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NUR 210 Exam 4 Study Guide
Principles of Pharmacology - Galen
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- Amoxicillin: class, MOA and use: - penicillin -inhibits bacterial cell wall synthesis
- respiratory infections, otits media, H. pylori, E. coli
- Amoxicillin side effects and adverse reactions: Side effects: rash, dermatitis, stomatitis, dizziness
Adverse reactions: thrombocytopenia, angioedema, anaphylaxis, SJS, superinfec- tions
- Amoxicillin pt teaching and nursing interventions: Pt teaching: -use alternate form of birth control -injest probiotics -avoid acidic -take w food
Nursing intervnetions:
-obtain culture and sensitivity -monitor renal and liver functions, urinary output, CBC, VS, bleeding -administer over 30mins
- Ceftriaxone: class, MOA and use: -cephalosporin -prevents bacterial cell wall synthesis, bacteriocidal
- STIs, Otitis Media, Skin/Bone Infections, Surgical Prophylaxis
- Ceftriaxone side effects and adverse reactions: Side effects: epitaxis(nose bleed), rash/dermatis, stomatits
Adverse reactions: bleeding/anemia, renal failure, hepatotoxicity, SJS
- Ceftriaxone pt teaching and nursing interventions: Pt teaching: -avoid loop diruectics and anatcids -report changes in skin -ingest probiotic -teach stomatitis managment oral: take w food
Nursing interventions: -Obtain Culture & Sensitivity -Assess for PCN allergy. -Monitor liver -Monitor for bleeding.
- Gentamicin side effects and adverse reactions: Side effects: confusion, tremors, stomatitis, photosensitivity, tinnitus, vitamin B6/12 deficiency
Adverse reactions: Ototoxicity, Nephrotoxicity, Peripheral Neuropathy, pancytopenia
- Gentamicin pt teaching and nursing interventions: Pt teaching: -Increase fluid intake -Ingest a probiotic. -s/s of superinfections. -Report changes in hearing or dizziness. -Consider Vitamin B supplementation. -Monitor UOP - report any decreases. -Deactivates OCP -use alternate birth control.
Nursing interventions: -Obtain C & S. -Monitor for Nephrotoxicity (BUN; CRT; UOP; Urine Changes) -Ototoxicity. -Monitor Vitals.
-Monitor peak and trough serum levels. -Vit. B deficiency. -Limit to 10 days.
- Doxycycline: class, MOA and use: -tetracycline -Blocks bacterial protein synthesis - bacteriostatic or bactericidal depending on dose -acne
- Doxycycline side effects and adverse reactions: Side effects: tooth/nail dis- coloration, liver enzymes elevation
Adverse reactions: hepatotoxicity, superinfections, SJS
- Doxycycline pt teaching and nursing interventions: Pt teaching: -Avoid calcium products, sun exposure -s/s superinfection -ingest probiotic. -Report changes in skin. -Avoid co-administration with iron. -take w food -Increases effects of warfarin and digoxin -not for kids under 8 or pregnant women Nursing interventions: -monitor renal/liver function, potassium levels
- Ciprofloxacin: class, MOA and use: -fluoroquinolones -Inhibits bacterial DNA, bacteriocidal -systemic infections, UTIs, respiratory infections, stds, skin/joint/bone infections
- Ciprofloxacin side effects and adverse reactions: Side effects: tinnitus, dizzi- ness, blood glucose changes, tendon rupture, photosensitivity
Adverse reactions: hepatotoxity, nephrotoxicity, increased ICP, ECG changes, hy- perglycemia, pancytopenia,
- Ciprofloxacin pt teaching and nursing interventions: Pt teaching: -take on an empty stomach w/ full glass of water -report joint pain, changes in skin or urinary output -Ingest probiotic -s/s superintection. -Do no take with calcium products. Increase fluids -Diabetics need to monitor BG levels
Nursing interventions: -culture and sensitivity -monitor CBC, renal and liver function, cardiac rhythm, and BG
- Trimethoprim/Sulfamethoxazole: class, MOA and use: -sulfonamide -Inhibits folic acid synthesis and protein synthesis of nucleic acids; bactericidal
effect. -uti's, MRSA, respiratory infections, otitis media,
- Trimethoprim/Sulfamethoxazole side effects and adverse reactions: Side effects: stomatitis, photosensitivity, crystalluria
Adverse reactions: pancytopenia, rhabdo, renal failure, hypoglycemia
- Trimethoprim/Sulfamethoxazole pt teaching and nursing interventions: Pt teaching: -take on empty stomach w/ full glass of water -report muscle pain/discomfort -increase fluids -ingest probiotic
Nursing interventions: -culture and sensitivity -monitor CBC, BG, kidneys, I's & O's, -increase fluids to 2L/day
- Fluconazole pt teaching and nursing interventions: Pt teaching: -no ETOH
Nursing interventions: -Monitor liver and renal function
- Acyclovirn: class, MOA and use: -antiviral -Inhibits viral DNA synthesis and viral replication. -herpes
- Acyclovir side effects and adverse reactions: Side effects: lethargy, crystal- luria, orthostasis
Adverse reactions: liver or renal failure, blood dyscrasia, parathesia, neuropathy
- Acyclovir pt teaching and nursing interventions: Pt teaching: -Begin taking at the first sign of outbreak. -Increase fluids -Report skin changes.
-Wear gloves or finger cots when applying
Nursing interventions: -monitor renal/liver functions -encourage fluids -monitor CBC, neuro status, and VS (BP)
- Metronidazole: class, MOA and use: -peptide -Disrupts the bacterial DNA, bacteriocidal
- sti's , c. diff, skin/respiratory infection
- Metronidazole side effects and adverse reactions: Side effects: metallic/bitter aftertaste
Adverse reactions: bone marrow suppression, hepatotoxicity
- Metronidazole pt teaching and nursing interventions: Pt teaching: -NO ETOH 72hrs while on/ after discontinuing med -IR: w/ food -ER: empty stomach Nursing interventions: -monitor CBC, liver/renal function
- Nitrofurantoin: class, MOA and use: -urinary anti-infective -May be bacteriostatic or bactericidal, depending on the drug dosage. -Acute and Chronic UTIs and Cystitis
- Nitrofurantoin side effects and adverse reactions: Side effects: brown urine discoloration
Adverse reactions: chest pain, neuropathy, c. diff
Adverse reactions: nephrotoxicity and hepatotoxicity
- Phenazopyridine pt teaching and nursing interventions: Pt teaching: -Not indicated for long-term use, limit to 2-3 days. -Follow-up with HCP to obtain ABT. -Anticipate urine discoloration BUT report changes in urine output.
Nursing interventions: -Monitor renal/liver functions
- Promethazine: class, MOA, and use: -antiemetics: phenothiazine -blocks one site in stomach (histamine receptors) and one site in brain (dopamine CTZ) to suppress vomiting reflex -suppress vomiting reflex
- Promethazine side effects and adverse reactions: Side effects: anticholiner- gic effect (high and dry), photosensitivity, drowsiness/sedation
Adverse reactions: EPS Syndrome/ Pseudoparkinsonism, seizures, respiratory, CNS depression (dizzy, drop in BP)
- Promethazine pt teaching and nursing interventions: Pts teaching:
Nursing interventions: -monitor liver
- Metoclopramide: class, MOA, and use: -misc. antiemetic -blocks dopamine receptors in CTZ (chemo trigger zone: area of brain responsible for triggering vomiting) to block vomiting, increases speed of gi motility -nausea and vomiting
- Metoclopramide side effects and adverse reactions: Side effects: dizziness, drowsiness, diarrhea
Adverse reactions: EPS Syndrome/ Pseudoparkinsonism (very common in kids) suicidal ideation, seizures
- Metoclopramide pt teaching and nursing interventions: Pts teaching: -take 30mins before meals -avoid driving, etoh, and cns depressants -report increase in bowel movements -report EPS symptoms -monitor mood status Nursing interventions:
mouth, confusion, constipation, anticholinergic
Adverse reactions: respiratory depression, paralytic ileus (portion of colan is asleep, causing backage),
- Diphenoxylate/Atropine pt teaching and nursing interventions: Pts teach- ing: -fluid and electrolyte management -no driving, change positions slowly -report constipation -report changes on respiratory function -contact HCP if diarrhea last longer than 48hrs -increase fluids
Nursing interventions:
- rule out acute Gi infection -avoid in pts w glaucoma
- Bisacodyl: class, MOA, and use: -laxatives stimulate -increases peristalsis by direct stimulation of intestinal smooth muscle -constipation, bowel prep (empties colan)
- Biscodyl side effects and adverse reactions: Side effects: diarrhea, ABD cramping
Adverse reactions: dependency, fluid and electrolyte balance
- Biscodyl pt teaching and nursing interventions: Pts teaching:
- rectal form works faster -indicated for short term use only -notify HCP if severe ABD cramping/diarrhea occurs -non pharmacological methods
Nursing interventions:
- assess Gi function, fluid and electrolyte balance
- Epoetin alfa: class, MOA, and use: -erythropoietin stimulating agents -stimulates RBC production in the bone marrow -increases hemoglobin (red blood cells) levels in pts w chronic anemia (goal is prevent need for blood transfusions)
- Epoetin side effects and adverse reactions: Side effects: bone/joint/muscle pain, injection site reaction/itching, dizziness
Adverse reactions: hypertension, MI/ Strokes
- Filgrastim side effects and adverse reactions: Side effects: nausea/vomit- ing/diarrhea, flu-like symptoms
Adverse reactions: MI/chest pain, capillary leak syndrome,
- Filgrastim pt teaching and nursing interventions: Pts teaching: -do not administer 24hrs before or 24hrs after chemotherapy -monitor weight, report weight gain of 2-3lbs in one day -educate on s/s of infection -educate on s/s of MI
Nursing interventions: -monitor CBC (ANC) -do not administer 24hrs before or 24hrs after chemotherapy
- conjugated estrogens: class, MOA, and use: -estrogen replacement -estrogen hormone replacement -hormone replacement for post-menopausal women
- Conjugated estrogen side effects and adverse reactions: Side effects: fluid retention, breast tenderness, vaginal bleeding
Adverse reactions: thromboembolic disorders, jaundice/gallbladder disease, CVA/PE/MI/DVT
- conjugated estrogens pt teaching and nursing interventions: Pts teaching: -limited to 5years use -calcium and vitamin D supplementation -no smoking -continue w/ GYN screening and mammograms
-take on empty stomach to enhance absorption Nursing interventions: -educate pts ^^ -contraindicated in women with history of thrombophlebitis
- Alendronate: class, MOA, and use: -bisphosphonate -reduces breakdown of bone to increase bone density -osteoporosis, osteopenia
- Alendronate side effects and adverse reactions: Side effects: bone pain, acid reflux, ABD pain, nausea
Adverse reactions: esophageal erosions, kidney failure
- Alendronate pt teaching and nursing interventions: Pts teaching: -take first thing in the morning, on empty stomach w no food OR OTHER MEDICA-
