-broad spectrum -ceph/cefs -Similar to PCN/ don't give if PCN allergy -can cause bleeding w/ other bleeding meds monitor bleeding time (tonsil story) - Disulfiram reaction (puke & puke & puke) just like Flagyl, the protozoal drug - Store in fridge & take with food
- serious infections like MRSA - colitis by c-diff - ototoxicity: get hearing test, tell dr. if hearing getting worse -given over 60 minutes
- Sumycin, Doxycycline (Vibramycin) - broad, rocky mtn fever, lyme disease, acne, GI infections by H. Pylori - bad GI discomfort - Don't give to kids ≤8; teeth permanently yellow - Bad photosensitivity- wear sunscreen! - Can't take with milk, iron, or antacids - Take on empty stomach with a full glass of water
When is Arythromycin given? What class of drugs is it? worse adverse effect?
When pt allergic to PCN and needs abx. Bacteriostatic inhibitor bad GI issues
ototoxicity, Renal toxicity, Can't take with PCN at all! - gentamicin, neomycin, streptomycin
-Contains Sulfa - use for UTI - Blood problems; get CBC baseline -photosensitivity wear sunscreen and glasses! - empty stomach with a full glass of water
-antiTB - take daily for 6-12 months and most likely with other meds too -worked if 3 neg. sputum cultures, no temp. - Liver toxicity (hepato) check liver fxn - Don't take with alcohol (liver fxn remember?) - Take on empty stomach
Antiviral: Acyclovir, Ganciclovir
Teratogenic preg. X; put on rubber gloves if topical! remember my purple glove experience -thrombocytopenia, lowers WBC
What class of drugs if Flagyl? What is the weird effect it has?
protozoal. works on C. diff & H. Pylori PUD. Antibuse effect if taken with alcohol
anti-fungal. HIGHLY TOXIC - infusin rxns (fever and chills) - nephrotoxicity - hypokalemia - hepatoxicity - gynecomasita - C/I with aminoglycosides (just like PCN)
______ causes malignant hyperthermia. Use ____ to stop it
PTT lab value should stay at >_________ for what medication? What is the therapeutic PTT level?
2 times the baseline, Heparin. 60-80 seconds
To prevent HIT, stop heparin at platelet count of <________
How to inject heparin, starting from drawing up
draw up with 22-25 ga needle from vial, then use 25 or 26 ga to put into abdomen 2in from umbilicus.
Drug to help with heparin overdose
Warfarin C/I (2)
liver failure (no clotting proteins will lead to too much bleeding), alcoholism (additive risk of bleeding)
Lab values to watch with Warfarin
-PT (18-24 sec) -INR (2-3)
patient education with aspirin (food-wise)
take with food
Prevention of strokes, MI, and reinfarctions can be accomplished with low-dose aspirin of ___mg
Thrombolytic drug prototype
Streptokinase, dissolves clots that have already been formed
When should thrombolytics, streptokinase, be given?
4-6 of onset of symptoms
Do/Do not mix any medications in IV with thrombolytic agents
What medications are usually given with thrombolytics, streptokinase? (think when this drug is used)
Beta-blockers to lower myocardial oxygen consumption H2 antagonists like Zantac or PPI like Prilosec to prevent GI bleeding
Ferrous Sulfate use
Iron Deficiency Anemia
Ferrous Sulfate Patient Education (adverse effects, among other things)
-GI distress however can't take with food b/c that will decrease it's absorption greatly -Teeth staining; drink w/ straw or dilute in water or juice and rinse mouth after swallowing - Don't take with tetracycline, or antacids -Poop will be a harmless dark green or black color - Drink more water and exercise more to counter constipation effects
why would a patient be given vitB12-cyanocobalamin
pernicious anemia, partial removal of stomach
What vit/min masks the signs of Vit b12 deficiency?
E-alfa, hematopoietic growth factor, is dependent on adequate levels of ___ ___ & ___
Iron, Folic acid, Vitamin B12
In giving whole blood, what do you do before and during?
obtain vital signs, stay with the client and monitor VS q5 min for 15 minutes
When giving whole blood, what do you need the 2nd person for?
check identification of the donor blood and recipient, blood compatibility and expiration date.
Only give blood products with what type of IV fluid?
0.9% NS. anything else will cause lysis of the RBC
Bronchodilator albuterol: therapeutic uses
Prevention of asthma attack long-term control of asthma Short acting treatment for asthma attack
Bronchodilator side effects; overall stimulation of the B2-adrengeric receptors...
How to use a MDI (metered dose inhaler)
shake the inhaler, 1/2-2 in away from mouth and tilt head back slightly and open mouth wide. press inhaler same time you breath in deep. Hold breath for 10 seconds. Wait 1 full minute b4 another puff.
When prescribed a beta2-agonist and an glucocorticoid, which do they inhale first?
the beta-2 agonist promotes bronchodilation and enhances absorption of the glucocorticoid
What does the med theophylline do? short term or long-term control?
relaxes bronchial smooth muscle and does bronchodilation. Long-term control of asthma attacks.
Inhaled atrovent what class of medication is it
anti-cholinergic used for long term control of asthma
Glucocorticoids for asthma are used for _____ and oral glucocorticoids are only give for ___-___ days
long-term control of asthma attacks. 3-10 days
Codeine is used for ___. classification of drug?
chronic, non-productive cough. it's an opiod.
Codeine adverse effects
-CNS effects -GI distress take with food and increase fluids!
Mucomyst (Acetylcysteine) is a mucolytic and it's therapeutic effect is to:
make nasal and bronchial secretions watery to enhance their passage
Mucomyst's adverse effects are: (think of its effect on mucus)
aspiration and bronchospasm
What does Mucomyst acetylcysteine smell like? How to take it?
rotten eggs. dilute with water or juice
What do nasal decongestants like phenylephrine do to the body?
CNS stimulation b/c they stimulate alpha-1 adrenergic receptors. Vasoconstriction-watch HTN and CAD patients!
How fast do you infuse K chloride in IV pump?
no faster than 10 mEq/hr
You should dilute ___and give no more than 40 mEq/L to prevent vein irritation
KCl. remember in clinical he said it was really burning his vein.
SERMS raloxifene is used for _______
osteoporosis and prevent bone fractures
Raloxifiene can give the women ___ ____ and increase the risk for _ _ _s
hot flashs, DVTs
Bisphosphonates, like Fosamax or Boniva
sit or stand for 30 minutes after taking -have enough vit d and calcium
Neostigmine for myasthenia gravis; adverse reaction
Dilantin (phenytoin) and adverse effects
Anti-seizure; blurred vision, bad rash, beardy chesty, teratogenesis, dysrhythmias
Which vitamin promotes iron absorption but increases its side effects?
Carbamazipine (Tegretol) 1) Use 2) cannot be used with _____ ______ (all of these meds can't)
anti-convulsant -oral contraceptives
PTU is given for ______ & clinically see its working by:
hyperthyroidism lowered Hr, weight gain, lowered T4 levels
All ACE inhibitors cause: (2)
dry, persistant, irritating, cough and increases body's uptake of K causing hyperkalemia
70% of patients on an SSRI experience _____ ______
Fentanyl is used for:
severe cancer pain, will cause constipation
____ will increase the toxicity of Lithium
NSAIDS, tylenol is NOT an NSAID
Carbonic Anhydrase inhibitor use
Bupropion (Zyban) to help stop smoking has what action on the CNS system?
Therapeutic level of Digoxin?
Gold Salts for RA toxicity. RA drugs dosing
rash, sores in mouth, intense itching - once-a-week at first then down to once-a-month
HBA1c goal for DM
Amitryptoline (Elavil) has _______ effects. What is Elavil drug class?
Lithium adverse effects
hand tremors, thirst, GI upset
Digoxin toxicty can occur in the presence of ________ which can happen with what medication?
Name 4 NSAIDS
Aspirin, celebrex, ibuprofen, naproxen
Neostigmine, for myasthenia gravis, side effects. Medication given to counteract neostigmine?
cholinergic effects: high GI motility, bradycardia, urinary urgency. -Atropine
Dilantin (phenytoin) is used for _____ and it's side effects are