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
