pharm 6

A client is about to begin a 6-month course of therapy with isoniazid. The nurse should plan to teach the client what

Can cause peripheral neuropathy and treat with pyridoxine

A client with diabetes mellitus visits a health care clinic. The client's diabetes mellitus previously had been well controlled with glyburide daily, but recently the fasting blood glucose level has been 180-200 mg/dL. Which medication, if added to the client's regimen, may have contributed to the hyperglycemia?

Hydrocortisone and prednisone (glucocorticoids), sustain through a stressor and give you energy

Metformin what will the patient say

I will report muscle aches and tiredness, I can drink alcohol in moderation, I may experience Gl side effects

patient is admitted for surgical removal of a cancerous tumor of the colon. He is concerned about the prospect of living with a colostomy and asks the nurse why the prescriber cannot just give him some drugs to kill the cancer. What is the basis of the nurse's response?

Solid tumors have fewer cells that are actively dividing, have poor blood supply at the core

A patient is going to be started on a protease inhibitor (indinavir). Which statement by the patient would be most concerning?

The way I look is very important, body is going to change

The nurse would expect what when two or more anticancer chemo agents are used together?

They affect different organs

When administering a known vesicant chemo agent, which information is most important for the nurse to know?

To stop infusion immediately if extravasation occurs to prevent necrosis

The nurse has given a client taking ethambutol info about the medication. The nurse determines that the client understands the instructions if the client states that he or she will immediately report which finding?

Vision changes

Spot myopathy

achy muscle pain

Principles of treating HIV positive pregnant women include

benefits outweighs the risks, prophylaxis is recommended for the infant, zidovudine azt

Cmv leading cause of

blindness

1st to 5th is

broader, treats resistant infections and gram negative as you get to newer

Percent kill

cant aim for 100% bc that would kill the body

Hiv infection

cd4 helper cells

ceftriaxone

cephalosporin

Ganciclovir to treat

cmv infections

The father of a child with leukemia is concerned about his son's fear and discomfort during chemo. He asks the nurse why the child cannot receive one large dose of a single powerful drug instead of multiple doses of different drugs. After teaching, which statement, if made by the father, is right

different drugs kill cancer cells in different ways, it is especially important for him to receive multiple doses because one of the drugs only kills cancer cells at a particular point in the cell cycle, if multiple drugs are used the cancer is less likely to develop resistance to all of them, My son will experience adverse effects if We receive multiple drugs administered at different times

Before administering ceftriaxone to this client, the nurse should assess for

drug allergies and culture the affected area

St johns wart

for depression, dont take w hiv meds

Enfuvirtide

fusion inhibitor, subcu injections, expensive other two were oral, Guillan barre numbness and tingling

Nephrotoxicic

gentamicin, vancomycin

azt (zidovudine) s/s

gi effects, lactic acidosis

Appearance might change with fat

glucocorticoids and cushings, indinavir

Cancer cells in resting phase

harder to treat

acyclovir treat

herpes 1 and 2, chicken pox, shingles

Chemo strategy

intermittently to give body time to recover

Iv iron

iron dextran

Acyclovir ways to give and their side effects

iv/orally/topically, iv is more toxic, oral causes gi effects, topical causes stinging and wear gloves and throw gloves away

Metformin worried ab

lactic acidosis, not a lot of alc, monitor kidneys

Erythropoietic stimulating agents esa epoetin alfa

last resort, if red blood count is very low

Ethambutol

like alcohol symptoms

Avoid mono therapy

like with tb to prevent resistance

Ast alt

liver

Nadir

most at risk for infection, lowest neutrophil count

Valacyclovir

newer version, less effects

Oral iron

on empty stomach, dont mix w antacids

Ganciclovir

opportunistic, granulocytes and platelets decrease, teratogenic, not for pregnant or children, gloves to handle it

Iron ways to give

oral (gi effects but safer) and iv

Ganciclovir ways to give

orally iv or into eye to prevent blindness in hiv positive people

Gentamicin (aminoglycoside)

oto and nephro

Cephalosporin check for

penicillin allergies

Pyrazinamide

peripheral neuropathy

Indinavir

protease inhibitor, gi effects, hyperlipidemia, watch cholesterol, cause diabetes, fat accumulation

Epogen

red blood cell production

Rifampin

reddish orange secretions

Sulphonylurea glipizides

stim pancreas to secrete insulin, worried about low blood sugar

Filgrastim

stimulates production of white blood cells, treat neutropenia, cause bone pain

Amoxicillin for Uti

take meds with water, continue meds when symptoms resolve, monitor temp and rash/itching/hives

azt (zidovudine)

take when pregnant, viral goes down and cd4 goes up is goal

Isoniazid for

tb (and prophylactically to prevent), first line drug

Liver toxicity with

tb drugs, avoid alc and other nephrotoxic drugs

What causes aching and joints

tendon rupture fluoroquinolones ciprofloxacin and zidovudine

Dont mix w antacids

tetracyclines and iron

Drink water with

uti, sulphonamides

Harder to treat viral bc

viruses need us to survive

Neupogen

white blood cell production

Augmentin/amox

works against beta lactamase

Metformin

works at liver and glucose, not worried ab low blood sugar