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Terms in this set (117)
What are the most common s/e of clarithromycin?
nausea, diarrhea, distortion of taste
what is the most common side effect of amoxicillin?
what are the antibacterial drugs used for?
Which drug causes a harmless black discoloration of tongue and stool?
Wich drug can stain developing teeth?
Metrondiazole has what reaction when mixed with alcohol?
what is the regimen to treat hpylori in low resistance areas?
clarithromycin triple (clarithro+amox+PPI)
what is regimen to treat hpylori in high resistance areas?
bismuth quadruple (bismuth+metrondiazole+tetracycline+PPI OR H2RA)
How do H2RA's promote ulcer healing?
by suppressing secretion of gastric acid
What does food do when taken with cimetidine?
decreases rate of absorption
How long does it take to heal a duodenal ulcer on cimetidine?
How long does it take to heal a gastric ulcer on cimetidine?
Which respiratory risk is increased because of bacterial colonization in the stomach on cimetidine?
which medications should you reduce the doses when combining with cimetidine?
warfarin, phenytoin, theophylline, lidocaine
what are two major differences between cimetidine and ranitidine?
ranitidine more potent and can take with or without food
What most serious side effects associated with PPI's
fractures, pnuemonia, acid rebound and cdiff
Is acid suppression better with H2RA's or PPI's?
which electrolyte can be caused by rebound acid hypersecretion
hypomagnesemia (S/S tremors cramps seizures)
When should you take omeprazole?
Right before eating
How does sucralfate promote healing?
By creating a protective sticky layer against acid and pepsin
What type of ulcers does misoprostol protect against?
Should antacids be used PRN or on a schedule?
on a schedule, for prophylaxis of ulcers
What do aluminum containing products produce?
What drugs can antacids influence absorption?
cimetidine and ranitidine
Which antacid can cause hypophosphatemia?
What decreases the absorption of tetracyline?
milk, Ca/iron/mag supplements, laxatives and antacids (give 1 hr before or two hours after)
What should aprepitant be combined with for CINV and post op?
ondansetron and dexamethasone
What does lorazepam help in phenothiazines?
controls extrapyramidal rxns
What is haloperidol and droperidol used for?
post op n/v and emesis from chemo, radiation and toxins
What can droperidol cause?
fatal dysrythmias prolonging QT interval
Drobinol, a cannibinoid antiemetic, has what special ability?
stimulates appetite in aids patients
What types of pt is metoclopramide contraindicated in since it stimulates GI motility
with GI obstruction, perforation or hemorrhage
What are the 2 antidiarrheals?
diphenoxylate and loperimide
What is diphenoxylate formulated with to offset opioid effects?
How do bulk forming laxatives work?
absorbs water to soften stool, grow fecal mass, and promote peristalsis.
How should you take bulk forming laxative?
with full glass of water or juice
How do surfactant laxatives work?
by decreasing surface tension which facilitates water into the feces
How do you take sufactant laxatives?
with full glass of water
What kind of patients can poly glycol-electrolyte solutions be used in?
Dehydration pt because dehydration does not occur
What can sodium phosphate osmotic laxatives cause?
dehydration (drink large volumes of water)
What is the underlying cause of motor symptoms in parkinsons?
loss of dopamine
Describe acute loss of effect associated with levodopa?
gradual is "wearing off" at the end of dosing and abrupt is "on off" phenomenon that occurs at any time
What does protein rich foods do to the effects of levodopa?
decrease the effects
Which drug is given to reduce dyskinesias?
Besides parkinson's disease, what is pramipexole also used for?
restless leg syndrome
What drug must entacapone and tolcapone be combined with?
What is transdermal selegiline used for? What are the oral disintegrating tabs used for?
major depression only. Parkinsons
What does selegiline get converted to that causes insomnia?
What does rasaligiline lack that does not produce insomnia?
What kind of effects does amantidine have because it blocks cholingergic receptors?
anticholinergic effects; dry mouth, urinary retention, constipation
Which neurotransmitter has declined levels thats associated with alzheimers?
What can bradycardia lead to in cholinesterase inhibitors?
fainting, falls and fractures
How is Rivastigmine administered?
transdermal patch applied to chest, upper arm/back or lower back
In what time of day should donepezil be dosed?
in the evening
What can memantidine do in alzheimers that other drugs cannot?
can slow decline and may cause symptoms to improve
What occurs when phenytoin is in high doses?
nystagmus, sedation, ataxia, diplopia, cog impairment
Which drug is gingival hyperplasia associated with?
Carbamazepine causes what, that can cause anemia, thrombocytopenia and leukopenia
bone marrow suppression
What should you avoid mixing with carbamazepine?
When taken in high doses, what does phenobarbital produce?
nystagmus, ataxia, CNS depression/resp depression
What is depleted in myastenia gravis?
What is the end result of neostigmine?
it increases force of contraction in the muscles
What type of stimulation does neostigmine produce? How can you treat these?
excessive muscarinic stimulation; increased salivation, increased gastric secretions, increased tone and motility of GI, sweating, spasms. Give atropine!!
Which drug can you use to determine if there is a cholinergic crisis or a myasthenic crisis? how do you know when which is alleviated?
Endrophonium; if alleviated its a myastenic crisis. if it gets worse is a cholinergic crisis
What is the antidote for baclofen? How should you treat an overdose?
there is none! treatment is supportive
What is the action of dantrolene?
Acts directly on skeletal muscle to relieve spasticity
What drugs should you avoid combining with cyclobenzaprine? Why?
MAOI's and SSRI's because of serotonin syndrome
What is mulitple sclerosis?
autoimmune disorder characterized by demylenation
What is a common side effect for interferon beta? What can you give at the same time to treat it?
Flu-like reactions: treat with analgesic and antipyretic
How should interferon beta be stored?
How can you minimize the flushing reaction that occurs with dimethyl fumarate?
give with food and giving a non-enteric coated aspirin 30 minutes before
What happens to the heart rate when giving fingolimod? When does this happen? How can this be treated?
bradycardia 6 hours after the first daily dose, it diminishes overtime. treat with atropine or isoproterenol
What can occur in the eyes when taking fingolimod?
What type of drug is mitoxantrone? Because of this, what can it cause?
immunosuppressent/cytoxic drug; kills actively diving cells such as bone marrow, hair, GI, reproductive
What can happen to the skin when taking mitoxantrone?
harmless blue green discoloration
What do first generation antipsychotics all have in common?
Expyramidal effects (dystonia, parkinsonism,akathisia, tardive dyskinesia) and lead pipe rigidity
How is lead pipe rigidity treated?
with dantrolene and supportive hyperthermia actions
What potency does haloperidol have? Because of this, what does it cause more of?
What potency does chloropromazine have?
What is clozapines most dangerous side effect?
How is risperidone administered? What should nurses use when giving?
film tabs, ODT, IM depot. use caution
What is the drug of choice for chronic bipolar disorder?
what is the drug of choice for acute bipolar episodes?
What should lithiums levels always be between? What should it be below?
04.1. below 1.5
What is acute therapy for bipolar disorder?
mood stabilizer+ antipsychotic
What is therapy for depressive episodes of bipolar disorder?
mood+ atypical, or mood+antidepressant, or antipsychotic+antidepressant
what is therapy for long term bipolar disorder?
one or more mood stabilizers can be used together or alone
What electrolyte should be monitored when administering lithium? What can happen if it gets out of range?
Na. toxicity, with coarse hand tremor, blurred vision, severe hypo, seizure
Which medication interacts with lithium that increases it's levels? What can you use instead though?
What is the most serious side effect of valproate?
T/F carbamazepine can be used for BPD, but are less effective for depressive episodes?
Are SSRI's or MAOI's better tolerated for depression?
Fluoxetine, an SSRI has what most common adverse effect?
fluoxetine combined with an SSRI causes what?
What is sertraline and what can it cause?
CNS stimulant, insomnia
What does fluvoxamine cause, therefore when can it be given?
moderate sedation, at night
When should you give paroxetine? with or without food?
whole dose in morning with food
venlafaxine and duloxetine belong to which class?
Which drugs causes midriasis of the pupil?
venlafaxine and duloxetine
Which drug should you not give to heavy drinkers?
What uses do TCA's have?
major depression, bpd, fibromyalgia and neuropathic pain
What happens if a TCA is combined with an MAOI
What side effect do all antidepressant and antiseizure drugs have?
When should TCA's be given because they cause what?
at bed, bc they produce sedation
What foods can cause HTN crisis MOA?
tyramines; cheeses processed meats
T/F MAOI's are CNS depressants
What kind of meds should you avoid when taking an MAOI?
ALL MEDS not approved by doc
What is the transdermal MAOI used for major depression?
T/F bupropion causes sexual dysfunction and significant weight gain
F. doesn't cause either
What is buproprion similar in structure to, because of this what does it cause?
amphetamines, suppresses appetite
What is mirtazapines most common side effect?
What does st. johns wart cause when combined with SSRI's?
Which drugs are best for anxiety and insomnia?
What is anterograde amnesia and what is it a side effect of? what other sleep activities can occur? (class)
benzo's. sleep driving, eating, calling
T/F sleep aides should be used long term
F. short term only
What drugs are first line for anxiety?
antidepressants such as venlafaxine, duloxetine, paroxetine and escitalopram
Buspirone for anxiety should NOT be used for what type of treatment?
not for PRN or immediate relief
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