What lab test should be ordered for patients on Carbamazepine?
CBC every 3-4 months because it can cause decreased WBC, decreased platelets, and trouble with RBC<\/p>\n\n\n\n
What kind of teaching needs to be done with families of patients who have seizure disorders?
Prevention is important, patient safety is important, Do NOT abruptly stop taking medication.<\/p>\n\n\n\n
Ethosuximide (Zarontin), an anti-seizure medication can cause what?
Blood dyscrasias<\/p>\n\n\n\n
Patients taking Topiramate need to be monitored for what electrolyte imbalance?
Decreased sodium bicarb leading to hyperchloremic metabolic acidosis<\/p>\n\n\n\n
Topiramate treats seizures and what is one common side effect?
Normal side effect is weight loss, especially in higher dose patients<\/p>\n\n\n\n
A child on Topiramate that wants to play sports should monitor what?
Don’t get overheated. Topiramate may affect his ability to sweat in the heat.<\/p>\n\n\n\n
What should a pregnant patient be told about taking Valproate (Depakote)?
It is a known teratogen and category X medication. It should not be used in the first trimester, it may be restarted in second trimester.<\/p>\n\n\n\n
What patient population should tricyclic antidepressants be used cautiously in?
Heart Disease patients<\/p>\n\n\n\n
Phenelzine (Nardil) is a MAOI. What teaching needs to be done with this medication?
He should not use serotonergic drugs like Imitrex. Also, this class of medication interacts with yogurt, sour cream, soy sauce, etc.<\/p>\n\n\n\n
Phenelzine (Nardil) may cause what if there is an interaction with known contraindicated foods?
Hypertensive crisis<\/p>\n\n\n\n
What are the side effects of tricyclic antidepressants?
Anticholinergic type effects like dry mouth, sedation, constipation, increased appetite, blurred vision, tinnitus, euphoria, mania<\/p>\n\n\n\n
How long does it take for SSRIs to take effect
2-6 weeks<\/p>\n\n\n\n
SSRIs may cause what onset of action symptoms?
Nausea, but this will usually resolve in a week.<\/p>\n\n\n\n
What is one thing you should not do with SSRIs?
Drink alcohol<\/p>\n\n\n\n
What should happen when going off an SSRI?
Wean slowly, do not stop abruptly<\/p>\n\n\n\n
What medications would a patient with depression and anxiety respond well to?
Buspar and an SSRI combined
Celexa (Citalopram)
Lexapro (Escitalopram)<\/p>\n\n\n\n
Why should you combine an SSRI with Buspar?
Buspar augments the SSRI and is a good combo for anxiety and depression<\/p>\n\n\n\n
What is a first line drug for mild to moderate generalized anxiety disorder?
Buspirone<\/p>\n\n\n\n
How fast does Celexa start to demonstrate effects?
Improved appetitie and concentration in 1-2 weeks.<\/p>\n\n\n\n
What is a major drug to treat bipolar disease?
Lithium<\/p>\n\n\n\n
Blood levels need to be monitored with Lithium because why?
Lithium has a narrow therapeutic range so it is important to recognize toxicity<\/p>\n\n\n\n
What are symptoms of lithium toxicity?
Drowsiness and Nausea<\/p>\n\n\n\n
What dietary teaching needs to be done with patients taking lithium?
Salt intake needs to be consistent<\/p>\n\n\n\n
What are the side effects of SSRIs (selective seratonin reuptake inhibitor)?
N\/V, dizziness, light headedness, dry mouth, increased sweating, weight changes, agitation, sexual side effects.<\/p>\n\n\n\n
What are the side effects of SNRIs (serotonin norepinephrine reuptake inhibitor)
Headache, somnolence, dizziness, insomnia, nervousness, dry mouth, constipation, abnormal ejaculation, anorexia\/weight loss, elevated BP<\/p>\n\n\n\n
What are the side effects of MAOIs?
Insomnia, anxiety, agitation, dizziness, headache, restlessness, hypotension, dry mouth, blurred vision, constipation<\/p>\n\n\n\n
What Benzo has the greatest likelihood of dependence?
Xanax \/alprazolam<\/p>\n\n\n\n
What receptors do Benzos act on?
Enhances the neurotransmitter GABA (gamma-aminobutyric acid) receptors<\/p>\n\n\n\n
What result do Benzos have on the body?
sedative
hypnotic
anxiolytic
anticonvulsant
muscle relaxer<\/p>\n\n\n\n
What are long acting Benzos prescribed for?
Treatment of anxiety<\/p>\n\n\n\n
What are short acting Benzos prescribed for?
Treatment of insomnia<\/p>\n\n\n\n
What would be a good medication to prescribe for panic disorder?
Diazepam (Valium)<\/p>\n\n\n\n
What is a anorexiant medication to treat obesity?
Phentermine<\/p>\n\n\n\n
What is a precaution with Phentermine?
Anorexiants may cause tolerance and should only be used for 6 months<\/p>\n\n\n\n
What medications or herbals should be avoided with Phentermine? Why?
SSRIs and St. Johns Wort\u2026the combination may cause serotonin syndrome<\/p>\n\n\n\n
Phentermine releases what two chemicals?
Epinephrine and norepinephrine<\/p>\n\n\n\n
Epi and norepi causes what to break down?
Fat cells to break down stored fat<\/p>\n\n\n\n
What are Signs and symptoms of seratonin syndrome?
Headache, agitation, mental confusion, hallucinations, coma<\/p>\n\n\n\n
What are autonomic effects that you can get from seratonin syndrome?
Shivering, sweating, hyperthermia, vasoconstriction, tachycardia, nausea, diarrhea<\/p>\n\n\n\n
What factors place a patient at risk for developing antimicrobial resistant organisms?
Inappropriate use of antibiotics
Children less than 2 years of age
Adults older than 65 yrs of age
Patients who do not finish their antibiotic regimen<\/p>\n\n\n\n
What are appropriate antibiotics to prescribe to pregnant women and children?
PCN or Cephalosporins
(Amoxicillin, or Augmentin)<\/p>\n\n\n\n
Which antibiotics inhibit cell wall synthesis?
Beta-lactam antibiotics
Vancomycin<\/p>\n\n\n\n
Why is clavulanate added to Amoxicillin?
Clavulanate is a Beta-lactam inhibitor. This increases the spectrum of action and is effective at preventing amoxicillin-resistant bacteria that produce Beta-lactamase<\/p>\n\n\n\n
What type of antibiotics should be avoided in children and pregnant women?
Tetracycline, fluoroquinolones<\/p>\n\n\n\n
What is a normal side effect of amoxicillin?
Diarrhea and it is recommended to continue to take the medicine, drink lots of water, and take probiotics daily, eat yogurt<\/p>\n\n\n\n
The American Heart Association recommedations for prophylaxis antibiotic use prior to dental care are\u2026<\/p>\n\n\n\n
- \n
- Prosthetic cardiac valve or prosthetic material used in valve repair<\/li>\n\n\n\n
- Previous Endocarditis<\/li>\n\n\n\n
- The following congenital diseases
I. Unrepaired cyanotic congenital heart disease including palliative shunts and conduits
II. Completely repaired congenital heart disease with prosthetic material device, whether placed surgically or with a catheter for 6 months following the procedure
III. Repaired congenital heart disease with residual effects at the site or adjacent to the site of a prosthetic patch or prosthetic device which inhibit endothelialization
IV. Cardiac transplantation recipients with cardiac valvular disease<\/li>\n<\/ol>\n\n\n\nWhat antibiotic is used for dental appointments?
Amoxicillin 2 gm for adults
50mg\/kg in children<\/p>\n\n\n\nWhat should fluoroquinolones be reserved to treat?
Community acquired pneumonia in patients with comorbidities and Hospital acquired pneumonia<\/p>\n\n\n\nWhat is the black box warning for fluoroquinolones?
It may cause tendon ruptures. Specifically of the achilles tendon.<\/p>\n\n\n\nWhat medication can be affected with the use of fluoroquinolones?
Warfarin because fluoroquinolones displace the flora of the gut and displaces warfarin from albumin and interferes with metabolism by the P450 system.<\/p>\n\n\n\nWhy are tetracyclines not recommended in pregnancy and in children less than 8 yrs of age?
They can cause staining of teeth, and cause problems with bone growth.<\/p>\n\n\n\nWhat population can tetracyclines like minocycline be used on? And patients who use it might develop what?
Adolescents. It may cause psuedotumor cerebri, drug-induced lupus and hepatitis, skin photosensitivity, tinnitus, fatty liver<\/p>\n\n\n\nTetracycline should be avoided with what foods and medications?
Calcium ions
milk, yogurt, or other dairy products
Methotrexate<\/p>\n\n\n\nWhat drug interactions should be avoided when taking levaquin?
It is a fluoroquinolone, so do not take with coumadin or corticol steroid use.<\/p>\n\n\n\nGentamycin is known to cause what?
Ototoxicity and hearing loss<\/p>\n\n\n\nWhich medications interact with Linezolid?
Linezolid is a MAOI, so it should not be used with other MAOIs, pethidine, or demerol because of the risk of seratonin syndrome.<\/p>\n\n\n\nWhat are the food restrictions while taking linezolid?
Tyramine rich foods such as pork, aged cheese, alcohol, smoked or pickled foods.<\/p>\n\n\n\nWhat is the treatment for Lymes Disease?
Doxycycline 100mg PO BID x 21 days<\/p>\n\n\n\nWhat vitamin can prevent peripheral neuropathy from isoniazid?
Vitamin B 6 (Pyridoxine)<\/p>\n\n\n\nWhat should you monitor before prescribing valacyclovir?
Renal function. Patients should drink lots of water while on this medication.<\/p>\n\n\n\nWhich medication would be appropriate for Influenza A?
Oseltamivir, if started within the first 48 hours<\/p>\n\n\n\nName 3 things ta Rifampin is prescribed for?
TB, leprosy, legionella<\/p>\n\n\n\nWhat are the adverse effects for Isoniazid?
Hepatotoxicity and peripheral neuropathy<\/p>\n\n\n\nWhat are the main side effects of Doxycycline?
Mainly GI upset. Take with food. Can cause photosensitivity, Stephens Johnson syndrome, and toxic epidermal necrosis<\/p>\n\n\n\nWhat is the difference between oral and I.V. Vanco?
Oral is given for C-Diff as it goes right to the site of infection. I.V. vanco is given for MRSA infections and needs to be administered through a picc line or central line because it is toxic to veins.<\/p>\n\n\n\nWhat is the mechanism of action for Azithromycin?
It inhibits bacterial protein biosynthesis and prevents peptidyl transferase from adding to the growing peptide attached to the transfer RNA to the amino acid. It also inhibits ribosome ranslation.<\/p>\n\n\n\nWhich class of antibiotics block bacterial protein production?
Bacteriostatic antibiotics: Tetracyclie, Sulfonamides, Macrolides, Clindamycin, Ethambutol, Nitrofuantoin, Novobiocin, tigecycline, oxazolidinone<\/p>\n\n\n\nWhat labs need to be monitored for long term antifungal therapy with ketoconazole?
AST, ALT, Phosphatase, bilirubin<\/p>\n\n\n\nWhat teaching should be done with Flagyl?
Do not consume alcohol in any form with this medication<\/p>\n\n\n\nWhich antihelmintic is used to treat parasitic worms?
Mebendazole, and agromectin
and ivermectin to treat true parasites<\/p>\n\n\n\nWhat antifungal can be used topically?
Clotrimazole<\/p>\n\n\n\nWhat medication treats scabies and lice?
Ivermectin and permethrin cream<\/p>\n\n\n\nRifampin is used to treat what?
TB<\/p>\n\n\n\nSide effects of rifampin?
Joint pain because it can precipitate gout and it is hepatotoxic.<\/p>\n\n\n\nIF patients are hypersensitive to Sulfa, what other medications will they be sensitive to?
Loop Diuretics, thiazide diuretics, and sulfonylureas<\/p>\n\n\n\nSulfa antibiotics can cause what?
Stephen Johnsons Syndrome and toxic epidermal necrolysis<\/p>\n\n\n\nNurs 615 pharm exam 2 questions and answers
Nurs 615 pharm exam 2 questions
Nurs 615 pharm exam 2 pdf
Nurs 615 pharm exam 2 answers
Nurs 615 pharm exam 2 answer key<\/p>\n\n\n\n![\"\"](\"https:\/\/d3tvd1u91rr79.cloudfront.net\/9206c2917a6268c2fb5375005857ea70\/html\/bg1.png?Policy=eyJTdGF0ZW1lbnQiOlt7IlJlc291cmNlIjoiaHR0cHM6Ly9kM3R2ZDF1OTFycjc5LmNsb3VkZnJvbnQubmV0LzkyMDZjMjkxN2E2MjY4YzJmYjUzNzUwMDU4NTdlYTcwL2h0bWwvKiIsIkNvbmRpdGlvbiI6eyJEYXRlTGVzc1RoYW4iOnsiQVdTOkVwb2NoVGltZSI6MTY5MDY1MjY0NH19fV19&Signature=cYNAiSytWfBrjschaz2Ey73FiuVZ11S2zvYhoqv9F-V3jmPqnurCSHevfrguDHfibSb1o37NK1~QfXOpEpv57e1i2kg1ejA5bEDkIcAcUZ3DUJJynju9lFPJ0XLvWeY2075RMudjqow-T9IPRaartbVneLLTv7fCP2uJ800AcL-4eES42u9ZShPDv2Xjw03AiIVSNj7Aiss9d3f-V7ASGS8K8C1E4APkpS5B9MHT7kyw-NT7xPiu~OQpHiVgJuz76YSnuO7nKXSfSJJNI9EOgEa5JPSngrCFZsbAaIpdQ2o5xEDJsJ0vsOPXS0Ya1rTbb37QOgtQZH4kCwJrpYZMhA__&Key-Pair-Id=APKAJ535ZH3ZAIIOADHQ\")
<\/p>\n\n\n\nNURS 615 -Pharm Exam 2-Super Duper Exam<\/p>\n\n\n\n
2 Q&A<\/p>\n\n\n\n
1. Henry has recently started on carbamazepine to treat seizures. He comes<\/p>\n\n\n\n
to see you and you note that while his carbamazepine levels had been in<\/p>\n\n\n\n
the therapeutic range, they are now low. The possible cause for the low<\/p>\n\n\n\n
carbamazepine levels include: Carbamazepine auto-induces metabolism,<\/p>\n\n\n\n
leading to lower levels despite good compliance.<\/p>\n\n\n\n
2. Carbamazepine has a Black Box Warning due to life-threatening:<\/p>\n\n\n\n
Dermatologic reaction, including Steven\u2019s Johnson and toxic epidermal<\/p>\n\n\n\n
necrolysis<\/p>\n\n\n\n
3. Long-term monitoring of patients who are taking carbamazepine<\/p>\n\n\n\n
includes: Complete blood count every 3 to 4 months (can be a<\/p>\n\n\n\n
decrease in WBC & platelets)<\/p>\n\n\n\n
4. Six-year-old Felisha has recently been started on ethosuximide<\/p>\n\n\n\n
(Zarontin) for seizures. She should be monitored for:<\/p>\n\n\n\n
Blood dyscrasias, which are uncommon but possible<\/p>\n\n\n\n
NURS 615 -Pharm Exam 2-Super Duper Exam<\/p>\n\n\n\n
2 Q&A<\/p>\n\n\n\n
![\"\"](\"https:\/\/d3tvd1u91rr79.cloudfront.net\/9206c2917a6268c2fb5375005857ea70\/html\/bg2.png?Policy=eyJTdGF0ZW1lbnQiOlt7IlJlc291cmNlIjoiaHR0cHM6Ly9kM3R2ZDF1OTFycjc5LmNsb3VkZnJvbnQubmV0LzkyMDZjMjkxN2E2MjY4YzJmYjUzNzUwMDU4NTdlYTcwL2h0bWwvKiIsIkNvbmRpdGlvbiI6eyJEYXRlTGVzc1RoYW4iOnsiQVdTOkVwb2NoVGltZSI6MTY5MDY1MjY0NH19fV19&Signature=cYNAiSytWfBrjschaz2Ey73FiuVZ11S2zvYhoqv9F-V3jmPqnurCSHevfrguDHfibSb1o37NK1~QfXOpEpv57e1i2kg1ejA5bEDkIcAcUZ3DUJJynju9lFPJ0XLvWeY2075RMudjqow-T9IPRaartbVneLLTv7fCP2uJ800AcL-4eES42u9ZShPDv2Xjw03AiIVSNj7Aiss9d3f-V7ASGS8K8C1E4APkpS5B9MHT7kyw-NT7xPiu~OQpHiVgJuz76YSnuO7nKXSfSJJNI9EOgEa5JPSngrCFZsbAaIpdQ2o5xEDJsJ0vsOPXS0Ya1rTbb37QOgtQZH4kCwJrpYZMhA__&Key-Pair-Id=APKAJ535ZH3ZAIIOADHQ\")
<\/p>\n\n\n\n5. What should families be taught regarding seizure activity monitoring?<\/p>\n\n\n\n
Prevention of seizures, patient safety, quality of life issues, reach<\/p>\n\n\n\n
acceptable goals for treatment, & do not abruptly stop taking seizure meds<\/p>\n\n\n\n
6. What electrolyte imbalance is associated with topiramate?<\/p>\n\n\n\n
Decreased sodium bicarb leading to hyperchloremic metabolic acidosis<\/p>\n\n\n\n
7. Lisa, who is overweight, recently started taking topiramate for seizures<\/p>\n\n\n\n
and at her follow- up visit you note she has lost 4 kg. The appropriate<\/p>\n\n\n\n
action would be:<\/p>\n\n\n\n
Reassure her that this is a normal side effect of topiramate and continue to<\/p>\n\n\n\n
monitor her weight.<\/p>\n\n\n\n
8. Travis\u2019s seizures are well controlled on topiramate and he wants to start<\/p>\n\n\n\n
playing baseball. Education for Travis regarding his topiramate includes:<\/p>\n\n\n\n
He should monitor his temperature and ability to sweat in the heat while<\/p>\n\n\n\n
playing<\/p>\n\n\n\n
9. Brandy is taking valproate (Depakote) for seizures and would like to get<\/p>\n\n\n\n
pregnant. What advice would you give her?<\/p>\n\n\n\n
NURS 615 -Pharm Exam 2-Super Duper Exam<\/p>\n\n\n\n
2 Q&A<\/p>\n\n\n\n
![\"\"](\"https:\/\/d3tvd1u91rr79.cloudfront.net\/9206c2917a6268c2fb5375005857ea70\/html\/bg3.png?Policy=eyJTdGF0ZW1lbnQiOlt7IlJlc291cmNlIjoiaHR0cHM6Ly9kM3R2ZDF1OTFycjc5LmNsb3VkZnJvbnQubmV0LzkyMDZjMjkxN2E2MjY4YzJmYjUzNzUwMDU4NTdlYTcwL2h0bWwvKiIsIkNvbmRpdGlvbiI6eyJEYXRlTGVzc1RoYW4iOnsiQVdTOkVwb2NoVGltZSI6MTY5MDY1MjY0NH19fV19&Signature=cYNAiSytWfBrjschaz2Ey73FiuVZ11S2zvYhoqv9F-V3jmPqnurCSHevfrguDHfibSb1o37NK1~QfXOpEpv57e1i2kg1ejA5bEDkIcAcUZ3DUJJynju9lFPJ0XLvWeY2075RMudjqow-T9IPRaartbVneLLTv7fCP2uJ800AcL-4eES42u9ZShPDv2Xjw03AiIVSNj7Aiss9d3f-V7ASGS8K8C1E4APkpS5B9MHT7kyw-NT7xPiu~OQpHiVgJuz76YSnuO7nKXSfSJJNI9EOgEa5JPSngrCFZsbAaIpdQ2o5xEDJsJ0vsOPXS0Ya1rTbb37QOgtQZH4kCwJrpYZMhA__&Key-Pair-Id=APKAJ535ZH3ZAIIOADHQ\")
<\/p>\n\n\n\nValproate is a known teratogen, but may be taken after the first trimester if<\/p>\n\n\n\n
necessary. Keppra is a better drug to be on until the second trimester, then<\/p>\n\n\n\n
she can go back to valproate.<\/p>\n\n\n\n
10.What category is<\/p>\n\n\n\n
valproate? Category X<\/p>\n\n\n\n
11.The tricyclic antidepressants should be prescribed cautiously in<\/p>\n\n\n\n
patients with: Heart disease<\/p>\n\n\n\n
12.A 64-year-old male was prescribed phenelzine (Nardil) while in an acute<\/p>\n\n\n\n
psychiatric unit for recalcitrant depression. The NP managing his primary<\/p>\n\n\n\n
health care needs to understand the following regarding phenelzine and<\/p>\n\n\n\n
other monoamine oxidase inhibitors (MAOIs):<\/p>\n\n\n\n
He should not be prescribed any serotonergic drug such as sumatriptan<\/p>\n\n\n\n
(Imitrex), MAOIs interact with many common foods, including yogurt, sour<\/p>\n\n\n\n
cream, and soy sauce, and symptoms of hypertensive crisis (headache,<\/p>\n\n\n\n
tachycardia, sweating) require immediate treatment<\/p>\n\n\n\n
13.What are the precautions and contraindications for tricyclic<\/p>\n\n\n\n
antidepressants? Side effects are similar to anticholinergic<\/p>\n\n\n\n
activity such as dry mouth, sedation,<\/p>\n\n\n\n
NURS 615 -Pharm Exam 2-Super Duper Exam<\/p>\n\n\n\n
2 Q&A<\/p>\n\n\n\n
![\"\"](\"https:\/\/d3tvd1u91rr79.cloudfront.net\/9206c2917a6268c2fb5375005857ea70\/html\/bg4.png?Policy=eyJTdGF0ZW1lbnQiOlt7IlJlc291cmNlIjoiaHR0cHM6Ly9kM3R2ZDF1OTFycjc5LmNsb3VkZnJvbnQubmV0LzkyMDZjMjkxN2E2MjY4YzJmYjUzNzUwMDU4NTdlYTcwL2h0bWwvKiIsIkNvbmRpdGlvbiI6eyJEYXRlTGVzc1RoYW4iOnsiQVdTOkVwb2NoVGltZSI6MTY5MDY1MjY0NH19fV19&Signature=cYNAiSytWfBrjschaz2Ey73FiuVZ11S2zvYhoqv9F-V3jmPqnurCSHevfrguDHfibSb1o37NK1~QfXOpEpv57e1i2kg1ejA5bEDkIcAcUZ3DUJJynju9lFPJ0XLvWeY2075RMudjqow-T9IPRaartbVneLLTv7fCP2uJ800AcL-4eES42u9ZShPDv2Xjw03AiIVSNj7Aiss9d3f-V7ASGS8K8C1E4APkpS5B9MHT7kyw-NT7xPiu~OQpHiVgJuz76YSnuO7nKXSfSJJNI9EOgEa5JPSngrCFZsbAaIpdQ2o5xEDJsJ0vsOPXS0Ya1rTbb37QOgtQZH4kCwJrpYZMhA__&Key-Pair-Id=APKAJ535ZH3ZAIIOADHQ\")
<\/p>\n\n\n\nconstipation, increased appetite, blurred vision, tinnitus, euphoria, and<\/p>\n\n\n\n
mania. Caution in patients with cardiac disease (terminate ventricular<\/p>\n\n\n\n
fibrillation, decrease cardiac contractility, increase collateral blood<\/p>\n\n\n\n
circulation to ischemic heart muscles).<\/p>\n\n\n\n
14.Marla is started on paroxetine (Paxil), a selective serotonin reuptake<\/p>\n\n\n\n
inhibitor (SSRI), for depression. Education regarding her antidepressant<\/p>\n\n\n\n
includes:<\/p>\n\n\n\n
SSRIs may take 2 to 6 weeks before she will have maximum drug effects.<\/p>\n\n\n\n
15.What \u201conset of action\u201d symptoms should be reviewed with patients<\/p>\n\n\n\n
who have been newly prescribed a selective serotonin reuptake<\/p>\n\n\n\n
inhibitor?<\/p>\n\n\n\n
They can feel a bit of nausea, but this resolves in a week.<\/p>\n\n\n\n
16.Which of the following should not be taken with a selective<\/p>\n\n\n\n
serotonin reuptake inhibitor?<\/p>\n\n\n\n
Alcohol<\/p>\n\n\n\n
17.Why is the consistency of taking paroxetine (Paxil) and never running out<\/p>\n\n\n\n
of medication more important than with most other selective serotonin<\/p>\n\n\n\n
reuptake inhibitors (SSRIs)?<\/p>\n\n\n\n
NURS 615 -Pharm Exam 2-Super Duper Exam<\/p>\n\n\n\n
2 Q&A<\/p>\n\n\n\n
![\"\"](\"https:\/\/d3tvd1u91rr79.cloudfront.net\/9206c2917a6268c2fb5375005857ea70\/html\/bg5.png?Policy=eyJTdGF0ZW1lbnQiOlt7IlJlc291cmNlIjoiaHR0cHM6Ly9kM3R2ZDF1OTFycjc5LmNsb3VkZnJvbnQubmV0LzkyMDZjMjkxN2E2MjY4YzJmYjUzNzUwMDU4NTdlYTcwL2h0bWwvKiIsIkNvbmRpdGlvbiI6eyJEYXRlTGVzc1RoYW4iOnsiQVdTOkVwb2NoVGltZSI6MTY5MDY1MjY0NH19fV19&Signature=cYNAiSytWfBrjschaz2Ey73FiuVZ11S2zvYhoqv9F-V3jmPqnurCSHevfrguDHfibSb1o37NK1~QfXOpEpv57e1i2kg1ejA5bEDkIcAcUZ3DUJJynju9lFPJ0XLvWeY2075RMudjqow-T9IPRaartbVneLLTv7fCP2uJ800AcL-4eES42u9ZShPDv2Xjw03AiIVSNj7Aiss9d3f-V7ASGS8K8C1E4APkpS5B9MHT7kyw-NT7xPiu~OQpHiVgJuz76YSnuO7nKXSfSJJNI9EOgEa5JPSngrCFZsbAaIpdQ2o5xEDJsJ0vsOPXS0Ya1rTbb37QOgtQZH4kCwJrpYZMhA__&Key-Pair-Id=APKAJ535ZH3ZAIIOADHQ\")
<\/p>\n\n\n\nIt has a shorter half-life and withdrawal syndrome has a faster onset<\/p>\n\n\n\n
without taper<\/p>\n\n\n\n
18.Janet presents with depression associated with complaints of fatigue,<\/p>\n\n\n\n
sleeping all the time, and lack of motivation. An appropriate initial<\/p>\n\n\n\n
antidepressant for her would be: Duloxetine (Cymbalta)<\/p>\n\n\n\n
19.A patient with anxiety and depression may<\/p>\n\n\n\n
respond to: Buspirone (Buspar) and an SSRI<\/p>\n\n\n\n
combined<\/p>\n\n\n\n
20.When is buspirone (Buspar) and an SSRI combined?<\/p>\n\n\n\n
Buspar is helpful in augmenting the SSRI and in treating patients with<\/p>\n\n\n\n
agitated or anxious depression<\/p>\n\n\n\n
21.An appropriate first-line drug to try for mild to moderate generalized<\/p>\n\n\n\n
anxiety disorder would be:<\/p>\n\n\n\n
Buspirone (Buspar)<\/p>\n\n\n\n
22.Larry has been prescribed citalopram (Celexa) to treat his depression.<\/p>\n\n\n\n
Education regarding how quickly selective serotonin reuptake inhibitor<\/p>\n\n\n\n
(SSRI) antidepressants work would be:<\/p>\n\n\n\n
Appetite and concentration improve in the first 1 to 2 weeks<\/p>\n\n\n\n
NURS 615 -Pharm Exam 2-Super Duper Exam<\/p>\n\n\n\n
2 Q&A<\/p>\n\n\n\n
![\"\"](\"https:\/\/d3tvd1u91rr79.cloudfront.net\/9206c2917a6268c2fb5375005857ea70\/html\/bg6.png?Policy=eyJTdGF0ZW1lbnQiOlt7IlJlc291cmNlIjoiaHR0cHM6Ly9kM3R2ZDF1OTFycjc5LmNsb3VkZnJvbnQubmV0LzkyMDZjMjkxN2E2MjY4YzJmYjUzNzUwMDU4NTdlYTcwL2h0bWwvKiIsIkNvbmRpdGlvbiI6eyJEYXRlTGVzc1RoYW4iOnsiQVdTOkVwb2NoVGltZSI6MTY5MDY1MjY0NH19fV19&Signature=cYNAiSytWfBrjschaz2Ey73FiuVZ11S2zvYhoqv9F-V3jmPqnurCSHevfrguDHfibSb1o37NK1~QfXOpEpv57e1i2kg1ejA5bEDkIcAcUZ3DUJJynju9lFPJ0XLvWeY2075RMudjqow-T9IPRaartbVneLLTv7fCP2uJ800AcL-4eES42u9ZShPDv2Xjw03AiIVSNj7Aiss9d3f-V7ASGS8K8C1E4APkpS5B9MHT7kyw-NT7xPiu~OQpHiVgJuz76YSnuO7nKXSfSJJNI9EOgEa5JPSngrCFZsbAaIpdQ2o5xEDJsJ0vsOPXS0Ya1rTbb37QOgtQZH4kCwJrpYZMhA__&Key-Pair-Id=APKAJ535ZH3ZAIIOADHQ\")
<\/p>\n\n\n\n23.An appropriate drug for the treatment of depression with<\/p>\n\n\n\n
anxiety would be: Escitalopram (Lexapro)<\/p>\n\n\n\n
24.One major drug used to treat bipolar disease is lithium. Because<\/p>\n\n\n\n
lithium has a narrow therapeutic range, it is important to recognize<\/p>\n\n\n\n
symptoms of toxicity, such as: Drowsiness and nausea<\/p>\n\n\n\n
25.Simon is taking lithium for bipolar disorder. He should<\/p>\n\n\n\n
be taught to: Eat a diet with consistent levels of salt<\/p>\n\n\n\n
(sodium)<\/p>\n\n\n\n
26.What are the side effects of tricyclic antidepressants?<\/p>\n\n\n\n
Dry mouth, constipation, urinary hesitancy or retention, blurred vision,<\/p>\n\n\n\n
sedation, orthostatic hypotension, weight gain, N\/V, gynecomastia, and<\/p>\n\n\n\n
changes in libido.<\/p>\n\n\n\n
Remember it is similar to anticholinergic side effects-\u201ccan\u2019t see, can\u2019t<\/p>\n\n\n\n
pee, can\u2019t spit, can\u2019t shit.\u201d<\/p>\n\n\n\n
27.What are the side effects of SSRIs?<\/p>\n\n\n\n
N\/V, H\/A, light-headedness, dizziness, dry mouth, increased sweating,<\/p>\n\n\n\n
weight changes, exacerbation of anxiety, agitation, and sexual side effects.<\/p>\n\n\n\n
Side effects are generally minor.<\/p>\n\n\n\n
NURS 615 -Pharm Exam 2-Super Duper Exam<\/p>\n\n\n\n
2 Q&ADocument continues below<\/p>\n\n\n\n
Discover more from:<\/strong><\/p>\n\n\n\n
Medical Surgical Nursing 1 (NUR 2210C)<\/a><\/strong>(NUR 2210C)<\/p>\n\n\n\n
17 documentsGo to course<\/p>\n\n\n\n
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![\"\"](\"https:\/\/d3tvd1u91rr79.cloudfront.net\/9206c2917a6268c2fb5375005857ea70\/html\/bg7.png?Policy=eyJTdGF0ZW1lbnQiOlt7IlJlc291cmNlIjoiaHR0cHM6Ly9kM3R2ZDF1OTFycjc5LmNsb3VkZnJvbnQubmV0LzkyMDZjMjkxN2E2MjY4YzJmYjUzNzUwMDU4NTdlYTcwL2h0bWwvKiIsIkNvbmRpdGlvbiI6eyJEYXRlTGVzc1RoYW4iOnsiQVdTOkVwb2NoVGltZSI6MTY5MDY1MjY0NH19fV19&Signature=cYNAiSytWfBrjschaz2Ey73FiuVZ11S2zvYhoqv9F-V3jmPqnurCSHevfrguDHfibSb1o37NK1~QfXOpEpv57e1i2kg1ejA5bEDkIcAcUZ3DUJJynju9lFPJ0XLvWeY2075RMudjqow-T9IPRaartbVneLLTv7fCP2uJ800AcL-4eES42u9ZShPDv2Xjw03AiIVSNj7Aiss9d3f-V7ASGS8K8C1E4APkpS5B9MHT7kyw-NT7xPiu~OQpHiVgJuz76YSnuO7nKXSfSJJNI9EOgEa5JPSngrCFZsbAaIpdQ2o5xEDJsJ0vsOPXS0Ya1rTbb37QOgtQZH4kCwJrpYZMhA__&Key-Pair-Id=APKAJ535ZH3ZAIIOADHQ\")
<\/p>\n\n\n\n28.What are the side effects of SNRIs? (serotonin and norepinephrine<\/p>\n\n\n\n
reuptake inhibitor) H\/A, somnolence, dizziness, insomnia, nervousness,<\/p>\n\n\n\n
nausea, dry mouth, constipation, abnormal ejaculations,<\/p>\n\n\n\n
anorexia\/weight loss, and elevated BP at higher doses.<\/p>\n\n\n\n
29.What are the side effects of MOIs?<\/p>\n\n\n\n
Insomnia, anxiety, agitation are initial adverse reactions. Common side<\/p>\n\n\n\n
effects include dizziness, H\/A, restlessness, and hypotension. Also, dry<\/p>\n\n\n\n
mouth, blurred vision, urinary retention and constipation<\/p>\n\n\n\n
30.In choosing a benzodiazepam to treat anxiety the prescriber needs to<\/p>\n\n\n\n
be aware of the possibilityofdependence.Thebenzodiazepamwith<\/p>\n\n\n\n
the greatest likelihood of rapidly developing dependence is:<\/p>\n\n\n\n
Alprazolam (Xanax)<\/p>\n\n\n\n
31.What receptors do benzodiazepines act on?<\/p>\n\n\n\n
Enhance the effect of the neurotransmitter gamma-aminobutyric acid<\/p>\n\n\n\n
(GABA-A) receptors which results in a sedative hypnotic<\/p>\n\n\n\n
anxiolytics\/anticonvulsant\/muscle relaxer properties.<\/p>\n\n\n\n
NURS 615 -Pharm Exam 2-Super Duper Exam<\/p>\n\n\n\n
2 Q&A<\/p>\n\n\n\n
![\"\"](\"https:\/\/d3tvd1u91rr79.cloudfront.net\/9206c2917a6268c2fb5375005857ea70\/html\/bg8.png?Policy=eyJTdGF0ZW1lbnQiOlt7IlJlc291cmNlIjoiaHR0cHM6Ly9kM3R2ZDF1OTFycjc5LmNsb3VkZnJvbnQubmV0LzkyMDZjMjkxN2E2MjY4YzJmYjUzNzUwMDU4NTdlYTcwL2h0bWwvKiIsIkNvbmRpdGlvbiI6eyJEYXRlTGVzc1RoYW4iOnsiQVdTOkVwb2NoVGltZSI6MTY5MDY1MjY0NH19fV19&Signature=cYNAiSytWfBrjschaz2Ey73FiuVZ11S2zvYhoqv9F-V3jmPqnurCSHevfrguDHfibSb1o37NK1~QfXOpEpv57e1i2kg1ejA5bEDkIcAcUZ3DUJJynju9lFPJ0XLvWeY2075RMudjqow-T9IPRaartbVneLLTv7fCP2uJ800AcL-4eES42u9ZShPDv2Xjw03AiIVSNj7Aiss9d3f-V7ASGS8K8C1E4APkpS5B9MHT7kyw-NT7xPiu~OQpHiVgJuz76YSnuO7nKXSfSJJNI9EOgEa5JPSngrCFZsbAaIpdQ2o5xEDJsJ0vsOPXS0Ya1rTbb37QOgtQZH4kCwJrpYZMhA__&Key-Pair-Id=APKAJ535ZH3ZAIIOADHQ\")
<\/p>\n\n\n\n32.Long-acting benzos are<\/p>\n\n\n\n
prescribed for? Treatment of<\/p>\n\n\n\n
anxiety<\/p>\n\n\n\n
33.Short and intermediate-acting benzos are<\/p>\n\n\n\n
prescribed for? Treatment of insomnia<\/p>\n\n\n\n
34.An appropriate drug to initially treat panic<\/p>\n\n\n\n
disorder is: Diazepam (Valium)<\/p>\n\n\n\n
35.Bernadette, a 42-year-old female, requests a prescription for an<\/p>\n\n\n\n
anorexiant to treat her obesity. A trial of phentermine is prescribed.<\/p>\n\n\n\n
Prescribing precautions include:<\/p>\n\n\n\n
NURS 615 -Pharm Exam 2-Super Duper Exam<\/p>\n\n\n\n
2 Q&A<\/p>\n\n\n\n
![\"\"](\"https:\/\/d3tvd1u91rr79.cloudfront.net\/9206c2917a6268c2fb5375005857ea70\/html\/bg9.png?Policy=eyJTdGF0ZW1lbnQiOlt7IlJlc291cmNlIjoiaHR0cHM6Ly9kM3R2ZDF1OTFycjc5LmNsb3VkZnJvbnQubmV0LzkyMDZjMjkxN2E2MjY4YzJmYjUzNzUwMDU4NTdlYTcwL2h0bWwvKiIsIkNvbmRpdGlvbiI6eyJEYXRlTGVzc1RoYW4iOnsiQVdTOkVwb2NoVGltZSI6MTY5MDY1MjY0NH19fV19&Signature=cYNAiSytWfBrjschaz2Ey73FiuVZ11S2zvYhoqv9F-V3jmPqnurCSHevfrguDHfibSb1o37NK1~QfXOpEpv57e1i2kg1ejA5bEDkIcAcUZ3DUJJynju9lFPJ0XLvWeY2075RMudjqow-T9IPRaartbVneLLTv7fCP2uJ800AcL-4eES42u9ZShPDv2Xjw03AiIVSNj7Aiss9d3f-V7ASGS8K8C1E4APkpS5B9MHT7kyw-NT7xPiu~OQpHiVgJuz76YSnuO7nKXSfSJJNI9EOgEa5JPSngrCFZsbAaIpdQ2o5xEDJsJ0vsOPXS0Ya1rTbb37QOgtQZH4kCwJrpYZMhA__&Key-Pair-Id=APKAJ535ZH3ZAIIOADHQ\")
<\/p>\n\n\n\nAnorexiants may cause tolerance and should only be prescribed for 6<\/p>\n\n\n\n
months<\/p>\n\n\n\n
36.Before prescribing phentermine to Bernadette, a thorough drug history<\/p>\n\n\n\n
should be taken including assessing for the use of serotonergic agents<\/p>\n\n\n\n
such as selective serotonin reuptake inhibitors (SSRIs) and St John\u2019s wort<\/p>\n\n\n\n
due to:<\/p>\n\n\n\n
The risk of serotonin syndrome<\/p>\n\n\n\n
37.Outside the brain phentermine releases norepi & epi causing what to<\/p>\n\n\n\n
break down? Fat cells to break down stored fat<\/p>\n\n\n\n
38.When prescribing phentermine what should you assess for?<\/p>\n\n\n\n
You must inquire if the patient is taking St. John\u2019s Wort and or an SSRI as<\/p>\n\n\n\n
these things can increase the risk of serotonin syndrome (H\/A, agitation,<\/p>\n\n\n\n
hyomania, mental confusion, hallucinations, & coma). Wait, there\u2019s<\/p>\n\n\n\n
more\u2026you also get autonomic effects like shivering, sweating,<\/p>\n\n\n\n
hyperthermia, vasoconstriction, tachycardia, nausea, diarrhea, and<\/p>\n\n\n\n
somatic effects such as myoclonis, hyperreflexia, and tremor!<\/p>\n\n\n\n
39.Factors that place a patient at risk of developing an antimicrobial-<\/p>\n\n\n\n
resistant organism include:<\/p>\n\n\n\n
NURS 615 -Pharm Exam 2-Super Duper Exam<\/p>\n\n\n\n
2 Q&A<\/p>\n\n\n\n
![\"\"](\"https:\/\/d3tvd1u91rr79.cloudfront.net\/9206c2917a6268c2fb5375005857ea70\/html\/bga.png?Policy=eyJTdGF0ZW1lbnQiOlt7IlJlc291cmNlIjoiaHR0cHM6Ly9kM3R2ZDF1OTFycjc5LmNsb3VkZnJvbnQubmV0LzkyMDZjMjkxN2E2MjY4YzJmYjUzNzUwMDU4NTdlYTcwL2h0bWwvKiIsIkNvbmRpdGlvbiI6eyJEYXRlTGVzc1RoYW4iOnsiQVdTOkVwb2NoVGltZSI6MTY5MDY1MjY0NH19fV19&Signature=cYNAiSytWfBrjschaz2Ey73FiuVZ11S2zvYhoqv9F-V3jmPqnurCSHevfrguDHfibSb1o37NK1~QfXOpEpv57e1i2kg1ejA5bEDkIcAcUZ3DUJJynju9lFPJ0XLvWeY2075RMudjqow-T9IPRaartbVneLLTv7fCP2uJ800AcL-4eES42u9ZShPDv2Xjw03AiIVSNj7Aiss9d3f-V7ASGS8K8C1E4APkpS5B9MHT7kyw-NT7xPiu~OQpHiVgJuz76YSnuO7nKXSfSJJNI9EOgEa5JPSngrCFZsbAaIpdQ2o5xEDJsJ0vsOPXS0Ya1rTbb37QOgtQZH4kCwJrpYZMhA__&Key-Pair-Id=APKAJ535ZH3ZAIIOADHQ\")
<\/p>\n\n\n\nInappropriate use of antimicrobials<\/p>\n\n\n\n
40.Infants and young children are at higher risk of developing antibiotic-<\/p>\n\n\n\n
resistant infections due to:<\/p>\n\n\n\n
The fact that children this age are more likely to be in daycare and<\/p>\n\n\n\n
exposed to pathogens from other children<\/p>\n\n\n\n
41.What must you instruct your patients do when taking an antibiotic?<\/p>\n\n\n\n
Counsel your patients that they need to take the entire antibiotic course<\/p>\n\n\n\n
for all of the days until the bottle is empty<\/p>\n\n\n\n
42.There is often cross-sensitivity and cross-resistance between<\/p>\n\n\n\n
penicillins and cephalosporins because:<\/p>\n\n\n\n
Both drug classes contain a beta-lactam ring that is vulnerable to beta-<\/p>\n\n\n\n
lactamase- producing organisms<\/p>\n\n\n\n
NURS 615 -Pharm Exam 2-Super Duper Exam<\/p>\n\n\n\n
2 Q&A<\/p>\n\n\n\n
![\"\"](\"https:\/\/d3tvd1u91rr79.cloudfront.net\/9206c2917a6268c2fb5375005857ea70\/html\/bgb.png?Policy=eyJTdGF0ZW1lbnQiOlt7IlJlc291cmNlIjoiaHR0cHM6Ly9kM3R2ZDF1OTFycjc5LmNsb3VkZnJvbnQubmV0LzkyMDZjMjkxN2E2MjY4YzJmYjUzNzUwMDU4NTdlYTcwL2h0bWwvKiIsIkNvbmRpdGlvbiI6eyJEYXRlTGVzc1RoYW4iOnsiQVdTOkVwb2NoVGltZSI6MTY5MDY1MjY0NH19fV19&Signature=cYNAiSytWfBrjschaz2Ey73FiuVZ11S2zvYhoqv9F-V3jmPqnurCSHevfrguDHfibSb1o37NK1~QfXOpEpv57e1i2kg1ejA5bEDkIcAcUZ3DUJJynju9lFPJ0XLvWeY2075RMudjqow-T9IPRaartbVneLLTv7fCP2uJ800AcL-4eES42u9ZShPDv2Xjw03AiIVSNj7Aiss9d3f-V7ASGS8K8C1E4APkpS5B9MHT7kyw-NT7xPiu~OQpHiVgJuz76YSnuO7nKXSfSJJNI9EOgEa5JPSngrCFZsbAaIpdQ2o5xEDJsJ0vsOPXS0Ya1rTbb37QOgtQZH4kCwJrpYZMhA__&Key-Pair-Id=APKAJ535ZH3ZAIIOADHQ\")
<\/p>\n\n\n\n43.Andy has been diagnosed with strep throat and needs a prescription for<\/p>\n\n\n\n
an antibiotic. He says the last time he had penicillin he developed a red,<\/p>\n\n\n\n
blotchy rash. An appropriate antibiotic to prescribe would be:<\/p>\n\n\n\n
Azithromycin<\/p>\n\n\n\n
44.Janis is a 25-year-old female who is 8 weeks pregnant and has a urinary<\/p>\n\n\n\n
tract infection. What would be the appropriate antibiotic to prescribe<\/p>\n\n\n\n
for her?<\/p>\n\n\n\n
Amoxicillin (Trimox)<\/p>\n\n\n\n
45.Which antibiotics inhibit bacterial cell wall synthesis?<\/p>\n\n\n\n
These are the bactericidal antibiotics which inhibit the cell wall synthesis<\/p>\n\n\n\n
and include the beta-lactam ABX and vancomycin<\/p>\n\n\n\n
46.Why is clavulanate added to amoxicillin?<\/p>\n\n\n\n
It is a combination of ABX consisting of amoxicillin trihydrate, a beta-<\/p>\n\n\n\n
lactam ABX and potassium clavulanate, it\u2019s a beta-lactamse inhibitor. This<\/p>\n\n\n\n
combination results in an ABX with increased spectrum of action and<\/p>\n\n\n\n
restored efficacy against amoxicillin-resistant bacteria that produce beta-<\/p>\n\n\n\n
lactamase<\/p>\n\n\n\n
NURS 615 -Pharm Exam 2-Super Duper Exam<\/p>\n\n\n\n
2 Q&A<\/p>\n\n\n\n
![\"\"](\"https:\/\/d3tvd1u91rr79.cloudfront.net\/9206c2917a6268c2fb5375005857ea70\/html\/bgc.png?Policy=eyJTdGF0ZW1lbnQiOlt7IlJlc291cmNlIjoiaHR0cHM6Ly9kM3R2ZDF1OTFycjc5LmNsb3VkZnJvbnQubmV0LzkyMDZjMjkxN2E2MjY4YzJmYjUzNzUwMDU4NTdlYTcwL2h0bWwvKiIsIkNvbmRpdGlvbiI6eyJEYXRlTGVzc1RoYW4iOnsiQVdTOkVwb2NoVGltZSI6MTY5MDY1MjY0NH19fV19&Signature=cYNAiSytWfBrjschaz2Ey73FiuVZ11S2zvYhoqv9F-V3jmPqnurCSHevfrguDHfibSb1o37NK1~QfXOpEpv57e1i2kg1ejA5bEDkIcAcUZ3DUJJynju9lFPJ0XLvWeY2075RMudjqow-T9IPRaartbVneLLTv7fCP2uJ800AcL-4eES42u9ZShPDv2Xjw03AiIVSNj7Aiss9d3f-V7ASGS8K8C1E4APkpS5B9MHT7kyw-NT7xPiu~OQpHiVgJuz76YSnuO7nKXSfSJJNI9EOgEa5JPSngrCFZsbAaIpdQ2o5xEDJsJ0vsOPXS0Ya1rTbb37QOgtQZH4kCwJrpYZMhA__&Key-Pair-Id=APKAJ535ZH3ZAIIOADHQ\")
<\/p>\n\n\n\n47.What ABX are appropriate to prescribe to<\/p>\n\n\n\n
children? Penicillins and cephalosporins are<\/p>\n\n\n\n
generally regarded as safe<\/p>\n\n\n\n
48.Which ABX class of drugs should be avoided in<\/p>\n\n\n\n
children? Fluoroquinolones and tetracyclines are to be<\/p>\n\n\n\n
avoided in childhood<\/p>\n\n\n\n
49.Jaide is a 12-month-old child who is being treated with amoxicillin for<\/p>\n\n\n\n
acute otitis media. Her parents call the clinic and say she has developed<\/p>\n\n\n\n
diarrhea. The appropriate action would be to:<\/p>\n\n\n\n
Advise the parents that some diarrhea is normal with amoxicillin and<\/p>\n\n\n\n
recommend probiotics daily<\/p>\n\n\n\n
50.Allison is a 13-year old child who comes to clinic with a 4-day history of<\/p>\n\n\n\n
cough, low-grade fever, and rhinorrhea. When she blows her nose or<\/p>\n\n\n\n
coughs the mucous is greenish- yellow. The appropriate antibiotic to<\/p>\n\n\n\n
prescribe would be:<\/p>\n\n\n\n
No ABX should be prescribed because this is a virus (mucous is greenish-<\/p>\n\n\n\n
yellow)<\/p>\n\n\n\n
NURS 615 -Pharm Exam 2-Super Duper Exam<\/p>\n\n\n\n
2 Q&A<\/p>\n\n\n\n
![\"\"](\"https:\/\/d3tvd1u91rr79.cloudfront.net\/9206c2917a6268c2fb5375005857ea70\/html\/bgd.png?Policy=eyJTdGF0ZW1lbnQiOlt7IlJlc291cmNlIjoiaHR0cHM6Ly9kM3R2ZDF1OTFycjc5LmNsb3VkZnJvbnQubmV0LzkyMDZjMjkxN2E2MjY4YzJmYjUzNzUwMDU4NTdlYTcwL2h0bWwvKiIsIkNvbmRpdGlvbiI6eyJEYXRlTGVzc1RoYW4iOnsiQVdTOkVwb2NoVGltZSI6MTY5MDY1MjY0NH19fV19&Signature=cYNAiSytWfBrjschaz2Ey73FiuVZ11S2zvYhoqv9F-V3jmPqnurCSHevfrguDHfibSb1o37NK1~QfXOpEpv57e1i2kg1ejA5bEDkIcAcUZ3DUJJynju9lFPJ0XLvWeY2075RMudjqow-T9IPRaartbVneLLTv7fCP2uJ800AcL-4eES42u9ZShPDv2Xjw03AiIVSNj7Aiss9d3f-V7ASGS8K8C1E4APkpS5B9MHT7kyw-NT7xPiu~OQpHiVgJuz76YSnuO7nKXSfSJJNI9EOgEa5JPSngrCFZsbAaIpdQ2o5xEDJsJ0vsOPXS0Ya1rTbb37QOgtQZH4kCwJrpYZMhA__&Key-Pair-Id=APKAJ535ZH3ZAIIOADHQ\")
<\/p>\n\n\n\n51.Cindy was recently treated with clindamycin for an infection. She calls<\/p>\n\n\n\n
the advice nurse because she is having frequent diarrhea that she thinks<\/p>\n\n\n\n
may have blood in it. What would be the appropriate care for her?<\/p>\n\n\n\n
Assess her for pseudomembranous colitis<\/p>\n\n\n\n
52.MEMORIZE: the American College of Cardiology and the American<\/p>\n\n\n\n
Heart Association\u2019s guide to ABX prophylactic use for dental<\/p>\n\n\n\n
appointments. See below\u2026<\/p>\n\n\n\n
53.According to the American College of Cardiology and the American<\/p>\n\n\n\n
Heart Association, what are the guidelines related to prophylactic<\/p>\n\n\n\n
antibiotics prior to a dental appointment?<\/p>\n\n\n\n
a. Thisisaveryimportantquestion.Thiswillbeonyourexam.If<\/p>\n\n\n\n
you go to the American Heart Association and look up the<\/p>\n\n\n\n
guideline, I would memorize this because these questions can<\/p>\n\n\n\n
be very tricky.<\/p>\n\n\n\n
b. Antibiotic prophylaxis with dental procedures is reasonable only for<\/p>\n\n\n\n
patients with<\/p>\n\n\n\n
NURS 615 -Pharm Exam 2-Super Duper Exam<\/p>\n\n\n\n
2 Q&A<\/p>\n\n\n\n
![\"\"](\"https:\/\/d3tvd1u91rr79.cloudfront.net\/9206c2917a6268c2fb5375005857ea70\/html\/bge.png?Policy=eyJTdGF0ZW1lbnQiOlt7IlJlc291cmNlIjoiaHR0cHM6Ly9kM3R2ZDF1OTFycjc5LmNsb3VkZnJvbnQubmV0LzkyMDZjMjkxN2E2MjY4YzJmYjUzNzUwMDU4NTdlYTcwL2h0bWwvKiIsIkNvbmRpdGlvbiI6eyJEYXRlTGVzc1RoYW4iOnsiQVdTOkVwb2NoVGltZSI6MTY5MDY1MjY0NH19fV19&Signature=cYNAiSytWfBrjschaz2Ey73FiuVZ11S2zvYhoqv9F-V3jmPqnurCSHevfrguDHfibSb1o37NK1~QfXOpEpv57e1i2kg1ejA5bEDkIcAcUZ3DUJJynju9lFPJ0XLvWeY2075RMudjqow-T9IPRaartbVneLLTv7fCP2uJ800AcL-4eES42u9ZShPDv2Xjw03AiIVSNj7Aiss9d3f-V7ASGS8K8C1E4APkpS5B9MHT7kyw-NT7xPiu~OQpHiVgJuz76YSnuO7nKXSfSJJNI9EOgEa5JPSngrCFZsbAaIpdQ2o5xEDJsJ0vsOPXS0Ya1rTbb37QOgtQZH4kCwJrpYZMhA__&Key-Pair-Id=APKAJ535ZH3ZAIIOADHQ\")
<\/p>\n\n\n\ncardiac conditions associated with the highest risk of adverse<\/p>\n\n\n\n
outcomes from endocarditis including:<\/p>\n\n\n\n
i. Prosthetic cardiac valve or prosthetic material used in valve<\/p>\n\n\n\n
repair<\/p>\n\n\n\n
ii. Previous endocarditis<\/p>\n\n\n\n
iii. Congenital heart disease only in the following categories:<\/p>\n\n\n\n
1. Unrepaired cyanotic congenital heart disease including<\/p>\n\n\n\n
those with palliative shunts and conduits<\/p>\n\n\n\n
2. Completely repaired congenital heart disease with<\/p>\n\n\n\n
prosthetic<\/p>\n\n\n\n
material device, whether place by surgery or catheter<\/p>\n\n\n\n
intervention during the six months after the procedure<\/p>\n\n\n\n
3. Repaired congenital heart disease with residual effects<\/p>\n\n\n\n
at the site<\/p>\n\n\n\n
or adjacent to the site of a prosthetic patch or prosthetic<\/p>\n\n\n\n
device, which inhibit endothelialization<\/p>\n\n\n\n
4. Cardiac transplantation recipients with cardiac valvular<\/p>\n\n\n\n
disease<\/p>\n\n\n\n
c. Pay very close attention to those subtypes<\/p>\n\n\n\n
NURS 615 -Pharm Exam 2-Super Duper Exam<\/p>\n\n\n\n
2 Q&A<\/p>\n\n\n\n
![\"\"](\"https:\/\/d3tvd1u91rr79.cloudfront.net\/9206c2917a6268c2fb5375005857ea70\/html\/bgf.png?Policy=eyJTdGF0ZW1lbnQiOlt7IlJlc291cmNlIjoiaHR0cHM6Ly9kM3R2ZDF1OTFycjc5LmNsb3VkZnJvbnQubmV0LzkyMDZjMjkxN2E2MjY4YzJmYjUzNzUwMDU4NTdlYTcwL2h0bWwvKiIsIkNvbmRpdGlvbiI6eyJEYXRlTGVzc1RoYW4iOnsiQVdTOkVwb2NoVGltZSI6MTY5MDY1MjY0NH19fV19&Signature=cYNAiSytWfBrjschaz2Ey73FiuVZ11S2zvYhoqv9F-V3jmPqnurCSHevfrguDHfibSb1o37NK1~QfXOpEpv57e1i2kg1ejA5bEDkIcAcUZ3DUJJynju9lFPJ0XLvWeY2075RMudjqow-T9IPRaartbVneLLTv7fCP2uJ800AcL-4eES42u9ZShPDv2Xjw03AiIVSNj7Aiss9d3f-V7ASGS8K8C1E4APkpS5B9MHT7kyw-NT7xPiu~OQpHiVgJuz76YSnuO7nKXSfSJJNI9EOgEa5JPSngrCFZsbAaIpdQ2o5xEDJsJ0vsOPXS0Ya1rTbb37QOgtQZH4kCwJrpYZMhA__&Key-Pair-Id=APKAJ535ZH3ZAIIOADHQ\")
<\/p>\n\n\n\nd. The treatment used for a dental appointment is amoxicillin orally<\/p>\n\n\n\n
two grams. In children it would be 50 milligrams per kilogram<\/p>\n\n\n\n
e. Dental Procedures and Infective EndocarditisIn the past, patients<\/p>\n\n\n\n
with nearly<\/p>\n\n\n\n
every type of congenital heart defect needed to receive antibiotics<\/p>\n\n\n\n
one hour before dental procedures or operations on the mouth,<\/p>\n\n\n\n
throat, gastrointestinal genital, or urinary tract. However, in 2007 the<\/p>\n\n\n\n
American Heart Association simplified its recommendations. Today,<\/p>\n\n\n\n
antibiotics before dental procedures are only recommended for<\/p>\n\n\n\n
patients with the highest risk of IE, those who have:<\/p>\n\n\n\n
NURS 615 -Pharm Exam 2-Super Duper Exam<\/p>\n\n\n\n
2 Q&A<\/p>\n\n\n\n
![\"\"](\"https:\/\/d3tvd1u91rr79.cloudfront.net\/9206c2917a6268c2fb5375005857ea70\/html\/bg10.png?Policy=eyJTdGF0ZW1lbnQiOlt7IlJlc291cmNlIjoiaHR0cHM6Ly9kM3R2ZDF1OTFycjc5LmNsb3VkZnJvbnQubmV0LzkyMDZjMjkxN2E2MjY4YzJmYjUzNzUwMDU4NTdlYTcwL2h0bWwvKiIsIkNvbmRpdGlvbiI6eyJEYXRlTGVzc1RoYW4iOnsiQVdTOkVwb2NoVGltZSI6MTY5MDY1MjY0NH19fV19&Signature=cYNAiSytWfBrjschaz2Ey73FiuVZ11S2zvYhoqv9F-V3jmPqnurCSHevfrguDHfibSb1o37NK1~QfXOpEpv57e1i2kg1ejA5bEDkIcAcUZ3DUJJynju9lFPJ0XLvWeY2075RMudjqow-T9IPRaartbVneLLTv7fCP2uJ800AcL-4eES42u9ZShPDv2Xjw03AiIVSNj7Aiss9d3f-V7ASGS8K8C1E4APkpS5B9MHT7kyw-NT7xPiu~OQpHiVgJuz76YSnuO7nKXSfSJJNI9EOgEa5JPSngrCFZsbAaIpdQ2o5xEDJsJ0vsOPXS0Ya1rTbb37QOgtQZH4kCwJrpYZMhA__&Key-Pair-Id=APKAJ535ZH3ZAIIOADHQ\")
<\/p>\n\n\n\ni. A prosthetic heart valve or who have had a heart valve<\/p>\n\n\n\n
repaired with prosthetic material.<\/p>\n\n\n\n
ii. A history of endocarditis.<\/p>\n\n\n\n
iii. A heart transplant with abnormal heart valve function<\/p>\n\n\n\n
iv. Certain congenital heart defects including:<\/p>\n\n\n\n
1. Cyanotic congenital heart disease (birth defects with<\/p>\n\n\n\n
oxygen levels lower than normal), that has not been<\/p>\n\n\n\n
fully repaired, including children who have had a<\/p>\n\n\n\n
surgical shunts and conduits.<\/p>\n\n\n\n
2. A congenital heart defect that’s been completely<\/p>\n\n\n\n
repaired with<\/p>\n\n\n\n
prosthetic material or a device for the first six months<\/p>\n\n\n\n
after the repair procedure.<\/p>\n\n\n\n
3. Repaired congenital heart disease with residual defects,<\/p>\n\n\n\n
such as<\/p>\n\n\n\n
persisting leaks or abnormal flow at or adjacent to a<\/p>\n\n\n\n
prosthetic patch or prosthetic devices<\/p>\n\n\n\n
f. Key changes for patients with congenital heart defectsPreventive<\/p>\n\n\n\n
antibiotics are<\/p>\n\n\n\n
NURS 615 -Pharm Exam 2-Super Duper Exam<\/p>\n\n\n\n
2 Q&A<\/p>\n\n\n\n
![\"\"](\"https:\/\/d3tvd1u91rr79.cloudfront.net\/9206c2917a6268c2fb5375005857ea70\/html\/bg11.png?Policy=eyJTdGF0ZW1lbnQiOlt7IlJlc291cmNlIjoiaHR0cHM6Ly9kM3R2ZDF1OTFycjc5LmNsb3VkZnJvbnQubmV0LzkyMDZjMjkxN2E2MjY4YzJmYjUzNzUwMDU4NTdlYTcwL2h0bWwvKiIsIkNvbmRpdGlvbiI6eyJEYXRlTGVzc1RoYW4iOnsiQVdTOkVwb2NoVGltZSI6MTY5MDY1MjY0NH19fV19&Signature=cYNAiSytWfBrjschaz2Ey73FiuVZ11S2zvYhoqv9F-V3jmPqnurCSHevfrguDHfibSb1o37NK1~QfXOpEpv57e1i2kg1ejA5bEDkIcAcUZ3DUJJynju9lFPJ0XLvWeY2075RMudjqow-T9IPRaartbVneLLTv7fCP2uJ800AcL-4eES42u9ZShPDv2Xjw03AiIVSNj7Aiss9d3f-V7ASGS8K8C1E4APkpS5B9MHT7kyw-NT7xPiu~OQpHiVgJuz76YSnuO7nKXSfSJJNI9EOgEa5JPSngrCFZsbAaIpdQ2o5xEDJsJ0vsOPXS0Ya1rTbb37QOgtQZH4kCwJrpYZMhA__&Key-Pair-Id=APKAJ535ZH3ZAIIOADHQ\")
<\/p>\n\n\n\nno longer recommended for any other congenital heart disease than<\/p>\n\n\n\n
these:<\/p>\n\n\n\n
i. Cyanotic congenital heart disease (birth defects with oxygen<\/p>\n\n\n\n
levels lower than normal), that has not been fully repaired,<\/p>\n\n\n\n
including children who have had a surgical shunts and<\/p>\n\n\n\n
conduits.<\/p>\n\n\n\n
ii. A congenital heart defect that’s been completely repaired with<\/p>\n\n\n\n
prosthetic<\/p>\n\n\n\n
material or a device for the first six months after the repair<\/p>\n\n\n\n
procedure.<\/p>\n\n\n\n
iii. Repaired congenital heart disease with residual defects, such<\/p>\n\n\n\n
as persisting leaks or abnormal flow at or adjacent to a<\/p>\n\n\n\n
prosthetic patch or prosthetic device.<\/p>\n\n\n\n
g. Additionally, taking antibiotics just to prevent endocarditis is not<\/p>\n\n\n\n
recommended<\/p>\n\n\n\n
for patients who have procedures involving the reproductive, urinary<\/p>\n\n\n\n
or gastrointestinal tracts.<\/p>\n\n\n\n
NURS 615 -Pharm Exam 2-Super Duper Exam<\/p>\n\n\n\n
2 Q&A<\/p>\n\n\n\n
![\"\"](\"https:\/\/d3tvd1u91rr79.cloudfront.net\/9206c2917a6268c2fb5375005857ea70\/html\/bg12.png?Policy=eyJTdGF0ZW1lbnQiOlt7IlJlc291cmNlIjoiaHR0cHM6Ly9kM3R2ZDF1OTFycjc5LmNsb3VkZnJvbnQubmV0LzkyMDZjMjkxN2E2MjY4YzJmYjUzNzUwMDU4NTdlYTcwL2h0bWwvKiIsIkNvbmRpdGlvbiI6eyJEYXRlTGVzc1RoYW4iOnsiQVdTOkVwb2NoVGltZSI6MTY5MDY1MjY0NH19fV19&Signature=cYNAiSytWfBrjschaz2Ey73FiuVZ11S2zvYhoqv9F-V3jmPqnurCSHevfrguDHfibSb1o37NK1~QfXOpEpv57e1i2kg1ejA5bEDkIcAcUZ3DUJJynju9lFPJ0XLvWeY2075RMudjqow-T9IPRaartbVneLLTv7fCP2uJ800AcL-4eES42u9ZShPDv2Xjw03AiIVSNj7Aiss9d3f-V7ASGS8K8C1E4APkpS5B9MHT7kyw-NT7xPiu~OQpHiVgJuz76YSnuO7nKXSfSJJNI9EOgEa5JPSngrCFZsbAaIpdQ2o5xEDJsJ0vsOPXS0Ya1rTbb37QOgtQZH4kCwJrpYZMhA__&Key-Pair-Id=APKAJ535ZH3ZAIIOADHQ\")
<\/p>\n\n\n\n54.Kristine had a small ventricle septal defect (VSD) repaired when she was 3<\/p>\n\n\n\n
years old and has no residual cardiac problems. She is now 28 and is<\/p>\n\n\n\n
requesting prophylactic antibiotics for an upcoming dental visit. The<\/p>\n\n\n\n
appropriate antibiotic to prescribe according to current American College<\/p>\n\n\n\n
of Cardiology and American Heart Association guidelines is: None, no<\/p>\n\n\n\n
antibiotic is required for dental procedures<\/p>\n\n\n\n
55.What patient teaching will you provide to a patient who is experiencing<\/p>\n\n\n\n
non-infectious diarrhea related to ABX administration?<\/p>\n\n\n\n
Patient will need to be assessed for C. dif colitis. Advise patient to<\/p>\n\n\n\n
increase their probiotic intake with yogurt to repopulate the gut flora<\/p>\n\n\n\n
NURS 615 -Pharm Exam 2-Super Duper Exam<\/p>\n\n\n\n
2 Q&A<\/p>\n\n\n\n
![\"\"](\"https:\/\/d3tvd1u91rr79.cloudfront.net\/9206c2917a6268c2fb5375005857ea70\/html\/bg13.png?Policy=eyJTdGF0ZW1lbnQiOlt7IlJlc291cmNlIjoiaHR0cHM6Ly9kM3R2ZDF1OTFycjc5LmNsb3VkZnJvbnQubmV0LzkyMDZjMjkxN2E2MjY4YzJmYjUzNzUwMDU4NTdlYTcwL2h0bWwvKiIsIkNvbmRpdGlvbiI6eyJEYXRlTGVzc1RoYW4iOnsiQVdTOkVwb2NoVGltZSI6MTY5MDY1MjY0NH19fV19&Signature=cYNAiSytWfBrjschaz2Ey73FiuVZ11S2zvYhoqv9F-V3jmPqnurCSHevfrguDHfibSb1o37NK1~QfXOpEpv57e1i2kg1ejA5bEDkIcAcUZ3DUJJynju9lFPJ0XLvWeY2075RMudjqow-T9IPRaartbVneLLTv7fCP2uJ800AcL-4eES42u9ZShPDv2Xjw03AiIVSNj7Aiss9d3f-V7ASGS8K8C1E4APkpS5B9MHT7kyw-NT7xPiu~OQpHiVgJuz76YSnuO7nKXSfSJJNI9EOgEa5JPSngrCFZsbAaIpdQ2o5xEDJsJ0vsOPXS0Ya1rTbb37QOgtQZH4kCwJrpYZMhA__&Key-Pair-Id=APKAJ535ZH3ZAIIOADHQ\")
<\/p>\n\n\n\n56.To prevent further development of antibacterial resistance it is<\/p>\n\n\n\n
recommended that fluoroquinolones be reserved for treatment of:<\/p>\n\n\n\n
Community-acquired pneumonia in patients with comorbidities<\/p>\n\n\n\n
57.Fluoroquinolones have a Black Box Warning regarding even months<\/p>\n\n\n\n
after treatment.<\/p>\n\n\n\n
Tendon rupture<\/p>\n\n\n\n
58.Fluoroquinolones have been reported to enhance the effective of<\/p>\n\n\n\n
and appropriate laboratory tests should be routinely monitored. It\u2019s<\/p>\n\n\n\n
postulated to affect gut flora, which displaces warfarin from albumin and<\/p>\n\n\n\n
interfere with hepatic metabolism by inhibiting the cytochrome P450<\/p>\n\n\n\n
enzyme system.<\/p>\n\n\n\n
Warfarin<\/p>\n\n\n\n
59.Tetracyclines should not be prescribed to children younger than 8<\/p>\n\n\n\n
years due to: Adverse effects on bone growth<\/p>\n\n\n\n
60.Tetracyclines such as minocycline are safe<\/p>\n\n\n\n
to use in: Adolescents<\/p>\n\n\n\n
NURS 615 -Pharm Exam 2-Super Duper Exam<\/p>\n\n\n\n
2 Q&A<\/p>\n\n\n\n
![\"\"](\"https:\/\/d3tvd1u91rr79.cloudfront.net\/9206c2917a6268c2fb5375005857ea70\/html\/bg14.png?Policy=eyJTdGF0ZW1lbnQiOlt7IlJlc291cmNlIjoiaHR0cHM6Ly9kM3R2ZDF1OTFycjc5LmNsb3VkZnJvbnQubmV0LzkyMDZjMjkxN2E2MjY4YzJmYjUzNzUwMDU4NTdlYTcwL2h0bWwvKiIsIkNvbmRpdGlvbiI6eyJEYXRlTGVzc1RoYW4iOnsiQVdTOkVwb2NoVGltZSI6MTY5MDY1MjY0NH19fV19&Signature=cYNAiSytWfBrjschaz2Ey73FiuVZ11S2zvYhoqv9F-V3jmPqnurCSHevfrguDHfibSb1o37NK1~QfXOpEpv57e1i2kg1ejA5bEDkIcAcUZ3DUJJynju9lFPJ0XLvWeY2075RMudjqow-T9IPRaartbVneLLTv7fCP2uJ800AcL-4eES42u9ZShPDv2Xjw03AiIVSNj7Aiss9d3f-V7ASGS8K8C1E4APkpS5B9MHT7kyw-NT7xPiu~OQpHiVgJuz76YSnuO7nKXSfSJJNI9EOgEa5JPSngrCFZsbAaIpdQ2o5xEDJsJ0vsOPXS0Ya1rTbb37QOgtQZH4kCwJrpYZMhA__&Key-Pair-Id=APKAJ535ZH3ZAIIOADHQ\")
<\/p>\n\n\n\n61.Hanna is a 17-year-old female who is taking minocycline for acne. She<\/p>\n\n\n\n
comes to the clinic complaining of a headache. What would be the plan of<\/p>\n\n\n\n
care?<\/p>\n\n\n\n
Evaluate her for pseudotremor cerebri<\/p>\n\n\n\n
62.Valerie has been prescribed doxycycline for a chlamydia infection. She is<\/p>\n\n\n\n
healthy and her only medication is an oral combined contraceptive.<\/p>\n\n\n\n
Patricia\u2019s education would include: Use a back-up method of birth control<\/p>\n\n\n\n
(condom) until her next menses. Recent research has shown no<\/p>\n\n\n\n
significant loss of effectiveness of oral contraceptives while using most<\/p>\n\n\n\n
tetracycline ABX but most practitioners still encourage another barrier<\/p>\n\n\n\n
method.<\/p>\n\n\n\n
63.Adverse effects of tetracycline ABX use include:<\/p>\n\n\n\n
Can stain developing teeth when taken by the mother during pregnancy<\/p>\n\n\n\n
and can impair bone growth in children.<\/p>\n\n\n\n
64.Interactions and precautions with tetracycline include:<\/p>\n\n\n\n
Can be inactivated by calcium ions and are NOT to be taken with milk,<\/p>\n\n\n\n
yogurt, or other dairy products. Can cause skin photosensitivity, drug-<\/p>\n\n\n\n
induced lupus and hepatitis.<\/p>\n\n\n\n
NURS 615 -Pharm Exam 2-Super Duper Exam<\/p>\n\n\n\n
2 Q&A<\/p>\n\n\n\n
![\"\"](\"https:\/\/d3tvd1u91rr79.cloudfront.net\/9206c2917a6268c2fb5375005857ea70\/html\/bg15.png?Policy=eyJTdGF0ZW1lbnQiOlt7IlJlc291cmNlIjoiaHR0cHM6Ly9kM3R2ZDF1OTFycjc5LmNsb3VkZnJvbnQubmV0LzkyMDZjMjkxN2E2MjY4YzJmYjUzNzUwMDU4NTdlYTcwL2h0bWwvKiIsIkNvbmRpdGlvbiI6eyJEYXRlTGVzc1RoYW4iOnsiQVdTOkVwb2NoVGltZSI6MTY5MDY1MjY0NH19fV19&Signature=cYNAiSytWfBrjschaz2Ey73FiuVZ11S2zvYhoqv9F-V3jmPqnurCSHevfrguDHfibSb1o37NK1~QfXOpEpv57e1i2kg1ejA5bEDkIcAcUZ3DUJJynju9lFPJ0XLvWeY2075RMudjqow-T9IPRaartbVneLLTv7fCP2uJ800AcL-4eES42u9ZShPDv2Xjw03AiIVSNj7Aiss9d3f-V7ASGS8K8C1E4APkpS5B9MHT7kyw-NT7xPiu~OQpHiVgJuz76YSnuO7nKXSfSJJNI9EOgEa5JPSngrCFZsbAaIpdQ2o5xEDJsJ0vsOPXS0Ya1rTbb37QOgtQZH4kCwJrpYZMhA__&Key-Pair-Id=APKAJ535ZH3ZAIIOADHQ\")
<\/p>\n\n\n\nTetracyclines can also cause microvassicular fatty liver, tinnitus, and can<\/p>\n\n\n\n
interfere with methotrexate by displacing it from various protein binding<\/p>\n\n\n\n
sites they can cause breathing complications such as anaphylactic shock<\/p>\n\n\n\n
in some individuals.<\/p>\n\n\n\n
65.What are the most common drug interactions with levofloxacin?<\/p>\n\n\n\n
Potential tendon damage, black box warning (pregnancy), caution with<\/p>\n\n\n\n
older population and cortical steroid use, and interaction with warfarin<\/p>\n\n\n\n
66.A patient is administered gentamicin and complains of sudden hearing<\/p>\n\n\n\n
loss. What should the NP do?<\/p>\n\n\n\n
The NP should immediately instruct the patient to stop the medication as<\/p>\n\n\n\n
there is a concern for ototoxicity<\/p>\n\n\n\n
67.Which medications interact with linezolid (a weak MAO inhibitor)?<\/p>\n\n\n\n
Should not be used with other MAOIs, tyramine rich foods such as pork,<\/p>\n\n\n\n
aged cheese, alcohol, smoked or pickled foods, or serotonergic drugs<\/p>\n\n\n\n
(all the good stuff). It should also not be given with pethidine or<\/p>\n\n\n\n
meperidine (Demerol) under any circumstance d\/t risk of serotonin<\/p>\n\n\n\n
syndrome.<\/p>\n\n\n\n
NURS 615 -Pharm Exam 2-Super Duper Exam<\/p>\n\n\n\n
2 Q&A<\/p>\n\n\n\n
![\"\"](\"https:\/\/d3tvd1u91rr79.cloudfront.net\/9206c2917a6268c2fb5375005857ea70\/html\/bg16.png?Policy=eyJTdGF0ZW1lbnQiOlt7IlJlc291cmNlIjoiaHR0cHM6Ly9kM3R2ZDF1OTFycjc5LmNsb3VkZnJvbnQubmV0LzkyMDZjMjkxN2E2MjY4YzJmYjUzNzUwMDU4NTdlYTcwL2h0bWwvKiIsIkNvbmRpdGlvbiI6eyJEYXRlTGVzc1RoYW4iOnsiQVdTOkVwb2NoVGltZSI6MTY5MDY1MjY0NH19fV19&Signature=cYNAiSytWfBrjschaz2Ey73FiuVZ11S2zvYhoqv9F-V3jmPqnurCSHevfrguDHfibSb1o37NK1~QfXOpEpv57e1i2kg1ejA5bEDkIcAcUZ3DUJJynju9lFPJ0XLvWeY2075RMudjqow-T9IPRaartbVneLLTv7fCP2uJ800AcL-4eES42u9ZShPDv2Xjw03AiIVSNj7Aiss9d3f-V7ASGS8K8C1E4APkpS5B9MHT7kyw-NT7xPiu~OQpHiVgJuz76YSnuO7nKXSfSJJNI9EOgEa5JPSngrCFZsbAaIpdQ2o5xEDJsJ0vsOPXS0Ya1rTbb37QOgtQZH4kCwJrpYZMhA__&Key-Pair-Id=APKAJ535ZH3ZAIIOADHQ\")
<\/p>\n\n\n\n68.What is the treatment of Lyme<\/p>\n\n\n\n
Disease? Doxycylcline 100 mg PO<\/p>\n\n\n\n
q12 hrs x21 days<\/p>\n\n\n\n
69.To prevent the development of peripheral neuropathy in patients<\/p>\n\n\n\n
taking isoniazid for tuberculosis the patient is also prescribed:<\/p>\n\n\n\n
Pyridoxine (vitamin B6)<\/p>\n\n\n\n
70.Mary is an 82-year-old patient who has herpes zoster (shingles) and<\/p>\n\n\n\n
would benefit from an antiviral such as valacyclovir. Prior to prescribing<\/p>\n\n\n\n
valacyclovir she will need an assessment of:<\/p>\n\n\n\n
Renal function<\/p>\n\n\n\n
71.When prescribing acyclovir, patients should be educated regarding the:<\/p>\n\n\n\n
Need to drink lots of fluids during treatment (need to flush the kidneys<\/p>\n\n\n\n
as this class of drug can be nephrotoxic)<\/p>\n\n\n\n
72.Michael has been diagnosed with type A influenza. Appropriate<\/p>\n\n\n\n
prescribing of oseltamivir (Tamiflu) would include:<\/p>\n\n\n\n
NURS 615 -Pharm Exam 2-Super Duper Exam<\/p>\n\n\n\n
2 Q&A<\/p>\n\n\n\n
![\"\"](\"https:\/\/d3tvd1u91rr79.cloudfront.net\/9206c2917a6268c2fb5375005857ea70\/html\/bg17.png?Policy=eyJTdGF0ZW1lbnQiOlt7IlJlc291cmNlIjoiaHR0cHM6Ly9kM3R2ZDF1OTFycjc5LmNsb3VkZnJvbnQubmV0LzkyMDZjMjkxN2E2MjY4YzJmYjUzNzUwMDU4NTdlYTcwL2h0bWwvKiIsIkNvbmRpdGlvbiI6eyJEYXRlTGVzc1RoYW4iOnsiQVdTOkVwb2NoVGltZSI6MTY5MDY1MjY0NH19fV19&Signature=cYNAiSytWfBrjschaz2Ey73FiuVZ11S2zvYhoqv9F-V3jmPqnurCSHevfrguDHfibSb1o37NK1~QfXOpEpv57e1i2kg1ejA5bEDkIcAcUZ3DUJJynju9lFPJ0XLvWeY2075RMudjqow-T9IPRaartbVneLLTv7fCP2uJ800AcL-4eES42u9ZShPDv2Xjw03AiIVSNj7Aiss9d3f-V7ASGS8K8C1E4APkpS5B9MHT7kyw-NT7xPiu~OQpHiVgJuz76YSnuO7nKXSfSJJNI9EOgEa5JPSngrCFZsbAaIpdQ2o5xEDJsJ0vsOPXS0Ya1rTbb37QOgtQZH4kCwJrpYZMhA__&Key-Pair-Id=APKAJ535ZH3ZAIIOADHQ\")
<\/p>\n\n\n\nStarting oseltamivir within the first 48 hours of influenza symptoms<\/p>\n\n\n\n
73.What is rifampin ABX prescribed<\/p>\n\n\n\n
for? TB, leprosy, and legionella<\/p>\n\n\n\n
among others<\/p>\n\n\n\n
74.What are the adverse effects of isoniazid (INH)?<\/p>\n\n\n\n
Used as the first line agent for the prevention and treatment of both<\/p>\n\n\n\n
waiting and active TB. Adverse effects include hepatotoxicity and<\/p>\n\n\n\n
peripheral neuropathy.<\/p>\n\n\n\n
75.What are the main effects of doxycycline?<\/p>\n\n\n\n
GI upset including anorexia, N\/V, & diarrhea. Advise patient to<\/p>\n\n\n\n
take with food todecrease GI irritation. Dermatologic side effects<\/p>\n\n\n\n
include photosensitivity, rashes, Stevens-Johnson Syndrome<\/p>\n\n\n\n
(serious), and toxic epidermal necrolysis.<\/p>\n\n\n\n
76.What is the difference between oral Vanco and parenteral Vanco?<\/p>\n\n\n\n
First of all, Vanco is a large hydrophilic molecule that partitions poorly<\/p>\n\n\n\n
across the GI mucosa with a short half-life (usually admin 2xday). Oral is<\/p>\n\n\n\n
given for the treatment of pseudomembranous colitis (c.diff) so it can<\/p>\n\n\n\n
reach the site of infection, usually the colon. Parenteral Vanco is given for<\/p>\n\n\n\n
NURS 615 -Pharm Exam 2-Super Duper Exam<\/p>\n\n\n\n
2 Q&A<\/p>\n\n\n\n
![\"\"](\"https:\/\/d3tvd1u91rr79.cloudfront.net\/9206c2917a6268c2fb5375005857ea70\/html\/bg18.png?Policy=eyJTdGF0ZW1lbnQiOlt7IlJlc291cmNlIjoiaHR0cHM6Ly9kM3R2ZDF1OTFycjc5LmNsb3VkZnJvbnQubmV0LzkyMDZjMjkxN2E2MjY4YzJmYjUzNzUwMDU4NTdlYTcwL2h0bWwvKiIsIkNvbmRpdGlvbiI6eyJEYXRlTGVzc1RoYW4iOnsiQVdTOkVwb2NoVGltZSI6MTY5MDY1MjY0NH19fV19&Signature=cYNAiSytWfBrjschaz2Ey73FiuVZ11S2zvYhoqv9F-V3jmPqnurCSHevfrguDHfibSb1o37NK1~QfXOpEpv57e1i2kg1ejA5bEDkIcAcUZ3DUJJynju9lFPJ0XLvWeY2075RMudjqow-T9IPRaartbVneLLTv7fCP2uJ800AcL-4eES42u9ZShPDv2Xjw03AiIVSNj7Aiss9d3f-V7ASGS8K8C1E4APkpS5B9MHT7kyw-NT7xPiu~OQpHiVgJuz76YSnuO7nKXSfSJJNI9EOgEa5JPSngrCFZsbAaIpdQ2o5xEDJsJ0vsOPXS0Ya1rTbb37QOgtQZH4kCwJrpYZMhA__&Key-Pair-Id=APKAJ535ZH3ZAIIOADHQ\")
<\/p>\n\n\n\nthe treatment of MRSA infections and due to its caustic properties it<\/p>\n\n\n\n
should be administered through a PICC or central line.<\/p>\n\n\n\n
77.What mechanism of action (MOA) of azithromycin?<\/p>\n\n\n\n
Azithromycin is a macrolide which inhibits bacterial protein biosynthesis<\/p>\n\n\n\n
preventing peptidyl transferase from adding to the growing peptide<\/p>\n\n\n\n
attached to the transfer RNA to the next amino acid. It also inhibits<\/p>\n\n\n\n
ribosomal translation.<\/p>\n\n\n\n
78.Which class of antibiotics block bacterial protein production?<\/p>\n\n\n\n
Bacteriostatic ABX limit growth of bacteria by interfering with bacterial<\/p>\n\n\n\n
protein production, DNA replication, or other aspects of cellular bacterial<\/p>\n\n\n\n
metabolism. This group includes tetracyclines, sulfonamides,<\/p>\n\n\n\n
spectinomycin, trimethoprim, chloramphenicol, macrolides,<\/p>\n\n\n\n
lincosamides, clindamycin, ethambutol, nitrofurantoin, novobiocin,<\/p>\n\n\n\n
tigecycline, and oxazolidinone.<\/p>\n\n\n\n
79.Monitoring for patients who are on long-term antifungal therapy with<\/p>\n\n\n\n
ketoconazole includes:<\/p>\n\n\n\n
AST, ALT, alkaline phosphatase, and bilirubin<\/p>\n\n\n\n
NURS 615 -Pharm Exam 2-Super Duper Exam<\/p>\n\n\n\n
2 Q&A<\/p>\n\n\n\n
![\"\"](\"https:\/\/d3tvd1u91rr79.cloudfront.net\/9206c2917a6268c2fb5375005857ea70\/html\/bg19.png?Policy=eyJTdGF0ZW1lbnQiOlt7IlJlc291cmNlIjoiaHR0cHM6Ly9kM3R2ZDF1OTFycjc5LmNsb3VkZnJvbnQubmV0LzkyMDZjMjkxN2E2MjY4YzJmYjUzNzUwMDU4NTdlYTcwL2h0bWwvKiIsIkNvbmRpdGlvbiI6eyJEYXRlTGVzc1RoYW4iOnsiQVdTOkVwb2NoVGltZSI6MTY5MDY1MjY0NH19fV19&Signature=cYNAiSytWfBrjschaz2Ey73FiuVZ11S2zvYhoqv9F-V3jmPqnurCSHevfrguDHfibSb1o37NK1~QfXOpEpv57e1i2kg1ejA5bEDkIcAcUZ3DUJJynju9lFPJ0XLvWeY2075RMudjqow-T9IPRaartbVneLLTv7fCP2uJ800AcL-4eES42u9ZShPDv2Xjw03AiIVSNj7Aiss9d3f-V7ASGS8K8C1E4APkpS5B9MHT7kyw-NT7xPiu~OQpHiVgJuz76YSnuO7nKXSfSJJNI9EOgEa5JPSngrCFZsbAaIpdQ2o5xEDJsJ0vsOPXS0Ya1rTbb37QOgtQZH4kCwJrpYZMhA__&Key-Pair-Id=APKAJ535ZH3ZAIIOADHQ\")
<\/p>\n\n\n\n80.When prescribing metronidazole (Flagyl) to treat bacterial vaginosis,<\/p>\n\n\n\n
patient education would include:<\/p>\n\n\n\n
Consuming alcohol in any form may cause a severe reaction<\/p>\n\n\n\n
81.Every antibiotic drug class has resistant organisms that influence<\/p>\n\n\n\n
prescribing decisions. T or F?<\/p>\n\n\n\n
True<\/p>\n\n\n\n
82.Identify which antihelmintic is used to treat intestinal<\/p>\n\n\n\n
parasitic worms. Mebendazole and agromectin<\/p>\n\n\n\n
83.Identify which antihelmintic is used to treat tissue parasites<\/p>\n\n\n\n
(apparently there is a difference).<\/p>\n\n\n\n
Mebendazole, albendazole or ivermectin<\/p>\n\n\n\n
84.What antifungal medications can be used topically to treat<\/p>\n\n\n\n
fungal infections? Clotrimazole (treatment for candidiasis)<\/p>\n\n\n\n
85.What medication is used to treat scabies?<\/p>\n\n\n\n
Ivermectin and permethrin cream (can also treat lice)<\/p>\n\n\n\n
86.What is pyrazinamide used to treat?<\/p>\n\n\n\n
NURS 615 -Pharm Exam 2-Super Duper Exam<\/p>\n\n\n\n
2 Q&A<\/p>\n\n\n\n
![\"\"](\"https:\/\/d3tvd1u91rr79.cloudfront.net\/9206c2917a6268c2fb5375005857ea70\/html\/bg1a.png?Policy=eyJTdGF0ZW1lbnQiOlt7IlJlc291cmNlIjoiaHR0cHM6Ly9kM3R2ZDF1OTFycjc5LmNsb3VkZnJvbnQubmV0LzkyMDZjMjkxN2E2MjY4YzJmYjUzNzUwMDU4NTdlYTcwL2h0bWwvKiIsIkNvbmRpdGlvbiI6eyJEYXRlTGVzc1RoYW4iOnsiQVdTOkVwb2NoVGltZSI6MTY5MDY1MjY0NH19fV19&Signature=cYNAiSytWfBrjschaz2Ey73FiuVZ11S2zvYhoqv9F-V3jmPqnurCSHevfrguDHfibSb1o37NK1~QfXOpEpv57e1i2kg1ejA5bEDkIcAcUZ3DUJJynju9lFPJ0XLvWeY2075RMudjqow-T9IPRaartbVneLLTv7fCP2uJ800AcL-4eES42u9ZShPDv2Xjw03AiIVSNj7Aiss9d3f-V7ASGS8K8C1E4APkpS5B9MHT7kyw-NT7xPiu~OQpHiVgJuz76YSnuO7nKXSfSJJNI9EOgEa5JPSngrCFZsbAaIpdQ2o5xEDJsJ0vsOPXS0Ya1rTbb37QOgtQZH4kCwJrpYZMhA__&Key-Pair-Id=APKAJ535ZH3ZAIIOADHQ\")
<\/p>\n\n\n\nTB and the most common side effect is joint pain. Can precipitate gout<\/p>\n\n\n\n
flares by decreasing renal excretion of uric acid. Most dangerous side effect<\/p>\n\n\n\n
is hepatotoxicity.<\/p>\n\n\n\n
87.If a patient is allergic to sulfonamide antibiotics, he or she will most<\/p>\n\n\n\n
likely have cross- sensitivity to:<\/p>\n\n\n\n
Loop diuretics, sulfonylureas, and thiazide diuretics<\/p>\n\n\n\n
88.Sulfa ABX when used in large doses has the potential to cause?<\/p>\n\n\n\n
Strong allergic reactions including Stevens-Johnson syndrome and toxic<\/p>\n\n\n\n
epidermal necrolysis<\/p>\n\n\n\n
NURS 615 -Pharm Exam 2-Super Duper Exam<\/p>\n\n\n\n
2 Q&A<\/p>\n\n\n\n
![\"\"](\"https:\/\/d3tvd1u91rr79.cloudfront.net\/0b27f4cc3f43f902008412600f39ca20\/html\/bg1.png?Policy=eyJTdGF0ZW1lbnQiOlt7IlJlc291cmNlIjoiaHR0cHM6Ly9kM3R2ZDF1OTFycjc5LmNsb3VkZnJvbnQubmV0LzBiMjdmNGNjM2Y0M2Y5MDIwMDg0MTI2MDBmMzljYTIwL2h0bWwvKiIsIkNvbmRpdGlvbiI6eyJEYXRlTGVzc1RoYW4iOnsiQVdTOkVwb2NoVGltZSI6MTY5MDY1MjY0NX19fV19&Signature=C9AW6LOahBwPjsDlk8Oe9vXyLH3Dz79BOrZ3f0PFR2jMIiUSOlaynMuW8JATdBfJgg1ICloPrTvLkqxvinPmv7IfDuNdqb5bOlZroVu~cuqa7lZOx8jGqTkVbN0VFRnndSdh1VBTG06rJZZxq3YCpALHPHeMRhzIQ6N5KQ5AFXVgblqa~2UWUE3CcaMxtjUqmc7eicsHoqybuJeabB5IFW8U74DX1HHckkbhI40dQI0S2FW-yVgqGmg4HguByDa1uv-ai~QfnNSd1wPtO~Pq5lLPvt233l9aPhtHpeY4NKKqPxGCvKWsr-Twhzqp6jDrIn~yPzjtF3HYm0k2HKE32g__&Key-Pair-Id=APKAJ535ZH3ZAIIOADHQ\")
<\/p>\n\n\n\nNURS 615 Pharm Exam 2 Mega<\/p>\n\n\n\n
Review Study Guide latest<\/p>\n\n\n\n
NURS 615 Pharm Exam 2 Mega Review Study Guide<\/p>\n\n\n\n
Law-Ham Pharm Exam 2 Review<\/p>\n\n\n\n
**Know every drug that is on the PowerPoint \u2013 have a one-line mechanism of action on a table for each drug and<\/p>\n\n\n\n
understand it, as well as how and where it works<\/p>\n\n\n\n
Carbamazepine (Tegretol) \u2013 is an anticonvulsant = thought to affect Na+ channels to slow spread of<\/p>\n\n\n\n
abnormal activity<\/p>\n\n\n\n
\u2022SE = decreases body\u2019s production of blood cells, rare reports of aplastic anemia and agranulocytosis, can<\/p>\n\n\n\n
cause Steven Johnson Syndrome and Toxic Epidermal Necrolysis<\/p>\n\n\n\n
\u2022Should get a CBC Q3-4 months (watch for WBC count in particular)<\/p>\n\n\n\n
\u2022Carbamazepine is a strong inducer of hepatic enzymes\/metabolism and can lead to lower levels<\/p>\n\n\n\n
\u2022Do NOT stop taking abruptly, has a shorter half-life w\/repeated uses<\/p>\n\n\n\n
Topiramate (Topamax) \u2013 is for tx of epilepsy, seizures, migraine prophylaxis<\/p>\n\n\n\n
\u2022Blocks sodium channels or potentiate GABA<\/p>\n\n\n\n
\u2022Peaks 2 hours after oral admin, mostly eliminated via urine<\/p>\n\n\n\n
\u2022Can cause \u2193 Na bicarb levels which can lead to hyperchloremic metabolic acidosis<\/p>\n\n\n\n
\u2022Serum bicarbonate should be monitored at baseline and periodically<\/p>\n\n\n\n
\u2022Can cause ocular syndrome (acute myopia and glaucoma) \u2013 should inform provider immediately if pt<\/p>\n\n\n\n
experiences eye pain or blurred vision<\/p>\n\n\n\n
\u2022Rare side effect is oligohidrosis (\u2193sweating) and hyperthermia<\/p>\n\n\n\n
\u2022Can increase the risk of suicidal behavior\/ideation, cause weight reduction<\/p>\n\n\n\n
\u2022Should NOT be discontinued abruptly<\/p>\n\n\n\n
\u2022Is a pregnancy category D and can increase risk of cleft lip\/palate in infants<\/p>\n\n\n\n
Levetiracetam (Keppra) \u2013 antiepileptic, does NOT affect GABA, does inhibit burst firing and spread of<\/p>\n\n\n\n
seizure activity<\/p>\n\n\n\n
\u2022Mostly cleared through renal system, is not extensively metabolized<\/p>\n\n\n\n
\u2022Absolute contraindication is sensitivity to the drug<\/p>\n\n\n\n
\u2022At increased risk for suicidal thoughts and depression, behavioral changes, somnolence, fatigue,<\/p>\n\n\n\n
dizziness, muscle coordination difficulties<\/p>\n\n\n\n
\u2022Potential for withdrawal seizures if keppra is stopped abruptly<\/p>\n\n\n\n
\u2022Safer med for seizures in children and pregnancy<\/p>\n\n\n\n
Valproate (Depakote)\u2013 is an anticonvulsant, for tx of bipolar disorder and mania also<\/p>\n\n\n\n
![\"\"](\"https:\/\/d3tvd1u91rr79.cloudfront.net\/0b27f4cc3f43f902008412600f39ca20\/html\/bg2.png?Policy=eyJTdGF0ZW1lbnQiOlt7IlJlc291cmNlIjoiaHR0cHM6Ly9kM3R2ZDF1OTFycjc5LmNsb3VkZnJvbnQubmV0LzBiMjdmNGNjM2Y0M2Y5MDIwMDg0MTI2MDBmMzljYTIwL2h0bWwvKiIsIkNvbmRpdGlvbiI6eyJEYXRlTGVzc1RoYW4iOnsiQVdTOkVwb2NoVGltZSI6MTY5MDY1MjY0NX19fV19&Signature=C9AW6LOahBwPjsDlk8Oe9vXyLH3Dz79BOrZ3f0PFR2jMIiUSOlaynMuW8JATdBfJgg1ICloPrTvLkqxvinPmv7IfDuNdqb5bOlZroVu~cuqa7lZOx8jGqTkVbN0VFRnndSdh1VBTG06rJZZxq3YCpALHPHeMRhzIQ6N5KQ5AFXVgblqa~2UWUE3CcaMxtjUqmc7eicsHoqybuJeabB5IFW8U74DX1HHckkbhI40dQI0S2FW-yVgqGmg4HguByDa1uv-ai~QfnNSd1wPtO~Pq5lLPvt233l9aPhtHpeY4NKKqPxGCvKWsr-Twhzqp6jDrIn~yPzjtF3HYm0k2HKE32g__&Key-Pair-Id=APKAJ535ZH3ZAIIOADHQ\")
<\/p>\n\n\n\n\u2022Blocks GABA uptake into presynaptic neurons<\/p>\n\n\n\n
\u2022SE = GI distress, heartburn, CNS depressant<\/p>\n\n\n\n
\u2022Is a pregnancy category X, known teratogen, may only be taken after the 1st trimester if necessary, bur<\/p>\n\n\n\n
should recommend switching to different anticonvulsant like Keppra<\/p>\n\n\n\n
![\"\"](\"https:\/\/d3tvd1u91rr79.cloudfront.net\/0b27f4cc3f43f902008412600f39ca20\/html\/bg3.png?Policy=eyJTdGF0ZW1lbnQiOlt7IlJlc291cmNlIjoiaHR0cHM6Ly9kM3R2ZDF1OTFycjc5LmNsb3VkZnJvbnQubmV0LzBiMjdmNGNjM2Y0M2Y5MDIwMDg0MTI2MDBmMzljYTIwL2h0bWwvKiIsIkNvbmRpdGlvbiI6eyJEYXRlTGVzc1RoYW4iOnsiQVdTOkVwb2NoVGltZSI6MTY5MDY1MjY0NX19fV19&Signature=C9AW6LOahBwPjsDlk8Oe9vXyLH3Dz79BOrZ3f0PFR2jMIiUSOlaynMuW8JATdBfJgg1ICloPrTvLkqxvinPmv7IfDuNdqb5bOlZroVu~cuqa7lZOx8jGqTkVbN0VFRnndSdh1VBTG06rJZZxq3YCpALHPHeMRhzIQ6N5KQ5AFXVgblqa~2UWUE3CcaMxtjUqmc7eicsHoqybuJeabB5IFW8U74DX1HHckkbhI40dQI0S2FW-yVgqGmg4HguByDa1uv-ai~QfnNSd1wPtO~Pq5lLPvt233l9aPhtHpeY4NKKqPxGCvKWsr-Twhzqp6jDrIn~yPzjtF3HYm0k2HKE32g__&Key-Pair-Id=APKAJ535ZH3ZAIIOADHQ\")
<\/p>\n\n\n\nNURS 615 Pharm Exam 2 Mega Review Study Guide<\/p>\n\n\n\n
Ethosuximide (Zarontin) \u2013 tx for seizures<\/p>\n\n\n\n
NURS 615 Pharm Exam 2 Mega Review Study Guide<\/p>\n\n\n\n
\u2022Should be monitored for blood dyscrasia (an abnormal condition or dx of the blood)<\/p>\n\n\n\n
Antiepileptics block transmission, raise the seizure threshold, so that the patient will not peak over the seizure threshold<\/p>\n\n\n\n
and have a seizure.<\/p>\n\n\n\n
Anticonvulsants in terms of monitoring (most common side effects, most serious side effects) \u2013 know that they are all<\/p>\n\n\n\n
monitored with blood work for their levels so that is a similarity amongst them<\/p>\n\n\n\n
\u2022Carbamazepine \u2013 CBC \u2013 Causes agranulocytosis so be watching the white count in particular<\/p>\n\n\n\n
although there is other bone marrow suppression as well<\/p>\n\n\n\n
\u2022What do you monitor? \u2013 TSH because the med can affect the thyroid<\/p>\n\n\n\n
\u2022Never want anyone to d\/c suddenly, must be weaned off<\/p>\n\n\n\n
\u2022Talk to patients about safety \u2013 driving limitations, may have to report patient to DMV if they are<\/p>\n\n\n\n
having active seizures<\/p>\n\n\n\n
\u2022Oral health can be affected by anti-seizure meds and extra trips to the dentist may be required<\/p>\n\n\n\n
Neurotransmitters<\/p>\n\n\n\n
\u2022GABA \u2013 calming<\/p>\n\n\n\n
\u2022Acetylcholine \u2013 muscle action, thought and learning<\/p>\n\n\n\n
***If a specific drug is listed on the PowerPoint, know all about it.<\/p>\n\n\n\n
\u2022All these drugs are listed on the PowerPoint<\/p>\n\n\n\n
\u2022Seizure<\/p>\n\n\n\n
oTopiramate \u2013 topamax<\/p>\n\n\n\n
oCarbamazepine \u2013 Tegretol<\/p>\n\n\n\n
oValproate \u2013 Depakote<\/p>\n\n\n\n
oLevetiracetam \u2013 Keppra<\/p>\n\n\n\n
\u2022MAOI<\/p>\n\n\n\n
o Phenelzine \u2013 Nardil<\/p>\n\n\n\n
\u2022Anxiolytics<\/p>\n\n\n\n
Phentermine (Adipex-P) \u2013 used for obesity, stimulating satiety centers<\/p>\n\n\n\n
\u2022Should only be used short-term (6 months or less)<\/p>\n\n\n\n
\u2022DO NOT mix w\/ SSRIs or St. John\u2019s Wart (Serotonin Syndrome), or w\/ MAOIs (HTN crisis)<\/p>\n\n\n\n
Lithium\u2014 tx of choice for manic-depressive (bipolar) illness, \u2193 severity\/frequency of mania<\/p>\n\n\n\n
\u25aaReplaces Na+ during depolarization in neurons = stops transmission of electrical impulses<\/p>\n\n\n\n
\u25aaInversely proportional to Na+ — \u2193Na+ = \u2191Lithium \u2191Na+ = \u2193Lithium<\/p>\n\n\n\n
\u25aaLithium Toxicity can occur = drowsiness, nausea, course tremors, diarrhea, confusion, stupor<\/p>\n\n\n\n
\u25aaNOT to be used in renal pts, children under 12, or pregnant women<\/p>\n\n\n\n
\u25aaPt education = avoid dehydration, eat a diet with consistent Na+ levels<\/p>\n\n\n\n
![\"\"](\"https:\/\/d3tvd1u91rr79.cloudfront.net\/0b27f4cc3f43f902008412600f39ca20\/html\/bg4.png?Policy=eyJTdGF0ZW1lbnQiOlt7IlJlc291cmNlIjoiaHR0cHM6Ly9kM3R2ZDF1OTFycjc5LmNsb3VkZnJvbnQubmV0LzBiMjdmNGNjM2Y0M2Y5MDIwMDg0MTI2MDBmMzljYTIwL2h0bWwvKiIsIkNvbmRpdGlvbiI6eyJEYXRlTGVzc1RoYW4iOnsiQVdTOkVwb2NoVGltZSI6MTY5MDY1MjY0NX19fV19&Signature=C9AW6LOahBwPjsDlk8Oe9vXyLH3Dz79BOrZ3f0PFR2jMIiUSOlaynMuW8JATdBfJgg1ICloPrTvLkqxvinPmv7IfDuNdqb5bOlZroVu~cuqa7lZOx8jGqTkVbN0VFRnndSdh1VBTG06rJZZxq3YCpALHPHeMRhzIQ6N5KQ5AFXVgblqa~2UWUE3CcaMxtjUqmc7eicsHoqybuJeabB5IFW8U74DX1HHckkbhI40dQI0S2FW-yVgqGmg4HguByDa1uv-ai~QfnNSd1wPtO~Pq5lLPvt233l9aPhtHpeY4NKKqPxGCvKWsr-Twhzqp6jDrIn~yPzjtF3HYm0k2HKE32g__&Key-Pair-Id=APKAJ535ZH3ZAIIOADHQ\")
<\/p>\n\n\n\nNURS 615 Pharm Exam 2 Mega Review Study Guide<\/p>\n\n\n\n
Antidepressants \u2013 SSRIs (fluoxetine, paroxetine, sertraline, citalopram, escitalopram)<\/p>\n\n\n\n
![\"\"](\"https:\/\/d3tvd1u91rr79.cloudfront.net\/0b27f4cc3f43f902008412600f39ca20\/html\/bg5.png?Policy=eyJTdGF0ZW1lbnQiOlt7IlJlc291cmNlIjoiaHR0cHM6Ly9kM3R2ZDF1OTFycjc5LmNsb3VkZnJvbnQubmV0LzBiMjdmNGNjM2Y0M2Y5MDIwMDg0MTI2MDBmMzljYTIwL2h0bWwvKiIsIkNvbmRpdGlvbiI6eyJEYXRlTGVzc1RoYW4iOnsiQVdTOkVwb2NoVGltZSI6MTY5MDY1MjY0NX19fV19&Signature=C9AW6LOahBwPjsDlk8Oe9vXyLH3Dz79BOrZ3f0PFR2jMIiUSOlaynMuW8JATdBfJgg1ICloPrTvLkqxvinPmv7IfDuNdqb5bOlZroVu~cuqa7lZOx8jGqTkVbN0VFRnndSdh1VBTG06rJZZxq3YCpALHPHeMRhzIQ6N5KQ5AFXVgblqa~2UWUE3CcaMxtjUqmc7eicsHoqybuJeabB5IFW8U74DX1HHckkbhI40dQI0S2FW-yVgqGmg4HguByDa1uv-ai~QfnNSd1wPtO~Pq5lLPvt233l9aPhtHpeY4NKKqPxGCvKWsr-Twhzqp6jDrIn~yPzjtF3HYm0k2HKE32g__&Key-Pair-Id=APKAJ535ZH3ZAIIOADHQ\")
<\/p>\n\n\n\nNURS 615 Pharm Exam 2 Mega Review Study Guide<\/p>\n\n\n\n
\u2022SSRI blocks the reuptake of serotonin which keeps it present in the synapse for longer, so you get more<\/p>\n\n\n\n
effect from it<\/p>\n\n\n\n
\u2022All of the antidepressants, whether a drug family or specific drug, you need to know and understand that drug<\/p>\n\n\n\n
and mechanism of action<\/p>\n\n\n\n
\u2022Common side effects of SSRIs \u2013 weight gain, sometimes weight loss, anticholinergic effects like dry mouth<\/p>\n\n\n\n
and constipation, nausea, vomiting, sexual side effects \u2013 diminished, delayed or absent orgasm, premature<\/p>\n\n\n\n
ejaculation, decreased libido<\/p>\n\n\n\n
\u2022Nausea can occur when first starting SSRI, but will resolve in a week or so<\/p>\n\n\n\n
\u2022With citalopram, appetite and concentration improve in the first 1-2 weeks, works quickly<\/p>\n\n\n\n
\u2022Interacts w\/ MAOIs<\/p>\n\n\n\n
\u2022SSRIs \u2013 serotonin syndrome \u2013 HA, hallucinations, shivering, agitation, sweating, high body temperature,<\/p>\n\n\n\n
tremor, hyperreflexia, dilated pupils, nausea, diarrhea<\/p>\n\n\n\n
\u2022DO NOT stop abruptly or miss doses = serotonin withdrawal \u2013 can see this in shorter acting SSRI\u2019s when people<\/p>\n\n\n\n
forget to take them (paroxetine is the shortest acting), sertraline and citalopram can also happen but not as<\/p>\n\n\n\n
quickly as paroxetine.<\/p>\n\n\n\n
\u2022Serotonin withdrawal syndrome \u2013 tremulous, paresthesia\u2019s, nausea, vomiting, sweating<\/p>\n\n\n\n
SNRIs<\/p>\n\n\n\n
\u2022Effect and block the reabsorption of norepinephrine \u2013 norepi effects specifically the sympathetic nervous<\/p>\n\n\n\n
system and also has serotonergic effects<\/p>\n\n\n\n
\u2022Sevilla, Cymbalta, etc. names of drugs<\/p>\n\n\n\n
\u2022An initial tx for depression w\/ symptoms of fatigue, sleeping all the time, and lack of motivation<\/p>\n\n\n\n
\u2022Side effects \u2013 headaches, nausea, somnolence, dry mouth, anticholinergic things, palpitations, hypertension,<\/p>\n\n\n\n
and hyperhidrosis (excessive sweating).<\/p>\n\n\n\n
TCAs (amitriptyline, nortriptyline, imipramine, trimipramine)<\/p>\n\n\n\n
\u2022Effect brain chemicals<\/p>\n\n\n\n
oSerotonin \u2013 5ht<\/p>\n\n\n\n
oNoradrenaline\/norepinephrine<\/p>\n\n\n\n
oActs on Histamine and Acetylcholine<\/p>\n\n\n\n
\u2022This group of medications has the highest anticholinergic effects \u2013 the highest amount of dry mouth<\/p>\n\n\n\n
and constipation<\/p>\n\n\n\n
\u2022People who have BPH, glaucoma, urinary problems should not take this medication due to the degree of<\/p>\n\n\n\n
anticholinergic effect<\/p>\n\n\n\n
\u2022Should be prescribed cautiously in patients with heart disease<\/p>\n\n\n\n
\u2022Can behave like class 1 antiarrhythmics = terminate Vfib, \u2193 heart contractility, increase collateral blood flow<\/p>\n\n\n\n
to ischemic heart muscles<\/p>\n\n\n\n
\u2022SE = anticholinergic, sedating, increased appetite, tinnitus, nausea, as well as cardiac conduction disorders<\/p>\n\n\n\n
including a prolonged QT interval with this drug \u2013 a baseline EKG is imperative before starting on this medication.<\/p>\n\n\n\n
Tardive dyskinesia (movement), neuroleptic malignant syndrome<\/p>\n\n\n\n
\u2022If you ever put someone on this for their depression, understand that in the first few weeks they can<\/p>\n\n\n\n
have increased suicidal ideation<\/p>\n\n\n\n
\u2022An overdose of TCAs is fatal; whereas, with the SSRIs it isn\u2019t<\/p>\n\n\n\n
![\"\"](\"https:\/\/d3tvd1u91rr79.cloudfront.net\/0b27f4cc3f43f902008412600f39ca20\/html\/bg6.png?Policy=eyJTdGF0ZW1lbnQiOlt7IlJlc291cmNlIjoiaHR0cHM6Ly9kM3R2ZDF1OTFycjc5LmNsb3VkZnJvbnQubmV0LzBiMjdmNGNjM2Y0M2Y5MDIwMDg0MTI2MDBmMzljYTIwL2h0bWwvKiIsIkNvbmRpdGlvbiI6eyJEYXRlTGVzc1RoYW4iOnsiQVdTOkVwb2NoVGltZSI6MTY5MDY1MjY0NX19fV19&Signature=C9AW6LOahBwPjsDlk8Oe9vXyLH3Dz79BOrZ3f0PFR2jMIiUSOlaynMuW8JATdBfJgg1ICloPrTvLkqxvinPmv7IfDuNdqb5bOlZroVu~cuqa7lZOx8jGqTkVbN0VFRnndSdh1VBTG06rJZZxq3YCpALHPHeMRhzIQ6N5KQ5AFXVgblqa~2UWUE3CcaMxtjUqmc7eicsHoqybuJeabB5IFW8U74DX1HHckkbhI40dQI0S2FW-yVgqGmg4HguByDa1uv-ai~QfnNSd1wPtO~Pq5lLPvt233l9aPhtHpeY4NKKqPxGCvKWsr-Twhzqp6jDrIn~yPzjtF3HYm0k2HKE32g__&Key-Pair-Id=APKAJ535ZH3ZAIIOADHQ\")
<\/p>\n\n\n\nNURS 615 Pharm Exam 2 Mega Review Study Guide<\/p>\n\n\n\n
Buspirone (full agonist, serotonin) but can also be an antagonist<\/p>\n\n\n\n
\u2022Full agonist for the presynaptic 5ht1 receptorDocument continues below<\/p>\n\n\n\n
Discover more from:<\/strong><\/p>\n\n\n\n
Psychiatric\/Mental Health Nursing (NURS 404)<\/a><\/strong>(NURS 404)<\/p>\n\n\n\n
158 documentsGo to course<\/p>\n\n\n\n
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- <\/a>37<\/a><\/a><\/a>Hesi exit rn exam 2022 v3 real 160 questions and answers ggg<\/strong><\/a>Psychiatric\/Mental Health Nursing100% (6)<\/strong><\/a><\/li>\n<\/ul>\n\n\n\n
![\"\"](\"https:\/\/d3tvd1u91rr79.cloudfront.net\/0b27f4cc3f43f902008412600f39ca20\/html\/bg7.png?Policy=eyJTdGF0ZW1lbnQiOlt7IlJlc291cmNlIjoiaHR0cHM6Ly9kM3R2ZDF1OTFycjc5LmNsb3VkZnJvbnQubmV0LzBiMjdmNGNjM2Y0M2Y5MDIwMDg0MTI2MDBmMzljYTIwL2h0bWwvKiIsIkNvbmRpdGlvbiI6eyJEYXRlTGVzc1RoYW4iOnsiQVdTOkVwb2NoVGltZSI6MTY5MDY1MjY0NX19fV19&Signature=C9AW6LOahBwPjsDlk8Oe9vXyLH3Dz79BOrZ3f0PFR2jMIiUSOlaynMuW8JATdBfJgg1ICloPrTvLkqxvinPmv7IfDuNdqb5bOlZroVu~cuqa7lZOx8jGqTkVbN0VFRnndSdh1VBTG06rJZZxq3YCpALHPHeMRhzIQ6N5KQ5AFXVgblqa~2UWUE3CcaMxtjUqmc7eicsHoqybuJeabB5IFW8U74DX1HHckkbhI40dQI0S2FW-yVgqGmg4HguByDa1uv-ai~QfnNSd1wPtO~Pq5lLPvt233l9aPhtHpeY4NKKqPxGCvKWsr-Twhzqp6jDrIn~yPzjtF3HYm0k2HKE32g__&Key-Pair-Id=APKAJ535ZH3ZAIIOADHQ\")
<\/p>\n\n\n\nNURS 615 Pharm Exam 2 Mega Review Study Guide<\/p>\n\n\n\n
\u2022If someone has too much serotonin, it will act as an antagonist<\/p>\n\n\n\n
\u2022Or if they do not have enough serotonin, it will act as an agonist in the post synaptic<\/p>\n\n\n\n
\u2022Structure similar to clozapine which is an atypical antipsychotic<\/p>\n\n\n\n
\u2022Pt with anxiety and depression may respond to buspirone and an SSRI combined<\/p>\n\n\n\n
\u2022Is an appropriate first-line drug for mild to moderate generalized anxiety disorder<\/p>\n\n\n\n
\u2022Works well for anxiety and has a synergistic effect with SSRI for someone who has a resistant type of<\/p>\n\n\n\n
depression that needs an extra boost<\/p>\n\n\n\n
\u2022Will compete for metabolism site w\/ antipsychotics (Haldol)<\/p>\n\n\n\n
MAOI Inhibitors<\/p>\n\n\n\n
\u2022Phenelzine (Nardil)<\/p>\n\n\n\n
\u2022Parmate<\/p>\n\n\n\n
\u2022Marplan<\/p>\n\n\n\n
\u2022Not used often and are not popular due to the amount of adverse effects<\/p>\n\n\n\n
\u2022MAO \u2013 irreversibly inactivates the enzymes that metabolize NE, serotonin, and dopamine therefore increasing<\/p>\n\n\n\n
bioavailability of each so you get a longer serotonin, norepi effect such as more energy as well as a better<\/p>\n\n\n\n
mood)<\/p>\n\n\n\n
\u2022Adverse effects: tardive dyskinesia<\/p>\n\n\n\n
\u2022Do not mix with other substances (other MAOI\u2019s)<\/p>\n\n\n\n
\u2022Do NOT eat foods containing tyramine (aged cheese\/meats, alcohol) as these can cause symptoms of HTN<\/p>\n\n\n\n
crisis (increased BP, tachycardia, HA, dizziness, sweating, tremors) which requires immediate tx<\/p>\n\n\n\n
\u2022Do not mix well with other things so they need to be two weeks separated from anything else (assuming this is<\/p>\n\n\n\n
specifically referring to other antidepressants)<\/p>\n\n\n\n
\u2022When starting new antidepressant, wean patient off this medication. Pt must be off of this medication at<\/p>\n\n\n\n
least two weeks before starting another antidepressant<\/p>\n\n\n\n
Benzodiazepines \u2013 binds to GABA receptors to inhibit the neurotransmitter release<\/p>\n\n\n\n
\u2022Alprazolam, Chlordiazepoxide, Clonazepam, Diazepam, Lorazepam<\/p>\n\n\n\n
\u2022Effect\/binds to GABA receptors \u2013 which is sedating, acts as anticonvulsant, muscle relaxant, helps with<\/p>\n\n\n\n
alcohol withdrawal<\/p>\n\n\n\n
\u2022Tend to be very habituating \u2013 be aware of this and limit prescribing, CNS depressant<\/p>\n\n\n\n
\u2022If you have to put a patient on a benzo, try to choose something that is longer acting so that patient does<\/p>\n\n\n\n
not need to redose constantly. Longer acting benzo example is klonopin<\/p>\n\n\n\n
\u2022Short and intermediate acting benzos to tx insomnia, long-acting benzos to tx anxiety<\/p>\n\n\n\n
\u2022An appropriate drug to initially tx panic disorder is diazepam (Valium)<\/p>\n\n\n\n
\u2022CAUTION IN PRESCRIBING, alprazolam (Xanax) has greatest likelihood of rapid dependence<\/p>\n\n\n\n
Insomnia Meds<\/p>\n\n\n\n
\u2022Familiarize yourself with what it means to utilize sleep hygiene and be sure your clients are using that.<\/p>\n\n\n\n
\u2022Meds should only be for short term or occasional use because you want the patient to develop their own<\/p>\n\n\n\n
sleep patterns and not become dependent upon a pill to go to sleep at night.<\/p>\n\n\n\n
\u2022Ambien \u2013 non-benzo type of sleep aid \u2013 works within the GABA receptors but non-benzo \u2013 considered to work at<\/p>\n\n\n\n
a benzo booster site.<\/p>\n\n\n\n
\u2022Temazepam \u2013 benzodiazepine sleep aid \u2013 has same side effects as other<\/p>\n\n\n\n
benzos Anti-infective<\/p>\n\n\n\n
![\"\"](\"https:\/\/d3tvd1u91rr79.cloudfront.net\/0b27f4cc3f43f902008412600f39ca20\/html\/bg8.png?Policy=eyJTdGF0ZW1lbnQiOlt7IlJlc291cmNlIjoiaHR0cHM6Ly9kM3R2ZDF1OTFycjc5LmNsb3VkZnJvbnQubmV0LzBiMjdmNGNjM2Y0M2Y5MDIwMDg0MTI2MDBmMzljYTIwL2h0bWwvKiIsIkNvbmRpdGlvbiI6eyJEYXRlTGVzc1RoYW4iOnsiQVdTOkVwb2NoVGltZSI6MTY5MDY1MjY0NX19fV19&Signature=C9AW6LOahBwPjsDlk8Oe9vXyLH3Dz79BOrZ3f0PFR2jMIiUSOlaynMuW8JATdBfJgg1ICloPrTvLkqxvinPmv7IfDuNdqb5bOlZroVu~cuqa7lZOx8jGqTkVbN0VFRnndSdh1VBTG06rJZZxq3YCpALHPHeMRhzIQ6N5KQ5AFXVgblqa~2UWUE3CcaMxtjUqmc7eicsHoqybuJeabB5IFW8U74DX1HHckkbhI40dQI0S2FW-yVgqGmg4HguByDa1uv-ai~QfnNSd1wPtO~Pq5lLPvt233l9aPhtHpeY4NKKqPxGCvKWsr-Twhzqp6jDrIn~yPzjtF3HYm0k2HKE32g__&Key-Pair-Id=APKAJ535ZH3ZAIIOADHQ\")
<\/p>\n\n\n\nNURS 615 Pharm Exam 2 Mega Review Study Guide<\/p>\n\n\n\n
\u2022Antibiotics is a broad term for a lot of things including antibacterial, antifungals, antiprotozoal, anthelmintic,<\/p>\n\n\n\n
and antiviral<\/p>\n\n\n\n
![\"\"](\"https:\/\/d3tvd1u91rr79.cloudfront.net\/0b27f4cc3f43f902008412600f39ca20\/html\/bg9.png?Policy=eyJTdGF0ZW1lbnQiOlt7IlJlc291cmNlIjoiaHR0cHM6Ly9kM3R2ZDF1OTFycjc5LmNsb3VkZnJvbnQubmV0LzBiMjdmNGNjM2Y0M2Y5MDIwMDg0MTI2MDBmMzljYTIwL2h0bWwvKiIsIkNvbmRpdGlvbiI6eyJEYXRlTGVzc1RoYW4iOnsiQVdTOkVwb2NoVGltZSI6MTY5MDY1MjY0NX19fV19&Signature=C9AW6LOahBwPjsDlk8Oe9vXyLH3Dz79BOrZ3f0PFR2jMIiUSOlaynMuW8JATdBfJgg1ICloPrTvLkqxvinPmv7IfDuNdqb5bOlZroVu~cuqa7lZOx8jGqTkVbN0VFRnndSdh1VBTG06rJZZxq3YCpALHPHeMRhzIQ6N5KQ5AFXVgblqa~2UWUE3CcaMxtjUqmc7eicsHoqybuJeabB5IFW8U74DX1HHckkbhI40dQI0S2FW-yVgqGmg4HguByDa1uv-ai~QfnNSd1wPtO~Pq5lLPvt233l9aPhtHpeY4NKKqPxGCvKWsr-Twhzqp6jDrIn~yPzjtF3HYm0k2HKE32g__&Key-Pair-Id=APKAJ535ZH3ZAIIOADHQ\")
<\/p>\n\n\n\nNURS 615 Pharm Exam 2 Mega Review Study Guide<\/p>\n\n\n\n
\u2022Classified as gram positive or gram negative<\/p>\n\n\n\n
oGram positive bacteria have no capsule \u2013 have a thick peptidoglycan wall which stains purple<\/p>\n\n\n\n
oGram negative bacteria have a capsule that protects the cell peptidoglycan wall from staining so it<\/p>\n\n\n\n
will show as pink<\/p>\n\n\n\n
\u2022Also classified by shape \u2013 i.e. flagellated, spirilla, cocci<\/p>\n\n\n\n
\u2022Classified by oxygen use<\/p>\n\n\n\n
oAnaerobes \u2013 cannot grow in the presence of oxygen<\/p>\n\n\n\n
oAerotolerant – most bacteria that cause humans to be sick. They can survive for 72 hours in the<\/p>\n\n\n\n
presence of oxygen, even though they may not usually, and they may not grow in oxygen<\/p>\n\n\n\n
oMost human flora is anaerobic deep within our bodies.<\/p>\n\n\n\n
\u2022Anti-infective work in the following ways<\/p>\n\n\n\n
oCell walls \u2013 an<\/p>\n\n\n\n
oFolic Acid metabolism \u2013<\/p>\n\n\n\n
oProtein synthesis inhibitors at 30s and 50s ribosomal subunit<\/p>\n\n\n\n
o****MUST KNOW EACH ANTIBIOTICS FAMILIES MECHANISM OF ACTION*****<\/p>\n\n\n\n
\u2022Bacteriostatic vs bactericidal<\/p>\n\n\n\n
oBacteriostatic \u2013 stop bacteria from reproducing but do not kill it = utilized in people who have an<\/p>\n\n\n\n
intact immune system that is able to go in and kill the bacteria as long as it is not reproducing<\/p>\n\n\n\n
oBactericidal \u2013 wipes out the bacteria = the bad and the good which is where C. Diff and other<\/p>\n\n\n\n
things come from<\/p>\n\n\n\n
\u2022What effects antibiotic efficacy?<\/p>\n\n\n\n
oPeople\u2019s immune function \u2013 people with poor immune function may need bactericidal or higher levels<\/p>\n\n\n\n
of antibiotics<\/p>\n\n\n\n
\u25aaDiabetic<\/p>\n\n\n\n
\u25aaSteroids<\/p>\n\n\n\n
\u25aaChemotherapy<\/p>\n\n\n\n
\u25aaAsplenia (absence of normal spleen function)<\/p>\n\n\n\n
\u25aaHx. Of previous infections<\/p>\n\n\n\n
\u25aaElderly<\/p>\n\n\n\n
\u25aaForeign bodies – catheters, artificial joints, valves, and shunts = may need to be removed<\/p>\n\n\n\n
if possible, in order for patient to be properly treated<\/p>\n\n\n\n
\u25aaAutoimmune disease \u2013 autoimmune drugs lower ability to fight infection<\/p>\n\n\n\n
oAlteration in Distribution<\/p>\n\n\n\n
\u25aaNot high enough albumin level<\/p>\n\n\n\n
\u25aaOverweight<\/p>\n\n\n\n
\u25aaUnderweight \u2013 emaciated or cachectic (physical wasting)<\/p>\n\n\n\n
\u25aaRenal function decreased<\/p>\n\n\n\n
\u25aaAnything that can affect kinetics needs to be thought about in relation to antibiotic efficacy<\/p>\n\n\n\n
\u2022Bacteria cause resistance by<\/p>\n\n\n\n
oBreaking down beta lactam ring<\/p>\n\n\n\n
oOr breaking down whatever the drug is consisting of and inactivating it<\/p>\n\n\n\n
oPenicillin has things added to prevent the bacteria from breaking down the beta lactam ring<\/p>\n\n\n\n
oReduce bacterial efflux pumps or change the influx of it so it cannot work as well<\/p>\n\n\n\n
oAlter the binding site so the medicine cannot exert its action<\/p>\n\n\n\n
\u2022Every antibiotic drug class has resistant organisms that influence prescribing decisions<\/p>\n\n\n\n
\u2022Common resistant organisms<\/p>\n\n\n\n
oMRSA<\/p>\n\n\n\n
![\"\"](\"https:\/\/d3tvd1u91rr79.cloudfront.net\/0b27f4cc3f43f902008412600f39ca20\/html\/bga.png?Policy=eyJTdGF0ZW1lbnQiOlt7IlJlc291cmNlIjoiaHR0cHM6Ly9kM3R2ZDF1OTFycjc5LmNsb3VkZnJvbnQubmV0LzBiMjdmNGNjM2Y0M2Y5MDIwMDg0MTI2MDBmMzljYTIwL2h0bWwvKiIsIkNvbmRpdGlvbiI6eyJEYXRlTGVzc1RoYW4iOnsiQVdTOkVwb2NoVGltZSI6MTY5MDY1MjY0NX19fV19&Signature=C9AW6LOahBwPjsDlk8Oe9vXyLH3Dz79BOrZ3f0PFR2jMIiUSOlaynMuW8JATdBfJgg1ICloPrTvLkqxvinPmv7IfDuNdqb5bOlZroVu~cuqa7lZOx8jGqTkVbN0VFRnndSdh1VBTG06rJZZxq3YCpALHPHeMRhzIQ6N5KQ5AFXVgblqa~2UWUE3CcaMxtjUqmc7eicsHoqybuJeabB5IFW8U74DX1HHckkbhI40dQI0S2FW-yVgqGmg4HguByDa1uv-ai~QfnNSd1wPtO~Pq5lLPvt233l9aPhtHpeY4NKKqPxGCvKWsr-Twhzqp6jDrIn~yPzjtF3HYm0k2HKE32g__&Key-Pair-Id=APKAJ535ZH3ZAIIOADHQ\")
<\/p>\n\n\n\nNURS 615 Pharm Exam 2 Mega Review Study Guide<\/p>\n\n\n\n
\u25aaCommunity acquired<\/p>\n\n\n\n
\u2022Acquired from locker rooms, jails, prisons, gymnasiums, livestock handlers who<\/p>\n\n\n\n
handle animals who handle antibiotics<\/p>\n\n\n\n
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<\/p>\n\n\n\nNURS 615 Pharm Exam 2 Mega Review Study Guide<\/p>\n\n\n\n
\u2022Outpatient treatment options can be trimethoprim sulfa or doxycycline<\/p>\n\n\n\n
\u25aaHospital acquired \u2013 much more difficult to treat<\/p>\n\n\n\n
\u2022Requires extensive antibiotics that we do not use often such as vancomycin,<\/p>\n\n\n\n
linezolid, daptomycin, maybe even imipenem\u2019s and combinations of these things<\/p>\n\n\n\n
\u25aaThese occur in sicker patients who already have some bacterial resistance issues<\/p>\n\n\n\n
oVRE (Vancomycin-Resistant Enterococci)<\/p>\n\n\n\n
\u25aaNatural enterococcus in GI tract and female genital tract<\/p>\n\n\n\n
\u25aaIn weakened immune systems it can cause infection<\/p>\n\n\n\n
\u25aaTreatment is with penicillin-cephalosporin combos, aminoglycosides<\/p>\n\n\n\n
\u25aaVery difficult to treat<\/p>\n\n\n\n
\u2022Who is affected by antibiotic resistance?<\/p>\n\n\n\n
oDaycares \u2013 children are more likely to be exposed to pathogens from other children<\/p>\n\n\n\n
oReview the slide and be familiar<\/p>\n\n\n\n
\u2022Mentioned being familiar with drugs on the slides again \u2013 understand broad vs. narrow spectrum, bactericidal<\/p>\n\n\n\n
vs. bacteriostatic, common indications for use, concern or contraindications, interactions<\/p>\n\n\n\n
Both PCNs and Cephalosporins contain a beta-lactam ring that is vulnerable to beta-lactamase-producing organisms =<\/p>\n\n\n\n
why there is often cross-sensitivity and cross-resistance btw the two.<\/p>\n\n\n\n
PCNs and Cephalosporins are generally regarded as safe to prescribe to children, but Fluoroquinolones and Tetracyclines<\/p>\n\n\n\n
are to AVOIDED in childhood.<\/p>\n\n\n\n
The beta-lactam ABX (PCNs and Cephalosporins) and Vancomycin inhibit bacterial cell wall synthesis.<\/p>\n\n\n\n
Penicillins<\/p>\n\n\n\n
\u2022Bactericidal<\/p>\n\n\n\n
\u2022Inhibit cell wall synthesis<\/p>\n\n\n\n
\u2022Usually used for strep throat and upper respiratory types of things \u2013 otitis media<\/p>\n\n\n\n
\u2022Some pneumonias \u2013 amox-clavulanate used for this as it is a beta-lactamase inhibitor which increases its<\/p>\n\n\n\n
efficacy against amoxicillin-resistant bacteria \u2013 **Augmentin<\/p>\n\n\n\n
\u2022Maybe meningitis<\/p>\n\n\n\n
\u2022Valve infections<\/p>\n\n\n\n
\u2022Blood infections<\/p>\n\n\n\n
\u2022Abdominal<\/p>\n\n\n\n
\u2022Sensitive infections \u2013 bacteria that are sensitive to it<\/p>\n\n\n\n
\u2022SAFEST DRUG for pregnancy (UTI) and pediatrics \u2013 AUGMENTIN\/AMOXICILLIN<\/p>\n\n\n\n
\u2022Amoxicillin \u2013 risk for anaphylaxis \u2013 cross sensitivity with cephalosporin risk up to 25%<\/p>\n\n\n\n
oIf you cannot find something other than a cephalosporin to treat somebody with allergic reactions to<\/p>\n\n\n\n
penicillin\u2019s, go with a higher generation cephalosporin. Higher generations have a little bit less<\/p>\n\n\n\n
crossover with penicillin<\/p>\n\n\n\n
oSome anaphylactic risk comes from previous exposure with mold spores<\/p>\n\n\n\n
\u2022Remember that penicillin\u2019s and cephalosporins can give you diarrhea, continue tx but recommend<\/p>\n\n\n\n
probiotics daily and yogurt helps<\/p>\n\n\n\n
o Kaopectate and some other things can be used after verifying that this is not a c. diff or bacterial<\/p>\n\n\n\n
overgrowth type of diarrhea<\/p>\n\n\n\n
Cephalosporins<\/p>\n\n\n\n
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<\/p>\n\n\n\nNURS 615 Pharm Exam 2 Mega Review Study Guide<\/p>\n\n\n\n
\u2022Note that the first generation usually has gram positive coverage<\/p>\n\n\n\n
\u2022By the time you get to the fifth generation, there is a lot of gram-negative activity<\/p>\n\n\n\n
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<\/p>\n\n\n\nNURS 615 Pharm Exam 2 Mega Review Study Guide<\/p>\n\n\n\n
\u2022If you are wanting gram negative activity, do not choose cephalexin or cefazolin, you need to go to a<\/p>\n\n\n\n
different drug group altogether or something in a higher generation<\/p>\n\n\n\n
\u2022Widely distributed<\/p>\n\n\n\n
\u2022Renally excreted as is penicillin \u2013 if you have a patient that does not have a renal system that is working well,<\/p>\n\n\n\n
you may need to adjust your dosing and monitor the renal functions<\/p>\n\n\n\n
\u2022Generally a pretty safe drug<\/p>\n\n\n\n
\u2022Same adverse effects of penicillins; however, very uncomfortable at injection site<\/p>\n\n\n\n
o Rocephin \u2013 often mixed with lidocaine to ease discomfort<\/p>\n\n\n\n
\u2022Mechanisms of resistance \u2013 also add a beta lactamase inhibitor type of medication to it<\/p>\n\n\n\n
oHas other mechanism of resistance such as<\/p>\n\n\n\n
\u25aaMaking bacterial cell wall impermeable to the antibiotic<\/p>\n\n\n\n
\u25aaEffecting the upregulation and the pumping in of the antibiotic<\/p>\n\n\n\n
\u2022If a client with strep pharyngitis is allergic to penicillin or cephalosporins then what do you use?<\/p>\n\n\n\n
o Macrolides \u2013 erythromycin or azithromycin \u2013 do not risk allergic reaction<\/p>\n\n\n\n
Vancomycin<\/p>\n\n\n\n
\u2022Very toxic to the ear and the kidney<\/p>\n\n\n\n
\u2022Has gram positive coverage \u2013 particularly effective in IV form for staph aureus or MRSA infection<\/p>\n\n\n\n
\u2022Bactericidal \u2013 widely distributed and renally excreted \u2013 watch the kidneys<\/p>\n\n\n\n
\u2022Does not absorb well in GI tract so mostly given IV unless somebody has C. diff in which case we can give it<\/p>\n\n\n\n
PO because it will work topically<\/p>\n\n\n\n
\u2022Can cause phlebitis at IV site as well as nephro and ototoxicity<\/p>\n\n\n\n
\u2022Red Man syndrome if infused too rapidly \u2013 histamine type release and patient feels flushed, fever, chills,<\/p>\n\n\n\n
tachycardia, pruritis, paresthesia\u2019s \u2013 does not mean this is an allergic response, means we need to slow it<\/p>\n\n\n\n
down<\/p>\n\n\n\n
Bacteriostatic ABX limit bacterial growth by interfering w\/bacterial protein production, DNA replication = Tetracyclines,<\/p>\n\n\n\n
Sulfonamides, Spectinomycin, Trimethoprim, Chloramphenicol, Macrolides, Lincosamides, Clindamycin,<\/p>\n\n\n\n
Ethambutol, Nitrofurantoin, Oxazolidinone.<\/p>\n\n\n\n
Tetracyclines<\/p>\n\n\n\n
\u2022Doxycylcine 100 mg PO Q12H or BID for 14-28 days depending<\/p>\n\n\n\n
\u2022If pt is on doxycycline for a chlamydia infection, recommend she use a back-up method of birth control<\/p>\n\n\n\n
(condom) since this med can \u2193 effectiveness of oral contraception<\/p>\n\n\n\n
\u2022Doxycycline can cause anorexia, N\/V, diarrhea = should take w\/food<\/p>\n\n\n\n
\u2022Tetracyclines such as Minocycline are safe to use in adolescents for the tx of acne<\/p>\n\n\n\n
\u2022If pt taking Minocycline complains of a HA, evaluate for pseudotremor cerebri<\/p>\n\n\n\n
\u2022Do not give to children less than age 8 because it effects bone growth as well as causing stained teeth<\/p>\n\n\n\n
\u2022Adverse effects = photosensitivity, lupus\/hepatitis, fatty liver, tinnitus, SJS (serious), TEN<\/p>\n\n\n\n
\u2022Can be inactivated by calcium ions, DO NOT give with an antacids or dairy (yogurt, milk) because that<\/p>\n\n\n\n
decreases the absorption<\/p>\n\n\n\n
\u2022Bacteriostatic<\/p>\n\n\n\n
Macrolides, Azalides<\/p>\n\n\n\n
\u2022Bacteriostatic as a general rule, inhibits bacterial protein biosynthesis (peptidyl transferase), binds to the P site<\/p>\n\n\n\n
of the 50S ribosome subunit<\/p>\n\n\n\n
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<\/p>\n\n\n\nNURS 615 Pharm Exam 2 Mega Review Study Guide<\/p>\n\n\n\n
\u2022Vary in excretion \u2013 stool and urine<\/p>\n\n\n\n
\u2022Cover some of the unusual or uncommon respiratory problems such as mycoplasma pneumonia,<\/p>\n\n\n\n
chlamydia pneumonia, Bordetella pertussis<\/p>\n\n\n\n
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<\/p>\n\n\n\nNURS 615 Pharm Exam 2 Mega Review Study Guide<\/p>\n\n\n\n
\u2022There is a molecule with a macrolide ring on this drug<\/p>\n\n\n\n
\u2022Have been around a really long time so we are starting to appreciate problems with resistance now<\/p>\n\n\n\n
\u2022Azithromycin for sinus infection is not really used much more because of problems with resistance \u2013 gets to<\/p>\n\n\n\n
the ears and throat better as they are deeper in the body<\/p>\n\n\n\n
\u2022Azithromycin is a good abx for strep throat especially if pt has developed a rash\/rxn to PCN<\/p>\n\n\n\n
\u2022Besides causing significant GI upset, can cause acute hepatitis, rash, prolonged QT and malignant arrhythmias<\/p>\n\n\n\n
\u2013 serious side effects that need to be monitoring<\/p>\n\n\n\n
\u2022Given for upper and lower respiratory infections, uncomplicated skin infections<\/p>\n\n\n\n
\u2022STIs<\/p>\n\n\n\n
Lincosamides<\/p>\n\n\n\n
\u2022Clindamycin \u2013 relative of erythromycin \u2013 binds like they do to the bacterial 50s ribosomes<\/p>\n\n\n\n
\u2022Bacteriostatic for certain bugs<\/p>\n\n\n\n
\u2022Works deep within the body<\/p>\n\n\n\n
\u2022Bactericidal for certain bugs<\/p>\n\n\n\n
\u2022If a bacteria is resistant to macrolides, it will be resistant to clindamycin as well<\/p>\n\n\n\n
\u2022If pt begins to have frequent diarrhea w\/blood in it, assess pt for pseudomembranous colitis<\/p>\n\n\n\n
\u2022Adverse effects: nausea, vomiting, diarrhea \u2013 can cause c. diff diarrhea, metallic taste in mouth, dizziness,<\/p>\n\n\n\n
vertigo, hypotension, arrhythmias \u2013if patient is having bad c. diff diarrhea from this med, that could be<\/p>\n\n\n\n
the reason the patient offloads their metabolism and has arrythmias<\/p>\n\n\n\n
Oxazolidinones<\/p>\n\n\n\n
\u2022Linezolid \u2013<\/p>\n\n\n\n
oBacteriostatic although can be cidal against a few gram positives<\/p>\n\n\n\n
oUtilized for the big bads \u2013 pneumonias and more complicated infections, VREs \u2013 not first drug of choice<\/p>\n\n\n\n
oSHOULD NEVER BE USED within two weeks or concurrently with maoi d.t drug interactions<\/p>\n\n\n\n
ocauses BONE MARROW SUPPRESSION \u2013 MONITOR CBC can cause lactic acidosis so be concerned<\/p>\n\n\n\n
with acid base balances, optic and peripheral neuropathies<\/p>\n\n\n\n
\u25aaEspecially if used greater than 28 days<\/p>\n\n\n\n
oHeadache and nausea also ADRs<\/p>\n\n\n\n
oOriginally developed as an MAOI, indirect acting sympathomimetic \u2013 giving an SSRI with this would<\/p>\n\n\n\n
cause serotonin syndrome and also interactions with tyramine rich foods (aged cheese, wines, etc.)<\/p>\n\n\n\n
Sulfonamides<\/p>\n\n\n\n
\u2022Sulfamethoxazole \u2013 often utilized with trimethoprim (Bactrim)<\/p>\n\n\n\n
\u2022Silver sulfadiazine \u2013 cream used in burns<\/p>\n\n\n\n
\u2022Bacteriostatic, highly protein bound and well distributed<\/p>\n\n\n\n
\u2022Effect folic acid so never use in somebody who has a folic acid deficit<\/p>\n\n\n\n
\u2022If pt has sulfonamide allergy, then they are cross-sensitive to loop\/thiazide diuretics and sulfonylureas<\/p>\n\n\n\n
\u2022Excreted via the kidneys so make sure this is prescribed in somebody with good kidney function<\/p>\n\n\n\n
\u2022Used to treat E. coli UTIs and occasionally strep pneumonia and pyrogens \u2013 used to be used for c. trachomatous<\/p>\n\n\n\n
\u2022Adverse effects \u2013 folate deficiency because it disrupts folic acid synthesis. Can also cause SJS or TEN so systemic<\/p>\n\n\n\n
reaction can occur (esp. w\/large doses). Glossitis, stomatitis, hepatitis \u2013 can cause transient jaundice, CNS<\/p>\n\n\n\n
effects<\/p>\n\n\n\n
\u2013 can suppress bone marrow, renal impairment<\/p>\n\n\n\n
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<\/p>\n\n\n\nNURS 615 Pharm Exam 2 Mega Review Study Guide<\/p>\n\n\n\n
\u2022Contraindicated in people that are folate deficient or G6PD deficient (condition causing RBCs to break down<\/p>\n\n\n\n
in response to certain meds, infections, stressors)<\/p>\n\n\n\n
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<\/p>\n\n\n\nNURS 615 Pharm Exam 2 Mega Review Study Guide<\/p>\n\n\n\n
o People with G6PD deficiency are missing an enzyme needed for cellular processes \u2013 what happens is that<\/p>\n\n\n\n
you give a sulfonamide and the persons RBCs will hemolyze and they will develop an anemia and so forth<\/p>\n\n\n\n
\u2022Avoid in lactation and infants under 2 months because they are G6PD deficient just by being too new, also<\/p>\n\n\n\n
avoid in sulfa allergies<\/p>\n\n\n\n
Macrobids<\/p>\n\n\n\n
\u2022Nitrofurantoin (Macrodantin)<\/p>\n\n\n\n
\u2022Used for urinary tract infections, also works well with kidney infections (basically goes directly to the kidneys)<\/p>\n\n\n\n
so it would be contraindicated in somebody with kidney disease<\/p>\n\n\n\n
\u2022Renally excreted<\/p>\n\n\n\n
\u2022Crosses the placenta<\/p>\n\n\n\n
\u2022Same effect as sulfa in terms of g6pd though<\/p>\n\n\n\n
Fluoroquinolones<\/p>\n\n\n\n
\u2022One of the latest and greatest medications<\/p>\n\n\n\n
\u2022End in floxacin<\/p>\n\n\n\n
\u2022Bactericidal working on the bacterial DNA replication<\/p>\n\n\n\n
\u2022Work very well on inner anaerobe type of bacteria that live deep within us \u2013 Haemophilus,<\/p>\n\n\n\n
enterococcus, pseudomonas<\/p>\n\n\n\n
\u2022Save for the \u2018big bads\u2019 \u2013 pneumonias, things that could really hurt us, things that are resistant to all other types<\/p>\n\n\n\n
of medications<\/p>\n\n\n\n
\u2022Fluoroquinolones should be reserved for tx of community-acquired PNA in pts w\/ comorbidities<\/p>\n\n\n\n
\u2022Can go where many other antibiotics cannot<\/p>\n\n\n\n
\u2022Avoid antacids, dairy, and iron within a few hours of taking this medication<\/p>\n\n\n\n
\u2022Understand that it does concentrate in the prostate and the kidneys \u2013 it is a good prostatitis medication for<\/p>\n\n\n\n
this reason<\/p>\n\n\n\n
\u2022Is renally excreted \u2013 alter dose and monitor functions with patients that have renal disease<\/p>\n\n\n\n
\u2022Not recommended in pregnancy or children under 18<\/p>\n\n\n\n
o Damage to cartilage \u2013 black box warning for tendon rupture even months after tx\u2013 elderly are the most<\/p>\n\n\n\n
susceptible<\/p>\n\n\n\n
\u2022Can prolong the QT interval<\/p>\n\n\n\n
oKnow the patient\u2019s cardiac status<\/p>\n\n\n\n
oKnow other medications that patient is on that also prolong the QT<\/p>\n\n\n\n
\u2022Know drug to drug interactions with fluoroquinolones<\/p>\n\n\n\n
oWhat does fluoroquinolones and warfarin do? Enhances the effect of warfarin<\/p>\n\n\n\n
oWhat does fluoroquinolones and NSAIDs do?<\/p>\n\n\n\n
Aminoglycosides<\/p>\n\n\n\n
\u2022Gentamicin<\/p>\n\n\n\n
\u2022Amikacin<\/p>\n\n\n\n
\u2022Tobramycin<\/p>\n\n\n\n
\u2022Neomycin<\/p>\n\n\n\n
\u2022Things mostly systemically given \u2013 eye drops and ear drops most frequent<\/p>\n\n\n\n
oPoor GI absorption so IV drug<\/p>\n\n\n\n
oRenally excreted and concentrates in the kidneys as well as the inner ear which is why the issue with<\/p>\n\n\n\n
![\"\"](\"https:\/\/d3tvd1u91rr79.cloudfront.net\/0b27f4cc3f43f902008412600f39ca20\/html\/bg12.png?Policy=eyJTdGF0ZW1lbnQiOlt7IlJlc291cmNlIjoiaHR0cHM6Ly9kM3R2ZDF1OTFycjc5LmNsb3VkZnJvbnQubmV0LzBiMjdmNGNjM2Y0M2Y5MDIwMDg0MTI2MDBmMzljYTIwL2h0bWwvKiIsIkNvbmRpdGlvbiI6eyJEYXRlTGVzc1RoYW4iOnsiQVdTOkVwb2NoVGltZSI6MTY5MDY1MjY0NX19fV19&Signature=C9AW6LOahBwPjsDlk8Oe9vXyLH3Dz79BOrZ3f0PFR2jMIiUSOlaynMuW8JATdBfJgg1ICloPrTvLkqxvinPmv7IfDuNdqb5bOlZroVu~cuqa7lZOx8jGqTkVbN0VFRnndSdh1VBTG06rJZZxq3YCpALHPHeMRhzIQ6N5KQ5AFXVgblqa~2UWUE3CcaMxtjUqmc7eicsHoqybuJeabB5IFW8U74DX1HHckkbhI40dQI0S2FW-yVgqGmg4HguByDa1uv-ai~QfnNSd1wPtO~Pq5lLPvt233l9aPhtHpeY4NKKqPxGCvKWsr-Twhzqp6jDrIn~yPzjtF3HYm0k2HKE32g__&Key-Pair-Id=APKAJ535ZH3ZAIIOADHQ\")
<\/p>\n\n\n\nNURS 615 Pharm Exam 2 Mega Review Study Guide<\/p>\n\n\n\n
gentamicin and ototoxicity and hearing loss<\/p>\n\n\n\n
oAlso can cause renal problems (nephrotoxicity) so monitoring of hearing and renal functions<\/p>\n\n\n\n
incredibly necessary<\/p>\n\n\n\n
![\"\"](\"https:\/\/d3tvd1u91rr79.cloudfront.net\/0b27f4cc3f43f902008412600f39ca20\/html\/bg13.png?Policy=eyJTdGF0ZW1lbnQiOlt7IlJlc291cmNlIjoiaHR0cHM6Ly9kM3R2ZDF1OTFycjc5LmNsb3VkZnJvbnQubmV0LzBiMjdmNGNjM2Y0M2Y5MDIwMDg0MTI2MDBmMzljYTIwL2h0bWwvKiIsIkNvbmRpdGlvbiI6eyJEYXRlTGVzc1RoYW4iOnsiQVdTOkVwb2NoVGltZSI6MTY5MDY1MjY0NX19fV19&Signature=C9AW6LOahBwPjsDlk8Oe9vXyLH3Dz79BOrZ3f0PFR2jMIiUSOlaynMuW8JATdBfJgg1ICloPrTvLkqxvinPmv7IfDuNdqb5bOlZroVu~cuqa7lZOx8jGqTkVbN0VFRnndSdh1VBTG06rJZZxq3YCpALHPHeMRhzIQ6N5KQ5AFXVgblqa~2UWUE3CcaMxtjUqmc7eicsHoqybuJeabB5IFW8U74DX1HHckkbhI40dQI0S2FW-yVgqGmg4HguByDa1uv-ai~QfnNSd1wPtO~Pq5lLPvt233l9aPhtHpeY4NKKqPxGCvKWsr-Twhzqp6jDrIn~yPzjtF3HYm0k2HKE32g__&Key-Pair-Id=APKAJ535ZH3ZAIIOADHQ\")
<\/p>\n\n\n\nNURS 615 Pharm Exam 2 Mega Review Study Guide<\/p>\n\n\n\n
\u2022Topically administered medications have different side effects<\/p>\n\n\n\n
Metronidazole (Flagyl)<\/p>\n\n\n\n
\u2022Bacterial vaginosis, h. pylori, diverticulitis, etc. used for<\/p>\n\n\n\n
\u2022Great for anaerobic coverage \u2013 things found deep within the body<\/p>\n\n\n\n
\u2022Bactericidal<\/p>\n\n\n\n
\u2022Works on nucleic acid synthesis<\/p>\n\n\n\n
\u2022Can be IV or PO<\/p>\n\n\n\n
\u2022Metabolized in the liver<\/p>\n\n\n\n
\u2022**Biggest take away from this is to tell patients they can have nothing with alcohol (not even cough<\/p>\n\n\n\n
medicine) because they will vomit profusely (disulfiram like reaction) \u2013 tachycardia, nausea, vomiting<\/p>\n\n\n\n
Antimycobacterial and meds (TB)<\/p>\n\n\n\n
\u2022Know what TB looks like \u2013 clinical manifestations \u2013 weight loss, night sweats, hemoptysis, fatigue<\/p>\n\n\n\n
\u2022Rifampin used to tx TB, leprosy, and legionella<\/p>\n\n\n\n
\u2022Isoniazid (INH) \u2013 used as 1st line agent for prevention and tx of both waiting and active TB<\/p>\n\n\n\n
\u2022Rifampin \u2013 causes red orange secretions and urine if someone is wearing contacts, they should be taken<\/p>\n\n\n\n
out because this med will ruin their contacts<\/p>\n\n\n\n
o Often see this given to people exposed to meningococcus as a preventative<\/p>\n\n\n\n
\u2022Isoniazid \u2013 peripheral neuritis or neuropathy can occur so recommend Pyridoxine (vitamin B6) be taken while<\/p>\n\n\n\n
on INH<\/p>\n\n\n\n
\u2022Pyrazinamide \u2013 increases uric acid (Gout flare-ups) but can also decrease liver functions and cause someone to<\/p>\n\n\n\n
become hepatotoxic (most dangerous side effect)<\/p>\n\n\n\n
\u2022Ethambutol \u2013 can cause optic neuritis leading to visual problems such as green red color blindness, tell pt<\/p>\n\n\n\n
to report these symptoms immediately as it can be permanent<\/p>\n\n\n\n
Lyme disease medications \u2013 Doxycycline 100 mg Q12H for 21 days<\/p>\n\n\n\n
A pt with a small ventricle septal defect (VSD) that was repaired some years ago with no residual cardiac problems DOES<\/p>\n\n\n\n
NOT need ABX before dental procedures.<\/p>\n\n\n\n
A pt who is experiencing non-infectious diarrhea related to ABX administration will need to be assessed for C. diff colitis,<\/p>\n\n\n\n
so advise pt to increase probiotic intake w\/yogurt to repopulate the gut flora.<\/p>\n\n\n\n
If a child comes to the clinic with a cough, low-grade fever, rhinorrhea, and the mucous is greenish-yellow then NO ABX<\/p>\n\n\n\n
should be prescribed because this is a virus.<\/p>\n\n\n\n
Antivirals<\/p>\n\n\n\n
\u2022Make sure you know what the names are for influenza drugs and simplex and zoster drugs<\/p>\n\n\n\n
\u2022Influenza \u2013 oseltamivir (Tamiflu) or zanamivir (Relenza) \u2013 start within 48 hours of influenza symptoms in order<\/p>\n\n\n\n
to successfully treat<\/p>\n\n\n\n
o Prophylactic treatment will occur in places such as nursing homes to prevent death<\/p>\n\n\n\n
\u2022Acyclovir, famciclovir, valacyclovir \u2013 antivirals of choice for herpes simplex 1 and 2 as well as zoster<\/p>\n\n\n\n
oStart as soon as symptoms begin \u2013 numbness or tingling feeling<\/p>\n\n\n\n
oDrink lots of fluids when taking acyclovir (to help prevent nephrotoxicity)<\/p>\n\n\n\n
\u2022Zoster<\/p>\n\n\n\n
![\"\"](\"https:\/\/d3tvd1u91rr79.cloudfront.net\/0b27f4cc3f43f902008412600f39ca20\/html\/bg14.png?Policy=eyJTdGF0ZW1lbnQiOlt7IlJlc291cmNlIjoiaHR0cHM6Ly9kM3R2ZDF1OTFycjc5LmNsb3VkZnJvbnQubmV0LzBiMjdmNGNjM2Y0M2Y5MDIwMDg0MTI2MDBmMzljYTIwL2h0bWwvKiIsIkNvbmRpdGlvbiI6eyJEYXRlTGVzc1RoYW4iOnsiQVdTOkVwb2NoVGltZSI6MTY5MDY1MjY0NX19fV19&Signature=C9AW6LOahBwPjsDlk8Oe9vXyLH3Dz79BOrZ3f0PFR2jMIiUSOlaynMuW8JATdBfJgg1ICloPrTvLkqxvinPmv7IfDuNdqb5bOlZroVu~cuqa7lZOx8jGqTkVbN0VFRnndSdh1VBTG06rJZZxq3YCpALHPHeMRhzIQ6N5KQ5AFXVgblqa~2UWUE3CcaMxtjUqmc7eicsHoqybuJeabB5IFW8U74DX1HHckkbhI40dQI0S2FW-yVgqGmg4HguByDa1uv-ai~QfnNSd1wPtO~Pq5lLPvt233l9aPhtHpeY4NKKqPxGCvKWsr-Twhzqp6jDrIn~yPzjtF3HYm0k2HKE32g__&Key-Pair-Id=APKAJ535ZH3ZAIIOADHQ\")
<\/p>\n\n\n\nNURS 615 Pharm Exam 2 Mega Review Study Guide<\/p>\n\n\n\n
oFor herpes zoster (shingles) \u2013 asses renal function prior to taking valacyclovir<\/p>\n\n\n\n
![\"\"](\"https:\/\/d3tvd1u91rr79.cloudfront.net\/0b27f4cc3f43f902008412600f39ca20\/html\/bg15.png?Policy=eyJTdGF0ZW1lbnQiOlt7IlJlc291cmNlIjoiaHR0cHM6Ly9kM3R2ZDF1OTFycjc5LmNsb3VkZnJvbnQubmV0LzBiMjdmNGNjM2Y0M2Y5MDIwMDg0MTI2MDBmMzljYTIwL2h0bWwvKiIsIkNvbmRpdGlvbiI6eyJEYXRlTGVzc1RoYW4iOnsiQVdTOkVwb2NoVGltZSI6MTY5MDY1MjY0NX19fV19&Signature=C9AW6LOahBwPjsDlk8Oe9vXyLH3Dz79BOrZ3f0PFR2jMIiUSOlaynMuW8JATdBfJgg1ICloPrTvLkqxvinPmv7IfDuNdqb5bOlZroVu~cuqa7lZOx8jGqTkVbN0VFRnndSdh1VBTG06rJZZxq3YCpALHPHeMRhzIQ6N5KQ5AFXVgblqa~2UWUE3CcaMxtjUqmc7eicsHoqybuJeabB5IFW8U74DX1HHckkbhI40dQI0S2FW-yVgqGmg4HguByDa1uv-ai~QfnNSd1wPtO~Pq5lLPvt233l9aPhtHpeY4NKKqPxGCvKWsr-Twhzqp6jDrIn~yPzjtF3HYm0k2HKE32g__&Key-Pair-Id=APKAJ535ZH3ZAIIOADHQ\")
<\/p>\n\n\n\nNURS 615 Pharm Exam 2 Mega Review Study Guide<\/p>\n\n\n\n
oUnilateral rash along nerve root \u2013 will also be put on gabapentin or possible tricyclic to help with<\/p>\n\n\n\n
the pain<\/p>\n\n\n\n
oPeople who are on antivirals for any length of time need monitoring for their liver function<\/p>\n\n\n\n
Antifungals<\/p>\n\n\n\n
\u2022Organized according to polyenes, azoles, allyamines<\/p>\n\n\n\n
\u2022Can be systemic or topical depending on the infection<\/p>\n\n\n\n
\u2022Some require system \u2013 example is griseofulvin for ringworm (often seen on client\u2019s head)<\/p>\n\n\n\n
\u2022Ketonazole \u2013 can cause hepatoxicity (need to monitor AST\/ALT, alkaline phosphatase, and bilirubin)<\/p>\n\n\n\n
\u2022Amphotericin B is systemic and for serious type of fungal infection<\/p>\n\n\n\n
\u2022Candidiasis \u2013 topical tx (clotrimazole) = yeast, thrush, commonly used things are nystatin, mycostatin,<\/p>\n\n\n\n
itraconazole, fluconazole (big treatment for oral, oropharyngeal, or esophageal yeast, as well as vaginal<\/p>\n\n\n\n
yeast infection).<\/p>\n\n\n\n
\u2022Take note that these drugs can be hepatotoxic (need baseline LFTs) and nephrotoxic so good follow up<\/p>\n\n\n\n
is required for use<\/p>\n\n\n\n
Antihelminetics<\/p>\n\n\n\n
\u2022Lice and scabies = use permethrin cream and Ivermectin<\/p>\n\n\n\n
\u2022Mebendazole and agromectin used to tx intestinal parasitic worms<\/p>\n\n\n\n
\u2022Elimite cream \u2013 apply from head to toe, leave on for 8 hours before rinsing off<\/p>\n\n\n\n
How do we know what we use?<\/p>\n\n\n\n
\u2022Lexicomp \u2013 expensive program but most hospitals have this<\/p>\n\n\n\n
\u2022Uptodate online \u2013 also expensive for individuals \u2013 most practices have one or the other<\/p>\n\n\n\n
\u2022Harriet lane is a good book \u2013 also online and is a good reference for pediatrics<\/p>\n\n\n\n
\u2022Consult infectious disease society of America<\/p>\n\n\n\n
\u2022American college of physicians<\/p>\n\n\n\n
\u2022Sanford guide \u2013 can place as download on phone<\/p>\n","protected":false},"excerpt":{"rendered":"
Carbamazepine (Tegretol) can sometimes show subtherapeutic range due to what?Carbamazepine auto-induces metabolism, leading to lower levels despite good compliance What are the black box warnings for Carbamazepine?Dermatologic reactions What lab test should be ordered for patients on Carbamazepine?CBC every 3-4 months because it can cause decreased WBC, decreased platelets, and trouble with RBC What kind […]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"default","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","ast-disable-related-posts":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"footnotes":""},"categories":[],"tags":[],"class_list":["post-110972","post","type-post","status-publish","format-standard","hentry"],"_links":{"self":[{"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/posts\/110972","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/comments?post=110972"}],"version-history":[{"count":0,"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/posts\/110972\/revisions"}],"wp:attachment":[{"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/media?parent=110972"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/categories?post=110972"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/tags?post=110972"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}
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