Pharmacology for Nursing
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| T/F: Penicillin-resistance bacteria are the most common type of antibiotic resistant "bugs". | show 🗑
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| show | Allergic reaction (carry ID, bands in hospital, cross-sensitivty; Diarrhea—usually superinfection; Increasing, mucoid→C. Dificile?
IV preparations may be high Na+; Caution with CHF
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| What are the nursing implications for administration of **Cephalexin (Keflex) PO | show 🗑
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| What are some common uses for **Sulfamethoxazole? | show 🗑
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| What are adverse effects of **Sulfamethoxazole? | show 🗑
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| show | **Sulfamethoxazole
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| show | Usually PO—common for UTI’s, can be IV for severe pneumonias
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| What should a nurse teach when administering **Trimethoprim? | show 🗑
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| show | Primarily for aerobic gram negative.
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| Aminoglycosides: high risk implications? | show 🗑
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| show | Nephrotoxicity, ototoxicity (tinnitius), neuromuscular blockade (paralysis), hypocalcemia, myasthenia gravis
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| What should a nurse monitor when administering **Gentamycin (Garamycin) | show 🗑
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| show | False: usually it's from pushing IV Vancomycin to quickly.
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| What are adverse reactions with **Vancomycin | show 🗑
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| What bacteria do Quinolone Antibiotics (Fluoroquinolones) target? | show 🗑
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| show | GI—nausea, vomiting, diarrhea
CNS—dizziness, headache, confusion
(Rare) seizures (usually with NSAID or theophylline)
Allergic reactions, rashes
Effects on growing cartilage—not used in children (<18) or pregnancy; renal function (reduce dose)
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| What are the nursing implications of ***Cipro and/or Levaquin? | show 🗑
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| show | ➢ Allergies (rare)
➢ GI upset common with PO, less with IV
➢ Newer agents, less GI upset
➢ Teach to take with food if needed
➢ High dose IV—reversible hearing loss
➢ Thrombophlebitis—slow IV infusion
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| show | - Allergy rare
- Photosensitivity common—teach!
- GI upset common—take with food
- Diarrhea→C. Diff
(see notes for more)
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| What's not shitty about Flagyl? | show 🗑
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| show | - Nausea, vomiting, diarrhea
- Headache, metallic taste in mouth
- Disulfiram-like reaction with Ethanol
- Interaction with several drugs: Coumadin, Phenytoin, Lithium (increases effects)
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| What are important nursing implications with Metronidazole (Flagyl)**? | show 🗑
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| What are some adverse effects of the antitubercular drug **Isoniazid (INH)? | show 🗑
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| show | ➢ Monitor hepatic enzymes, CBC
➢ Teach need for long term use
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| What are some adverse effects of **Rifampin, Rifapentin? | show 🗑
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| show | ➢ Plan for body fluid stain
➢ Do not miss a dose
➢ Monitor hepatic enzymes
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| What are the adverse reactions for **Pyrazinamide? | show 🗑
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| What should a nurse administering **Ethambutol for TB monitor for? | show 🗑
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| show | Report visual changes—blurring, color blindness
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| What is the most effective therapy for TB? | show 🗑
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| Why do we use combination therapy with TB? | show 🗑
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| show | As a prophylactic alternative to flu vaccine.
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| show | Reduces severity and length of symptomatic period...made Liz sick
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| What is the issue with taking **Amantadine for influenza? | show 🗑
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| When must one take **Amantadine for treating influenza? | show 🗑
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| What are the adverse effects to consider when taking **Amantadine for the flu? | show 🗑
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| show | Aerosol for RSV—can cause eye irritation
Pregnancy CATEGORY X—do NOT GIVE, pregnant nurse should not administer
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| **Zidovudine (AZT) is used for tx against HIV. What are the common side effects? | show 🗑
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| show | Nausea, vomiting, diarrhea, Abd. Pain—common
Headache, altered taste, perioral paresthesia
Increased liver enzymes - Dose related
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| What are some long-term effects of **Saquinavir (Invirase, Fortovase)? | show 🗑
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| show | Rash, stomach upset, increase liver enzymes
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| show | A protease inhibitor, or non-NRTI combined with 2 NRTI drugs
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| What route(s) are appropriate for administration **Amphotericin B? | show 🗑
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| What are some adverse effects of **Amphotericin B ? | show 🗑
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| show | 1. Preload with Sodium, fluids (normal saline IV)
2. Pretreat with Corticosteriods,
(antipyretics, antihistamines, antiemetics)
3. Meperidine for pain and rigors
4. Careful monitoring of VS
Give slowly IV—well diluted, Monitor IV site for thrombophle
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| show | Suppresses glucocorticoid production***
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| show | • For onchomycosis (of the nails)—up to 3 months
• Adverse: hepatotoxicity (rare)
• PO or topical (less toxicity)
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| show | Liquid, powder, cream, vaginal tablets
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| How are anti-fungals often named? | show 🗑
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| show | • **Must take adequate fluids—Can cause impaction;
• Adverse effects: Bloating
• May take a while to work
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| What is an important effect of the saline cathartic such as **Magnesium hydroxide (Milk of Magnesia) ? | show 🗑
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| show | • May induce low grade inflammation
• Can precipitate laxative dependence
• Higher incidence of cramping
• Use short-term
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| show | • May induce low grade inflammation
• Can precipitate laxative dependence
• Higher incidence of cramping
• Use short-term
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| So, John is going into Liver failure. As his ammonia levels rise what should we consider giving John to prevent hepatic encephalopathy? | show 🗑
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| When is the stool softener **Docusate used? | show 🗑
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| Why wouldn't we want to use **Kaolin (Kaopectate) for diarrhea? | show 🗑
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| Jake wasn't traveling, but he did have traveler's diarrhea. He decided to take **Bismuth Subsalicylate. What should we tell jake about the side effects of Pepto-Bismol? | show 🗑
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| show | • Anticholinergic side effects—dry mouth
• Decrease GI motility, decrease secretion
• Blurred vision, urinary retention, tachycardia
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| What kind of effects might one experience when taking **Loperamide (Imodium) for diarrhea? | show 🗑
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| What is the downside of using **Sodium Bicarbonate (Baking Soda) as an antacid? | show 🗑
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| What are the implications of taking Calcium Carbonate (Tums)? | show 🗑
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| show | • Poor acid neutralizers alone
• Phosphate binder--used in renal failure
• Constipation--push fluids
• (Amphogel, Basalgel)
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| show | Moderate neutralizers
Cause diarrhea
DO NOT USE WITH RENAL FAILURE
Milk of Magnesia (MOM)
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| show | Effects diarrhea and constipation cancel each other out; still CANNOT have in renal failure.
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| What is important education for someone taking the non-antacid **Sucralfate (Carafate) | show 🗑
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| show | TRUE
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| What are some adverse reactions of Zantec? | show 🗑
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| _____ is an H2 receptor antagonists that is used IV as a third-line drug in anaphylaxis. | show 🗑
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| What are the three components to "Triple Therapy" | show 🗑
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| show | • GI—N/V/D, constipation
• CNS—HA, dizzy
• Mild, rare elevation of hepatic enzymes
• May interfere with elimination of some drugs—more interactions with Omeprazole
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| What are some adverse effects of prokinetic drugs such as **Metoclopramide (Reglan)? | show 🗑
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| show | IV or PO
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| show | ** Inhibits gastric secretion. Also, Misoprostol (Cytotec) is sometimes referred to as "the abortion pill."
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| show | ➢ GI—Abd cramps, nausea, vomiting
➢ Diarrhea in 15-40%--dose dependent
➢ Increased uterine contractions
Spotting, spontaneous abortions
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| What kind of drug interactions are present with **Promethazine (Phenergan)? | show 🗑
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| show | • Sedation, dizziness, weakness, hypotension
• Pain on injection
• Anticholinergic effects: dry mouth, urinary retention, constipation, blurred vision—caution with glaucoma
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| T/F: The phenothiazine **Prochlorperazine (Compazine), and/or the butyrophenone **Droperidol (Inapsine) would be suffice in treating nausea and vomiting r/t chemotherapy? | show 🗑
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| show | It burns like a mutha, so push it slow, yo.
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| When can **Ondansetron (Zofran) be given for N,V r/t chemotherapy? | show 🗑
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| show | With meals (immediately before or with food)
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| show | Enzyme in pathway of synthesis of prostaglandins from arachadonic acid (COX 1, COX 2)
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| show | COX-1 → affect gastric mucosa and platelets
COX-2 → affect inflammation, pain receptors, temperature control
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| T/F: NSAIDs have been found to actually slow the progress of certain degenerative diseases | show 🗑
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| What client's should avoid NSAIDs? | show 🗑
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| show | Tinnitus, nausea, vomiting, confusion
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| show | Do not give ASA to children <16 yrs in viral illness as it is associated with Reye’s Syndrome
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| show | Low dose for stroke/MI prevention should only be 80-160 mg q.d.
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| show | **Ketorolac (Toradol)
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| What is the main issue with acetic acid derivatives like **Ketorolac (Toradol)? | show 🗑
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| What are the major advantages of propionic acid derivatives such as **Ibuprofen (Motrin, Advil, Nuprin, etc)? | show 🗑
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| What are the benefits of taking a COX-2 inhibitor like **Celecoxib (Celebrex) instead of Ibuprofen? | show 🗑
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| show | **Analgesic for mild to moderate pain
**Antipyretic
**Not anti-inflammatory (not an NSAID substitute for arthritis)
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| How much Tylenol is too much Tylenol? | show 🗑
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| How do we determine dosages for Tylenol for children? | show 🗑
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| What is a major risk in using the biologic response modifier ***Infliximab (Remicaid) for treating for RA or Crohn’s disease? | show 🗑
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| What are nursing implications for ***Infliximab (Remicaid)? | show 🗑
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| ***Infliximab (Remicaid) is often given on top of ____________? | show 🗑
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| What route is used for ***Infliximab (Remicaid)? | show 🗑
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| What are first-line drugs for RA? | show 🗑
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| What are the adverse effects of ***Methotrexate? | show 🗑
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| show | • Edema, hypertension
• Bone marrow suppression
• Osteoporosis
• Cataracts
• GI irritation
• Muscle wasting, truncal obesity
• Moon face, acne
• Hyperglycemia
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| What kind of teaching should be included with ***Prednisolone (Prednisone) ? | show 🗑
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| What is important to monitor when caring for a client taking corticosteroids? | show 🗑
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| John is taking ***Colchicine IV in the hospital for an acute gout attack. They switch John to PO to avoid toxicity. After a few days, John reports the trifecta of symptoms (N,V,D). What should John do? | show 🗑
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| What are the S/S of late ***Colchicine toxicity? | show 🗑
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| show | Monitor for hypersensitivity—rash with pruritis—stop the drug!
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| show | Aminoglycosides (e.g. Gentamycin): hi-risk w/hypocalcemia, MG, and NM BLOCKERS.
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| Which drugs should not be taken with dairy, antacids, or grapefruit juice? | show 🗑
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| show | Cephalosporins (keflex), and Flagyl
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| Which antibiotic increases the efects of Lithium? | show 🗑
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| Which antitubercular drug can cause peripheral neuropathy if not supplemented with pyridoxine (vit. B-6)? | show 🗑
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| **Isoniazid (INH) + **Rifampin (= rifamate) + ETOH = _______. | show 🗑
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| show | **Rifampin
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| show | **Pyrazinamide
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| show | **Ethambutol
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| show | Let her know that these symptoms are common, and usually resolve in first few weeks
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| What is a client taking **Zidovudine (AZT) with progressed HIV at risk for? | show 🗑
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| What are the effects of the poisonous kiss of **Saquinavir? | show 🗑
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| show | Bulk Laxatives: *Psyllium, Mitrolan
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