Exam 3 pharm

Priority assessment before giving any antibiotics?
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Priority assessment before giving any antibiotics?
Allergies
What do cephalosporins and penicillins have in common?
They both are antibiotics, assess for allergies, if pt is allergic to one most likely is allergic to the other one
A/e tetracycline?
Tooth discoloration, delayed bone development, liver and kidney damage
Causes of antibiotic resistance?
Prescribing antibiotics for viruses, overuse of antibiotics, not taking as prescribed, not completing therapy
Patient teaching with Sulfomides?
Avoid with food, avoid sun, increase fl
Gentamicin / Tobramycin
Aminoglycosides
Adverse affects amino glycosides?
Nephrotoxcity, ototoxcity
**monitor pts renal functions
Teachings of antibiotics?
Increase fl
Take full course
Notify md if a/e
Hand hygiene
*antibiotics also mess with bodies natural flora causing increased risk fungal infection
alenodronate (Fosamax)
Bisphonates
***osteoporosis med
Bisphosphonates teachings
1) take on empty stomach first thing in the morning
2) tske with full glass of water
3) do not lay down after taking (30 min sit or stand)
CalcitoninOsteoporosisCalcitonin teachingsAccess for fish allergies (salmon)Labs to monitor with rifampin and INF?LFT URIC acid Sputum sample Cholesterol levels ****key cautions-liver damage***A/E rifampin/ inf & how to treat?Peripheral neuropthathy Tx with pyridoxine (viatamin b6)How long does pt take tub medications?6-12 monthsHow do you know if tb meds are working?Negative sputum sample Improved cxray Decreased sxINH, Rifampin, Pyrazinamide, and EthambutolDrug combo for TBGancyclovir (Cytovene)IV or PO Monitor pts CBC! **viral medTeaching with HIV meds?Need routine bloodwork Meds help slow disease process Compliance is key Meds prevent further infectionLabs to monitor HIV?Viral load, cd4What med treats herpes?AcyclovirWhat does acyclovir do?Helps lesions become dry and crustyMed to treat influenza?TamifluMeds used to treat gout?Probenecid or glucosterioidsA/E : glucocorticoidsOsteoporosis, infection, increased bs, increased weight, increased infection, fl retention, adrenal crisisDDI with gout medications?Diuretics (hctz, loop)MethotrexateTreats RAA/E methotrexateBone marrow suppression, heart failure, category x pregnancyPriority intervention with severe dehydration?Push IV fluidsGI med to avoid due to many ddI's?CimedtidinePriority teaching with stool softeners?Take with full glass of water/push fldsHow long do suppositories work?15-60 minWhat GI med to avoid with renal pts?MOM- milk of magLabs to monitor with PPIs?Bun, creatine, uric acidPPI ending?-prazole Ex- omeprazolePPIs (omeprazole) a/eFirst choice gi ulcers A/e- pancreatitis, blood disorders ****monitor pt for bloody stoolsBisacodyl (Dulcolax)stimulant laxativeA/e ducolax?Hyponatremia, hypokalemiaPriority tx for h pylori?1 PPI, 2 antobioticsPt teachings with antacids?1) take after meals 2) chew whole tablet 3) take one hour before other meds or 2 hours after other meds (DDIs)Key teaching with pepto-bismal?Can turn body fluids, stool and tongue a dark color (harmless)Labs to monitor diabetics?A1C (below 6%)- long term Blood glucoseSymptoms of diabetic ketoacidosis?deep rapid breathing, dry skin/mouth, flushed face, fruity smelling breath, nausea, vomiting, stomach painWill patients have increased potassium levels with DKA?YesContributing factors DKA?Elevated potassium Dehydration Decreased kidney function Very high glucose levelsPriority intervention with DKA?1) normal saline (Iv fluids) 2) regluar insulinMetformin contraindications?pts at risk for lactic acidosis **contrast dye***Peak action time rapid insulin?60 minpeak action of regular insulin?2-3 hoursSx of hypoglycemia?cold and clammy need some candy *sweating, confusion, hungerSx hyperglycemiahot and dry-sugar high *increased thirst, fruity breathWhat insulin's cannot be mixed?Lantus & levemirWhat insulin can be mixed and what order?NPH, Regular Nph air Regular air Draw regular Draw nphRapid Insulin?Novolog, humologRegular insulinHumulin R, Novolin RIntermediate insulin?NPH (Humulin N, Novolin N)Long acting insulin?Lantus, LevemirNormal blood glucose range?70-100 mg/dLTeachings with insulin?Vials are good for 4 weeks Monitor glucose when pt is sick Never mix lantas Monitor glucose before/during/after excerise Always check glucose before giving insulin Always make sure pt has sugar source with them Know sx of hyper and hypoglcemia and how to treatTetracycline, monocylineAntibiotics Drug class- tetracylcineEnding of tetracyclines-cyclineEnding of aminoglycosides?(-ycin) Ex-gentamycin, thrombmycin, neomycinBactrum/SeptraSulfomides (Antibiotics) Teachings- avoid sun, take with food, increase fluids