-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
ALL antibiotics have these side effects
- allergy, hypersensitivity
- organ (kidney & ear) toxicity
- lowers OC effectiveness
- 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
- use for UTI
- Blood problems; get CBC baseline
-photosensitivity wear sunscreen and glasses!
- empty stomach with a full glass of water
- 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)
- C/I with aminoglycosides (just like PCN)
Morphine adverse effects
- Orthostatic HOTN
- Cough suppression
Morphine drug-drug interactions (think of what morphine does to the body)
-opiod antagonists (narcan)
Opiod withdrawl (stop abruptly is taking ≥6weeks). Is it life-threatening? Will it subside?
sweating, restless, agitated, dilated pupils, tremors, tachycardia, increased BP, N/V, cramps, muscle spasms with kicking movements. NO, subside in 7-10 days.
Migraine medicine & can you take them right after each other?
vasoconstriction, ergot's and triptans. NO, space out ergot and triptan by at least 24 hours.
What pain med reduces platelet aggregation?
NSAIDS (aspirin), reduce thrombus but will bleed easier, too
NSAIDS education w/ how to take med. NSAIDS=
with food, milk, or full glass of water to reduce gastric discomfort. Ibuprofen, Celebrex, Naproxen, Aspirin
Rheumatoid Arthritis Drugs name potent toxic drug
DMARDs, 1st choice: methotrexate. Bone Marrow Suppression and Fetal Death
What are the s/s of circulatory overload? Seen if giving too much fluids
flush, SOB, cough, heart palpitations
Lasix drug-drug interaction: for manic depressive ppl it'll get to toxic levels in the body
Lithium will become toxic
Signs of hypokalemia
weakness, dysrhymias, increased cardiac sensitivity of digoxin, ileus, Flat T wave
Glucocorticoids adverse effects
potent; suppress adrenal glad fxn, hyperglycemia, osteoporosis, if taken with NSAIDS, increase risk of GI ulcer, mask infection and suppress immune system
Reo Pro (-mab) what is it for & adverse effects. What other use does Reo Pro have?
Immunosuppressant for RA, Lupus. toxic to bone marrow, acute pulm edema, infection risk, neoplasia risk. Antiplatelet action.
Classic CNS depressant drug classes and what they're used for
Benzodiazepines, Barbituates. Anxiety.
Other anxiolytics: and what they're for
-Valproic Acid: anti-seizure, bi-polar
- Phenergan: NV, anxiety, extrapyramidal effects
Amitriptiyline (Elavil) drug drug interactions and how to take med
Anticholinergics b/c TCA already have anticholinergic effects
- void prior to dosing & take at bedtime to sleep through fatigue side effect
MAOI's ___ line of choice for depression b/c of the adverse effects with _____. If eat _____ will cause an _____ ______
2nd or 3rd, tyramine. Tyramine, hypertensive crisis
MAOI adverse effects are related to stimulation of the _____ and include:
SNS, CNS stimulation,
CV-hypertensive crisis, palpitations, Liver toxicity
1st drugs of choice for depression and are equally as effective as _ _ _ but don't see _____ & ____
SSRI, TCA, hypotension and sedation
Anti-depressants have ___________ effects
anticholinergic: dry mouth, constipation, lack of sweat, lack of voiding
all anti-depressants have _____ ______ effect and pt must have their __ monitored
orthostatic hypotension. BP
If patient taking an antihypertensive and just got ordered MAOI, Nardil, Marplan, or Parnate, then...
monitor their BP and call the Dr if theres a significant drop and may need to reduce the anti-htn dosage
Chemotherapy Agents, name as much as you can!
neosar (cyclophosphamide), methotrexate, doxorubicin, tamoxifen
PTT lab value should stay at >_________ for what medication? What is the therapeutic PTT level?
2 times the baseline, Heparin. 60-80 seconds
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.
Warfarin C/I (2)
liver failure (no clotting proteins will lead to too much bleeding), alcoholism (additive risk of bleeding)
Prevention of strokes, MI, and reinfarctions can be accomplished with low-dose aspirin of ___mg
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 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
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
Mucomyst (Acetylcysteine) is a mucolytic and it's therapeutic effect is to:
make nasal and bronchial secretions watery to enhance their passage
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!
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.
Bisphosphonates, like Fosamax or Boniva
sit or stand for 30 minutes after taking
-have enough vit d and calcium
Dilantin (phenytoin) and adverse effects
Anti-seizure; blurred vision, bad rash, beardy chesty, teratogenesis, dysrhythmias
Carbamazipine (Tegretol) 1) Use 2) cannot be used with _____ ______ (all of these meds can't)
PTU is given for ______ & clinically see its working by:
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
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
Digoxin toxicty can occur in the presence of ________ which can happen with what medication?
Neostigmine, for myasthenia gravis, side effects. Medication given to counteract neostigmine?
cholinergic effects: high GI motility, bradycardia, urinary urgency.
Dilantin (phenytoin) is used for _____ and it's side effects are
seizures, double vision, hirsuitism, skin rash, teratogenesis, dysrhythmias,
Multiple drug interactions with Heart medications:
MAOI, TCA enhance epinephrine effect (vasocontriction)
- Phentolamine -A blocker
- Propanolol B blocker
Alpha Adrenergic Blockers (minipress) all have a first-dose ____________ ___________ effect and what OTC analgesics counteract the anti-hypertensive effect?
orthostatic hypotension b/c venous dilation
-pril ACE inhibitors block Ang I from becoming II resulting in:
vasodilation, excretion of water & sodium, retain K,
The main difference between ARB's and ACE inhibitros is that ______ and _______ are not side effects of ARB
Ca Channel Blocker (-ipine/-amil) vasodilate and adverse effects (2)
- reflex tachycardia
- Peripheral edema
Action of Digoxin (2)
increase myocardial contraction
Lower Heart Rate giving ventricles more time to fill
The most dangerous adverse effect of Digoxin is it's ability to create ________, particularly in patients who have _______
ACE inhibitors (-prils), ARBs (-sartan), Thiazide & looop diuretics increase the likelihood of ________ and it's level should be monitored when taking _______ with these meds.
Clonidine (catapress) is a alpha agonist and has what two adverse effects
drowsiness & sedation
Ca Channel Blockers adverse effects are related to __________ & the immediate-acting drugs can cause _____ ________
vasodilation: headache, dizziness, edema, flushing
Ranitidine Hydrochloride (Zantac) is a __ ____ ______ and is used for _____ and _____
H2 receptor antagonist
-PUD and GERD by suppressing the secretion of gastric acid
-tidines and -prazole's lowers gastric pH which promotes bacteria in the stomach and _______ _______ so use cautiously in pts who are at high risk for ______
How many times does the patient take antacids?
7 times a day! it'll relieve their pain and heal the ulcer
Misoprostol: who used them & intended use
-ppl taking long-term NSAID therapy and pregnant women
-prevent ulcers and induce labor
examples of anti-emetics
- Prochlorperazine (Compazine)
- Dramamine prevents motion sickness
- metoclopradmie (reglan)
All anti-emetics should not be used with these 3 medications b/c they intensify anti-emetic side-effects
opiods- intensify CNS depression
Metoclopramide (reglan) use and side effects
-extra pyramidal effects
Is PTU safe to use in pregnancy? What side effects are there for PTU
NO c/i b/c neonatal hypothyroidism can occur
- overmedication goes to hypothyroidism
-can increase anticoagulant effects
What medication class lower the effectiveness of birth control? (4)
- rifampin (TB drug)