Cephalosporin
-broad spectrum
-ceph/cefs
-Similar to PCN/ don't give if PCN allergy
-can cause bleeding w/ other bleeding meds monitor bleeding time
... [Show More] (tonsil story)
- Disulfiram reaction (puke & puke & puke) just like Flagyl, the protozoal drug
- Store in fridge & take with food
ALL antibiotics have these side effects
- allergy, hypersensitivity
- suprainfection
- organ (kidney & ear) toxicity
- lowers OC effectiveness
Vancomyocin
- serious infections like MRSA
- colitis by c-diff
- ototoxicity: get hearing test, tell dr. if hearing getting worse
-given over 60 minutes
Tetracyclines
- Sumycin, Doxycycline (Vibramycin)
- broad, rocky mtn fever, lyme disease, acne, GI infections by H. Pylori
- bad GI discomfort
- Don't give to kids ≤8; teeth permanently yellow
- Bad photosensitivity- wear sunscreen!
- Can't take with milk, iron, or antacids
- Take on empty stomach with a full glass of water
When is Arythromycin given? What class of drugs is it? worse adverse effect?
When pt allergic to PCN and needs abx. Bacteriostatic inhibitor
bad GI issues
Aminoglycosides
ototoxicity, Renal toxicity, Can't take with PCN at all!
- gentamicin, neomycin, streptomycin
TMP-SMZ
-Contains Sulfa
- use for UTI
- Blood problems; get CBC baseline
-photosensitivity wear sunscreen and glasses!
- empty stomach with a full glass of water
Isoniazid (INH)
-antiTB
- take daily for 6-12 months and most likely with other meds too
-worked if 3 neg. sputum cultures, no temp.
- Liver toxicity (hepato) check liver fxn
- Don't take with alcohol (liver fxn remember?)
- Take on empty stomach
Antiviral: Acyclovir, Ganciclovir
Teratogenic preg. X; put on rubber gloves if topical! remember my purple glove experience
-thrombocytopenia, lowers WBC
What class of drugs if Flagyl? What is the weird effect it has?
protozoal. works on C. diff & H. Pylori PUD. Antibuse effect if taken with alcohol
Amphotericin B
anti-fungal. HIGHLY TOXIC
- infusin rxns (fever and chills)
- nephrotoxicity
- hypokalemia
- hepatoxicity
- gynecomasita
- C/I with aminoglycosides (just like PCN)
-azole
Fungal
______ causes malignant hyperthermia. Use ____ to stop it
succinylcholine, Dantrium/Dantrolene.
Morphine adverse effects
-Constipation
-Resp depression
-urinary retention
-Sedation
- Orthostatic HOTN
- Cough suppression
Morphine drug-drug interactions (think of what morphine does to the body)
- MAOIs
-anticholinergics
-CNS depressants
-hypotensive drugs
-opiod antagonists (narcan)
- antihistamines
Morphine patient education re how to take
Take with food for N/V, lie still will help
Opiod withdrawl (stop abruptly is taking ≥6weeks). Is it life-threatening? Will it subside?
sweating, restless, agitated, dilated pupils, tremors, tachycardia, increased BP, N/V, cramps, muscle spasms with kicking movements. NO, subside in 7-10 days.
Migraine medicine & can you take them right after each other?
vasoconstriction, ergot's and triptans. NO, space out ergot and triptan by at least 24 hours.
What pain meds reduces fever?
ibuprofen, tylenol
What pain med reduces platelet aggregation?
NSAIDS (aspirin), reduce thrombus but will bleed easier, too
What pain med reduces fever but has NO anti-inflammatory effect and NO platelet effect?
tylenol
What can give child Reye's syndrome if they have viral illness?
Aspirin
NSAIDS education w/ how to take med. NSAIDS=
with food, milk, or full glass of water to reduce gastric discomfort. Ibuprofen, Celebrex, Naproxen, Aspirin
acetaminophen max dose/day?
4 grams
When to withhold morphine/opiates
RR <12/min & notify Dr
Triptans & pregnancy
Triptan= Teratogenic. Pregnancy X
Rheumatoid Arthritis Drugs name potent toxic drug
DMARDs, 1st choice: methotrexate. Bone Marrow Suppression and Fetal Death
Methotrexate: most concerned about...
bone marrow suppression; Baseline CBC and platelet counts,
What are the s/s of circulatory overload? Seen if giving too much fluids
flush, SOB, cough, heart palpitations
What type of diuretic is not effective in renal failure?
Thiazide - HCTZ
Bumex is ___x more potent than lasix
40
Thiazide diuretics are good for the ___ and perfect for the eldery __ with HTN
bones, woman
Lasix drug-drug interaction: for manic depressive ppl it'll get to toxic levels in the body
Lithium will become toxic
Signs of hypokalemia
weakness, dysrhymias, increased cardiac sensitivity of digoxin, ileus, Flat T wave
Aspirin toxicity symptoms
Tinnitus, HA
Glucocorticoids adverse effects
potent; suppress adrenal glad fxn, hyperglycemia, osteoporosis, if taken with NSAIDS, increase risk of GI ulcer, mask infection and suppress immune system
Reo Pro (-mab) what is it for & adverse effects. What other use does Reo Pro have?
Immunosuppressant for RA, Lupus. toxic to bone marrow, acute pulm edema, infection risk, neoplasia risk. Antiplatelet action.
Classic CNS depressant drug classes and what they're used for
Benzodiazepines, Barbituates. Anxiety.
-lam & -pam are the endings for ________
Benzodiazepines
Benzodiazepine Lorazepam (ativan) increases the possibility of ______.
seizures
Benzodiazepine antidote?
Romazicon 1/2 life of 1 hour
Other anxiolytics: and what they're for
-Valproic Acid: anti-seizure, bi-polar
- Phenergan: NV, anxiety, extrapyramidal effects
Amitriptiyline (Elavil) drug drug interactions and how to take med
Anticholinergics b/c TCA already have anticholinergic effects
- void prior to dosing & take at bedtime to sleep through fatigue side effect
MAOI's ___ line of choice for depression b/c of the adverse effects with _____. If eat _____ will cause an _____ ______
2nd or 3rd, tyramine. Tyramine, hypertensive crisis
MAOI adverse effects are related to stimulation of the _____ and include:
SNS, CNS stimulation,
CV-hypertensive crisis, palpitations, Liver toxicity
1st drugs of choice for depression and are equally as effective as _ _ _ but don't see _____ & ____
SSRI, TCA, hypotension and sedation
SSRI drug examples: prototype and 2 popular drugs
Prozac, Celexa, Zoloft
Atypical antidepressant _______ better use in elderly
Wellbutrin
SSRI uses
depresssion
OCD
bulimia
PTSD
Panic attacks
Social phobias
PMDD
What time of day to give SSRI
Give in the AM for optimal effects
Lithium is used for
Bipolar Disorder
Valproic Acid is used for
Anti-seizure
Lithium and Diuretics
toxicity if taking diuretics
Anti-depressants have ___________ effects
anticholinergic: dry mouth, constipation, lack of sweat, lack of voiding
Antidepressants and anti-anxiety meds may take _ to __ weeks to take effect
1-3 weeks
all anti-depressants have _____ ______ effect and pt must have their __ monitored
orthostatic hypotension. BP
If patient taking an antihypertensive and just got ordered MAOI, Nardil, Marplan, or Parnate, then...
monitor their BP and call the Dr if theres a significant drop and may need to reduce the anti-htn dosage
Lithium and Triptans? Safe in pregnancy?
NO both lithium and triptans are teratogenic
Therapeutic Levels of Lithium
0.4-1.0 mEq/L. Take 2-3 times a day.
Chemotherapy Agents, name as much as you can!
neosar (cyclophosphamide), methotrexate, doxorubicin, tamoxifen
Cyclosporine is an _________
immunosuppressive drug
PTT lab value should stay at >_________ for what medication? What is the therapeutic PTT level?
2 times the baseline, Heparin. 60-80 seconds
To prevent HIT, stop heparin at platelet count of <________
100,000
How to inject heparin, starting from drawing up
draw up with 22-25 ga needle from vial, then use 25 or 26 ga to put into abdomen 2in from umbilicus.
Drug to help with heparin overdose
Protamine Sulfate [Show Less]