16548060
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Flashcards by Aurelea Dyck, updated more than 1 year ago
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Created by Aurelea Dyck
almost 6 years ago
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| Question | Answer |
| Which antibiotics cause ototoxicity? | macrolides, aminoglycosides, glycopeptides |
| which antibiotics cause nephrotoxicity? | glycopeptides, aminoglyosides, macrolides cause nephritis |
| Which antibiotic may be used to treat pseudomembranous colitis? | Vancomycin (glycopeptide) |
| What are 5 SERIOUS SEs of cephalosporins and penecillins | Anaphylaxis, serum sickness, SJ syndrome, pseudomembranous colitis, seizures |
| Why might a CBC and differential be done for a pt taking cephalosporins? | may cause agranulocytosis, thrombocytopenia, and hemolytic anemia |
| whih antibiotics shoulds not be taken with food, fruit juice, or antacids? | macrolides |
| Why should you tell the patient taking macrolides to report yellowing of skin or eyes, dark urine, pale stools | hepatotoxic |
| Why not give antidiarrheals to someone with a superinfection after taking antibiotics? | the bacteria will not be removed from the body |
| What are the differences between indications of dimenhydramine, ondansetron, and metocloprapide? | dimenhydramine: nausea, vomiting, dizziness, and vertigo due to motion sickness ondansetron: nausea due to chemotherapy, postoperative metoclopramide: nausea and vomiting due to chemotherapy, postsurgical and diabetic gastric stasis, sm bowel intubation in radiographic procedures, GERD, post-op N/V when NG suction undesirable, hiccups, migraine |
| Ondansetron is a __ antagonist, but metoclopramide is a ___ antagonist. | serotonin, dopamine |
| SEs of Ondansetron | Headache, dizziness, drowsiness, fatigue, weakness, TORSADE DE POINTES, QT prolongation, constipation, diarrhea, abdo pain, dry mouth, increase liver enzymes, EPS |
| SEs of metoclopramide | drowsiness, EPS, restlessness, NMS, anxiety, depression, irritability, arrhythmias, HTN, hypotension, constipation, diarrhea, dry mouth, gynecomastia, metheglobinemia, neutropenia, leukopenia, agranulocytosis |
| How does dimenhydrinate decrease nausea? | inhibits vestibular stimulation |
| Dimenhydrinate has anticholinergic, antihistaminic, and CNS depressant properties. What SEs does it cause? | sedation, dizziness, drowsiness, headache, pedi: paradoxical excitation, blurred vision, tinnitus, hypotension, palpitations, anorexia, constipation, d, dry mouth, dysuria, frequency, photosensitivity, pain (IM) |
| Besides inhibiting dopamine, metaclopramide... | stimulates motility of upper GI tract and accelerates gastric emptying |
| Why is ASA CI often in children | It may cause Reye's syndrome |
| How does ASA cause PUD, kidney damage, and coagulation abnormalities? | It inhibits COX 1 (bad) as well as COX 2 (good) |
| What are signs of ASA OD? | tinnitus, headache, hyperventilation, confusion, lethargy, d, diaphoresis |
| How does acetaminophen work as an antipyretic? analgesic? | antipyretic: at level of hypothalamus; causes vasodilation, diaphoresis, and dissipation of heat analgesic: inhibits synthesis of prostaglandins |
| What is the antidote for acetaminophen? | ACETYLCYSTEINE |
| What SEs of Acetaminophen are specific to IV | agitation, anxiety, fatigue, insomnia, atelectasis, dyspnea, HTN, hypotension, constipation, n/v, hypokalemia, muscle spasms, trimus |
| Children should not take acetaminophen for more than __ consecutive days unless directed by an HCP | 5 |
| In addition to decreasing pain, narcotics also decrease __ and ___ | cough reflex GI motility and diarrhea |
| What are 5 teaching points for patients taking narotics? | 1. avoid activities requiring alertness until effects known 2. avoid alcohol and CNS depressants 3. change positions slowly 4. if on bedrest: turn, DB+C q 2 hrs 5. constipation prevention |
| Why do narcotics cause orthostatic hypotension? | blunts baroreceptor reflex and causes vasodilation |
| Why do narcotics cause urinary retention? | may cause increased tone of bladder sphincter |
| What are SEs of morphine? | Confusion, sedation, dizziness, dysphoria, euphoria, floating feeling, hallucinations, unusual dreams, blurred vision, diplopia, miosis, RESPIRATORY DEPRESSION, hypotension, bradycardia, constipation, n/v, urinary retention, flushing, itching sweating, dependence, tolerance |
| Which narcotic is most often prescribed as a cough suppressant? | codeine |
| Furosemide is a ___ diuretic because... | loop; it increases reabsorption of sodium and water in the loop of Henle |
| What are SEs of lasix? | Blurred vision, dizziness, headache, vertigo, hearing loss, tinnitus, hypotension, anorexia, constipation, diarrhea, dry mouth, dyspepsia, increase liver enzymes, n/v, pancreatitis, increased BUN, polyuria, nephrocalcinosis, SJ SYNDROME, TOXIC EPIDERMAL NECROLYSIS, photosensitivity, pruritis, rash, dehydration, hypocalcemia/chloremia/kalemia/magnesemia/natremia/volemia, metabolic alkalosis, APLASTIC ANEMIA, AGRANULOCYTOSIS, hemolytic anemia, leukopenia, thrombocytopenia, muscle cramps, paresthesia, fever |
| Teaching for pt on lasix: 1. monitor ____ intake 2. report significant _____ _____or gain 3. report fatigue and muscle ____ 4. change ____slowly 5. use _____ protection measures 6. eat foods high in ___ 7. carry ___ ___ 8. hold if BP ___ 9. report signs of ___ and ___ edema 10. monitor fluid ___ and weight daily 11. report symptoms of metabolic imbalance: ___, ___, ___, ____ ___, ___, ___, ___, ___ ___, ___, ___, ___, extreme ___, change in __ 12. report change in ___ or vision 13. avoid alcohol and ___ 14. continue drug even if ___ controlled and continue other methods to control | 1. monitor sodium intake 2. report significant weight loss (greater than 2.2 lbs/wk) gain (more than 3 lbs/day) 3. report fatigue and muscle cramping 4. change position slowly 5. use sun protection measures (to prevent photosensitivity) 6. eat foods high in K+ 7. carry medical identification (indicating you are on Lasix) 8. hold if BP low (as specified by HCP) 9. report peripheral and pulmonary edema (dyspnea, frothy sputum, fatigue, edema) 10. monitor fluid I/O and weight daily -report metabolic imbalance: N/V, weakness, lethargy, muscle cramps, depression, disorientation, hallucinations, heart spasms, palpitations, numbness, tingling, extreme thirst, change in O 12. report change in hearing or vision 13. avoid alcohol and caffeine 14. continue drug even is hypertension controlled and continue other methods to control |
| What is the action of digoxin? | decreases HR and increases contractility by blocking Na/K pumps from removing Na the cardiac cell. Accumulation of Na+ causes Ca+2 release from cell storage, resulting in stronger contraction |
| What are SEs of digoxin? | Fatigue, headache, weakness, blurred vision, yellow or green vision, ARRHYTHMIA, bradycardia, ECG change, AV block, SA block, anorexia, n/v/d, electrolyte imbalance, acute toxicity |
| Signs of digoxin toxicity | abdo pain, anorexia, n/v, visual disturb, bradycardia, arrhythmia; 1st signs cardiac in infants; DC and notify physician |
| digoxin has a narrow therapeutic window of ___ | 0.5-2 ng/mL |
| What is the antidote for digoxin? | DIGOXIN IMMUNE FAB |
| Why should diuretics be used cautiously with digoxin? | increase risk of toxicity |
| Before administering digoxin, assess the ___ HR for ___ min prior to administration; hold if less than 60 (adult), ___ (child), ___(infant) or as per order | Before administering digoxin, assess the apical HR for full min prior to administration; hold if less than 60 (adult), 70 (child), 90 (infant) or as per order |
| neonates have falsely __ digoxin levels | high |
| avoid___ or ___ within 2 hr of taking digoxin | antacids or antidiarrheals |
| a Histamine antagonist with CNS depressant and anticholinergic properties | diphenhydramine |
| Besides allergies and anaphylaxis, what are indications of diphenhydramine? | parkinson disease, EPS, mild nighttime sedation, prevent motion sickn, essantitussive (syrup only) |
| What are SEs of diphenhydramine? | drowsiness, dizziness, headache, paradoxical excitation, blurred vision, tinnitus, hypotension, palpitations, anorexia, dry mouth, constipation, n, dysuria, frequency, urinary retention, photosensitivity, chest tightness, thickened bronchial secretions, wheeze, pain (IM) |
| Albuterol is a selective ___ ___ ___ and acts by relaxing smooth muscle | Beta 2 agonist |
| What are two main indications of albuterol? | asthma and COPD |
| What are negative effects of excessive use of albuterol? | tolerance and paradoxical bronchospasm |
| What are SEs of Albuterol? | nervousness, restlessness, tremor, headache, insomnia (pedi), hyperactivity (pedi), PARADOXICAL BRONCHOSPASM (wheeze), chest pain, palpitations, angina, arrhythmias, HTN, n/v, hyperglycemia, hypokalemia |
| Teach the patient that albuterol Inhalers should be primed with __sprays before use and discarded after ___sprays | 4; 200 |
| In acute bronchospasm, use ___ first, and then wait ___ min before taking other inhaled medications | albuterol; 5 |
| What are SEs of Budesonide | Headache, agitation, depression, dizziness, fatigue, insomnia, restlessness, dysphonia, hoarseness, cataracts, nasal congestion, pharyngitis, sinusitis, bronchospasm, cough, wheeze, diarrhea, dry mouth, dyspepsia, esophageal candidiasis, taste disturb, n, adrenal suppression, decrease growth (children), decrease bone density, back pain, hypersensitivity ANAPHYLAXIS, LARYNGEAL EDEMA, URTICARIA, BRONCHOSPASM, CHURG STRAUS SYNDROME |
| -allow ___ min between inhalations of budesonide and __ ___ after use | 1-2; rinse mouth |
| What is the action of Ranitidine? | Inhibits histamine receptors in gastric parietal cells, decreasing secretion of HCl |
| Why would Ranitidine be used to tx pancreatic insufficiency? | ?The pancreas releases HCO3-? |
| What are SEs of ranitidine | confusion, dizziness, drowsiness, hallucinations, headache, ARRHYTHMIAS, constipation, diarrhea, drug-induced hepatitis, n, decreased sperm count, erectile dysfunction, gynecomastia, AGRANULOCYTOSIS, APLASTIC ANEMIA, anemia, neutropenia, thrombocytopenia, pain (IM), hypersensitivity, vasculitis |
| Teaching about Ranitidine: 1. take as directed even after ___ ___ 2. do not take max dose continuously greater than ___ without consulting HCP 3. report difficulty ___ or persisted abdo pain 4. avoid ___ (interferes with action) 5. avoid activities requiring ___ until effects known 6. avoid alcohol, NSAIDs, and foods that increase___ ___ 7. ___ and ___to decrease constipation 8. report ___ ___ stools, fever, sore ____, diarrhea, dizziness, rash, confusion, hallucinations | 1. feeling better 2. 2 wks 3. swallowing 4. smoking 5. alertness 6. GI irritation 7. fluid, fiber 8. black tarry, throat |
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