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WorksheetsPharm exam 1 part 2
Total questions: 37
Worksheet time: 23mins
Drugs that can cause hypoglycemia HYPOGLYCEMIC UNAWARENESS., masking sympathetic responses
Alcohol
sulfonylureas
glinides
beta blockers
insulin complications
Hypokalemia
Lipohypertrophy
Allergic reactions
Binds with testosterone receptors>enters cell nucleus>new proteins created>desired response
Androgens: Endogenous
Oral Contraceptives
estrogen
MOA: Monoclonal antibody products which modulate immune responses. Tumor necrosis factor alpha inhibitors
Immunomodulators: Inflixamab
5-Aminosalicylates: Sulfasalazine
Nursing considerations for Immunomodulators: Inflixamab
First line for severe disease or perianal Crohn's disease
◦Also used in rheumatoid arthritis.
Has immunosuppressant effects which can put clients at risk for bacterial sepsis, TB, HBV, invasive fungal infections
adverse reactions of Immunomodulators: Inflixamab
Infusion reactions can occur: fever, chills,
cardiopulmonary complications.
Possible increased risk of lymphoma
stroke
◦MOA:Metabolized in the gut to form 5-ASA and sulfapyridine. 5-ASA reduces inflammation in the gut. Used for acute, mild to moderate ulcerative colitis/Crohn's disease.
5-Aminosalicylates: Sulfasalazine
Immunomodulators
◦Actions: Block 5-HT3 receptors in the viscera, causing an increase in colonic transit time, reduced intestinal secretions, more normal bowel pattern with less pain.
◦Alosetron (Lotronex) for IBS-D
◦Lubiprostone (Amitiza) for IBS-C
◦Linaclotide (Linzess) for IBS-C
Metoclopromide (Reglan)
facts
Sedation and diarrhea with high doses
Tardkive dyskinesia (elderly)
◦ORAL for GERD and diabetic gastroparesis
◦IV dosage for post op N&V, chemo, facilitation of small bowel intubation/GI tract.
MOA: Suppresses nerve traffic in the neuronal pathway that connects vestibular apparatus of inner ear to the vomiting center.
◦Scopalamine
Antihistamines
•MOA: weaken the cell wall, causing bacteria to take up excessive water and rupture; bacteriocidal
Penicillins
Azoles
Macrolides
•MOA: bind to penicillin-binding proteins (PBPs), disrupt cell wall synthesis, and cause cell lysis
Cephalosporins
Penicillins
azoles
•MOA: inhibits cell wall synthesis
Cephalosporin
Vancomycin
Penicillin
Macrolides
Adverse effects of Vancomycin
ototoxicity
“red man” syndrome
thrombophlebitis
thrombocytopenia
•Tx of infectious disease
•Tx of acne
•Peptic ulcer disease
•Periodontal disease
•Rheumatoid arthritis
•Mycoplasma pneumoniae
•Lyme disease
•Anthrax
Helicobacter pylori
Tetracycline uses
Macrolides
Penicillins
avoid Tetracyclines with
Calcium supplements, milk products
iron supplements
magnesium-containing laxatives
most antacids
adverse effects of Tetracyclines
renal and hepatic toxicity
•Effects on bone and teeth
Photosensitivity
stroke
•MOA: inhibition of protein synthesis
•Usually bacteriostatic, but can be bactericidal
•Used if patient allergic to penicillin
Macrolides (erythromycin)
Tetracycline
vancomycin
Erythromycin uses
•May be used as alternative to penicillin G in patients with penicillin allergy
Whooping cough
, chlamydial infections
•group A Streptococcus pyogenes
adverse effects of Erythromycin
QT prolongation and sudden cardiac death
superinfections
transient hearing loss
anemias
Clindamycin (Cleocin)Can promote severe Clostridium difficile – associated diarrhea
true
false
adverse effects of Clindamycin (Cleocin)
•CDAD
•Hepatic toxicity
•Blood dyscrasias
unwanted pregnancy
•Bacteriostatic inhibitor of protein synthesis
•Active against multidrug-resistant, gram-positive pathogens (VRE and MRSA)
Linezolid (Zyvox)
macrolides
penicillins
Linezolid (Zyvox) facts
•Drug interaction: monoamine oxidase inhibitors (MAOIs)
•myelosuppresion
(bone marrow suppression)
active against (VRE and MRSA)
bacteriocidal
Aminoglycosides facts
•Nephrotoxicity
•Ototoxicity
•Neuromuscular blockade
•Blood dyscrasia
•Bactericidal
Gentamicin Used to treat which serious infections
•Pseudomonas aeruginosa
•Escherichia coli
•Klebsiella
•Serratia
Gentamicin is Nephro and OTO toxic
true
false
•amikacin is active against the broadest spectrum of gram-negative bacilli and is the least vulnerable to inactivation by bacterial enzymes
true
false
MOA:
•Suppress bacterial growth by inhibiting tetrahydrofolic acid, a derivative of folic acid or folate
Sulfonamides
Macrolides
Gentamicin
Sulfonamides is the DOC for
•UTI
Chlamydia trachomatis
ear infnx
ulcerative colitis
conjugation therapy for toxoplasmosis/malaria
Sulfonamides a/e:
hypersensitivity reactions (Stevens-Johnson syndrome),
hematologic effects
kernicterus
renal damage from crystalluria
•Use: to suppress bacterial colonization in patients with 2nd and 3rd degree burns
Macrolides
Silver Sulfadiazine (Silvadene)
Gentamicin
•Inhibits sequential steps in bacterial folic acid synthesis, making it much more powerful than TMP or SMZ alone
Trimethoprim/sulfamethoxazole (Bactrim)
Gentamicin
Macrolides
Bactrim DOC for
GI infection
UTI
otitis media
bronchitis
PNEUMONIAS
adverse effects of Bactrim
•Hyperkalemia
•GI (n/v)
•Hypersensitivity reactions (Stevens-Johnson syndrome)
•Blood dyscrasias
•Kernicterus
•Renal damage: crystalluria
ototoxic
•Uncomplicated: TMP/SMZ (Bactrim) or nitrofurantoin is the DOC for acute cystitis
true
false
Acute Uncomplicated Pyelonephritis you will give
TMP/SMZ (Bactrim), trimethoprim alone, ciprofloxacin, and levofloxacin
hospitalization and IV antibiotics
