Pharmacology ATI

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Pharm ATI: May 2013

Tetracycline

Side Effects: tooth discoloration, suprainfection, photosensitivity, hepatotoxicity
Avoid giving to children less than 8 years of age
Used for acne vulgaris and periodontal disease
Should not be given to pregnant women
Use cautiously in clients with renal and liver disease
Taken on an empty stomach with FULL glass of water
Decrease effect of oral contraceptives

Doxycycline and Minocycline

Side Effects: lightheadness, dizziness
May be taken with food

Abstinence Syndrome

Occurs when a client abruptly withdraws from a drug on which he is physically dependant on

Short Term Detoxification Meds to support withdrawal from Alcohol

Benzodiazepines: Chlordiazepoxide (Librium), Diazepam (Valium), Lorazepam (Ativan)
Adjunct Medications: Carbamazepine (Tegretol), Clonidine (Catapres), Propranolol (Inderal)

Abstinence Maintenance following Detoxification for Alcohol

Disulfiram (Antabuse), Naltrexone (ReVia), Acamprosate (Campral)

Medications to support withdrawal from Opioids

Methadone (Dolophine), Clonidine (Catapres), Buprenorphine (Subutex)

Medications to support withdrawal from Nicotine

Bupropion (Zyban), Nicotine replacement therapy (Gum or patch)

Examples of Macrolides

Erythromycin (E-mycin) and Azithromycin (Zithromax)

Erythromycin

Used to treat infections for clients with penicillin allergy, Legionnaires' disease, pertussis, and acute diphtheria
Side effects: hepatotoxicity, prolonged QT intervals (causing dysrhythmias and possible sudden cardiac death)
Take with food, but oral dose on empty stomach
Avoid using antihistamines, asthma meds, anticonvulsants, and anticoagulants: increase toxicity of these drugs

Aminoglycosides

Gentamicin (Garamycin), Streptomycin, Neomycin (Mycifradin)
Med of choice against aerobic gram negative bacilli
Neomycin is used orally prior to GI surgery to suppress normal flora
Most administered only by IM or IV

Side effects of Aminoglycosides

Ototoxicity, Nephrotoxicity
Clients should receive lower doses if renal impaired
Use cautiously with renal impairment, pre-existing hearing loss, and myasthenia gravis

Side effects of Streptomycin (Aminoglycoside)

Neurologic disorder

What should not be mixed with an Aminoglycoside?

Penicillin

When should the trough level be measured for aminoglycosides?

1 hour before the next dose

Prior to starting antilipemic medications, what should be obtained?

Baseline levels of Total Cholesterol, LDL Cholesterol level, HDL Cholesterol, and triglycerides
Baseline liver and renal function tests

What is the expected pharmacological action for Fibrates?

Decrease triglyceride levels (increase VLDL; very low-density lipoprotein; excretion for clients who are unable to lower triglyceride levels with lifestyle modification)

What are examples of Fibrates and what are the side effects?

Gemfibrozil (Lopid), Fenofibrate (TriCor, Lifibra), Clofibrate (Atromid-s)
Side Effects: gallbladder stones, myopathy, hepatotoxicity
Contraindicated in clients with liver disorders, severe renal dysfunction, and gallbladder disease
Administer orally and take medication 30 min prior to breakfast and dinner

Atorvastatin (Lipitor)

Side Effects: hepatotoxicity, myopathy, and peripheral neuropathy
Contraindicated in clients who have hepatitis induced by viral infection or alcohol
Use cautiously in older adult clients, debilitated conditions, and those with chronic renal disease
Erythromycin and ketoconazole can increase levels of statins
Grapefruit can increase levels: patients should not drink more than 1 Qt a day

What is an example of a cholesterol absorption inhibitor?

Ezetimibe (Zetia): inhibits absorption of cholesterol

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