Pharmacology Test 1

fluconazole mechanism of action?

passes into CS fluid and inhibits growth of cryptococcal fungi

which reduces the risk of perinatal transmission via vagina birth in an adolescent who is diagnosed with HIV

using antiretroviral during the intrapartum period

oseltamivir contraindications

Hypersensitivity, pregnancy, breast-feeding, asthma, CAL, renal insufficiency, chronic heart disease

which absorption route is faster for infants

IM

which vaccine is a booster immunization for polio to children?

IPV

when does a child become similar to adults in pharmacokinetic parameters?

1 yr

Aminoglycosides patient education

1. Drink plenty of fluids up to 3000mL 2. Finish ALL Medication course 3. Report difficulty breathing, severe headache, loss of hearing or ringing in the ears or changes in urine production/color. 4. Pregnancy/BF risks 5. Don't drive

most common side effect of azithromycin

diarrhea

Penicillin side effects

diarrhea, nausea, seizures, hypersensitivity reactions

which vaccine is used to prevent HPV infection?

gardasil

pharmacokinetic changes in infants

gastric pH is less acidic, gastric emptying is slow, first-pass metabolism is slow

which anti-infective agent can lead to blindness if not used correctly?

gentamicin

which med has a potential risk of causing hearing impairment in a child?

gentamicin

Cephalosporins contraindications

Allergies to cephalosporins or penicillin, hepatic or renal impairment

Rifampin classification?

Antitubercular

which med can cause nephrotoxicity in burn pts

gentamicin sulfate

rifampin indication?

Active tuberculosis (with other agents). Elimination of meningococcal carriers.

Carbapenem contraindications

Anaphylactic reactions to beta-lactam antibiotics

Penicillin mechanism of action

Antibiotic that works by inhibition of cell wall synthesis.

Tetracycline contraindications

Avoid administration in children younger than 8 and pregnant women (Category D). Use cautiously in patients with liver, kidney disease.

which lab reports would a nurse get before giving an older adult gentamicin for osteomyelitis

BUN and creatinine, electrolytes and urinalysis

Sofosbuvir Contraindications

Because of ribavirin risk, do not use in pregnant women, or men whose female partners are pregnant

Macrolide indications

C. diff, Gonnorhea, Chlamydia

Which lab value is important to monitor in the client who takes zidovudines?

CBC's

which cranial nerve would the nurse suspect is damaged after the client reports buzzing in the ear for 5 days and a decreased ability to hear after long term aminoglycoside therapy?

CN VIII

Which medication is appropriate?

Chlamydia- azithromycin

sofosbuvir indications

Chronic hepatitis C (CHC) infection with genotype 1, 2, 3, 4 as part of combination therapy

which topical meds are used to treat a client with acne vulgaris?

Clindamycin and erythromycin

which use toxoids but not live viruses?

Diphtheria, hep b, pertussis, polio, tetanus vaccine. Diphtheria and tetanus toxoids and acellular pertussis vaccine

Fluoroquinolones indications

Effective against gram-negative aerobic organisms; used to treat a wide range of bacterial infections, including respiratory, GI, GU, bones and joints, skin and soft tissue infections; severe urinary tract infections. Prevention of anthrax (following inhalation of anthrax spores)

Sofosbuvir adverse effects

Fatigue, headache, nausea

Which prescribed med would the nurse anticipate initiating for a client with a CDAD?

Fidaxomicin, metronidazole, vancomycin

Carbapenem side effects

GI distress, skin rash, CNS toxicity (seizures) at high plasma levels

zidovudine indications

HIV, reduction of maternal/fetal transmission

which vaccine would provide protection from precancerous lesions in young women and girls

HPV vaccine

Sulfonamides adverse effects

Hypersensitivity reactions: Stevens-Johnson syndrome Hematologic effects Kernicterus Renal damage from crystalluria

Acyclovir contraindications

Hypersensitivity to acyclovir or valacyclovir; hypersensitivity to milk protein concentrate

Penicillin Contraindications

Hypersensitivity to beta-lactams, seizure disorders, renal impairment

Macrolide mechanism of action

Inhibits protein synthesis by binding to the bacterial ribosome Effective against most gram-positive and many gram-negative bacteria

which vaccine can cause thrombocytopenia?

MMR

vancomycin indications

MRSA, C. diff

Vancomycin nursing implications

Monitor blood work (peak and trough levels and vanco levels), monitor kidney and hearing function; Infuse slowly over 60 minutes (to minimize Red Man Syndrome).

which antibiotics make oral contraceptives ineffective?

Penicillin, TetraCyclines, Cephalosporins ( penicillin bumps the pill, tetracylcines and cephalosporins require child car)

Penicillin Indications

Prevention and treatment of infections caused by susceptible bacteria, such as: Gram-positive bacteria, including Streptococcus spp., Enterococcus spp., Staphylococcus spp.

Acyclovir mechanism of action

Prevents viral DNA synthesis

Sulfonamides: Indications

Treatment of infections caused by gram-negative and gram-positive bacteria

Tetracycline indications

Treatment of various infections caused by susceptible strains of bacteria; acne; when penicillin is contraindicated for eradication of susceptible organisms

Rifampin nursing implications

Warn patients about color change Check for jaundice, light colored stools, N/V, anorexia, fever Monitor LFT *Stop and report if S&S liver damage, colitis Avoid alcohol ↓ effect warfarin and contraceptives

Amphotericin B mechanism of action

acts on fungal cell membranes to cause cell death

which med would the nurse expect to be prescribed to a pregnant teen reporting painful vesicles in the labia minora who is diagnosed with herpes simplex virus?

acyclovir

classification of metronidazole?

anti-infective (antibiotic); and also antiprotozoal

Clindamycin(Cleocin) classification?

antibiotics

Amphotericin B classification?

antifungal

Fluconazole classification?

antifungal

Isoniazid(Isotamine) classification?

antituberculars

Acyclovir classification

antiviral

Oseltamivir classification

antiviral

Ribavirin classification

antiviral

Sofosbuvir(Epelusa) classification

antiviral

Zidovudine(Retrovir) classification

antiviral

Fluoroquinolones adverse effects

aortic aneurysm, hepatotoxicity, seizures, suicidal thoughts, tendon rupture

zidovudine nursing implications

assess changes severity HIV symptoms and monitor CBC

Fluoroquinolones nursing implications

assess for suicidal thoughts, assess for rash or anaphylaxis. (may increase muscle weakness)

Acyclovir Nursing Implications

assess lesions, monitor neurological status. Start as soon as herpes symptoms start

Tetracycline Patient Education

avoid dairy, antacids, and iron supplements

special considerations of isoniazid?

avoid using alcohol(hepatotoxicity); if peripheral neuropathy happen, give B6(pyridoxine)

carbapenems mechanism of action

bactericidal, inhibit cell wall synthesis

Sulfonamides/Trimethoprim mechanism of action

bacteriostatic competitive folic acid inhibitors

Vancomycin(Vancocin) mechanism of action

binds to bacterial cell wall which causes cell death

what puts premature infants at risk for increased sensitivity?

blood-brain barrier, renal drug excretion, hepatic drug metabolism, protein binding of the drugs

adverse side effects of tobramycin

blurred vision, hearing impairment, decreased smell

Which is a sign of life- threatening toxicity of zidovudine in an infant?

bruises over body

why cant you have milk and antacids when on tetracyclines?

can lead to decreased absorption of the medication

Amphotericin B adverse reactions

cardiac dysrhythmias, neurotoxicity, renal toxicity, bone marrow suppression, anemia, hypotension

Ribavirin indications

chronic hep c when combined with other antiviral meds

Carbapenem indications

complicated body cavity and connective tissue infections

which assessment would be done prior to administering vancomycin?

creatining, trough level, hearing, iv site, bun

ribavirin adverse effects

depression, anemia, suppression BM function

Metranidazole (flagyl) mechanism of action

disrupt dna and protein synthesis

special considerations of metronidazole?

don't use alcohol; inhibits warfarin, phenytoin, and lithium.

Sofosbuvir patient education

dont take if history of hbv,

which are severe side effects of DTaP?

encephalopathy within 7 days, immediate anaphylactic reaction

TRUE/FALSE: pneumococcal vaccine is given every year?

false

isoniazid indications

first line drug for treatment of tuberculosis

which vaccine is needed in a 26 yr old who was diagnosed with HIV, has a CD4 count of 150 cells/mm and needs an immunization update

flu, mmr, varicella, and hepatitis a

antibiotics that cause photosensitivity?

fluoroquinolones, tetracyclines, sulfa drugs( fear the sun)

adverse reactions of isoniazid

hepatotoxicity peripheral neuropathy (most common)

Tetracycline Adverse Reactions

hepatotoxicity, diarrhea, pancreatitis

Macrolide(-thromycin) contraindications

hypersensitivity to fidaxomicin or macrolides. Risky when pregnant or breastfeeding

clindamycin adverse reactions

hypotension, stevens-johnson sydrome, C. diff, vertigo

sensitivity

identifies what type of medication needs to be given to treat/ eradicate the infection

culture

identify the type of germs/infection

flucanazole contradictions?

increases effects of warfarin

Oseltamivir indications

influenza prevention or treatment

which vaccine is administered through the intranasal route

influenza(live)

Fluoroquinolones(floxacin) mechanism of action

inhibit DNA synthesis

cephalosporin mechanism of action

inhibit cell wall synthesis

Aminoglycosides mechanism of action

inhibit protein synthesis(30s ribosome)

Sofosbuvir mechanism of action

inhibition of viral replication

Oseltamivir(tamiflu) mechanism of action

inhibits enzyme neuraminidase

Isoniazid mechanism of action

inhibits myobacterial cell wall synthesis

clindamycin mechanism of action

inhibits protein synthesis

ribavirin mechanism of action

inhibits viral replication

Zidovudine adverse effects

lactic acidosis, pancreatitis, seizures, abdomen pain, anemia, weakness, headache

what medication can cause tendon rupture?

levofloxacin

carbapenem nursing implications

may cause hyperkalemia, hyperglycemia, and hypoglycemia

Isoniazid nursing implications

may cause stevens-johnson syndrome

Pharmacokinetic reasons for med sensitivity in infants?

med absorption, renal med excretion, protein binding of drugs, hepatic med metabolism

which substance history of severe allergic reaction results in the avoidance of cephalosporins?

milk, aspirin, calcium, penicillin

Sulfonamides nursing implications

monitor CBC and urinalysis. can increases bilirubin, potassium, and creatinine

oseltamivir nursing implications

must be started within 2 days of symptoms

Ribavirin patient education

must be used with another antiviral med, may cause birth defects

Macrolide adverse effects

nausea, abdominal cramping and vomiting, diarrhea, superinfections, concern about resistant bacterial strains

olsetamivir adverse effects

nausea, seizures, agitation, hallucinations, insomnia

Vancomycin adverse effects

nephrotoxicity, ototoxicity, red man syndrome

when should levofloxacin be taken?

one hour before a meal or 2 hours after

rifampin adverse reactions?

orange color of body fluids, hepatotoxicity.

which medication would a nurse question for a client who has been diagnosed with the flu after having symptoms for 4 days?

oseltamivir

Aminoglycosides adverse effects

ototoxicity and nephrotoxicity

why should tetracycline be avoided in children under 8

permanent tooth discoloration

which vaccines are safe in a child receiving prednisone?

perussis, IP, tetanus immune globulin

Sulfonamides patient education

photosensitivity, follow ups to monitor blood counts, may cause fetal harm

Ribavirin contraindications

pregnancy, males with pregnant female partners

zidovudine mechanism of action

prevents viral replication, inhibits DNA polymerase

Tetracycline mechanism of action

protein synthesis inhibitor (30s) bacteriostatic

Aminoglycoside contraindications

pts with hypersensitivity to bisulfites

which med might damage the cartilage of children?

quinolones

what effects newborn reduced renal med excretion?

renal blood flow, gfr, active tubular secreiton

which condition would a nurse monitor for in the client on aminoglycoside therapy and skeletal muscle relaxants?

respiratory arrest

which vaccine is given orally in children?

rotavirus

which vaccine increases the risk of congenital abnormalities in a developing fetus?

rubella

cephalosporin side effects

stevens-johnson sydrome, anaphylaxis, diarrhea, nausea, rashes

Acyclovir adverse effects

stevens-johnson sydrome, renal failure, diarrhea, nausea, vomiting, phlebitis

which med may cause kernicterus in neonates?

sulfonamides

which response is right when a chronic hepatitis B pt asks "are there any meds to help me get rid of this problem?"

there are meds to help reduce viral load and liver inflammation

why is vancomycin infused slowly?

to reduce the risk of red man syndrome

Aminoglycosides nursing implications

toxicity and overdose. 8th cranial nerve function(hearing)

Metronidazole indications?

treatment of GU, skin, lower respiratory, bone, and CNS infections.

Acyclovir indications

treatment of recurrent genital herpes, shingles, varicella, cold sores

Aminoglycoside indications

treatment of serious gram negative bacterial infections

clindamycin indications

treatment of skin, respiratory, and GU infections; severe acne, bacterial vaginosis

TRUE/FALSE: infants have thinner skin and are at a higher risk for toxicity when transdermal administration is used?

true

TRUE/FALSE: meds have easy access to an infant's CNS

true

TRUE/FALSE: tetanus is safe for a pregnant woman of any gestational stage

true

fluconazole adverse reactions?

use caution in pts with renal and liver dysfunction, increases liver enzymes, nausea

metronidazole contradictions and adverse reactions

use cautiously in first trimester of pregnancy, pts with: kidney, cardiac, fungal or yeast infections. Stevens-Johnson syndrome, optic neuropathy, superinfection, dark urine.

rifampin contradictions?

use cautiously in pts with liver dysfunction; increased metabolism of warfarin, oral contraceptives and NNRITS (results in decreased effectiveness)

adverse effects of aminoglycoside treatment for klebsiella infection

vertigo, tinnitus, dizziness, persistent headache

which condition would result in a high intensity and long duration of response?

when absorption is rapid but elimination