worksheet (exam 1) Flashcards
what are some important patient education topics for antibiotics?
-finish them
-Discard any antibiotics that are discontinued
Allergies are common: what are the signs and symptoms: can happen after first dose
Unable to breathe
Rash
Confusion (especially in elderly)
GI distress is common: know which ones to take with food
what are examples of aminoglycosides?
GENTAMYCIN, TOBRAMYCIN, neomycin, amikacin, streptomycin
black box warnings for aminoglycosides (gentamycin and tobramycin)?
Black Box: nephrotoxicity, ototoxicity
Damage to CN 8 → dizziness, tinnitus, dec. hearing, can block Ach at receptor site and end muscular blockade
Edema
examples of carbapenems?
MEROPENEM, ertapenem, imipenem and cilstatin
notable adverse effects of carbapenems (meropenem)?
-c-diff
-pseudomembranous ulcerative colitis
what is important to know about carbapenem injections
include lidocaine, they hurt
examples of cephalosporins
Cefazolin
Cephalexin
Cefuroxime
Ceftriaxone
Cefepime
Ceftaroline
what are notable adverse effects of cephalosporins
superinfections - yeast infections, c-diff
what is an important nursing consideration for Ceftriaxone?
IM administration is painful
examples of fluoroquinolones?
ciprofloxacin, levofloxacin
what are some notable adverse effects of fluoroquinolones?
QT prolongation (life-threatening dysrhythmias) hypo/hyperglycemia, photosensitivity
-BBW: tendonitis, tendon rupture.
what are contraindications of fluoroquinolones?
myasthenia gravis
what meds have notable interactions with fluoroquinolones?
meds that prolong QT interval
examples of macrolides?
Erythromycin
Azithromycin
Clarithromycin
Fidaxomicin
notable adverse effects of macrolides?
-cardiac dysrhythmias and liver toxicity
notable drug interactions with macrolides?
be careful with drugs that can prolong QT interval
important nursing considerations for macrolides?
Antacids reduce the absorption of macrolides so tell patients to take an hour before our two hours after
examples of penicillins
Penicillin G (IM injection)
Amoxicillin
Ampicillin
Piperacillin
notable adverse effects for penicillins?
-Hypersensitivity: highest rates of hypersensitivity reactions
important nursing considerations for penicillins?
Ampicillin: rapid infusion may cause seizures
examples of sulfonamides
-Trimethoprim-sulfamethoxazole (Bactrim)
-Sulfasalazine
notable adverse effects of sulfonamides
Sulfasalazine: turns secretions orange
what is the mechanism of action for sulfonamides
-Mechanism of Action: Folate antagonist (contraindicated in pregnancy)
nursing considerations for sulfonamides?
-Sulfasalazine should be taken after meals and can stain skin (and contact lenses = orange)
-silver sulfadiazine you need sterile gloves
examples of tetracyclines?
1) Tetracycline (Oral)
2) Doxycycline (Oral – preferred)
what are GI effects of tetracyclines?
espohagitis
what are derm effects of tetracyclines
photosensitivity
what are nursing considerations of tetracyclines?
-Doxycycline: administer on empty stomach WITH a lot of water!
-Remain upright for min of 30 min
-Outdated meds can damage kidneys so throw any outdated meds away
examples of urinary antiseptics?
Phenazopyridine (AZO)
notable adverse effects of urinary antiseptics (AZO)?
orange/red urine
important nursing considerations of phenazopyridine?
can not conduct a urinalysis while on it because of red/orange urine
what is vancomycin used to treat?
c-diff (first line)
what is the rate of infusion for vancomycin IV
30 mins fir every 500 mg
notable adverse effects for vancomycin?
IV is vesicant/irritant
Hyaluronidase subdermal for extravasation
Nephrotoxic
Trough - 10 - 15 mcg/mL
what are contraindications of vancomycin?
Nephrotoxic (caution in renal dysfunction)
what is recommended for a vancomycin infusion?
central line
what med is used topically for staph infections?
clindamycin
what is a black box warning of clindamycin?
diarrhea and pseudomembranous colitis
what med is used systemically for very serious infections?
clindamycin
________, ______, and _____ increase the risk of serotonin syndrome
linezolid, SSRIs, SNIRs
what med is very effective at treating E. coli, travelers diarrhea, and HEPATIC ENCEPHALOPATHY?
rifaximin
what med is a broad spectrum IV antibiotic for meningitis, plaque, and CHF
chloramphenicol
black box warning for chloramphenicol?
aplastic anemia (bone marrow damage)
what is isoniazid used to treat?
TB
what is an adverse effect of isoniazid (INH)
peripheral neuropathy
black box warning for INH?
liver toxicity
what are important nursing considerations of INH?
-Administer Vitamin B6 to help with peripheral neuropathy (combination therapy does exist)
- direct observation to ensure compliance
what is rifampin used to treat?
TB
what is an important consideration of rifampin?
red/orange secretions
what is ethambutol used to treat?
TB
what is a side effect of ethambutol?
optic neuritis
what is Pyrazinamide (PZA) used to treat?
TB
what is a contraindication of Pyrazinamide (PZA)?
wait for gout to pass before giving med
what are nursing considerations for Pyrazinamide (PZA)?
Pancreatitis labs = amylase + lipase, back pain
Hepatotoxicity - ast/alt. RUQ pain
what is ribavirin used to treat?
Respiratory Syncytial Virus (RSV)
what is oseltamivir used for?
influenza
what is a contraindication for RSV / flu drugs?
pregnant people can not be in the room with administration
what is a nursing consideration for oseltamivir?
administer within 48 hours of onset of symptoms
what is Nirmatrelvir-ritonavir used to treat?
COVID-19
what is important to know about Nirmatrelvir-ritonavir?
there are many drug interactions
when should you start taking Nirmatrelvir-ritonavir?
within 5 days of symptom onset
what is remdesivir used to treat?
COVID-19
what is an important consideration for remdesivir?
Hard for outpatient to take because they have to come in 3 days in a row
Day 1: 200 mg IV
Day 2&3: 100 mg IV
what is acyclovir used to treat?
herpes
what is a notable adverse effect of acyclovir?
teratogenic
what is ganiciclovir used to treat?
cytomegalovirus
what is zidovudine used for?
given oral throughout pregnancy if mom has HIV and is sued during L&D if viral load of mom is high
what is important to know about HIV/AIDS drugs?
they all work together to lower viral load
what are lamivudine, adefovir, entecavir, and tenofovir used for?
hepatitis
what are notable adverse effects of hepatitis drugs?
pancreatitis
examples of azole antifungals
fluconazole
ketoconazole
what are azoles used for?
fungal infections
what are notable adverse effects of azoles?
liver toxicity
what are nursing considerations of azoles?
administer with food. (helps with GI distress - smaller, more frequent meals)
adverse effects of echinocandins?
bone marrow suppression
what are echinocandins used for?
anti-fungal
what are important considerations for echinocandins?
monitor CBC
what are polyenes used for?
anti fungal, disrupt cell membrane
what are adverse effects of polyenes?
multiple organ failure
what is terbinafine used for?
broad-spectrum anti-fungal
what are notable drug interactions of terbinafine?
All of the CYP2D6 drugs (fluconazole, digoxin, there are many)
what are nursing considerations for terbinafine?
How long will the client take this?
-for the hand, it’s 6 weeks and for the foot it’s 12 weeks
Will the infection be completely resolved?
-symptoms will not have completely resolved by the time treatment is complete
what is chloroquine phosphate used for?
anti-malarial
what is hydroxychloroquine used for?
anti-malarial
what are notable adverse effects of anti-malarials
EKG changes and retinal toxicity
what is metronidazole used for?
anti-parasitic
what are contraindications for anti-parasitics?
avoid alcohol
how long should alcohol be avoided on anti-parasitic drugs and why?
-during and 48 hours afterward
-can develop flushing, headaches, N/V
how often should you get eye exams on anti-malarials?
routinely and 1-2 weeks prior to exposure and 4 weeks after exposure
what is permethirin used for?
scabicide / pediculicide
notable adverse effects of scabicides / pediculicides
burn, itch, tingle
notable nursing cinsiderations of scabicides / pediculicides
-needs to be on for 8-14 hours before washing off (permethrin)
contraindications for anthelmintics?
avoid alcohol
example of antineoplastic / alkylating drugs
cisplatin, cyclophosphamide
what is used for advanced treatment of bladder, ovarian, and testicular cancer
cisplatin
what is the antidote for cisplatin?
sodium thiosulfate
what is important to know about cyclophosphamide (cancer drug)
drink 2L of fluids for 1-2 days after dose
what is hydroxyurea used to treat?
sickle cell
what are 2 important things to know about hydroxyurea?
-do not crush / break
-wear chemo drugs
what med treats and lowers risk of breast cancer?
tamoxifen
what is important about antineoplastic hormone inhibitors?
periodic bone density testing
what are complications from antineoplastic drugs?
-n/v
-anorexia
-fatigue
-alopecia
-mucositis
-infection
-bleeding
-hyperuricemia
-hand-foot syndrome!
how to treat n/v related to anti-cancer (antineoplastic) drugs?
-with serotonin reuptake antagonist and corticosteroid
-palonosetron
-benzodiazepines
how to treat anorexia related to antineoplastics?
use supplements
what to educate patient about alopecia related to anti-cancer drugs?
its temporary
what is a complication of antineoplastics that are ulcers on mucosal cavities and even thru GI
mucositis
how long does mucositis last?
7-10 days
how to help the effect of mucositis on antineoplastics?
chew ice before chemo
why does infection happen on antineoplastics?
it trashes bone marrow
how to help infection due to antineoplastics?
-handwashing, no swimming in freshwater
-filgrastim or sargramostim administration
-redo vaccinations
how to help hyperuricemia related to antineoplastics?
-encourage fluid intake
-saline IV
-allopurinol administration
how to help hand-foot syndrome related to antineoplastics?
-reduce heat and friction
-ice and acetaminophen
what are cytoprotectants used for?
cancer
what cytoprotectant stimulates RBC production?
Epoetin alfa
what cytoprotectant stimulates WBC production
filgrastim
what cytoprotectant acts like folic acid
Leucovorin
what is the rescue drug if given too much methotrexate?
Leucovorin
what is seen in the treatment of bone cancer that proliferates bulky tumors
tumor lysis syndrome
safe handling of chemo drugs?
-double chemo gloves, gown
-eye/face protection if risk for emesis or splash, ALWAYS for irrigation or aerosol
