Week 2 Med Cards Flashcards
1
Q
Penicillin is what?
A
Antibiotic
2
Q
Penicillin side effects?
A
N/V/D Superinfection Rash, fever, etc. (anaphylaxis) Black, hairy tongue Hyperkalemia Hypersensitivity
3
Q
Penicillin: interactions with other drugs
A
Tetracylines, aminoglycosides given in same parenteral route
4
Q
Penicillin: antidote
A
Epinephrine, antihistamines, and steroids for allergies
5
Q
Penicillin: what would you give it for?
A
Strep and staph infections
6
Q
What should you assess for before giving penicillin?
A
Hx of renal disease
Hx of carbapenem, cephalosporin or penicillin allergies
7
Q
What do you monitor while someone is taking penicillin?
A
Creatinine, BUN, and resistant or opportunistic infections
- WBC, temp., site of infection
8
Q
How do you administer penicillin?
A
PO, IV, or IM depending on the type of penicillin
9
Q
What is tetracycline?
A
Antibiotics
10
Q
What does tetracycline treat?
A
E. Coli, chlamydia, Klebisella
11
Q
How do you administer tetracycline?
A
PO
12
Q
What should you be aware of before giving someone tetracycline?
A
Hx of bone marrow problems, hyperparathyroid or bone problems
Pregnancy, lactating, or children under 8 y/o
13
Q
What does tetracycline interact with?
A
Oral contraceptives
Pencillin G (decreases effectiveness)
Digoxin
14
Q
What are side of effects of tetracycline?
A
Tooth and bone damage
Bone marrow suppression
Photosensitivity
15
Q
What is tobramycin?
A
Antibiotic
16
Q
What does tobramycin treat?
A
Bacterial infections susceptible to penicillins
17
Q
tobramycin administration rought
A
IV
18
Q
What do you monitor for when someone is taking tobramycin
A
Urine output 2mL/kg/hr
Creatinine
Tinnitus
19
Q
tobramycin interactions
A
Synergistic with Cephalosporin or penicillins, but cannot be given with penicillins same IV bag.
Diuretics can increase toxicity.
Neuromuscular blockers increase duration of paralysis one given with aminoglycosides
20
Q
tobramycin side effects
A
Nephrotoxic Ototoxicity Bone marrow suppression GI upset Decreased urine output
21
Q
When giving tobramycin, what patients should you monitor closely?
A
Hx of renal disease
Hx hearing loss
Hx of myasthenia
22
Q
Metronidazole is what?
A
Antiprotozoal
23
Q
How is Metronidazole administered?
A
IV
24
Q
Why is Metronidazole narrowly used?
A
Confirmed sensitivity test due to emerging resistance
25
When giving Metronidazole, what patients should be monitored closely?
Hx allergy to carbapenems or penicillins
| Hx pregnancy
26
Metronidazole interactions
Animoglycosides (toxicity)
| Serious ETOH toxicity
27
Metronidazole side effects
Bleeding risk
HA
Dizziness
Phlebitis
28
What is Aztreonam?
Mono-antibiotic
29
What do you use Aztreonam to treat
Gram positive enterobacteria
30
Aztreonam administration route
IV, IM, inhalant
31
When giving Aztreonam, what patients should you closely monitor?
Elderly
Hx renal insufficiency
Hx liver disease (monitor liver enzymes, GI problems and injection pain)
32
Aztreonam interactions
Aminoglycosides
| Cefoxitin
33
Aztreonam side effects
Sz
Hypotension
N/V/D
34
Clarithromycin is what?
Antibiotic
35
What can you give Clarithromycin to treat?
Strep
| H. Pylori
36
Clarithromycin side effects
GI upset
QT prolongation
Hepatic metabolism inhibition
37
Clarithromycin interactions
Alfa is in
Atazanavir
Carbamazepine
38
What patients should you monitor if they are taking Clarithromycin
Hx cardiac problems
| Hx allergy
39
What physiologic functions should you monitor while any patient is taking Clarithromycin ?
Metabolic enzymes of liver
INR
QT prolongation
40
Ciprofloxacin is what
Antibiotic
41
Ciprofloxacin is used to treat what
Sinusitis, bronchitis and UTI
42
Ciprofloxacin administration route
PO or IV
43
Ciprofloxacin interactions
Theophylline (increases half-life)
Cyclosporine (toxicity)
Steroids (increase risk of tendinitis)
St. John’s wort
44
Ciprofloxacin side effects
Sz
HA
Pseudomembranous colitis tendinitis and tendon rupture risk
45
Ciprofloxacin teaching considerations
Sun exposure and protection
46
What should you monitor if they are taking Ciprofloxacin
```
Hx liver disease
Hx muscle weakness / muscle pain/spasms
Liver enzymes
Calcium levels
CNS
```
47
Clindamycin is a what?
Antibiotic (lincosamide)
48
What do you treat with Clindamycin?
Anaerobes, streptococci, and PID causing bacteria
49
How do you administer Clindamycin?
PO or topically
50
What are signs you should monitor for when someone is taking Clindamycin?
Signs of superinfection and skin color changes
51
What does Clindamycin have a cross sensitivity to?
Lincomycin
52
What interactions does Clindamycin have with other meds?
Lincomycin and erythromycin
53
Side effects of Clindamycin
N/V/D
Superinfection
Join pain/swelling
54
Linezolid is what?
Antibiotic
55
How do you administer linezolid?
IV, injection, PO (suspension)
56
What interactions should you keep in mind when giving someone linezolid?
Adrenergic, insulin, seratonergic
57
What are you treating if you are giving someone linezolid?
Vancomycin-resistant bacteria, hospital acquired staph infections, other skin conditions (uncomplicated)
58
What should you monitor when treating someone with linezolid? (Side effects)
CBC, leukocyte differential, skin irritations (indicates super infection)
59
What is tenofovir?
Antiretroviral
60
What does tenofovir interact negatively with?
Atazanvir, boceprevir, didanosine
61
What does tenofovir treat?
HBV, HIV-1
62
Who should you monitor when giving someone tenofovir?
Contraindicated <2 y/o (non prophylactic at birth)
Lactating mother’s
People with osteoporosis
63
tenofovir administration
PO
64
tenofovir side effects
```
HA
Depression
Insomnia
Flu-like s/s
Nephrotoxicity (creatinine)
Hepatotoxicity (liver enzymes)
```
65
What is Efavirenz
Antiretroviral
66
What does Efavirenz treat
HIV
67
Efavirenz administration
PO
68
Efavirenz interactions
Amprenavir
Clarithromycin
Bupropion
69
Efavirenz side effects
N/V/D (flu like symptoms)
Dizziness
Rash / lesions
70
What should you monitor when someone is taking Efavirenz?
LFT
Psychiatric changes
ECG for possible QT changes
Liver functions
71
What is Trimethoprim / sulfamethoxazole?
Antibiotic
72
What do you use Trimethoprim / sulfamethoxazole to treat?
UTI, STI, RA
73
Trimethoprim / sulfamethoxazole administration
PO
74
Trimethoprim / sulfamethoxazole interactions
Cyclosporine
Digoxin toxicity
Sulfonyluea (will increase hypoglycemia)
75
What should you monitor if someone is taking Trimethoprim / sulfamethoxazole?
```
Someone with hx of thrombocytopenia
Infants younger than 2mo
RFT
CBC
LFT
```
76
Trimethoprim / sulfamethoxazole side effects
Sz.
Thrombophlebitis
Pancrease
77
Acyclovir is what
Antiviral
78
What does acyclovir treat?
HSV
Varicella zoster
Herpes
79
Acyclovir administration
PO
Buccal
IV
Topical
80
Which patients should you monitor closely if they are taking acyclovir?
Hx neurological problems
81
acyclovir interactions
Varicella vaccine may be diminished
Probenecid
Foscarnet (nephrotoxicity)
82
acyclovir side effects
```
HA
Malaise
N/V/D
GI upset
Nephrotoxicity
Fatigue
```
83
Amphotericin B is what
Antifungal
84
Amphotericin B interactions
Antineoplastics, cardiac glycosides, cyclosporine
85
Amphotericin B - things / people to monitor
Hx renal failure, elderly, pregnant women
Watch all electrolytes, creatinine, liver enzymes
Several toxic
86
Amphotericin B administration
IV
87
What does Amphotericin B treat?
Systemic fungal infections, sometimes in the immunocompromised
88
Amphotericin B side effects
Fever
CP
Anemia
Hematuria
89
Fluconazole is what?
Antifungal
90
Fluconazole administration
PO
91
What does Fluconazole treat?
Candidiasis infections and fungal meningitis
92
Fluconazole interactions
PMS medications
| Medications that prolong QT (clarithromycin)
93
What patients should be monitored closely if they are taking Fluconazole?
Those with hx of pregnancy, lactation, hepatic disease, QT prolongnation
Monitor LFT
94
Fluconazole side effects
Hepatotoxicity
HA
Dizziness
95
What is Nitrofurantoin?
?
96
Nitrofurantoin - what should you assess / monitor closely
Children less than one month of age
Allergies
History of blood disorders, kidney or liver disease
Diabetes
97
What does Nitrofurantoin treat?
UTI
98
Nitrofurantoin administration
Oral
99
What should be monitored while taking Nitrofurantoin?
Those pregnant, with poor kidney functions as well as electrolytes
100
Nitrofurantoin interactions
Urine glucose tests
| Sulfinpyrazone
101
Nitrofurantoin side effects
Nausea
Peripheral neuropathy
Sz
Dark urine
102
What is Oseltamivir ?
?
103
What does Oseltamivir treat?
Influenza
104
Oseltamivir administration
Oral
105
Oseltamivir interactions
Flue vaccine
106
Oseltamivir side effects
N/V
Mental/mood changes (esp. kids)
Nephrotoxicity
107
What should you be evaluating when someone is taking Oseltamivir?
Kidney function
Worsened or new side effects
Cough, sore throat, fever
Urine output
108
When is it best to take Oseltamivir
< 48 hours after onset of flu symptoms
109
What is vancomycin?
?
110
vancomycin administration
Oral, generally IV
111
vancomycin interactions
Cholestol medication
112
What does vancomycin treat?
Colitis
113
What should you be monitoring when someone is taking vancomycin?
Diarrhea
Peak / trough
Urine output
Growth of bacteria / stool
114
vancomycin side effects
Nephrotoxicity
Ototoxicity
Easy bruising / bleeding
115
What are examples of penicillin
Amoxicillin
| Piperacillin / tazobactam
116
What should you do before prescribing penicillin?
Culture before first dose
117
What should be in the patients stomach before giving penicillin
Nothing
| Can take with water - no acid juices (will impede absorption)
118
What does penicillin decrease the effectiveness of?
Oral contraceptives
119
Cephalosporins are what
Antibacterial
120
What are examples of cephalosporins?
Cephalexin
Cefazolin
Ceftriaxone
Cefepime
Start with “ceph/cef”
121
Cephalosporins have a cross sensitivity to what
Penicillin
122
What reaction can you expect if you drink alcohol while taking a cephalosporin?
Disulfiram reaction - you get really really sick
123
Why might you want to drink a lot of water while taking cephalosporins
They can be nephrotoxic. Drinking fluids washes the medicine out of the kidneys so it isn’t harming the kidneys
124
Antibiotics interfere with what
Anticoagulation
125
Cephalosporin side effects
N/V/D
Nephrotoxicity
INR (can elevate)
Hemolytic anemia
126
Does it matter if you have food in your stomach when you take cephalosporins?
Absorption is not impacted whether or not you have food in your stomach - can take with food
127
What disorder should you be cautious about when giving someone cephalosporins
Use in caution to seizure disorder
128
What do you want to monitor when giving someone cephalosporins
BUN and creatinine and urine output (if urine output is low, call provider)
S/s of infection
Culture results
129
Antibiotics interfere / have negative reactions with what
Alcohol, anticoagulation, oral contraception
130
What are carbapenems?
Antibiotics
131
What is an example of carbapenems
Imipenem
132
carbapenems administration
IV only
133
carbapenems cross sensitivities
Penicillin and cephalosporins
134
Use caution when giving carbapenems with what disorders?
Seizure disorder or renal impairment
135
carbapenems side effects
N/V/D
Elevated INR
Hemolytic anemia
136
A normal INR is less than what
Less than 1 (double check this)
137
Monobactams are what
Narrow spectrum antibiotics
138
Monobactams cross sensitivities
Penicillin
Cephalosporins
Carbapenems
139
Monobactams administration
IM
IV
Inhalation
140
Monobactams side effects
N/V/D
Nephrotoxicity
Elevated INR
Hemolytic anemia
141
What is an example of a Monobactam
Azetreonam
142
Sulfonamides are
Antibiotic
143
What are examples of sulfonamides
Trimethoprim-sulfamethoxazole (synergistic)
144
sulfonamides have what in the name
Sulf
145
sulfonamide side effects
```
Rash (discontinue)
Photosensitivity
Crystalluria
Nephrotoxic
Bruising
```
146
Why do you want to monitor UOP with sulfonamides
Can cause kidney stones
147
sulfonamides interactions
Sulfonylureas (meds that are used to lower blood pressure)
| Cardiac arrhythmic meds
148
What should you take sulfonamides with
Full glass of h2o
149
If someone is allergic to sulfonamides, they are also allergic to what
Sulfonylureas
150
What are fluoroquinolones
Antibiotics
151
What are examples of fluoroquinolones?
Levofloxacin
| Ciproflaxin
152
Most fluoroquinolones are what
Broad spectrum
153
Ciproflaxin is used for what
Anthrax
154
fluoroquinolones side effects
```
GI upset
Hypersensitivity
Photosensitivity
Hypoglycemia
C. Diff
```
155
fluoroquinolones - what should you have in stomach
Nothing
| Take full glass of water 2 hours after meals
156
When taking fluoroquinolones, you should avoid meals with what?
Calcium, aluminum, iron or zinc (will impeded absorption)
157
What people should you be cautious of / monitor patients when taking fluoroquinolones
Children (contraindicated)
| Hx seizures
158
fluoroquinolones prolongs what in ECG
QT segment (ventricular relaxation ?)
159
fluoroquinolones: black box warning with what
```
Tendinitis and tendon rupture (esp. young boys)
Peripheral neuropathy (lack of feeling / inflammation)
CNS effects (HA / dizzy)
```
160
Macrolides are what?
Antibiotics
161
Macrolides: examples
Erythromycin
| Azithromycin
162
Macrolides: side effects
```
GI upset
Hypersensitivity
Photosensitivity
Hepatotoxicity
Onset / worsening of myasthenia
Drowsiness
QT prolongation
Dysrhythmias
```
163
What should be in your stomach with Macrolides
Take with FOOD
164
What lab values do you want to monitor with hepatotoxic drugs
AST and ALT
165
Aminoglycosides are what?
Antibiotics
166
Aminoglycosides examples
Streptomycin
| Gentamycin
167
Aminoglycosides side effects
GI upset
Rash
Respiratory paralysis if given too soon after neuromuscular blocking medication
Can cause harm to fetus and breast fed infants (teratogenic)
Neurotoxic (HA, dizzy, sz.)
Nephrotoxicity
Ototoxic
168
What do you want to monitor when giving someone Aminoglycosides
Peak and trough
169
Tetracycline is what
Antibiotic
170
Tetracycline side effects
GI upset
C. Diff
Permanent teeth discoloration / enamel hypoplasia if given to under 8 y/o
Intracranial hypertension (HA, blurred vision, vision loss, diplopia)
Photosensitivity
171
What should you not take while on Tetracycline
Oral contraception
172
What are three instances in which you would NOT want to take Tetracycline
Pregnant
If its expired (toxic)
With calcium
173
What is a common problem with patience who take acyclovir
Medication compliance
174
Can you take acyclovir with food
Yes
175
Oseltamivir is what
Anti-viral
| Anti-influenza
176
What does oseltamivir do
Shortens duration and decreases s/s of influenza within 48 hours of onset
177
oseltamivir side effects
GI upset
Neuropsych
Fatigue
Nephrotoxicity
178
You should use oseltamivir cautiously with what
Cardiac or respiratory disease
179
oseltamivir can be used _____
Prophylactically
180
Adefovir is what
Antiviral (anti hepatitis)
181
How long does Adefovir therapy last
Prolonged >1 year
182
Adefovir therapeutic effects
Maintain or improve liver function when active disease is present
183
Adefovir side effects
Severe or acute exacerbation of Hep. B
Nephrotoxicity
Lactic acidosis
Severe hepatomegaly
184
Hepatotoxic therapy requires what
LFTs monitored after the therapy is complete
185
Lamivudine-zidovudine is what
Antiviral (anti-retro viral)
186
Lamivudine-zidovudine: therapeutic effects
Decreases changes of developing AIDS and HIV related illnesses (infections, cancers)
187
Lamivudine-zidovudine side effects
```
Lactic acidosis
Pancreatitis
Severe hepatomegaly
Nephrotoxicity
Fatigue
Hepatotoxicity
```
188
What are downsides to taking Lamivudine-zidovudine
Compliance
| Prolonged therapy
189
Mycoses
Illness caused by fungi
190
Characteristics of fungus
Opportunistic
Decompose in the environment
Critical for food (cheese)
Major source of antibiotics (penicillin)
191
Candida albicans is an example of what
Fungal infection
192
Midzaoles are an example of what
Anti-fungal
193
Midzaoles: examples
Miconazole
Ketoconazole
Clotrimazole
194
Midzaoles: used where other than healthcare
Used in agriculture to keep seeds and crops from molding
195
What do Midzaoles treat
Fungal skin infections
196
Midzaoles: therapeutic effects
Improve s/s of athletes foot, jock itch, or ringworm
197
Midzaoles adverse side effects
Topical skin irritation
| Rash
198
Triazole is what?
Anti-fungal medication
199
Triazole examples
Fluconazole
200
Triazole treats what
Systemic yeast
Oral thrush
Cryptococcal meningitis
201
Triazole administration
Oral or IC
202
Triazole side effects
Hepatotoxic (increase fluids, monitor for signs of liver failure)
203
Allylamines are what
Antifungals
204
Allyamines: examples
Terbinafine
205
What does Allyamines treat
Athletes foot, jock itch, ringworm
206
Allyamines: administration
Topical
| Orally for nail fungus
207
Allyamines: therapeutic action
Improved s/s of tines infections
208
Allyamines side effects
Hepatotoxic
| External use only (? Says I can do oral or nail fungus)
209
Polyenes are what
Anti-fungals
210
Polyenes: examples
Nystatin and amphotericin B
211
Polyenes (Nystatin)
Yeast of skin, mouth, vagina
| GI fungal infections
212
Polyenes (Nystatin) therapeutic action
Improve s/s of yeast infections
213
Polyenes (nystatin) side effects
External use only
214
Polyenes administration Nystatin
Topically
| ? Can be used for GI fungal infections, can you take orally?
215
Polyenes: amphotericin B — administration
IV
216
Polyenes (Amphotericin B) side effects
Ototoxicity
Hypokalemia
Hepatotoxicity
Nephrotoxicity
217
Polyenes (Amphotericin B): things to monitor
BUN and creatinine
I&O
LFTs
218
Polyenes (Amphotericin B): BLACK box warning
Do not use if fungal disease is noninvasive
| — only use if you have to; very hepatotoxic
219
What are examples of anti malarials
Chloroquine
| Anti-Protozoa
220
Anti-Malarial: therapeutic action
Prevention or improvement of acute attack of malaria
Prophylacticly, take for 4 weeks after leaving the area / exposure
221
Anti-Malarial side effects
A. Vision changes
B. Ototoxic
C. Nephrotoxic
D. HA, drowsiness, N/V, CV collapse and convulsions (all these are w/ severe toxicity)
222
Anti-Malarial drugs, things to monitor
OD
Alcohol use
Hx psoriasis, GI, neurological or blood disorders
AST and ALT
223
Anti-Malarial drugs are contraindicated in who
People with retinal or visual field changes
224
Anti-Malarial - with or without food
With food
225
Anti-Malaria: why do people not take it consistently
Extended length of therapy
226
What are examples of anti-Protozoa drugs
Metrogel
| Metronidazole IV
227
Metrogel / Metronidazole IV: administration
PO
IV
Topical
vaginal
228
Anti-Protozoa drugs (Metrogel / Metronidazole IV): monitor foe what
Siezures, peripheral neuropathies, dizziness
229
Anti-Protozoa drugs (Metrogel / Metronidazole IV): side effects
```
Dry mouth
Dark urine
Siezures
Peripheral neuropathy
Psychotic reactions
Hepatotoxic
```
230
Anti-Protozoa drugs (Metrogel / Metronidazole IV): contraindicated ind.
Pregnant women
231
Anti-Protozoa drugs (Metrogel / Metronidazole IV) treat what
STIs - self and partner need to be treated
| — makes sure patient is taking ENTIRE course of medication
232
Anti-Protozoa drugs (Metrogel / Metronidazole IV): special reactions
Disulfuram interactions
233
Anti-Helmintic medications are used to treat what
```
Roundworms = nematoda
Flatworms = platyhelminthes
```
234
Anti-Helmintic: example
Mebendazole
235
What are special considerations when someone has an helminic infection
Wash hands, linens, towels and clothing
Wash food / cook thoroughly
Wear shoes
236
Anti-Helmintic (mebendazole): contraindicated ind.
Pregnant women
237
Anti-Helmintic (Mebendazole): therapeutic action
Get rid of s/s or worms
238
Anti-Helmintic (Mebendazole): side effects
Hepatotoxic
| Bone marrow suppression (leave you at risk for other illnesses)
239
Anti-Tuberculars treat what
Mycobacterium TB
240
What are examples of Anti-Tuberculars
Isoniazid, Rifampin
241
Anti-Tuberculars (isoniazid and rifampin): side effects
```
Hepatotoxic
GI upset
Decrease effectiveness of oral contraceptives
Peripheral neuropathy
Vision changes
Rifampin (orange secretions)
```
242
Anti-Tuberculars (isoniazid and rifampin): what do you want to avoid
Tyramine foods (aged meats, cheeses, wine)
243
Anti-Tuberculars (isoniazid and rifampin): what might you want to add to your diet
Vitamin B6
244
Anti-Tuberculars (isoniazid and rifampin): therapeutic goals
Negative sputum
| Eliminate s/s TB (productive cough, fever, night sweats)
245
Glycopeptides are what
Antibacterials
246
Glycopeptide example
Vancomycin
247
Glycopeptide (vancomycin) administration
IV - poorly absorbed by GI tract
Oral for C. Diff
Avoid rapid administration
248
Glycopeptide (vancomycin) side effects
Ototoxic
Red Man Syndrome
Nephrotoxic
Stephen Johnson Syndrome
249
Glycopeptide (Vancomycin): red man syndrome - what is it and what do you do when it happens
When administered too fast
- flushed, red, hot, sweaty
- must stop infusion
- call provider
- administer Benadryl
- resume at slower rate
- this is NOT an allergic reaction
250
Glycopeptide (vancomycin): Stephen Johnson syndrome
Skin blistering side effect to vancomycin
| - very uncommon but it does happen with many anti-infective medications
251
What are things to keep in common with Vancomycin
Narrow window for therapeutic index (measure peak and trough)
This is the drug that we treat first line if someone has developed C. Diff
