

294
Q

NURSING IMPLICATIONS - ANTIRETROVIRAL DRUGS

• Instruct patients to consult their physician before taking any other ________________

A

medication

295
Q

NURSING IMPLICATIONS - ANTIRETROVIRAL DRUGS

• Emphasize the importance of good __________

A

hygiene

296
Q

NURSING IMPLICATIONS - ANTIRETROVIRAL DRUGS

• Inform patients that antiviral drugs are not ____________ but do help to manage symptoms

A

cures

297
Q

NURSING IMPLICATIONS - ANTIRETROVIRAL DRUGS

• Instruct patients on the _______________ of taking these medications exactly as prescribed and for the full course of treatment

A

importance

298
Q

NURSING IMPLICATIONS - ANTIRETROVIRAL DRUGS

• Patients should be informed to start therapy with antiviral drugs at the _____________ sign of recurrent episodes of genital herpes or herpes zoster

A

earliest

299
Q

NURSING IMPLICATIONS - ANTIRETROVIRAL DRUGS

• Monitor for signs of ______________ diseases

A

opportunistic

300
Q

DEFINTION: Treatment of an infection before specific culture information has been reported or obtained

A

Empirical therapy

301
Q

DEFINTION: Treatment with antibiotics to prevent an infection, as in intra-abdominal surgery or after trauma

A

Prophylactic therapy (PREVENTION)

302
Q

DEFINTION: Decrease in specific signs and symptoms of infection are noted (fever, elevated white blood cell count, redness, inflammation, drainage, pain)

A

Therapeutic response

303
Q

DEFINTION: Signs and symptoms of infection do not improve

A

Subtherapeutic response

304
Q

DEFINTION: INFECTION YOU GET WHEN YOUR IMMUNE SYSTEM IS WEAKENED BY ANTIBIOTICS

A

Superinfection* (in L.A.)

305
Q

DEFINTION: DOESN’T WORK BECAUSE BACTERIA DEVELOP RESISTANCE

A

Antibiotic resistance

306
Q

DEFINTION: one that kills bacteria

A

Bactericidal antibiotic

307
Q

DEFINTION: one that inhibits growth of susceptible bacteria rather than killing them immediately; will eventually lead to bacterial death

A

Bacteriostatic antibiotic

308
Q

DEFINTION: @ WHAT POINT YOU KILL IT

A

Minimum inhibitory concentration (MIC)

309
Q

DEFINTION: Varying degrees of reduced renal function

A

Nephrotoxicity

310
Q

_______________ are difficult to kill because they live inside the cells

A

Viruses

311
Q

TRUE OR FALSE. Any drug that kills a virus may also kill cells

A

TRUE

312
Q

Viruses have four routes for entering the body:

A

o Inhalation
o Ingestion
o Transplacentally
o Inoculation

313
Q

Immunocompromised patients have frequent viral infections & NEED ____________

A

TREATMENT

314
Q

DEFINITION
o Are infections that would not normally harm an immunocompetent person
o Occur in immunocompromised patients
o Require long-term prophylaxis and anti-infective drug therapy

A

• Opportunistic infections

315
Q

DEFINITION: Used to treat infections caused by viruses other than HIV

A

Antiviral drugs

316
Q

DEFINITION: Used to treat infections caused by HIV, the virus that causes AIDS

A

Antiretroviral drugs

317
Q

BRONCHODILATORS

• Important part of therapy for ___________

A

COPD

318
Q

3 classes of bronchodilators

A

o Beta Agonists
o Anticholinergics
o Methylxanthine derivatives

319
Q

BETA AGONISTS (sympathomimetic bronchodilators)

• Used during _____________ phase of asthma attacks

A

ACUTE

320
Q

BETA AGONISTS (sympathomimetic bronchodilators)

• Quickly ___________ airway constriction and restore normal airflow

A

reduce

321
Q

BETA AGONISTS (sympathomimetic bronchodilators)

• ___________ smooth muscles around the airway and allows for more air to flow in.

A

Relaxes

322
Q

INDICATIONS - BETA AGONISTS (sympathomimetic bronchodilators)

• Relief of ____________________

A

bronchospasm

323
Q

INDICATIONS - BETA AGONISTS (sympathomimetic bronchodilators)

• Treatment of hypotension and shock – especially in ____________ reaction

A

allergic

324
Q

INDICATIONS - BETA AGONISTS (sympathomimetic bronchodilators)

• To produce ____________ relaxation to prevent premature labour

A

uterine

325
Q

INDICATIONS - BETA AGONISTS (sympathomimetic bronchodilators)

• Treatment of severe ________________

A

hyperkalemia

326
Q

CONTRAINDICATIONS - BETA AGONISTS (sympathomimetic bronchodilators)

• ______________ cardiac dysrhythmias

A

Uncontrolled

327
Q

CONTRAINDICATIONS - BETA AGONISTS (sympathomimetic bronchodilators)

• High risk of ____________

A

stroke

328
Q

ADVERSE EFFECTS - epinephrine

• Can cause many issues – especially _________ ________________

A

HEART STIMULATION

329
Q

2 ADVERSE EFFECTS - isoproterenol & salbutamol

A
  • Tremor

* Vascular headache

330
Q

WHICH MEDICATION if used too frequently, loses its β2-specific actions at larger doses

A

salbutamol

331
Q

NURSING IMPLICATIONS - BETA AGONISTS

• Encourage patients to get ____________ treatment for flu or other illnesses and to get vaccinated against pneumonia or flu

A

prompt

332
Q

NURSING IMPLICATIONS - BETA AGONISTS

• Patients should ___________ insomnia, jitteriness, restlessness, palpitations, chest pain, or any change in symptoms

A

report

333
Q

ANTICHOLINERGICS

Result is that ____________________ is prevented and airways dilate

A

bronchoconstriction

334
Q

WHICH KIND OF DRUG? _______-______________ prevent constriction of bronchi & narrowing of airways

A

Anti-cholinergics

335
Q

ANTICHOLINERGICS

Have a slow and prolonged ____________

A

action

336
Q

WHICH KIND OF DRUG? Are used to prevent bronchoconstriction

A

ANTICHOLINERGICS

337
Q

WHICH KIND OF DRUG? Are NOT used for acute asthma exacerbations

A

ANTICHOLINERGICS

338
Q

WHICH KIND OF DRUG?
• ipratropium bromide (Atrovent)
• tiotropium (Spiriva)

A

ANTICHOLINERGICS

339
Q

WHICH KIND OF DRUG?

• Causes smooth muscle relaxation, bronchodilation, and increased airflow

A

(METHYL) XANTHINE DERIVATIVES

340
Q

WHICH KIND OF DRUG?

• Stimulate cardiovascular system

A

(METHYL) XANTHINE DERIVATIVES

341
Q

WHICH KIND OF DRUG?

• Has diuretic effect

A

(METHYL) XANTHINE DERIVATIVES

342
Q

ANTILEUKOTRIENES montelukast (Singulair)

Blocks _______________ in the lungs and relieves asthma symptoms

A

inflammation

343
Q 
ANTILEUKOTRIENES montelukast (Singulair)
•	Decrease \_\_\_\_\_\_\_\_\_\_ secretion
A

mucus

344
Q

WHICH KIND OF BRONCHODILATOR? These are CONTROLLER meds. NOT FOR RAPID TREATMENT

A

ANTILEUKOTRIENES montelukast (Singulair)

345
Q

NURSING IMPLICATIONS - ANTILEUKOTRIENES montelukast (Singulair)

• ________________ should be seen in about 1 week

A

Improvement

346
Q

NURSING IMPLICATIONS - ANTILEUKOTRIENES montelukast (Singulair)

• Assess _________ function before beginning therapy

A

liver

347
Q

CORTICOSTEROIDS

• Have _______-______________ effects

A

anti-inflammatory

348
Q

CORTICOSTEROIDS

• Are used for __________ asthma

A

chronic

349
Q

CORTICOSTEROIDS

• May take _____________ weeks before full effects are seen

A

several

350
Q

ADVERSE EFFECTS - CORTICOSTEROIDS

  • Pharyngeal irritation
  • Oral __________ infections
A

fungal

351
Q

WHAT KIND OF DRUG?
• fluticasone propionate
• budesonide

A

CORTICOSTEROIDS

352
Q

NURSING IMPLICATIONS - CORTICOSTEROIDS

Teach patients to gargle and rinse the mouth with ________________ _____________ afterward to prevent the development of oral fungal infections

A

lukewarm water

353
Q

NURSING IMPLICATIONS - CORTICOSTEROIDS

the _______________ should be used several minutes before the ________________ to provide bronchodilation before administration of the corticosteroid

A

bronchodilator

corticosteroid

354
Q

NURSING IMPLICATIONS - CORTICOSTEROIDS

Encourage use of a ______________ device to ensure successful inhalations

A

spacer

355
Q

ANTIHISTAMINES

More effective in ________________ the actions of histamine rather than reversing them

A

preventing

356
Q

ANTIHISTAMINES

May cause _______________

A

drowsiness

357
Q

ANTIHISTAMINE

Does the ____________ of histamine

Reduces

  • dilation of blood vessels
  • increased permeability of blood vessels
  • salivary, gastric, lacrimal, and bronchial secretions
  • capillary permeability, itching
A

opposite

358
Q

2 TYPES OF ANTIHISTAMINES:

A
  1. TRADITIONAL

2. NONSEDATING

359
Q

WHICH ANTIHISTAMINE?
Have anticholinergic effects, making them more effective in some cases

Include:
• diphenhydramine (Benadryl)
• chlorpheniramine (Chlor-Tripilon)

A

TRADITIONAL

360
Q

WHICH ANTIHISTAMINE?
Have a longer duration of action (increases compliance)

Eliminate unwanted adverse effects, mainly SEDATION

Include:
• fexofenadine (Allegra)
• loratadine (Claritin)
• cetirizine (Reactine)

A

NONSEDATING

361
Q

CONTRAINDICATIONS - ANTIHISTAMINES

Should not be used for the sole drug therapy during ______________ asthmatic attacks

A

acute

362
Q

2 ADVERSE EFFECTS - ANTIHISTAMINES

A

o Difficulty urinating

• Drowsiness

363
Q

_________________ effects may be potentiated excessively by interactions with apple, grapefruit, and orange juice as well as St. John’s wort

A

Antihistamine

364
Q

Alcohol, monoamine oxidase inhibitors (MAOIs) – psych drug, and central nervous system (CNS) depressants may increase the CNS depressant effects - WHEN TAKEN WITH THIS:

A

ANTIHISTAMINE

365
Q

NURSING IMPLICATIONS - ANTIHISTAMINES

Use with caution in those with ______________, BPH (benign ___________ hyperplasia), & the usual other people

A

hypertension

prostatic

366
Q

NURSING IMPLICATIONS - ANTIHISTAMINES

Instruct patients to avoid driving or operating heavy machinery; advise against consuming ___________ or other CNS depressants

A

alcohol

367
Q

DECONGESTANTS

3 main types are used:

A 
1. Adrenergics (sympathomimetics)
•	Largest group
2. Anticholinergics (parasympatholytics)
•	Less commonly used
3. Corticosteroids (intranasal steroids)
•	Topical
368
Q

DECONGESTANTS

• Two methods of administration can be used:

A
  1. 0ral

2. inhaled/topical

369
Q

WHICH METHOD OF DECONGESTANT ADMINISTRATION ?

  • Longer decongestant effect, but delayed onset
  • Less potent than topical
  • No rebound congestion
  • EX: Pseudophedrine
A

ORAL

370
Q

WHICH METHOD OF DECONGESTANT ADMINISTRATION ?

  • Prompt onset
  • Potent effect
  • Result: Relieves stuffiness (not drippyness)
  • Decreases inflammation
  • Decreases congestion
  • Rebound congestion
A

TOPICAL

371
Q

DECONGESTANTS

Intranasal steroids (end in ‘ide’ or ‘sone’)

A

NOT A QUESTION… JUST A FUCKING HELPFUL TIP

372
Q

CONTRAINDICATIONS - DECONGESTANTS

A
  • Narrow-angle glaucoma
  • Hypertension
  • Prostatitis – swollen prostate
  • Diabetes
373
Q

ADVERSE EFFECTS – ADRENERGICS

A
  • Nervousness
  • Insomnia
  • Palpitations
  • Tremors
374
Q

ADVERSE EFFECTS - STEROIDS

A

• Local mucosal dryness and irritation

375
Q

ADRENERGIC systemic effects due to _____________ of the heart, blood vessels, and CNS

A

stimulation

376
Q

NURSING IMPLICATIONS - DECONGESTANTS

Decongestants may ___________ hypertension, palpitations, and CNS stimulation—avoid in patients with these conditions

A

cause

377
Q

NURSING IMPLICATIONS - DECONGESTANTS

Patients should avoid ____________ b.c of CNS stimulation

A

caffeine

378
Q

NURSING IMPLICATIONS - DECONGESTANTS

ADVISE PATIENTS ABOUT OVERUSE LEADING TO RISK OF ___________ ____________

A

REBOUND CONGESTION

379
Q

2 TYPES OF ANTITUSSIVES

A

1 OPIOID

2. NON-OPIOID

380
Q

WHICH TYPE OF ANTITUSSIVE

  • Suppress the cough reflex by acting directly on the cough centre in the medulla
  • Include
  • codeine (Dimetane-C, Dimetapp-C, Robitussin AC, others) – all have C’s
A

OPIOID

381
Q

WHICH TYPE OF ANTITUSSIVE?

  • Suppress the cough reflex by numbing the stretch receptors
  • Include
  • dextromethorphan (Benylin DM-E, Buckley’s, Dimetapp-DM, Robitussin-DM, Vick’s)
A

NON-OPIOID

382
Q

___________________ Are used only for nonproductive coughs!

A

ANTITUSSIVES

383
Q

________________ May be used in cases in which coughing is harmful

A

ANTITUSSIVES

384
Q

NURSING IMPLICATIONS - ANTITUSSIVES

• Perform respiratory and cough ____________, and assess for _____________

A

assessment

allergies

385
Q

NURSING IMPLICATIONS - ANTITUSSIVES

Instruct patients to avoid driving or operating heavy equipment due to possible ____________, ______________, or ____________

A

sedation, DROWSINESS, OR DIZZINESS

386
Q

NURSING IMPLICATIONS - ANTITUSSIVES

Patients taking chewable tablets or lozenges should not ___________ _____________ for 30 to 35 minutes afterward

A

drink liquids

387
Q

NURSING IMPLICATIONS - ANTITUSSIVES

• Patients should be advised to report any of the following symptoms to their health care provider: o ______________ that lasts more than a week

A

Cough

388
Q

WHICH KIND OF DRUG? Drugs that aid in the expectoration (removal) of mucus

A

EXPECTORANTS

389
Q

WHICH KIND OF DRUG? Reduce the viscosity of secretions

A

EXPECTORANTS

390
Q

WHICH KIND OF DRUG? Disintegrate and thin secretions

A

EXPECTORANTS

391
Q

WHICH KIND OF DRUG? By loosening and thinning sputum and bronchial secretions, the tendency to cough is indirectly diminished

A

EXPECTORANTS

392
Q

WHICH KIND OF DRUG? Used for the relief of productive coughs

A

EXPECTORANTS

393
Q

NURSING IMPLICATIONS - EXPECTORANTS

Expectorants should be used with caution in __________ ______________ or patients with asthma or respiratory insufficiency

A

older adults

394
Q

NURSING IMPLICATIONS - EXPECTORANTS

Patients taking expectorants should receive more ____________, if permitted, to help loosen and liquefy secretions

A

fluids

395
Q

NURSING IMPLICATIONS - EXPECTORANTS

A fever, cough, or other symptoms lasting longer than a ___________ should be reported

A

week

LINDSAY - PHARM I (4 decks)

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