Pharm test 4 study

Ibuprofen is a COX type

1 & 2

Zoster vaccine dose schedule

1 dose for patients 60+

How many liters of fluid should be given on the day you are administering amphotericin B

1 liter

How long after taking doxorubicin could the patient see alopecia

1 week after start of tx to 2 months after last treatment

Nursing care for immune stimulants

< Assess for pregnancy/lactation <monitor CBC <arrange for supportive care/comfort measures for flue-like symptoms <ensure patient is well hydrated during therapy to prevent severe adverse effects

Anti-infective adverse reaction: superinfection

<C-diff <vaginal yeast infections

signs of iron toxicity

<CNS effects leading to coma, death, shock, acidosis

Alkylating agent medications

<Cyclophosphamide <Cisplatin

Non-cytotoxic chemotherapy agent medications

<Flutamide <Tamoxifen <Imatinib

Complications of Imatinib

<GI discomfort <flu-like manifestations <edema <hypokalemia <neutropenia <anemia <thrombocytopenia

complications from colchicine

<GI distress <thrombocytopenia <bone marrow suppression <rhabdomyolysis

Other adverse effects of carbapenems

<GI distress (C-diff, diarrhea) *kills normal flora* <oral thrush <furry overgrowth on tongue <vaginal yeast infection

Adverse effects of salicylates

<GI disturbance blood loss <salicylism <salicylate toxicity <

What can salicylates cause?

<GI irritation <8th cranial nerve stimulation <salicylism

Other major adverse reactions seen when taking tetracyclines is associated with

<GI tract irritation <hepatotoxicity <photosensitivity <superinfection

Griseofulvin adverse effects

<HA <CNS

interferons have reports of

<HTN <arrhythmias <depression <personality changes

What are s/s of anti-hep c agents

<N/D <fatigue <rash <skin reaction

what are all the meds used to tx gouty arthritis?

<NSAIDS <glucocorticoids <colchicine <allopurinol <probenecid

Even though macrolides are used to treat a number of organisms it can also be used for

<Prophylaxis for endocarditis <prophylactically against skin abrasion & acne

Adult immunizations

<Tetanus & diphtheria (Td) <pneumococcal polysaccharide (PPV23) <pneumococcal conjugate vaccine (PCV13) <Hep A/B <influenza <Zoster

What are the lab values would you be watching for signs of leukocytosis?

<WBC > 100,000 <neutrophil >10,000 *may indicate need for decreased dose or withholding medication*

Herpes & cytomegalovirus medications

<acyclovir <ganciclovir

Anti-hep B agents

<adenovirus <etecavir <telbivudine

Foods that contain tyramine

<aged cheese <sausage (smoked/processed meats) <beer

what are the other cautions for interferons

<alter normal function of other systems <CNS depression/alteration

Respiratory virus medications

<amantadine <oseltamivir

Antibiotic meds

<aminoglycosides <carbapenems <cephalosporins <fluoroquinolones <penicillin/penicillinase resistance <sulfonamides <tetracyclines <antimycobacterials <Lincosamides <lipoglycopeptides <macrolides <oxazolidinones

Penicillin/penicillinase resistant medications

<amoxicillin <ampicillin

Other antifungal agents

<amphotericin B <griseofulvin <nystatin

what are some S/E of methotrexate:GI

<anorexia <GI bleed <jaundice <ulcers in the mouth

iron should be taken separate from medications due to them decreasing iron absorption?

<antacids <tetracyclines <cimetidine

What properties does nonsteroidal anti inflammatory is

<anti-inflammatory <analgesic properties

Metronidazole (flagyl) treats

<antibiotic induced C-diff <trichomoniasis (vaginitis spread through sex, male usually has this but has no s/s of it)

Immune suppressants

<assess for pregnancy/lactation status <protect patient from exposure to infections <maintain strict aseptic technique for any invasive procedures <obtain weigh to monitor for fluid retention <monitor temp <monitor pulse & BP to assess for cardiac effects of drugs <assess level of orientation & reflexes (shows any CNS changes associated with drug use)

What kind of nerve damage could you see with a patient taking vincristine

<autonomic nerve injury <peripheral neuropathy

Macrolide medications

<azithromycin <erythromycin <clarithromycin <fidaxomicin

What are the contraindications/precautions

<bleeding abnormalities <chicken/pox flu <pregnancy/lactation

Interleukin actions are

<block activity of interleukin (elevated in response to inflammation & immune response) <believed to be responsible for degradation of cartilage

Cyclophosphamide complications

<bone marrow suppression <GI discomfort <hemorrhagic cystitis

Complications from doxorubicin

<bone marrow suppression <GI manifestations <severe tissue damage <alopecia <cardiac changes (dysrhythmias) <red coloration to urine/sweat (not harmful_

Adverse effects of interferons

<bone marrow suppression <depression <SI

Patient's taking ganciclovir is at risk for

<bone marrow suppression <infertility

Complications of methotrexate

<bone marrow supression <GI <reproductive toxicity <renal damage

Complications of Filgrastin

<bone pain (because cells of bone marrow are increasing) <splenomegaly (because it stores WBC) <leukocytosis

Methotrexate is used to tx

<cancer <lupus <rheumatoid arthritis

Fluoroquinolone medications

<ciprofloxacin <levofloxacin

Lincosamide medications

<clindamycin <lincomycin

Topical antifungals

<clotrimazole (Lotrimin) <miconazole (Mobistar-3)

What are the other adverse effects of aminoglycosides?

<confusion <depression <disorientation <numbness <weakness *think safety*

S/s of autonomic nerve injury if patient is taking vincristine is

<constipation <urinary hesitancy

vitamin B12 medications

<cyanocobalamin <hydroxocobalamin

adverse effects of hydroxyurea

<cytotoxic effects (HA, fever, chills. maybe associated with cell death)

Which of the anti-tuberculosis drugs are offered as a combination of multiple drugs in 1 pill?

<dapsone

Complications of antiprotozoal

<darkening of urine (harmless) <neurotoxicity (seizures, numbness of extremities)

What does the inhibition of COX-2 have the effect of

<decrease pain/inflammation <prevents protective vasodilation

What does the inhibition of COX-1 have the effect of

<decrease swelling, pain, & inflammation <sodium retention, edema, increased BP <GI erosion <decrease fever

Tetracycline medications

<demeclocycline <doxycycline <mini cycling

Immunization nursing actions

<don't use to tx acute infection <arrange for proper preparation & administration of vaccine <check timing & dose of each injection <maintain emergency equipment on standby <arrange for supportive care & comfort measures for flu-like symptoms & injection discomfort <don't administer aspiring to children for tx of discomfort associated with immunizations

What are the medications that fall under the class of carbapenems?

<doripenem <ertapenem <Imipenem <cilastatin

Complications of tamoxifen

<endometrial cancer <hypercalcemia <N/V <thromboembolic events <hot flashes <vaginal discharge/bleeding

erythropoiesis medications

<epoetin Alfa <darbepoetin Alfa <methoxy polyethylene glycol epoetin beta

folic acid/folate

<essential to cell production, prevention of neural tubal defect (spina bifida) in the fetus <supplement for ETOH use disorder due to poor dietary intake

iron deficiency anemia tx drugs

<ferrous (sulfate,fumarate, gluconate) <iron sucrose <iron dextran

Azoles medications

<fluconazole <ketoconazole

With auranofin (gold compound) allergy s/s are

<flushing <fainting <anaphylactic shock

S/s of transfusion reaction (red man syndrome)

<flushing <sweating <hypotension

what should you educate the patient about when trying to avoid mouth ulcers while taking methotrexate

<frequent oral hygiene with nothing that is drying to the mouth (no alcohol based mouth wash) <use a soft toothbrush

Aminoglycoside medications

<gentamicin <neomycin <streptomycin <tobramycin <amikacin

What complications can you see from Flutamide?

<hot flashes <decreased muscle/bone mass <decreased libido <gynecomastia <N/V/D <liver toxicity

What are the other anti arthritis agents

<hyalurondiase derivatives <sodium hyaluronate <leflunomide <methotrexate

Immune suppressants

<immune modulators <T & B cell suppressors <interleukin receptor antagonist <monoclonal antibodies

erythropoiesis adverse effects

<increased BP (increased hematocrit level) <increased risk for thrombotic effect <HA

What are the contraindications for TNF blockers

<infection <cancer <hepatitis *it blocks the body's immune/inflammatory response*

Adverse effects of auranofin (gold compound)

<inflammatory process <bone marrow depression <allergic reactions

Vaginal administration of a monistat 3

<insert high into vagina <keep recumbent for 10-15 minutes after insertion

cyanocobalamin

<intranasal gel/spray preparation is an option <given weekly doesn't remain in the body as long as hydroxocobalamin

Anti-tuberculosis drugs that are first line of tx for tuberculosis

<isoniazid <rifampin <pyrazinamide <ethambutol <streptomycin <rifapentine

Adverse reactions of anti-infective

<kidney damage <GI toxicity <Neurotoxicity <Hypersensitivity/reactions <superinfections

For the complication of endometrial cancer what do you want to do for that if patient is taking tamoxifen

<monitor for abnormal bleeding <yearly gynecological exam

Nursing actions for hemorrhagic cystitis

<monitor for blood in urine <administer Mensa as prescribed (uroprotectant agent that helps reduce hematuria)

Anti-infective adverse reaction: kidney damage nursing actions

<monitor for signs of renal dysfunction <educate importance of keeping hydrated throughout course of treatment (prevents accumulation of drug)

Why is it so difficult to eradicate a virus in a host?

<mutates <viruses have to invade the host cells which would mean we would have to damage the host cell to kil it. Ultimately it does more bad then good.

GI s/e for methotrexate

<n/v (give ondansetron) <ulcers (provide frequent oral care, soft toothbrush, avoid alcohol containing mouthwashes)

Common adverse effects of cephalosporins with the GI tract

<n/v/d <anorexia <abd pain <flatulence

adverse effects of iron deficiency anemia drugs

<n/v/d <constipation <dark stools

What are the nonsteroidial antiinflammatory medications

<naproxen <ketorolac <meloxicam <celecoxib

What are some potential toxicity's found with aminoglycosides

<nephrotoxicity <ototoxicity

Vincristine complications

<nerve injury <severe tissue damage <alopecia

How does it take for salicylate toxicity to occur?

<over time with excessive use <15-20 g built up to cause liver issues or problems with metabolism

S/s of peripheral neuropathy if patient is taking vincristine

<paresthesia <decreased reflex <sensory loss

Preventative measures:

<perform hand hygiene before/after each client contact to prevent spread of infection <recognize invasive procedures have increased risk of infection <encourage up to date immunization status <instruct patient to take full antimicrobials as ordered <use infection control procedures to prevent exposure of resistant micro-organisms

Oxazilidinones used in

<pneumonia <skin structure infections (like staph) <diabetic foot infections without osteomyelitis

Actions of T&B cell suppressors

<possibly block antibody production by B cells <inhibits helper T cells <modifies release of interleukins

Contraindications for immune sera

<pregnancy <patients with coagulation defects, thrombocytopenia <known history of previous exposure to immune sera

Contraindications of immunizations

<presence of immune deficiency <pregnancy <patients with known allergy to any component of vaccine <patient who are receiving immune globulin <patient who has received blood/blood products within last 3 months

Adverse effects of monoclonal antibodies

<pulmonary edema (associated with severe fluid retention) <cytokine release syndrome

Adverse effects of immune sera

<rash, N/V, fever, chills (effect it has on immune system) <chest tightness, falling BP, difficulty breathing (allergic reactions) <swelling, tenderness, pain, muscle stiffness at injection site

What are some possibly s/s you may see at site of injection with TNF blockers

<redness <swelling <itching

Which anti-tuberculosis drugs cause organs discoloration of body fluid that may stain

<rifampin <rifapentine <rifabutine

what drugs increase risk of toxicity when taking methotrexate

<salicylates <NSAIDS

Complications for Cisplatin

<severe N/V (can persist for several days) <renal toxicity <hearing loss

Adverse reactions of amphotericin B

<severe renal impairment (monitor kidney function, give 1 L of 0.9 % NaCl on day of infusion <bone marrow suppression <n/v/d <anorexia <weight loss

what good increases gout?

<shrimp <animal organs

Anti-hep C agents

<simeprevir <sofosbuvir <daclatasvir

Cytokine release syndrome

<starts out as feeling like flue then progresses to fluid shift from intravascular to tissue (risk for shock)

How can resistance be minimized?

<stop giving antibiotics for viruses <complete antibiotic therapy completely <take prescriptions as prescribe to keep therapeutic response

S/s of salicylate toxicity

<tachypnea <excitement <confusion <pulmonary edema <CV/respiratory collapse

education for iron

<take on empty stomach but if GI effects intolerable then take with food <suspension formula can be consumed with a. straw &/or diluted with water to help prevent staining <rinse mouth with after swallowing

Most serious adverse reactions of fluoroquinolones

<tendonitis <tendon rupture <peripheral neuropathy

Salicylism s/s

<tinnitus <N/V <diarrhea <mental confusion <lassitude (tiredness, weakness, lack of interest) <acidosis

Another tx that sulfonamides is used for is

<ulcerative colitis <rheumatoid arthritis

What do you want to watch for with the bleeding abnormalities of anti-platelet properties

<watch stool for blood <s/s of internal bleeding

Serum levels of what are associated with toxicity when taking amphotericin B

>100 mcg/mL

Educate about what with macrolides

Take PO on an empty stomach or if experiencing GI issues take with food.

If you take a corticosteroid & fluoroquinolones together you have the higher risk of?

Tendonitis & tendon rupture

What antibiotic should you assess the patient for a tatrazine allergy?

Tetracycline

If a patient was to go deaf while taking an aminoglycosides, what could that mean?

That it is permanent

an adult client being treated for breast cancer inquired about required vaccinations. what information should the nurse provide to this client?

avoid all live vaccines

what food should be avoided and why with cyanocobalamin

avoid eating hot and spicy food for 1 hour before/after taking. absorption is decreased due to an increase

what are the contraindications of interferons

avoid pregnancy

an older adult client is treated for pneumonia with clindamycin. one week after the completion of the medication, the client develops diarrhea. what is the most probable cause of the diarrhea?

change in normal flora

deferoxamine is a

chelating agent used to tx iron toxicity

immune stimulants can help

clear up viruses

while studying the T- and B-cell immune supressors, the nursing students learn that the most commonly used immune suppressant is:

cyclosporine

what is the action of colchicine?

decrease inflammation caused by gout

taking methotrexate with folic acid does what

decreased the folic acid effects

a female patient is taking oral cyclophosphamide therapy for breast cancer. because of possible adverse effects of the drug, the nurse will instruct the patient to

drink a lot of water

a female patient is taking oral cyclophosphamide therapy for breast cancer. because of possible adverse effects of the drug, the nurse will instruct the patient to:

drink a lot of water

the elderly client returns for a health care visit and asks the nurse why another flu shot was necessary this year because the client got one last year. the nurse's best response is:

each year a new vaccine is developed based on strains most prevalent

iron deficiency drug actions is

elevate serum iron concentration to support RBC production

a nurse is conducting client teaching prior to discharge home. the client is taking ciprofloxacin. what would you teach this client is the best way to prevent crystalluria caused by ciprofloxacin?

encourage at least 2 L of fluid per day

vitamin B12

essential for cell growth, maintenance of myelin sheath in nerve tissue and supports activation of folic acid

what can you take with methotrexate to try to help reduce risk of toxicity?

folic acid

what is another tx for iron toxicity?

gastric lavage helps to remove iron from the stomach

hydroxocobalamin

given IM monthly for life to patients unable to absorb vitamin B12 via GI tract

what should be monitored when giving erythropoiesis

hemoglobin because you don't want any to exceed a level of 11 g/dL

which hepatic viruses can be prevented by a vaccination?

hepatitis A and hepatitis B

a client is diagnosed with rheumatoid arthritis. which medication would the nurse expect the primary health care provider to prescribe?

hydroxychloroquine

immune modulators modify

immune system

educate patient who is taking probenecid to do what to help reduce renal calculi/injury?

increase fluid intake to alkalinize urine

the nurse has been administering interleukins to a client. what change in the client's health status would indicate successful therapy?

increase the number of lymphocytes

a group of nursing students are presenting information on the hepatitis B vaccine. what would the students prepare to tell others about the recommended population?

infants and people at high risk for contracting the disease

allopurinol action is

inhibiting uric acid production

probenecid action

inhibits uric acid reabsorption

what does interferons stimulate?

interferons receptor sites on non invaded cells to produce antiviral proteins which then prevent viruses from entering the cell

immune stimulants include which classification of drugs?

interferons, interleukins

a client has been placed on amphotericin B. the nurse caring for this client should administer this medication:

intravenously

a client is prescribed filgrastim. which is the nurses best explanation of how this drug works?

it stimulates growth and production of WBCs to fight off infection

complications of allopurinol

kidney injury

which medications are used to treat viral infections?

lamivudine, cidofovir, zanamivir, acyclovir, saquinavir, zidovudine

when giving iron dextran you should have what on hand?

life support equipment

what assessment should the nurse perform when monitoring for the most serious adverse effects that can occur with the use of monoclonal antibodies?

lung auscultation

hydroxychloroquine may cause what? what should patient be educated on for this?

may cause retinal damage so educate for eye exams q 6 months

which instruction is appropriate to include in the health teaching for a client receiving anti-infective medication?

medication needs to be taken as prescribed

a client is receiving tamoxifen, an estrogen receptor blocker. which adverse effect would be most specific to the action of this drug?

menopausal effects

interferons

naturally released.in the body by T cells to promote communication between leukocytes

the nurse will apraise the success or failure of treatment of filgrastim therapy by regularly monitorig the results of what diagnostic test?

neutrophil count

If clients receive drugs that are known to induce superinfections, they should be monitored for signs of:

new infection

which intervention should be performed prior to initiating antibiotic therapy?

obtain a specimen for culture and sensitivity

which patients are at a greater risk for liver failure during administration of acetaminophen?

patients who consume alcohol habitually

the nurse is caring for a client receiving amphotericin B. which condition should the nurse assess for in this client?

phlebitis

hydroxyurea

reduces frequency of sickle crisis and reduces need for blood transfusions by increasing availability of effective hemoglobin sites and reducing abnormal hemoglobin

complications for probenecid

renal calculi/injury

interferons prevents virus particles from

replicating inside the cells

Auranofin (gold compound) is reserved for patients who don't

respond to traditional arthritis therapy but should be taken early on

hydroxychloroquine is used to tx

rheumatoid arthritis

a client enters the ED with reports of visual changes, drowsiness, and tinnitus. the client is found to be confused and hyperventilating. these signs and symptoms may be attributable to which condition.

salicylism

T&B cell suppressor are indicated for

Prevention & tx of transplant rejection

Fluoroquinolones are approved for what kind of tx

Prevention of anthrax infection

Use of aminoglycosides

Tx serious infections caused by gram-negative aerobic bacilli

First medication of tx for osteoarthritis is

Tylenol

What are you more likely to get from cox-1 non steroidal anti inflammatories

Ulcers

a client is prescribed ibuprofen for knee pain. when the client is admitted to the hospital with abdominal pain, which assessment should the nurse prioritize?

assessment for hematemesis

Anti-infective adverse reaction: hypersensitivity/reactions

May range form delayed response to anaphylaxis

Immune serum is

Preformed antibodies

The five generations of cephalosporins are generally building off

Previous generation in regard to organisms treated

With Azole medications you should assess for

S/s of hepatotoxicity

iron dextrase (IV/IM) adverse effects

associated with anaphylaxis risk especially if given IV

Carbapenems ten to exacerbate what condition?

Seizures

Class of aminoglycosides

Bactericidal

What is the action of the carbapenems?

Bactericidal

Due to the risk of infertility when giving a patient ganciclovir, you should educate them on

Barrier contraception during and after tx for 3 months

Penicillin/penicillinase resistant was the first

Clinical use antibiotic

Pregnancy regimen if patient needs anti-tuberculosis is

Combo of isoniazid,ethambutol, rifampin are the safest route

What is an example of being in a state of chronic inflammation

Lupus

Anti-infective adverse reaction: GI toxicity

*Common & probiotics can help replace flora S/S: n/v/d or upset stomach

Lincomycin is similar to

Macrolides and if patient doesn't respond to lincomycin's then you can give them macrolides

Another tx for methotrexate is

Management of RA (more likely use for this drug)

Amnioglycosides suffix

"-cin"

What is the suffix of non-steroidal anti inflammatories

"-profen"

a parent hears the health care provider using the word extravasation. the parent asks the nurse what this word means. what would be the correct answer?

"extravasation is when fluid escapes from a blood vessel into the surrounding tissue"

a female client has been admitted to the ED in distress and the nurse's review of the clients medication admin record reveals that the client take cyclosporine. what is the nurse's most appropriate assessment question for the client's family members?

"has she ever been the recipient of a tissue transplant?"

a client diagnosed with iron deficiency has been taking oral ferrous sulfate for the past several days. when the nure is assessing for therapeutic effects, what question is most warranted?

"how is your energy level compared with a few days ago?"

the nurse is teaching a client with HIV about his new antiretroviral drug regimen. which client statement would suggest that the teaching plan was effective?

"i might experience some nausea and vomiting while taking these medications"

A client with a fungal infection has been prescribed a miconazole vaginal suppository. What education should the nurse provide about safe and effective administration?

"if possible lie down for 10-15 minutes after inserting the medication"

which statement by a client receiving gold salts indicates understanding of the drug therapy?

"these drugs will help prevent further damage from my disease"

the client has just begun taking metronidazole and calls the clinic to report that her urine has turned very dark. what is the nurse's best response to this client?

"this is an expected side effect. your urine color will return to normal after you stop taking this drug"

Naproxen is a COX type

1

If a patient has a chronic condition when should they receive the PPSV23?

19-65

Celecoxib is a COX type

2

Hep A vaccine dose schedule

2 doses 6-18 months apart

a client with rheumatoid arthritis has been prescribed a gold salt. what medication should the nurse look for on the clients med admin record?

auranofin

At least how many antiviral dugs used to attack HIV virus at various points of its life cycle

3

Hep B vaccine dose schedule

3 total doses, 1 month between dose 1 & 2 followed by another dose 3 months after dose 2 (you want 4 months total between dose 1 & 3)

How long should you monitor a patient for a penicillin allergic reaction after giving the med?

30 minutes (penicillin sensitivity panel available)

What is the max amount you can give acetaminophen for a healthy adult

4 g/day

Most topical agents should not be used for longer than how many weeks and why?

4-6 weeks due to possible emergence of resistant strains of fungi

a nurse is preparing to administer amoxicillin 30 mg/kg/day in 2 equally divided doses Q 12 hrs to a toddler who weighs 33 lbs (15 kg). A: amoxil 200 mg/5mL suspension. How many mL should the nurse admin? (round to nearest tenth.)

5.6 mL

How many classes total for antivirals used to tx HIV/AIDS

6

how long after taking methotrexate should you wait to conceive

6 months

Pneumococcal polysaccharide (PPSV23)/pneumococcal conjugate vaccine (PCV13) should be given to what age range

65+

How long after taking cephalosporin should you avoid alcohol for?

72 hours (associated with disulfiram like reactions, makes alcohol taste like shit)

with arthiritis you experience s/s in what range

8-9

Topical agents are not

Absorbed systemically and assess for localized reactions/discomfort

What is the antidote for acetminophen

Acetylcysteine

What should happen if an adult receives a dose PPSV23 before age 65

Administer 1 dose of PPSV23 at least 5 years after previous dose

What should be assessed when a patient is taking sodium hyaluronate?

Allergies to animals, mostly chickens

What should you assess a patient for before giving salicylates

Allergies to salicylate, NSAIDS, tartrazine

What medication should be administered with methotrexate

Allopurinol

What specific drug of the class aminoglycosides have a really high risk of nephrotoxicity & ototoxicity?

Amikacin

If patient is allergic to penicillin what antibiotic might be a better choice for them?

Aminoglycosides

Flutamide

Androgen receptor blocker (blocks testosterone)

Influenza vaccine dose schedule

Annually

Antimitotic/mitosis inhibitor kills

Cells as process of mitosis occur

Interleukins stimulate

Cellular immunity & inhibit tumor growth

Assess for what allergies of when giving penicillin/penicillinase resistance medications

Cephalosporin

What is the main bleeding abnormality experienced with salicylates?

Anti- platelet properties (bleeding gastric ulcers)

What doesn't acetaminophen not have

Anti-inflammatory properly

What is the action of salicylates

Anti-pyretic & analgesic

Dapsone

Antibiotic to treat leprosy, pneumocystitis pneumonia in AIDS & brown recluse spider bites. Also inhibits folate synthesis

Immune serum can be

Antibodies to toxins, venoms, bacteria, virus, or even RBC antigenic factors

Immune sera is very specific to

Antigen they respond to

Filgrastin is the first to

Arrive in sites of inflammation

Salicylates

Aspirin

Interleukin adverse effects

Associated with effect on the body during inflammation

Monoclonal antibodies

Attach to specific receptor site & covid tx

Antiarthritic agents

Auranofin (gold compound)

Contraindications for interleukins

Avoid pregnancy due to teratogenic effects found in the animal study. Educate & encourage use of contraceptives while taking this medication.

Reproductive toxicity complication with methotrexate

Avoid pregnancy while taking med & 6 months after

Combo of penicillin with either tetracycline or aminoglycosides should be

Avoided because tetracycline decreases effectiveness of PCN. With aminoglycosides the PCN inactivates it.

Antifungal agent class

Azoles

Why when patient's are taking anti-her B agents are they encouraged not to run out of their medications?do these medications cure the disease?

Because these specific meds help lessen the S/S of hep b. It's also not a cure, the patient is still able to transmit hep B to someone else.

Salicylates are able to

Block inflammatory response

How is decreased inflammatory response achieved with non-steroidal ant-inflammatory medications?

Blocking the cox

How is the specificity of an anti-infections determined?

Blood cultures

Colony-stimulating factors stimulates

Bone marrow to produce more WBC's

What type of antibiotic is fluoroquinolones

Broad spectrum

Until clinician can ID organism causing infection, they usually give

Broad spectrum antibiotics

Metronidazole (flagyl) is a

Broad spectrum antimicrobial

Why should you caution use of tetracyclines in young children?

Can damage their bones & teeth (below 7 to 10 years of age)

Anti-infective adverse reaction: neurotoxicity

Can interfere with nerve tissue function in high concentrations

Cytotoxic chemotherapy kills

Cancer cells and health cells (includes skin, hair, intestinal mucosa & hematopoietic cells)

Nystatin used to tx

Candidiasis (thrush)

Treatment duration for anti- tuberculosis drugs

Continued for 6 months - 2 years

How does sodium haluronate provide relief to the patient

Cushions & lubricates joint which relieves the pain that is associated with degenerative arthritis

Common T&B cell suppressor

Cyclosporine

Ganciclovir treats

Cytomegalovirus

Antimetabolites inhibit

DNA production

What else does auranofin (gold compound) cause

Decreased leukocytes which means more risk for infection

Salicylism is r/t

Difficulty hearing

If patient consumes alcohol while taking antiprotozoal it can lead to

Disulfiram-like reaction (makes alcohol taste like shit)

Anti-tumor (anti-neoplastic) antibodies

Doxorubicin

You should always do what before starting an antibiotic

Draw cultures

Anti-infective agents are

Drugs that target foreign organisms that have infected the body but don't possess total selective toxicity

What is another way Immune sera is used

Early tx following exposure

Cyclophosphamide (nitrogen mustard)

Effective against a broad spectrum of neoplastic diseases

Why & how should tetracyclines be taken?

Empty stomach to promote absorption

A dentist should be notified if they are taking a macrolide for prophylaxis treatment for

Endocarditis

Tamoxifen

Estrogen receptor blocker

How is the carbapenems excreted & what kind of toxicity does it have?

Excreted unchanged in urine and can be toxic to the kidney. Test kidney function regularly.

Severe tissue damage possible is what with doxorubicin

Extravasation

You are at risk for developing what with TNF blockers?

Fatal infections & cancers

Colony-stimulating factor medication

Filgrastin (IV or SQ)

Encourage patient to increase what when taking methotrexate

Fluid intake

Sulfadiazine inhibits

Folic acid synthesis (necessary for cell reproduction/growth)

The length of a administration for aminoglycosides is

For at least 2 days after s/s resolve to decrease development of resistant strains

Fluconazole treats

Fungal/yeast infections

What does the COX-2 nonsteroidal antiflammatories support?

GI

Other adverse effects of vancomycin is r/t

GI tract (including taste alterations)

Why is it difficult to tx infections in patients who are immunocompromised?

Greater risk of toxicity

Anti-mycobacteria's

Group of bacteria that cause tuberculosis & leprosy. They have an outer coat of acid that protects them and allows them to survive for long periods of time.

Penicillin/penicillinase resistant is a

Group of drugs resistant to penicillinase that allows them to remain effective against organisms that have developed a resistance to penicillin ( give nafcillin, oxacillin)

Oseltamivir (tamiflu)is effective in treating

H1N1

Many adverse effects of cytotoxic chemotherapy agents are related to

Hair loss & immune suppression

Acyclovir treated

Herpes & varicella-zoster viruses

With the risk of nephrotoxicity you should educate the patient to do what to help minimize the risk

Hydrate

With acyclovir you should promote

Hydration to minimize nephrotoxicity

sickle cell anemia medication

Hydroxyurea

If a patient has a known history of previous exposure to immune sera it can increase risk of

Hypersensitivity reaction that occurs with each use

Renal damage s/e when methotrexate is related to

Hyperuricemia secondary to tumor lysis (secretes Uric acid after tumor death)

Amphotericin B is only giving by what route

IV

What does interleukins increase activity of

Immune cells & cells involved in the inflammatory process

Adverse effects of interferons are associated with stimulation of

Immune response, flue like symptoms because you have increased immune drive

Adverse effects of immunizations are associated with

Immune/inflammatory reaction

What does Filgrastin help reduce

Incidence of infection

Tyramine is an amino acid that helps

Increase BP

What type of infection is an aminoglycoside indicated for

Infections susceptible to penicillin when penicillin is contraindicated

Methyltrexate is first used to treat

Inflammation & preserve integrity of joint

Hemorrhagic cystitis

Inflammation of bladder involving bleeding & dysuria

Serum sickness

Massive immune reaction manifested by fever, arthritis, flank pain, myalgia, arthalgia

Cisplatin (platinum compound)

Interrupts DNA/RNA synthesis

Indication for treatment with carbapenems is

Intra-abd, urinary tract, skin, bone, joint, gynecological infections

With acetaminophen you should educate the patient about

It's found in a lot of OTC drugs. They need to be cautious as to what is in the medication they take to avoid an overdose.

Disease-modifying antirheumatic drugs (DMARDs) slows

Joint degeneration

For the complication of splenomegaly with Filgrastin you should assess

LUQ for pain

Patient has a potential for what when combining linezolid with large amount so tyramine containing food

Life-threading HTN

Oxazilidinones

Linezolid

What should be avoided while taking TNF blockers?

Live vaccines because the body can't respond to virus/agent like it should be able to

When rifampin & INH are combine the patient will have an elevated risk for what toxicity

Liver

Acetaminophen can cause what kind of toxicity

Liver so use with caution in patient's with a hx of chronic alcoholism

Acetaminophen increases what kind of toxicity

Liver toxicity

What is the use of auranofin (gold compound)

Long term therapy of rheumatic disorders

If you take a aminoglycoside what type of diuretic is contraindicated and why?

Loop because both have ototoxicity possibility

Adverse effects of sulfonamides are r/t to

Loss of normal flora & GI tract irritation

Adverse effects of penicillins are related to

Loss of normal flora (n/v/d, yeast infection)

Antimetabolite medication

Methotrexate (folic acid analog)

Antiprotozoal medication

Metronidazole (flagyl)

Monitor for what & why with vancomycin?

Monitor ECG because of risk for prolonged QT interval (ventricular contraction related)

Suffix of disease-modifying antirheumatic blockers is

Most end in "-mab" exception is etanercept

Salicylism occurs usually with overdose and s/s are

N/V/D

initial therapy for gouty arthritis

NSAIDS then glucocorticoids

a nurse is caring for a client in the early stage of rheumatoid arthritis. the nurse would expect which medication classification to be used in the treatment of this client?

NSAIDs

Alkylating agent

Non cell cycle specific

How can you evaluate for patient's clinical improvement

Notice clear breath sounds & resolution of fever

What are the nursing actions when trying to reduce risk of infusion reactions for amphotericin B and what should you assess for

Nursing action: pretreat with diphenhydramine & acetaminophen as prescribed (tx's possible fever, chills, HA) Assess for:thrombophlebitis (why you give in a large vein)

Another infection macrolides can be used for is

Ocular infections

Best way to take a penicillin is

On an empty stomach

Both ketoconazole & fluconazole are used as

Prevention & tx of fungal infections

What kind of patient is cox-2 nonsteroidal anti inflammatory mostly prescribed for

Ortho patients

Another risk a patient has if taking vancomycin is

Ototoxicity if taking it with other meds how have the same adverse reaction

What is the order that PPSV23 & PCV13 should be given

PCV12 first then PPSV23 6-12 months later

Agents for HIV/AIDS

PREP

What type of immunity is provided with immune sera?

Passive

Be sure to have documentation before the start of therapy with immune modulators of what

Patient is not pregnant

Chrysotherapy is reserved for

Patients not responding to conventional therapy

Fluoroquinolones have an adverse effect of what so you should educate patient on what?

Photosensitivity (possible skin reaction) advise patient to avoid sun & UV light exposure (wear protective clothing & sunscreen), avoid being outside for 10 am to 3 pm.

What does inhibition of COX-2 allow

Platelet clumping which can lead to MI, CVA

Amphotericin B is very what and reserved for what?

Potent with manny adverse reactions and reserved for potentially fatal infections

Be sure to educate the patient on the proper way to what when giving griseofulvin

Proper way to apply

What prescription could be written to go with anti-infective agents

Prophylactic prescriptions

NSAIDs block

Prostaglandin synthesis of COX-1/2 sites by doing this it blocks inflammation but also blocks protection of stomach lining and the kidney's regulation of water

Salicylates block

Prostaglandins activity which decreases inflammatory response & relieves the s/s of inflammation

Flutamide is used to tx

Prostate cancer

Td given

Q 10 years

Goal of anti-infective therapy is to

Reduce organism enough for immune response to complete the job

Immune modulators block

Release of substances involved in inflammatory response which results in immunosuppression

Monitor what when taking penicillin drugs?

Renal function (excreted unchanged in the urine)

Why should amantadine be used cautiously in what kind of patients & why

Renal patients because excreted in urine unchanged

Oseltamivir (tamiflu) should be given cautiously in

Renal patients because its metabolized by renal system

What doesn't Chrysotherapy do

Repair damage

Why is tetracycline use been decreased?

Resistance & toxicity in large douses

Aspirin is not recommended for children because of the risk of

Reye's syndrome

Hep C antigens are combinations with

Ribavirin & peginterferon

When should you not take tetracyclines?

Right before lying down because of esophageal ulceration risk

Cephalosporins are similar to what drug? What should you assess?

Similar to penicillins so you should assess for penicillin allergen

Do not give clotrimazole (lotrimin) if

Skin is broken

Leflunomides will

Slow disease progression but will not repair

How is most TNF blockers administered and what is the exception

Sq except for Etanercept, it is done IV

Imatinib

Stops cancer growth by inhibiting intracellular enzymes

Tamoxifen

Stops growth of breast cancer

By looking at the name sulfonamides, what allergy should you assess for before administering?

Sulfa allergies

Sulfonamide medication

Sulfadiazine

What medication is not widely used for its anti infective property due to many strains having developed resistance?

Sulfonamide.

Anti-hep B agents help

Suppresses exacerbations and are also anti-virals

What does sulfonamides prevent

Synthesis of folic acid in susceptible bacteria that needs folate for production of RNA & NA

What does salicylates inhibit

Synthesis of prostaglandin

When giving HIV/AIDS medications monitor what to help determine the effectiveness of the medication therapy

T-cells

What kind of blocker is disease-modding antirheumatic drugs consist of

Tumor necrosis factor blockers (TNF blockers)

Griseofulvin

Tx of ringworm, athlete's foot

Educate your patient who is taking vancomycin to notifying the physician if

They notice their urine starts to foam & if red man syndrome is experienced

Chrysotherapy can be

Toxic

Vancomycin has what kind of reaction

Transfusion reaction (red man syndrome) only with rapid infusion of medication

Miconazole (monistat-3) given by what route and how long for absorption

Vaginal, 15 minutes for absorption

Lipoglycopeptide medications

Vancomycin

Antimitotic/mitosis inhibitor

Vincristine

Hyaluronidase is administered how

Weekly injections x3

What is the administration for sodium haluronate

Weekly injections x5, injected directly into the patient's joint who have severe rheumatoid arthritis of knee

When is no additional dose needed when given PPSV23 & PCV13

When an adult has received a PPSV23 dose at 65+

Inflammatory response for auranofin (gold compound) depends on

Where gold deposits take place (dermatitis, pharyngitis, gingivitis)

Salicylism can occur

With high levels of salicylates

whuch client would likely be the most appropriate candidate for treatment with filgrastim?

a client whose acute myelogenous leukemia necessitated a bone marrow transplant

a nurse is aware that the concept of selective toxicity is foundational to antimicrobial therapy. which statement most accurately describes selective toxicity?

a drug harms microbes without harming human cells

a nurse has administered a prescribed dose of acetaminophen to a hospital client with a fever. this medication will reduce the client's temperature by what means?

acting directly on the hypothalamus to cause vasodilation and sweating

what kind of gout attacks does colchicine tx?

acute gout attacks

colchicine can be added with what med

allopurinol

a drug that does not exactly cause the death of a cell but does interfere with its ability to reproduce is said to be:

bacteriostatic

a client has been prescribed methotrexate. the nurse should caution the patient against using which OTC medication? a. milk of magnesia b. acetaminophen c. aspirin d. calcium carbonate

c. aspirin (rationale- Salicylates decrease the renal clearance of methotrexate, resulting in an increased risk of methotrexate toxicity)

what food products reduce iron absorption?

caffiene and dairy products

what else does erythropoiesis support

cancer growth

which NSAID appears to work by specifically inhibiting cyclooxygenase-2 (COX-2) without inhibiting COX-1?

celecoxib

a patient taking tamoxifen to reduce the risk of contralateral breast cancer asks the nurse about adverse effects of the drug. what is an adverse effect of tamoxifen?

cerebrovascular accidents

when monitoring the therapeutic efficacy of allopurinol therapy, the nurse should prioritize the results of what diagnostic test?

serum uric acid levels

the home care nurse is caring for a female client who underwent renal transplantation 8 weeks ago and is self-administering immunosuppressant drugs. what situation in the client's life is the greatest cause for concern?

she runs a sick child daycare

it is common practice to draw culture and sensitivity tests to determine the most effective antibiotic that will treat the causative agent of the client's infection. what does "culture" determine?

specifically what organism is causing the infection

erythropoiesis

stimulates RBC production in bone marrow which is commonly associated with clients in renal failure. maybe given prophylactically in preparation for surgery

erythropoiesis is what kind of agent?

stimulating

why should you monitor for s/s of infection

suppresses immune response

a client has been diagnosed with sever rheumatoid arthritis, and sodium hyaluronate has been ordered. what is the nurse's best action?

teach the client that an injection in the joint will be required

the nurse is caring for a client who is taking ciproflaxcin, a fluoroquinolone, for treatment of otitis externa. the nurse instructs the client to notify the health care provider immediately if the client experiences what symptoms?

tendon pain

a man who was working on his deck comes to the ED after sustaining a puncture wound of his hand from a large nail. which would the nurse expect to administer?

tetanus toxoid

a nurse is assigned to care for a client with tuberculosis who has been prescribed rifampin. what should the nurse confirm to be sure that rifampin is not contraindicated in the client?

the client does not have renal impairment

what assessment finding would signal the nurse to the possibility that the client's infusion of vancomycin, a glycopeptide, is infusing too quickly?

the client is flushed and has a visible skin rash (red man syndrome)

for patient to avoid kidney injury while taking allopurinol you should educate about

the need to increase their fluid increase

a patient began treatment with interferon alfa-2a several days ago and the care team is pleased with the patient's response at this point in treatment. however, the patient has stated to the nurse that he feels increasingly despondent and claims to have lost all hope of recovering from his disease, despite being an optimistic person. how should the nurse best interpret the patients statements?

the patient may be having psychological adverse effects on interferon alfa-2a

the college health nurse is providing education for freshmen. which piece of information about immunizations is applicable to individuals of this age group?

the yearly administration of flu vaccine is recommended

hydroxyurea interactions

uricosuric agents have decreased effects leading to increased uric acid levels

what can increases iron absorption and increase GI symptoms?

vit C

An HIV-positive patient has been taking nevirapine for 9 weeks. what clinical manifestation best indicates to the nurse that the patient is experiencing hepatotoxicity from this medication?

yellow sclera