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Description
Flashcards by Gwen Paparone, updated more than 1 year ago
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Created by Gwen Paparone
about 8 years ago
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| Question | Answer |
| Antibiotic | Destroy and or reduce the production of bacteria |
| Antiviral | Destroy, but many just slow, viral reproduction |
| Anti-fungal | Destroy and or reduce the production of fungi |
| What are the routes of antinfective medication? | Oral Buccal IM Intravenous infusion Into body cavities |
| What are considerations to the kidney when treating with anti-effective agents? | They can be toxic monitor I and O Monitor BUN and Creatinine |
| What are some considerations to the lier when treating with anti infective agents? | May be toxic Monitor hepatic Panel (LFT) |
| What symptoms are common with all antibiotics? | stomatitis hearing impairment Headache Depression |
| Stomatitis | Inflamed mouth |
| Culture use for antiinfective agent? | Blood or tissue is cultured to determine infecting organism |
| What is meant by sensitivity? | How sensitive the organism is to the drug determined by the culture panel |
| What does C and S stand for? | Culture and sensitivity |
| What is meant by broad spectrum? | Antibiotics that interfere with biochemical reactions in a wide variety of organisms |
| Resistance | The ability of organisms to change their cell wall or enzyme systems to resist antibiotics |
| Superinfections | overgrowth of resistant pathogens |
| Peak drug level | A drug reaches its highest plasma level |
| Trough | plasma level before next dose is administered |
| Why are peak and trough important to consider? | Because to kill bacteria peak levels must be high and to avoid toxicity trough levels must be low |
| are anti infective agents capable of causing an allergic response ? | YES |
| What is the most common antibiotic allergy? | Penicillin |
| Urticaria | Hives |
| Can urticaria be a precursor to anaphylaxis? | yes mild allergic reactions can be a warning sign for worsening allergies. |
| Angiodema | Edema of the lips mouth tongue neck and larynx |
| What is dangerous about angiodema? | It can cause airway obstruction |
| Anaphylaxis | Severe life threatening allergic reaction wheezing, SOB, chest pain , pallor, diaphoresis, hypotension, |
| What should you do as a response to anaphylaxis? | Stop medication Stay with the patient vital signs, oxygen , cpr if needed notify MD Administer epiniephrine as ordered |
| Why should patients always take the entire course of antibiotics? | So the medication can kill all the bacteria and not allow any to reproduce resistant to the drug. |
| What should be your first response when you notice signs and symptoms of an allergic reaction | Stop the medication |
| What foods should you take with an antibiotic? | Antibiotics should be taken on an empty stomach. |
| Should you drink water with a dose of antibiotics? | You should take each dose with a full glass of water. |
| Why should you maintain an adequate fluid intake when on an antibiotic? | Diarrhea is a common sx of antibiotics use |
| Digoxin | A cardiac Glycoside which increases the force of cardiac contraction and decreases the heart rate. |
| Indications for digoxin | heart failure Arterial arrhythmias |
| Administration of digoxin | Oral or IV *Narrow therapeutic Window* |
| What should you assess about the patient before administering digoxin? | Apical pulse (Dig lowers heart rate) Signs of Dig toxicity |
| What labs should you go over before administering digoxin? | Potassium level (K effects absorption) Renal function (BUN, Creatinine) Digoxin blood level |
| What are the symptoms of Digoxin toxicity? | nasuse/ vomitting Visual changes Arrhythmias rapid loading hypokalemia impaired renal function |
| What is the therapeutic range for digoxin ? | 0.8 to 2 ng/ml |
| What is the antagonist to digoxin? | Digoxin immune Fab (Digibind) |
| What should you teach your patient about digoxin ? | check pulse before administering consult HCP before taking other meds Avoid taking an extra dose when one is missed (lower heart rate to much at once) |
| Angiotensin-converting Enzyme (ACE) inhibitors | An anti-hypertensive medication that causes blood vessels to dilate and reduce circulatory volume. |
| indications for ace inhibitors ? | mild to severe hypertension heart failure |
| What is the suffix most ace inhibitors end in ? | "pril" |
| Adverse effects of ace inhibitors? | Dry cough/ hacking First dose syncope Hyperkalemia Angioedema |
| When should catopril be administered to a patient? | 1 hour before meals |
| Why should you monitor the blood pressure of somebody on ace inhibitors? | early detection of first dose syncope |
| What should you instruct the patient to do after the first dose, or a rapid increase in dose? | Lie down |
| What else should you monitor for a patient on catopril and why? | Potassium levels because catopril causes hyperkalemia |
| Angiotensin Receptor Blockers | Help blood vessels relax by blocking the action of angiotensin |
| What are commonly prescribed ARBs? | Losartan (cozaar) candesartan (atacand) valsartan (diovan) |
| Why are ARBs preferable to ACE inhibitors? | They are less likely to cause the hyperkalemia, cough and angioedema when used in the Rx of hypertension |
| What is meant when the sympathetic nervous system is referred to as adrenergic? | The nerve cells are acted upon by the neurotransmitter epinephrine |
| What is the term for drugs that mimic the sympathetic nervous system ? | Sympathomimetic |
| What are the symptoms of fight or flight? | Increased BP Increased HR Bronchodilation Increased blood sugar Pupillary Dilation Decreased peristalsis |
| What is meant by the parasympathetics nervous system being referred to as cholinergic? | Nerve cells in which acetylcholine is the prominent neurotransmitter |
| Drugs that mimic the parasympathetic nervous system are known as? | Parasympathomimetic |
| Symptoms of Parasympathomimetic drugs? | Decreased HR Decreased BP Broncho-constriction pupillary constriction Increased peristalsis |
| Beta receptor | an adrenergic receptor in the sympathetic nervous system, stimulation of which results especially in increased cardiac activity. |
| Beta 1 receptor | acts primarily on the heart |
| Beta 2 receptor | Acts primarily on the lungs |
| What is the significance of the fact that we have 1 heart and 2 lungs | Some drugs are more beta 1 selective |
| Propranolol (inderal) | Treats hypertension, Angina, Arrhythmias, Myocardial infarction |
| Types of Propranolol | Metoprolol (Lopressor) Nadolol (Corgard) Atenolol (Tenormin) Carvedilol (Coreg) |
| Side effects of Propranolol | Hypoglycemia Severe bradycardia Hypotension Airway resistance CNS- fatigue, weakness, dizziness GI- Nausea, vomit, constipation |
| What should you monitor for Propranolol? | Heart rate/ blood pressure Respirations Sympathetic over activity |
| How should you educate a patient on Propranolol | instruct them to report dizziness Instruct them to take it before meals inform diabetic patients their insulin dosage might change |
| Albuterol (Ventolin, Proair) | Beta 2 agonist - relaxes bronchial smooth muscle |
| routes for albuterol | oral / inhalation |
| Sx of Albuterol | Tremor, Tachycardia, anxiety |
| Lasix (Furosemide) | A loop diuretic (non-potassium sparing) reducing the body's total water and salt by increasing urinary excretion |
| indications for lasix | Fluid volume excess |
| Contraindications for lasix | Electrolyte depletion Allergy |
| Side effects pf lasix | Ototoxcity Hypokalemia Hypotension Photosensitivity Diarrhea Muslce spasms |
| ototoxicity | ear poisoning |
| What should you monitor in a patient taking lasix? | Monitor I and O Monitor Metabolic Profile |
| How should you educate the patient whose taking lasix? | They need to wear sunscreen They need to report signs of ototoxcicity |
| How do loop diuretics cause ototoxcicity ? | They effect the potassium gradient in the chochlear and can cause hearing loss or tinnitus |
| Tinnitus | Ringing in the ears |
| Nitroglycerin (NGT) | Organic Nitrate that acts on the vascular smooth muscle to promote venous dilation decreases cardiac workload. |
| Routes of NTG | Oral , IV, Sublingual |
| Side effects of NTG | Headache Hypotension tolerance |
| Tolerance | when there is a decreased responsiveness to a drug and larger doses are needed to achieve the same effect |
| How should a patient be taught in regards to NTG treatment? | Teach regarding diet, weight, lifestyle factors. especially in relation to angina Teach about compliance to drug therapy. |
| How often can you give Nitro? | 3x every 5 minutes for a total of 15 minutes |
| Contraindications to nitro - | Blood pressure under 100 |
| Heparin | Anticoagulant that disrupts the production of fibrin - disrupting coagulation cascade |
| Can heparin actively dissolve existing clots ? | no heparin can only inhibit the formation of new clots |
| Administration of heparin | IV or SQ only |
| What are some of the indications for heparin ? | Prevention and Rx of deep vein thrombosis Pulmonary emblosism Prevention of clotting suring cardiac surgery Prevention of clotting in general |
| How quickly does heparin work through IV administration? | Immediatly |
| How long does heparin work after a sub q shot is given? | 20 minutes |
| What lab should you monitor when you administer heparin? | Partial thromboplastin time |
| What is generally therapeutic for heparin? | 1.5 to 2 times |
| Adverse Reactions | Heparin induced Throbocytopenia, bleeding |
| Antagonist to heparin | Protamine Sulfate |
| Contraindications to heparin | bleeding hypertension kidney or liver disease hypersensitivity |
| Enoxaparin (Lovenox) | Low molecular weight heparin |
| indications of lovenox | prophalaxis of DVT post operatively |
| What is the benefit for Lovenox over heparin? | There is a decreased risk for HIT |
| Does heparin or lovenox have a longer half life? | Lovenox |
| how is lovenox administered? | Only subQ |
| What can be used to partially reduce the effects of lovenox | Protamine (50- 60%) |
| Warfarin (Coumadin) | Anticoagulant which acts on the liver to prevent synthesis of vitamin K dependent clotting factors. |
| What is the administration for warfarin? | Oral |
| What percentage protein bound is warfarin? | 98% |
| What is the onset of warfarin? | 3-5 days after administration |
| Antagonist for warfarin? | Aqua-mephyton (vitamin K) |
| Indications for warfarin? | Prevention of thromboembolic disorders it is a bridge therapy |
| Contraindications | bleeding hypertension kidney or liver disease hypersensitivity |
| Labs you need to look at for warfarin? | Prothrombin time (PT) International normalized ratio (INR) |
| how often should you check INR | every week for the first month |
| What is the acceptable range for INR? | 2-3 |
| Nursing implications for anticoagulants | monitor I and O Monitor labs Monitor for bleeding Instruct patient to report bleeding |
| What are some other agents that can act on the coagulation cascade? | Rivaroxaban (xarelto) Apixiban (Eliquis) Digigatran (pradaxa) |
| What is digatran (pradaxa)? | A direct thrombin inhibitor |
| What is Digatrans antagonist? | Idarucizumab (praxabind) |
| Pantoprazole (Prontonix) | A proton pump inhibitor used for GERD, gastric ulcers, hypersecretory conditions |
| Administration of Pantopraxole? | Oral or IV |
| Adverse reactions to Pantopraxole | Diarrhea, headache |
| Risks of injecting pantoprazole (Protonix)? | Infection of the injection site, thrombophlebitis and abcesses |
| Phentoin (Dilantin) | Anticonvulsant Antiepileptic stabilizes neuronal membranes limiting the spread of seizures |
| is the half life for dilantin longer or shorter than most drugs? | Phenytoin/Dilantin has a long half life |
| What should you always rememeber to do before you administer dilantin? | Check compatibility |
| What is another example of an anticonvulsant | Levetiracetam (Keppra) |
| What are the contraindications for dilantin? | Heart block high blood sugar (may cause an increase) Use of antacids may reduce effciciency |
| Adverse effects of dilantin | GI and CNS effects |
| Which population is dilantin most likely to effect? | geriatrics |
| What labs should you monitor when administering dilantin? | Dilantin (phentyoin) level Hepatic profile Comlete blood count |
| When should you instruct the patien to take dilantin (phenytoin)? | Immediatly after meals |
| Docusate Sodium (Colace) | A stool softener that emulsifies the stool by permitting water to penetrate the stool |
| Indications for colace | Constitpation Painful ano-rectal conditions Cardiac disease |
| Contraindications for colace | Abdominal pain obstipation |
| obstipation | pathological constipation |
| Zofran (Ondansetron) | Antiemetic which blocks the serotonin receptors thus blocking the vomiting center |
| indications for zofran/ ondansetron | Emetogenic cancer therapy other causes of NV used pre op or post op |
| what is a common side effect of zofran ? | headache |
| What should you educate the patien to do in relation to zofran? | Report cardiovascular symptoms |
| Insulin | Parenteral antidiabetic agent/hormone- premoting the uptake of glucose by cells as well as other functions related to carbohydrate metabolism |
| What are insulins classified based on? | their onset, peak , and duration |
| lispro (humalog) and Asparat (Novalog) Insulin | SQ onset- 15 minutes SQ peak 1 hour SQ duration 2-4 hours Short Acting |
| Regular insulin | SQ onset -30-60 minutes SQ peak - 2-4 hours SQ duration 4-6 hours Rapid acting, short duration |
| Neutral Protamine Hagedorn (NPH) Insulin | SQ onset- 1-2 hours SQ peak 4-6 hours SQ duration- 12 hours Intermediate insulin |
| what is an examle pf long acting insulin | Insulin Glargine (lantus) |
| What units is insulin available in ? | U-100 and U-300 |
| How is insulin glarinne available? | In a U-300 pen |
| What is the only insulin you can give IV? | Regular |
| Corticosteroids | Anti-inflammatory agents that act by suppressing the immune system responses |
| Indications | rheumatoid arthritis Asthma Oral prednisone |
| Adverse effects | Poor wound healing Hyperglycemia Electrolyte imbalance |
| Nursing impliactions of corticosteroids? | monitor blood glucose levels for hyperglycemia Monitor WBC and watch for signs of infection (supresses immune response) |
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