Fichas
N317 PHARM EXAM 1
Fichas del conjunto (35)
- 1PHARMACOKINETICSADME
- Absorption: Movt. of a drug from its site of administration into the bloodstream for distribution to tissues
- Distribution: transport of drugs to site of action
- Metabolism: Biotransformation LIVER
- Excretion: KIDNEY--> how it gets out - 2First Pass Effect-A drug getting metabolized at a specific location in the body that results in reduced concentration of the active drug upon reaching its site of action
- ONLY applies to the oral route (PO) - 3What does the pharmacologic class of the drug address?Mechanism of Action (MOA)
How a drug works in the body - 4Pregnant women should avoid which class of medication?X: (absolutely avoid)
C: (risk to fetus cannot be ruled out)
D: (benefits may outweigh risks for mom) - 5BEERS classificationElderly population
based on physiologic changes as we age
meds might build up more in elderly - 6When should a culture be obtained?BEFORE starting an antibiotic
-otherwise risk of not determining what infection - 7Nursing implications for all antibiotics1. Signs and symptoms of infections
2. WBC count (with differential)
3. GI assessment
4. Skin assessment
5. Focused assessment of infection location - 8Penecillin: (end in -cillin)One of the oldest classes of antibiotics
Nursing implications: nothing unique
Side effects: nothing unique (N/V/D) - 9Cephalosporins (almost all begin with -Cef) -cephNursing implications: nothing unique
Side effects: nothing unique BUT
CROSS-SENSITIVITY with penicillin! most have both allergies - 10Sulfonamides (2)trimethoprim/sulfamethoxazole
-inhibits folic acid metabolism
Nursing implication: pregnancy test
Side effects: agranulocytosis & aplastic anemia (loss of bone marrow function)
Lab value to check: CBC! - 11Tetracyclines (-cycline)Nursing implications: sun exposure (photosensitivity), AGE (no children under 8), and other med/food schedule
Side effects: photosensitivity, brown teeth
Patient should not take within 1-3 hours of calcium, iron, and antacids (decrease absorption by up to 50%) - 12Macrolides (-micin, -mycin)FACE
-F: fidaxomicin
-A: azithromycin
-C: clarithromycin
-E: erythromycin
Nursing implications: Check MAG levels
Side effects: torsade de points (bad heart rhythm) - 13Aminoglycosides (-micin/mycin)Major toxic effects to kidney (reversible) and hearing (non-reversible)
-Creates fissures in the outer membrane of cell
Nursing implications: monitor kidney labs (BUN/creatinine) and hearing - 14AMINOGLYCOSIDESGNATS! bad /toxic --> reserved for serious infections
-G: gentamicin
-N:neomycin
-A: amikacin
-T: tobramycin
-S: streptomycin - 15Fluroquinolones (-floxacin)Outlier: nalidixic acid
Nursing implications: musculoskeletal assessment (Achilles tendon), Psych assessment (suicidal thoughts), Mag levels, LFT's
Side effects: hepatotoxicity, torsade de pointes, cartilage toxicity - 16Carbapenems (-penem)LAST RESORT
-very broad spectrum, if bacteria is resistant to this theres nothing more to do
*** Can only be given parenterally (IV) - 17Clindamycin (MISC)not a macrolide--> lincosamide
nothing unique - 18Linezolidoxazolidinone
-Nursing implications: platelet level & neuro assessment
-Side effects: Serotonin Syndrome & thrombocytopenia - 19Signs of Serotonin Syndrome (10)Agitation
Pressured Speech
Seizures
Tremors
Hypertension
Dilated pupils (mydriasis
Shivering
Diaphoresis (sweaty)
Diarrhea
Tachycardia - 20VancomycinVery common - Broad spectrum anti-infective
Nursing implication: trough levels (every 4th dose), and hearing (IV Only), kidney labs
Side effects: nephrotoxicity, Red man syndrome (major antihistamine response of IV vancomycin) - 21MetronidazoleANTIBIOTIC
nitroimidazole
Used for CDIFF
Nursing implication: neuro assessment
Side Effects: seizures - 22Nitrofurantoinvery localized for urinary tract --> NOT used for systemic infection
Nursing implications: LFT's & respiratory assessment
Side effects: hepatotoxicity, pneumonitis, pulmonary fibrosis - 23Amphotericin BANTIFUNGAL (toxic side effects)
Nursing implications: fever, shaking, CBC, Kidney labs, mag levels
Side effects: (N/V/D), fever, hypotension, chest pain, nephrotoxicity, hypersensitivity (1-3hrs) --> premedicate to reduce some of these effects (antipyretic, antihistamine, antimedics) - 24Systemic Antifungals (-azole)largest & most versatile group of anti-fungals, broad spectrum
(ketoconazole, itraconazole, fluconazole)
Nursing implications: monitor LFT's and mag levels
Side effects: abdominal discomfort, nausea, vomiting - 25Topical Antifungals (-azole)Infections of mouth, vagina, and skin
(tioconazole/miconazole):monistat
Nursing implication: good hygiene care, skin assessment
Side effects: Burning and irritation, not life threatening - 26NystatinTreats groin fungal infection and THRUSH
Nursing implications: skin/oral assessment
Side effects: fairly safe, contact dermatitis
-powder, liquid, lozenge - 27What antiviral drugs are used for treatment of shingles and herpes/HSV 1 & 2 acyclovir/valacyclovir
- 28What should you monitor for regarding HSV 1 & 2?renal failure
kidney function - 29How long until a pt. can notice an improvement to symptoms when taking HSV 1 & 2?1 week
- 30Should a pt with shingles get the vaccine?yes, to prevent later flare ups
- 31What drug should you administer for treatment of symptoms of influenza?Tamiflu
(2 days or less after onset of symptoms)
-side effects: N/V/D
-flu does not need to be confirmed before using - 32What would you administer for Hepatitis C via blood/body fluids?Ribavirin combination therapy
Lab values: CBC and assess for signs of neuropsychiatric disorders (suicidal/homicidal thoughts)
Side effects: hemolytic anemia, depression, suicidal ideation/attempts, homicidal ideation - 33What could you use for HIV treatmentantiretroviral therapy
Nursing implications: GI assessment, psych assessment, cardiac assessment, CD4 count - 34What should you take to prevent HIV contraction via sex or injection needles?PrEP
Patient education: use condoms, could cause acute renal failure, lifestyle change
Lab values: KIDNEY (BUN & creatinine) - 35—