Pharm. EXAM 3
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112 terms
Terms | Definitions |
|---|---|
 NaCl - MOA | supplement that causes isotonic diuresis |
| NaCl - Uses | treats hyponatremia - sodium serum levels below 130 mEq/L |
| NaCl - Side effects and symptoms | hypernatremia: altered mental status, decreased LOC pulmonary edema: |
| KCl - MOA Admin Alert! | Potassoim/Electrolyte Supplement No IV push/bolus - only oral orSLOWLY through line - it's very irritating |
| KCl - uses | treats hypokalemia - less than 3.5mEq/L |
| KCl - side effects and thier symptoms | GI irritation hyperkalemia: dysrythmias, heart block |
| Sodium Bicarbonate - MOA Admin Alert! | neutralizes acids in the blood and other body fluids oral give 2-3 hours before meals/meds |
| Sodium Bicarb - uses | metabolic acidosis - increases pH level in patients |
| Sodium Bicarb - side effects and symptoms | metabolic alkalosis: CNS stimulation, convulsions constipation cyanotic slow irregular pulse slow respirations to hold onto CO2 Stop infusion first, THEN notify phycisian |
| Spirinolactone - MOA | blocks action of aldosterone so body dumps sodium but holds onto potassium |
| Spirinolactone - Uses | hypertension edema reduces mortality in heart faliure |
| Spirinolactone - side effects/symptoms | Hyperkalemia: dysrythmias hyponatremia: n+v, cramping, anorexia, confusion, lethargy, coma |
| Spirinolactone - roel of nurse | assess electrolytes |
| Spirinolactone - drug/drug interaction | With ACE Inhibitors increased risk of hyperkalemia so monitor the HEART |
| Spirinolactone - Patient Education | Aviod potassium rich foods - hyperkalemia! and hawthorn - hypotension! |
| Safety precautions in patients with renal problems | Start with lower doasges.... need to clarify this |
| PUD - tx indicated | Start drugs when diagnosed, used to reduce incidence of complications ( bleeding, perforartion, obstruction) |
| IBDs, Chron's, Ulcerative Colitis - tx indictated | depends on clinical picture, maintain as normal lifestyle as possible, prevent nutritional deficiencies, minimize psyche and social impact of dz |
| GERD - tx indicated | for severe GERD |
| Constipation - Tx indicated | when patient feels bloated or has trouble moving bowels |
| Diarrhea - Tx indicated | for patients at risk of developing complications - elderly, preggers, kids |
| Nausea/Vomiting - Tx indicated | after waiting 24 hours to see if symptoms abate and when these are not symptoms of an underlying condition that requires immediate attention |
| Risk factors for PUD | Anything that increases stomach acid stress caffiene smoking alcohol |
| Proton Pump Inhibitor often given with? | omeprazole (Prilosec) antibiotics |
| Prilosec - MOA | Reduces stomach acidsecretions by binding irreversibly to enzymes H+, K+ - ATPase |
| Prilosec - Uses | Short term use 4-8 weeks for peptic ulcers GERD * works better than other drugs |
| Prilosec - side effects/symptoms | headache nasuea diarrhea rash abdominal pain Long Term: increased acid so you can get gastric cancer |
| Prilosec - Admin Alert | Take 30 minutes prior to eating usually before breakfast, Eating yougurt is beneficial to replace bacteria. Enteric coated cannot be chewed or crushed must dissolve in stomach |
| H2 Receptor Agonist | Ranitidine (Zantac) |
| Ranitidine- MOA | block H2 receptors in stomach to decrease acid production |
| Ranitidine - uses | PUD |
| Ranitidine - side effects/symptoms | Constipation impotence/libido loss lower WBC, RBC and plateletts Pernicous anemia because b12 is not absorbed well |
| Ranitidine - admin alerts | can be can with or right after meals and at bedtime to prolong effect |
| Antacids | Aluminum hydroxide |
| Aluminum hydroxide - MOA | neutralizes stomach acid by raising pH of stomach contents |
| Aluminum hydroxide - uses | in combination with other drugs for relief of heartburn due to GERD or PUD |
| Aluminum hydroxide - side effects/symptoms | constipation |
| Aluminum hydroxide - admin alerts | take 2 hours before other meds so that absorption is not decreases |
| Pepto-Bismul - MOA | added to antibiotics, inhibits bacterial growth, prevents h. pylori from adhering to the stomach wall |
| Sulfucrate - MOA | sucrose plus aluminum hydroxide (antacid) produces a thick gel like substance that coats the ulcer protecting it against further erosion and promoting healing |
| Sulfucrate - admin alert | must be taken 4 times daily, must be taken BEFORE meals to be affective |
| misoprostole - MOA, uses | inhibits acid and stimulates mucus production prevents peptic ulcers in patinets taking NSAIDs and corticosteriods |
| psillium mucilloid - MOA | Laxative that swells and increases the size of fecal mass |
| psillium mucilloid - uses | to promote passage of stool |
| psillium mucilloid - side effects/symptoms | may cause obstruction in the esophagus or intestines if patinet doesn't drink enough water |
| docusate - MOA | stool softener causes more water/fat to be absorbed into the stool . most often used to prevent constipation |
| docusate - side effects/symptoms | abdominal cramping - report to phycisian |
| mineral oil - MOA side effects | lubricate stool and colon mucosa can interfere with absorption of fat soluble vitamines |
| Milk of Magnesia and Fleet phospho-soda - MOA | saline/osmotics not absorbed in the intestine. They pull water into the fecal mass. Dont use regularly, work quickly |
| bisacodyle - ducolax- MOA | stimulant that promotes peristalsis by irritaing the bowel mucosa - rapid acting, cause diarrhea and cramping, dont use often |
| Antiemetic | prochloperazine (compazine) |
| prochloperazine - MOA | blocks dopamine receptors in brainwhich inhibits signals to vomit center in medulla |
| prochloperazine - uses | for severe nausea and vomiting |
| prochloperazine - side effects/symptoms | dose related anticholinergic effects -dry mouth, sedation constipation - orthostatic hypotension, tachycardia - extrapyramidal symptoms with prolonged use |
| prochloperazine - antidote | Congentin via IM immediately for extrapyramidal effects |
| Antidiarrheals | diphenoxylate with atropine (Lomotil) - this is a non-analgesic opiod |
| Lomotil - MOA | slows peristalsis |
| Lomotil -uses | moderate to severe diarrhea |
| lomotil - side effects/symptoms | dizziness drowsiness |
| lomotil - tx od OD | nalaxone IV |
| Diet for diarrhea | BRAT bananas rice applesauce toast or ABCs apricots, bananas and carrots |
| Meds to administer for bowel prep surgery Assess? | bisacodyle fleet phospho-soda tap water enema Assess kidney function (creatine levels) |
| Why is culture & sensitivity testing done? | to identify sensitive or resistent bacteria Broad spectrum antibiotics may be started before culture is completed |
| What symptoms might the patient present with that might warrant a provider ordering culture and sensitivity testing? | Sepsis, systemic infection, severe symptoms whose underlying cause is not identifiable. |
| How/why are superinfections are caused by anti-infective therapy ? | antibiotics kill microrganisms (host flora) normally present in bidy which allows pathogenic microorganisms to multiply and take over |
| symptoms of superinfections | diarrhea bladder pain abnormal vaginal discharge painful urination |
| Pencillin G- MOA | Disrupts cell wall, fluid goes into cell and it bursts |
| Penicillin G - uses | Strep, Pneumonia, Staph infections that DON'T produce penicilinase. Gohnerrhea Syphallis |
| Penicillin G - side effects/symtpoms | nasuea vomiting abdominal pain super infections ( yeast) anaphylaxis |
| Penicillin G - interactions/admin alert | decreases effectiveness of oral contraceptives pbserve for 30m. after perenteral admin. especially afetr first dose |
| Caphalosporins | cefotaxime |
| cefotaxime - MOA | iterferes with cell wall building when GRAM negative bacteria divide |
| cefotaxime - uses | Treats infections of: lower repiratory tract CNS GU bones, blood, joint Prophylactic: pre-op |
| cefotaxime - side effects/symptoms | n/v diarrhea ab. pain anaphylaxis |
| cefotaxime - admin alerts | CI in pt.s allergic to penicillin IM in a deep large muscle mass to prevent injury to surrounding tissues |
| Tetracycline - MOA | borad range antibiotic, inhibits protien synthesis |
| Tetracycline - uses | Clamydia Ricketts Mycoplasma |
| Tetracycline - side effects/symptoms | -toxic to body as it's similar to protiens found in the body tooth discoloration photosensitivity rash superinfections GI - n/v, pain, diarrhea |
| Tetracycline - admin alert | caution in children under 8 dcreases effects of oral contraceptives Admin on empty stomach 1 hour before or 2-3 hours after meal/meds MILK reduces absorpotion |
| Macrolides | erythromyacin |
| erythromyacin- MOA | binds to bacterial cell membrane and changes protien function |
| erythromyacin - uses | whooping cough diptheria most gram positive bacteroa |
| erythromyacin - side effects/symptoms | GI hepatoxicity |
| Aminoglycoside | gentamycin |
| gentamycin | inhibits protien synthesis - broad spectrum, bacteriocidal |
| gentamycin - uses | gram negative infections E. coli, staph |
| gentamycin - side effects/symptoms | Ototoxicit don't give to patinets with hearing problems cause you can't measure toxicity \nephrotoxicity |
| gentamycin- admin alert | IM admin into deep muscle |
| isoniazide (INH) - MOA | inhibits synthesis of myoclic acids which are important to cell walls |
| isoniazide (INH) - uses | tuberculosis |
| isoniazide (INH) - side effects/symptoms | GI fever rash numbness of hands/feet - fatal hepatitis |
| Vancomyacin - Uses | severe infections of strep and S. aureas after other drugs have failed MRSA |
| Vancomyacin - side effects/symptoms | ototoxicity superinfections nephrotoxicity red-man syndrome |
| Vancomycin - admin alert | if upper bosy rash, decreased urine out put/ hearing - HOLD next dose THEN notify physician |
| Fluconazale - MOA | interferes with sythesis of ergosterol in the fungal cell membrane causing them to become permeable |
| fluconazale - uses | candida albicans |
| fluconozale - side effects/symptoms | GI w/ high doses Stevns-Johnson syndrome in immunosupressed pts |
| metronidazole (Flagyl) - MOA | inhibits DNA synthesis so protozoa can't reproduce, cell dies |
| metronidazole (Flagyl) - interaction | don't drink alcohol while opn or 3 days after meds, take 1h before or 2h after meals |
| metronidazole (Flagyl) - side effects/interactions | CNS GI superinefctions |
| zidovudine | slows AIDs , doen't cure it |
| zidovudine - MOA | virus uses drug as nucleotide thus creating an innefective DNA starnd |
| zidovudine - uses | used iwth otherantiretrovirals for HIV clienety used prophylactively for exposed healthcare workers reduces rate of transmisioin from mom to fetus |
| zidovudine - side effects | savere bone marrow supression anemia GI weakness/fatigue |
| acyclovir (Zovirax) - MOA | prevents viral DNA sythesis |
| acyclovir - uses | herpes -1and 2 : dcreases pain at high dodes treats: CMV varicella zoster |
| acyclovire -side effects | GI neuropathy hair loss rashes headache depression |
| acyclovir - admin alert | take with food |
| HAART | Highly Active Anti Viral Therapy |
| Advantages of HAART | reduces viral load to below the limit of detection, reducies the risk of drug resistance |
| laboratory tests associated with HIV/AIDlaboratory tests associated with HIV/AIDS | CD4-T cell count- determines immune functionand predicts for opportunistic infection measurement of HIV RNA in plasma - detrmines viral load |
| THE END | ... |
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