Pharmacology Tumor lysis syndrome : When cancerous tumors break down very quickly, the kidneys have to work extra hard to remove all the substances that were in those tumors. If they can’t keep up, it can cause tumor lysis syndrome (TLS). Most common in people w/ blood -related cancers, including some leukemias & lymphomas. Occurs w/in a few hours to several days after a first chemotherapy tx. S/S: High levels of potassium can lead to neurological changes & heart problems. Excess uric acid (hyperuricemia) can cause kidney stones & kidney damage, can also develop uric acid deposits in joints, causing a painful condition similar to gout. A buildup of phosphate can lead to kidney failure. Too much phosphate can also cause calcium levels to drop, possibly leadi ng to acute kidney failure. Hydroxyurea : (antimetabolites) tx psoriasis, chronic myelogenous leukemia (a cancer of the WBC’s), ovarian cancer, melanoma (a form of skin cancer), certain head & neck cancers, also helps w/ sickle cell anemia (an inherited blood disorder) by reducing the frequency of painful sickle cell crisis episodes & the need for blood transfusions. Hydroxyurea is sometimes used to treat polycythemia vera (a disorder of the bone marrow) by reducing the red blood cell mass. It works by slowing or stopping growth of cancer cells in body, & by helping to prevent the formation of abnormal red blood cells. Hydroxyurea toxicity: Hydroxyurea can cause a severe decrease in the number of blood cells in your bone marrow. This may increase the risk that you will develop a serious infection or bleeding. If you experience any of the following symptoms, call your doctor immediately: fever, chills, excessive tiredness or weakness, body aches, sore throat, shortness of breath, ongoing cough and congestion, or other signs of infection; unusual bleeding or bruising; bloody or black, tarry stools; or vomiting blood or brown material that resembles coffee grounds. Ceftazidime is used to treat a wide variety of bacterial infections. This medication belongs to a class of drugs known as cephalosporin antibiotics. It works by stopping the growth of bacteria. Don’t use if allergic to any cephalosporin abx or PCN abx. Call MD if you have: severe abd pain, watery or bloody diarrhea, confusion, problems w/ speech or memory;seizure (black -out or convulsions); or a cold feeling, discoloration, or skin changes in your fingers. Common side effects: pain, swelling, burning, or irritation around the IV needle; N/V/D, stomach pain; vaginal itching or discharge. sulfamethoxazole and trimethoprim: a combination of 2 abx to tx UTI’s, acute otitis media, bronchitis, Shigellosis, Pneumocystis pneumonia, traveler's diarrhea, methicillin -resistant Staphylococcus aureus (MRSA). Common SE: loss of appetite, N/V, painful or swollen tongue, Dizziness, spinning sensation, ringing in ears, tiredness, insomnia.Call MD if: bruising, bleeding, aplastic anemia, jaundice, hepatic necrosis, mouth sores, joint aches, severe skin rashes, itching, sore throat. Verapamil : tx HTN. Lowering high BP helps prevent strokes, heart attacks, & kidney problems. Verapamil class: calcium channel blockers. It works by relaxing blood vessels so blood can flow more easily. Verapamil is also used to prevent chest pain (angina). It may help to increase your ability to exercise and decrease how often you may get angina attacks. Verapamil is also used to control your heart rate if you have a fast/irregular heartbeat (such as atrial fibrillation). It helps to lower the HR, helping you to feel more comfortable and increase your ability to exercise. SE: Dizziness, slow heartbeat, constipation, nausea, headache, or tiredness may occur. get up slowly when rising from a sitting or lying position. Cephalosporins are beta -lactam antibiotics, similar to penicillins, that destroy bacterial cell walls. Tx: UTI’s, post op infections, pelvic infections, & meningitis. possible cross -sensitivity to penicillins.Use cautiously with clients who have renal impairment or bleed ing tendencies. No ETOH, take w/ food, refrigerate suspension. 4. A nurse is caring for a client who has a cerebrospinal fluid infection w/ gram -negative bacteria. Which of the following cephalosporin abx should the nurse expect to administer iV to treat this infection? A. cefaclor B. cefazolin C cefepime D. cephalexin cefepime , a fourth -generation cephalosporin, is more likely to be effective against this infection than the other meds, which are first or second gen. Meds from each progressive generation of cephalosporins are more effective against gram -negative bacteria, more resistant to destruction by beta -
lactamase, and more able to reach cerebrospinal fluid RN PHARMACOLOGY FOR NURSING CHAPTER 47 Mycobacterial, Fungal, and Parasitic inFections 1. A nurse is caring for a client who has diabetes mellitus, pulmonary tuber culosis, and a new prescription for isoniazid. Which of the following supplements should the nurse expect to administer to prevent an adverse effect of inH? a. ascorbic acid b.Pyridoxine c.Folic acid d.cyanocobalamin Pyridoxine is frequently prescribed along with inH to prevent peripheral neuropathy for clients who have increased risk factors, such as diabetes mellitus or alcohol use disorder. 2. A nurse is infusing V amphotericin b to a pt who has a systemic fungal infection the nurse should monitor pt for which adverse effects of this med? a. Hypoglycemia B. constipation C. Fever D. Hyperkalemia
lactamase, and more able to reach cerebrospinal fluid RN PHARMACOLOGY FOR NURSING CHAPTER 47 Mycobacterial, Fungal, and Parasitic inFections 1. A nurse is caring for a client who has diabetes mellitus, pulmonary tuber culosis, and a new prescription for isoniazid. Which of the following supplements should the nurse expect to administer to prevent an adverse effect of inH? a. ascorbic acid b.Pyridoxine c.Folic acid d.cyanocobalamin Pyridoxine is frequently prescribed along with inH to prevent peripheral neuropathy for clients who have increased risk factors, such as diabetes mellitus or alcohol use disorder. 2. A nurse is infusing V amphotericin b to a pt who has a systemic fungal infection the nurse should monitor pt for which adverse effects of this med? a. Hypoglycemia B. constipation C. Fever D. Hyperkalemia
