Pharm exam II:

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Basic Pharmacology for Nurses16
Chapters 30-35, 46, 47
Nursing 122 Spring 2014
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1

Nystatin is an ________________ class of

medication.

Antifungal

2

What is Nystatin used for?

Candida species: oral/vaginal & cutaneous candidiasis.
* Thrush or yeast infections.

3

What forms are Nystatin available in?

Cream, ointment, powder and oral/ vaginal tablets, troches (pastilles which are lozenges that need to be dissolved)and suspension, you swish & swallow or spit it out depending on order.
*Powder is used for oral & cutaneous.
*PO: has little absorption & is excreted in feces.

4

Which forms of nystatin are best for Thrush?

Troches and suspension

5

Common side effects of Nystatin (there are 5):

1. N/V
2. anorexia
3. diarrhea
4. cramps
5. rash (urticarial which is rare)

6

Proper instructions for nystatin tablet:

Must take with full glass of water!

7

Proper instructions for use of nystatin troches:

place lozenge between cheek and gum underneath the tongue (it's sublingual), let it dissolve.
*DO NOT CHEW OR SWALLOW LOZENGE*

8

Is nystatin safe to take while pregnant or breastfeeding?

It is unknown if nystatin will harm a fetus or nursing baby, YOU MUST LET YOUR DOCTOR KNOW IF YOU ARE PREGNANT OR BREASTFEEDING.

9

Proper instructions for nystatin suspension:

Shake suspension well before measuring, SWISH around in mouth and then SWALLOW suspension or SPIT it out depending on physicians orders.

10

Teaching for Nystatin:

-Long-term therapy may be needed to clear infection
-Finish all of medication
-Shake suspension before measuring each dose.
*AVOID COMMERCIAL MOUTH WASHES (they irritate)

11

Theophylline is a?

Bronchodilator

12

What is the action of Theophylline?

Relaxes smooth muscle of the respiratory system by blocking phosphodiesterase, which increases cAMP.

13

Theophylline uses:

-Bronchial asthma
-broncho spasm
-emphysema
-apnea during infancy for respiratory myocardial stimulation.

14

Available forms of Theophylline.

1. Elixir
2. Time released capsule
3. Extended release tablet
4. Soln (IV)

15

Theophylline side effects:

*There's a lot!

1. N/V 2. diarrhea 3. anorexia
4. anxiety 5. insomnia 6. dizziness
7. HA 8. tremors 9. urine frequency
10. tachypnea 11. increases resp. rate
12. flushing, 13. urticarial 14. tachycardia
15. hypotension

16

Serious side effects of Theophylline:

1. seizures

2. dysrhythmias

17

Cephalosporins:

Name the 4 medications in this category:

1. Keflex
2. Ceftin
3. Claforan
4. Maxipime

18

Cephalosporins:

What is Keflex (Cephalexin sodium) used for?

Severe infections of the-
1. Respiratory
2. GI
3. GU (Genital & urinary)
4. Endocarditis (inflammation of the endocardium)
5. Meningitis

19

As a nurse what signs & symptoms do you need to watch for after administering cephalosporins?

1. Rash
2. Anorexia
3. Hypersensitivity
4. GI pain

20

Why would it be contraindicated to take cephalosporins?

If you are allergic to Penicillin

21

True/False
Those that are allergic to penicillin should not take cephalosporins?

True

22

Isoniazid (INH)

What is INH used to treat?

Tuberculosis

23

Isoniazid (INH)

Side effects of this medication include:

1. Peripheral neuritis, clumsiness, unsteadiness, muscle ache

2. Epigastric distress, jaundice, *drug-induced hepatitis

24

Isoniazid (INH)
Which labs or tests should be taken for patients on this medication?

Liver function tests

25

What deficiency does Isoniazid (INH)cause?

B6 (pyridoxine)

26

Directions for Isoniazid (INH):

1. Must complete therapy
2. Take orally on an empty stomach 1hr before or 2hrs after a meal.

27

Peripheral neuritis, is the most common adverse effect of INH and is preceded by what condition?

Paresthesias (numbness, tingling, burning pain) of the feet and hands.

28

Antituberculosis treatment always involves how many medications?

2 or more.

29

What antibiotic is often combined with Isoniazid (INH)?

rifampin

30

Remember this mnemonic for antibiotics used in TB treatment:

STRIPE
ST- streptomycin
R- rifampin
I- Isoniazid (INH)
P- pyrazinamide
E- ethambutol

31

Name the four most common Aminoglycosides:

* Amikacin
* Garamycin (Gentamicin)
* Neomycin
* Tobramycin

32

The major toxic effects of aminoglycosides are:

Ototoxicity & nephrotoxicity

33

Aminoglycosides:

What do we need to watch for in patients taking aminoglycosides?

Ear and Kidney damage

34

Aminoglycoside:
What needs to be regularly assessed if taking this medication?

Peak & trough

35

Aminoglycosides parenteral restricted to treatment of

Serious infection of the-
Gastrointestinal (GI)
Respiratory tract
Urinary tract
CNS
Bone, skin & soft tissue including burns

36

Aminoglycosides topical is used to treat:

Primary & secondary skin infections.

37

Precautions for use of aminoglycosides for patients with the following conditions (4):

1. Renal impaired
2. History of 8th cranial nerve impairment
3. Myasthenia gravis patients
4. Possible fetal damage when given to pregnant & lactating women.

38

Most frequent side effect of aminoglycosides (2)?

Nephortoxicity & ototoxicity
Toxic to the Liver and ears (hearing)

39

Other common side effects of aminoglycosides that are not considered serious or life threatening:

1. Tremors
2. Urticaria- rash of round, red welts
3. Pruritus- severe itching of the skin
4. Rash
4. Oliguria

40

Serious/Life threatening implications of aminoglycosides include?

* Neuromusclular blockage leading to flaccid
paralysis
* Fatal respiratory depression can occur in pts.
receiving muscle relaxants

41

Aminoglycosides

Peak & trough levels should be assessed. Ototoxicity associated w/persistent ____ ____ ____, rather than high peak levels.

high trough levels

42

Aminoglycosides Nursing Implications (4):

1. Monitor Peak/trough
2. Monitor renal function (BUN & creatinine levels)
3. Monitor sensory problems (hearing loss)
4. Anticipate antidote of IV calcium gluconate for
treatment of neuromuscular blockade.

43

What is the aminoglycoside antidote?

IV calcium gluconate

* Used for neuromuscular blockade*

44

Patient teaching for aminoglycosides- What 6 symptoms should the patient report?

*Report tinnitus
*high-frequency hearing loss
*persistent headache
*nausea
*dizziness
*vertigo

45

psyllium (Metamucil) is a

Bulking laxative

46

3 main uses for psyllium (Metamucil)are?

1. For incapacitated patient that needs a laxative
regularly.
2. Irritable bowel syndrome
3. Control certain types of diarrhea by ABSORBING
THE IRRIATTING SUBSTANCES.

47

Psyllium (functional fiber)

What is it & what does it do?

Undigestible carbohydrates that adds bulk to fecal content to help timely passage of contents in GI tract, preventing constipation.

48

How can functional fiber(Psyllium)affect weight control?

It delays gastric emptying, giving a sense of fullness- contributing to weight control.

49

How does Psyllium (func. fiber) affect diabetics?

Delayed gastric emptying may also reduce post prandial blood glucose concentrations, potentially PREVENTING EXCESSIVE INSULIN SECRETION & INSULIN SENSITIVITY.

50

Directions for taking Psyllium?

Take with a full glass of water- it causes water to be retained in the stool.

51

Psyllium onset

12-24 hours, and even up to 72 hours.

* Onset time will depend on GI transit time*

52

What does Psyllium do?

Increase stool frequency in patients w/constipation.

53

Reglan (metoclopramide)- A prokinetic agent

What are the actions of Reglan (metoclopramide)?

Gastric stimulant- reducing reflex & increase stomach contractions.

*Reglan makes the smooth muscle move*

54

What Reglan (metoclopramide) used to relieve symptoms of (6)?

* Gastric reflux
* Esophagitis
* GERD
* Diabetic gastro paresis
* As an aid in small bowel intubation
* To stimulate gastric emptying

55

Reglan is mainly used for treatment of (2) ?

1. Delayed gastric emptying
2. GERD (Gastroesophageal reflux disease)

56

What is the therapeutic outcome of Reglan (3)?

*Relief of discomfort
*Lower frequency of heartburn
*healing of irritated tissues

57

What do you need to watch for in patient on Reglan (5)?

1. Sedation
2. Insomnia
3. Diarrhea
4. Headache
5. Dry mouth

58

Reglan's most frequent side effects (2):

Sedation & diarrhea

59

Reglan's serious side effect?

Extrapyramidal symptoms (is a movement disorder)
(toxic)

* Children & young adults are most susceptible*

60

Reglan Nursing implications (5):

1. Assess status of hydration.
2. Monitor for anxiety, restlessness,
extrapyramidal symptoms (movement disorders)
3. Monitor for therapeutic response
4. Give 30mins before meals & at bedtime
5. Monitor RENAL FUNCTION, B/P & HEART RATE

61

What are the 4 more important nursing implications of Reglan?

*Monitor for anxiety, restlessness & extrapyramidal
symptoms.
* Give 30min before meals & at bedtime.

62

Pre assessment for Reglan, what do you check for?

* Extrapyramidal symptoms
* History of epilepsy
* Do NOT GIVE if hx of GI perforation or hemorrhage
* For diabetics, monitor for HYPERglycemia. Food
absorption may be altered.

63

Forms of Reglan (3):

Tablets
Syrup
Ampules/ Injection

64

Proton Pump Inhibitors:

Short-term uses(4-8 wks)(3) -

*Duodenal ulcers
*gastric ulcers
*gastro esophageal reflux disease.

65

Proton Pump Inhibitors:

Long-term use (1)-

hyper secretory conditions

66

Proton Pump Inhibitors:

Most frequent side effect is?

Headache

67

Proton Pump Inhibitors:

Generic names end in __________.

"zole"

68

Proton Pump Inhibitors:

Name the 4 side effects:

1. Headache
2. Diarrhea
3. Nausea
4. Vomiting

69

Proton Pump Inhibitors: Patient Teaching (3)

1. Instruct pt. to avoid opening, chewing or crush-
ing capsules
2. Instruct pt. to return for F/U if symptoms are
unresolved after 4-8 weeks of therapy.
3. SHOULD BE TAKEN BEFORE MEALS

70

Examples of Proton Pump Inhibitors(4):

1. Omerprazole (Prilosec)
2. Esomeprazole (Nexium)
3. Lansoprazole (Prevacid)
4. Pantoprazole (Protonix)

*Hint,Hint.. generic names end in "zole"

71

Proton Pump Inhibitors:

GI problems should be better within a

week

72

Proton Pump Inhibitors:

Blood work to look for-

Helicobacter pylori.

*If positive the antibiotic can run in conjunctions w/Prilosec.

73

Proton Pump Inhibitors:

With Prilosec watch for the following (4):

* Fatigue
* Diarrhea
* Abdominal pain
* Constipation

74

Lactulose is a ________ laxative.

hyperosmotic

75

Lactulose is also an ______ detoxicant.

ammonia

76

Lactulose uses:

* Treat portal systemic (hepatic) encephalopathy

* Treats constipation

77

Action of Lactulose:

* Retains ammonia in the colon by producing osmotic effects.
* Promotes increased peristalsis, bowel evacuation (expelling ammonia from colon)

78

Lactulose Precautions (3):

1. DM (dehydration)
2. Conditions in which increased sodium can cause
problems (HF, or HTN)
3. Renal dysfunction

79

Lactulose side effects(4):

1. Dehydration
2. Increased thirst
3. *Abdominal discomfort
4. Frequent loose stools

80

Lactulose's most frequent side effect is?

Abdominal discomfort

81

Lactulose action time is?

1-3 hours and up to 6 hours for sodium phosphates

82

Lactulose- Important Nursing implications (2):

* Anticipate need for low-protein diet.
* May be given by mouth (PO) or by enema

83

Lactulose PO:

Mix with fruit juice, water, or milk to improve flavor.

84

Lactulose rectally:

Use rectal balloon catheter; need to retain enema for 30 to 60 minutes.

85

How long does the patient need to retain the lactulose enema?

30-60 minutes

86

Lactulose- Patient teaching:

Encourage them to increase fluid intake.

87

Examples of Antihistamines (3):

1. Benadryl (Diphenhydramine)
2. Vistaril (Hydroxyzine)
3. Cetirizine (Zyrtec)

*Hint, Hint the generics end in "ine"

88

What do you watch for in patients' taking antihistamines (4)?

* Drowsiness
* Dysrhythmias
* Dry mouth
* Hypotension

89

What are the 3 different uses for Benadryl?

1. Hypnotic
2. Antihistamine
3. Antiemetic

90

Benadryl can be used during pregnancy for which purpose?

Nausea & Vomiting

91

When giving an antihistamine (Benadryl)for motion sickness, when is best to take?

30mins before motion

92

Precautions for antihistamines, what are the 4 main things you should check for?

1. History of acute asthmatic problems
2. Pregnancy & lactation
3. Urinary obstruction
4. Glaucoma

93

Examples of Bronchodilators:

1. Albuterol (Proventil)
2. Salmeterol (Serevent)
3. Terbutaline sulfate (Brethine)

94

Side effects of Bronchodilators (5):

1. Tachycardia
2. Headache
3. Irritability
4. Anginal pain
5. Tremors

95

Bronchodilators listed below are used to treat:

1. Albuterol (Proventil)
2. Salmeterol (Serevent)
3. Terbutaline sulfate (Brethine)

Asthma, COPD, Emphysema

96

Bronchodilators

Albuterol is known as the _____ inhaler.

rescue

97

Which bronchodilator is used for long-term control of chronic airway problems?

Serevent, taken PO.

98

Terbutaline comes in what form

tablet only, to take by mouth

99

Bronchodilator side effects (5):

1. Anxiety
2. Tremors
3. Angina
4. Tachycardia
5. Headache

100

Bronchodilator most FREQUENT side effects (3):

1. Anxiety
2. Tremors
3. Tachycardia

101

Bronchodilator Precautions (5):

1. Cardiovascular disease
2. Thyroid disease
3. DM
4. Seizure disorders
5. Terbutaline: use w/caution in children under 12

102

What is the primary advantage for using an inhaler?

The medication is applied directly to the site of action.

103

Aerosolized Metered-Dose Inhaler:

What should the patient do after inhaling a corticosteroid medication?

Have them rinse out their mouth w/water when administration is complete.

104

Inhalers:
If medication is a suspension, shake the canister. This ____ & ___ the active bronchodilator & propellant.

disperses / mixes

105

Aerosolized Metered-Dose Inhaler:
Open patient's mouth & then place the canister outlet __ to __ inches in front of the mouth or use an extender. This space allows the propellant to evaporate & prevent large particles from settling in the mouth.

2 / 4

106

Aerosolized Metered-Dose Inhaler:
What is the benefit of the 2 to 4 inch space between the inhaler & the patients mouth?

That space allows the propellant to evaporate & prevent large particles from settling in the mouth.

107

Aerosolized Metered-Dose Inhaler:
Activate the MDI, & instruct the patient to inhale deeply over ____ to ensure that airways are open and that the drug is dispersed as deeply as possible.

10 sec

108

Dry powder inhaler instructions:

* Have pt. breathe out, away from the device
* Place the mouthpiece gently in the pt.'s mouth
& have the pt. close their lips around it, then administer.
* Remove the inhaler from the pt.'s mouth, then have pt. hold breath for about 10 sec before
breathing out
* ALWAYS CHECK THE NUMBER IN THE DOSE COUNTER.

109

SULFONAMIDES-Type Loop Diuretics: Name all 3

1. Bumetanide
2. furosemide (Lasix)
3. torsemide (demedex)

110

SULFONAMIDES-Type Loop Diuretics:
Bumetanide, furosemide, and torsemide are potent diuretics that act primarily by inhibiting _____ & _____ reabsorption from the ascending limb of the LOOP OF HENLE in the kidneys enhancing sodium, chloride, phosphate, magnesium, and bicarbonate _____ into the urine.

sodium / chloride / excretion

111

Furosemide the maximum diuretic effect occurs __ to __ hours after ___ administration.

1 to 2 / oral

112

Furosemide effects last how long?

4 to 6 hours

113

Furosemide given through IV:

Diuresis occurs 5 to 10mins after IV infusion, PEAKS within 30mins and LASTS approx. 2hrs.
* remember when given IV it only lasts 2hrs.

114

Bumetanide's activity start time is the fastest of all 3 after ORAL administration, diuretic activity starts within

Diuretic:

30 to 60mins after oral administration.

115

Bumetanide given IV, diuresis begins within MINUTES & reaches maximum levels in

15 to 30mins

116

Torsemide does not appear to affect _____ filtration rate or _____ blood flow.

glomerular / renal

117

Torsemide oral administration- how long does it take for maximum diuretic effect to occur?

1 to 2 hours

118

Torsemide IV administration- Duresis occurs __ to __ minutes after IV administration.

5 to 10mins

119

Torsemide IV administration-How long after administration will it take for this med to peak?

60mins

120

Torsemide IV administration- How long will it last?

6hrs

121

Benzodiazepines:
Action

Has similar mechanisms of action as CNS depressants, but individual drugs within the benzodiazepine family act more selectively at specific sites, thereby allowing for a variety of uses.

122

Benzodiazepines:
Because individual drugs within the benzodiazepine family act more selectively at specific sites, it allows them to be used for a variety of uses. Name all 4 of them?

1. Sedative-hypnotic effects
2. Muscle relaxation
3. Antianxiety effects
4. Anticonvulsant action

123

Benzodiazepines used for Sedation & Hypnosis (7):

1. estazolam - Intermediate acting
2. flurazepam- Long-acting
3. lorazepam* Also an anticonvulsant & treat
insomnia
4. midazolam- Short-acting
5. quazepam- Long-acting
6. temazepam- Intermediate acting
7. triazolam- Short-acting

*hint, hint they all end in "lam" OR "pam"

124

Short-acting Benzodiazepines (2):

* midazolam

* triazolam

125

Long-acting Benzodiazepines

* flurazepam

* quazepam

126

Benzodiazepines

lorazepam is used primarily for

* Insomnia
* Preoperative anxiety
* Status epilepticus (epileptic seizures follow one another w/out recovery of consciousness between them)

127

Benzodiazepines- Anticonvulsants (5):

1. clobazam (Onfi) Form= tablets
2. clonazepam (Klnopin, Rivotril)Form= tablets
3. clorazepate (Tranxene, Novo Clopate) Form=
tablets
4. Diazepam (Balium) Form= tablets, liquid,
Gel- rectal
5. Lorazepam (Ativan) Form= tablets, oral soln, IM,
IV

128

Benzodiazepines:

Diazepam has multi-uses what are they?

1. Anticonvulsant
2. Anxiety

129

Benzodiazepines:

Lorazepam has multi-uses what are they?

* Sedation/Hypnosis
* Anxiety
* Anticonvulsant
* Insomnia

130

Prophylactic antibiotics:
The use of prophylactic antibiotics is recommended for patients at risk for developing _______ ________ before dental, gastric, & genitourinary surgery.

infective endocarditis

131

Prophylactic antibiotics are given to prevent infective endocarditis before what type of surgeries?
Name 3 of the most common.

1. Dental
2. Gastric
3. Genitourinary

* And other invasive procedures*

132

Prophylactic antibiotics:

Association guidelines recommend prophylactic antibiotic treatment for patients with ____ ______ that put them at highest risk for infections.

cardiac conditions

133

Antimicrobial agents are

chemicals that eliminate living microorganisms that are PATHOGENIC to the patient.

134

Antimicrobial agents are often first classified according to the type of pathogen to be destroyed such as

* bacteria (antibacterial agents)
* fungal (antifungal agents)
* viral (antiviral agents

135

After pathogen classification antimicrobial agents are then subdivided by chemical families into drug classes such as...Name all 3.

1. Penicillins
2. Tetracyclines
3. Aminoglycosides

136

Antimicrobial agents:

What does the "big three" mean?

Adverse effects of Antimicrobial agents
1. Nausea
2. Vomiting
3. Diarrhea

137

Antimicrobial agents: Secondary infections

Assess for symptoms such as oral infection. You would observe for a

* black harry tongue
* white patches in oral cavity
* cold sores
* canker sores

138

Antimicrobial agents: Secondary infections
Secondary infections of the intestine can produce

severe life-threatening diarrhea

139

Antimicrobial agents: Toxicity

Assess for 3 forms of toxicity-

1. Nephrotoxicity
2. Hepatotoxicity
3. Ototoxicity

140

GERD Teaching

1. Avoiding certain foods & beverages:
*chocolate, peppermint, fatty food, coffee, soda &
alcoholic beverages.
2. Foods & beverages that can irritate a damaged
esophageal lining, such as citrus fruits (OJ)
& tomato products, spicy foods & pepper should
be avoided.
3. Avoid Anti-­‐inflammatories (ASA, IBprfen)
2. Meals:Decrease portion size & eat 1-2 before
bedtime.
3. Stop Smoking.
4. Elevate the head of the bed or sleep on wedge
allows gravity to keep acid reflux from coming
up.
5. Medications: Antacids taken regularly can
neutralize acid in the esophagus & stomach &
stop heartburn.

141

Pulimicort (budesonide phosphate)- turbo inhaler:

Pulimicort is an

inhalant corticosteroid.

142

Pulimicort:

Suspension via inhaler

Aerosol powder

143

Pulimicort: Uses

Asthma
COPD

144

Pulimicort: Common adverse effects (2)

*Hoarseness
*Dry mouth

145

Pulimicort: Serious adverse effects

Fungal infections- treat w/antifunal mouth wash
such as nystatin.

*instruct patient to gargle & rinse mouth after each aerosol treatment with mouthwash.

146

Cytotec (misoprostol): Uses

is used to prevent & treat gastric ulcers caused by NSAIDS, including aspirin.

147

Cytotec (misoprostol): Common adverse effects (there's only one)

* diarrhea- it's dose related & usually develops
after 2 weeks.

148

Cytotec (misoprostol): Contraindication

Pregnancy

It's crucial that therapy be DC'd if the patient is pregnant. Cytotec is a category X drug & may cause SPONTANEOUS ABORTION.

149

Amphotericin B: Systemic antifungal agent

Used for

treating systemic LIFE-THREATENING FUNGAL INFECTIONS.

150

Amphotericin B:

Should not be used for what type of infections?

Noninvasive
(thrush, vaginal candidiasis & esophageal candidiasis) in healthy people w/normal neutrophil counts.

151

Amphotericin B: Premedication assessment

1. Baseline vitals
2. Assess for normal renal function & normal
electrolyte before initiating therapy.
3. Assess for allergies
4. Baseline data on patients mental health status

152

Amphotericin B: Common adverse effects

* malaise (discomfort, illness or uneasiness)
* fever / chills
* HA
* N/V
* nephrotoxicity
* electrolyte imbalance
* thrombophlebitis

153

vancomycin (Vancocin): Uses

effective against only gram-positive bacteria such as streptococci, staphylococci (C-diff, Listeria monocytogenes & Corynebacterium)that may cause endocarditis, ostermyelitis, meningitis, pneumonia or septicemia.

154

vancomycin (Vancocin):
Because of potential adverse effects, vancomycin therapy is reserved for patients with

potentially life-threatening infections who cannot be treated w/less toxic agents such as penicillin's or cephalosporin's.

155

vancomycin (Vancocin): Serious AV effects are

Ototoxicity & Nephrotoxicity

* also watch for secondary infections- oral thrush, vaginitis etc.,

156

rifampin (Rifadin): Uses

Is used in combination with other agents for the treatment of TUBERCULOSIS.
* It's also used to eliminate meningococci from the nasopharynx of asymptomatic N. meningitides carriers & eliminate H. influenza type b from the nasopharynx of asymptomatic carriers.

157

Which medication is used to eradicate meningococci or HIB from asymptomatic carriers of these diseases?

rifampin (Rifadin)

158

rifampin (Rifadin): Common adverse effects

1. Reddish orange secretions
2. N/V
3. Anorexia
4. Abdominal cramps

159

Tetracyclines:

Action

A class of antibiotic that are effective against gram-negative AND gram-positive bacteria.

160

Tetracyclines: Uses

To treat patients allergic to the penicillin's for the treatment:
*Certain venereal diseases
*UTIs
*Upper respiratory tract infections.

161

Tetracyclines: Common adverse effects

1. N/V
2. Anorexia
3. Abdominal cramps
4. Diarrhea
5. PHOTOSENSITIVITY

162

PEAK & TROUGH

PEAK

30min to 1 hour after administeration

163

PEAK & TROUGH

TROUGH

30min before next dose

*time for next dose*

164

PEAK & TROUGH

Any level above the peak is Toxic to the

Kidneys

165

sucralfate (Carafate):

Uses-

* Treat or prevent ulcers in the intestine & stomach, GI bleed, and to prevent ulcers caused by aspirin.

166

sucralfate (Carafate):

Forms a coat over ulcers, for discomfort and the protection of tissues.

167

sucralfate (Carafate): Dosage directions

* Take by mouth 2 to 4 times a day
* Take on empty stomach
* Take 1hr. before meal
* Antacids can be used w/this med, BUT you must take them 30mins BEFORE or after sucralfate.

168

When should antacids be taken if patient is taking sucralfate (Carafate)?

30mins prior Carafate administration.

169

Should sucralfate (Carafate) be taken on a full stomach or an empty stomach?

Empty

170

ciprofloxacin (Cipro)is used for treatment of-

BACTERIAL infections of the
1. Urinary
2. Respiratory
3. GI tract

171

Toxic effects of Cipro:

Superinfection

* ENTEROCCAL

* FUNGAL

172

Enteroccal-

a streptococcus of a group that occurs naturally in the intestine but causes inflammation and blood infection if introduced elsewhere in the body (e.g., by injury or surgery).

173

Penicillin (PCN): Treats

1. Gonorrhea
2. Perionitis
3. UTI
4. Pneumonia & other respiratory infections
5. Septicemia
6. Meningitis

174

PCN: Adverse effects:

* GI distress
* Oral/vaginal candidiasis
* Gen. rash
* Anaphylaxis

175

Quinolones & Tetracyclines:

No Way!
Not during pregnancy!!!

176

Azithromycin (Zithromax):
Treatments for -

1. Upper & Lower resp. tract bacterial infections.
2. Sexually transmitted diseases
3. Uncomplicated skin/skin structure infections

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Azithromycin (Zithromax): STDs

* Nongonoccoccal urethritis
* gonorrhea
* Chrancroid in men

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Azithromycin (Zithromax):

Watch for

* The big 3 and....
* abdominal pain
* superinfections

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Azithromycin (Zithromax):

Comes in a convenient 7 day pack

180

Azithromycin (Zithromax):

Routes-

IV & PO

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cetirizine (Zyrtec): Is a

Antihistamine

182

cetirizine (Zyrtec):

Aids in

*sneezing
*rhinorrhea
*post nasal drip and discharge
*tearing

183

cetirizine (zyrtec):

Side effects-

1. Pharyngitis
2. Dry- mouth, nose & throat
3. May cause drowsiness

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benizonatate (Tessalon)

Is an Antitussive!
*Reduces coughing for NONproductive coughs

185

benizonatate (Tessalon):

Watch for

Drowsiness
GI upset
Constipation

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Guaifenesin (Robitussin):

Expectorant- it irritates mucus membranes to release mucus in a PROductive cough

187

Guaifenesin (Robitussin): Watch for

GI upset
Nausea
Drowsiness

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acetylcysteine (Mucomyst)-

Breaks the links that bind mucus together so it can be coughed up.
* To prevent bacteria growth in forming mucus

189

acetylcysteine (Mucomyst)-Watch for

* Dizziness
* Drowsiness
* Vomiting
* Bronchospasms
* Rinorrhea
* Nausea