NCLEX study from pharm videos
● IV therapy notes
○ BOLUS: large amt in short amt of time, usually in life threatening situation
○ Changing
■ Tubing - 72 hr
■ Site- 72 hr
■ bags - 24 hr
■ Blood 1x use
○ Do not push potassium
○ No adding meds to blood or TPN infusions
○ Make sure it’s compatible in the tube
○ Lost fluid from: dehydration, shock, hemorrhage, burns, syncope
● Best tips for antibiotics
○ Accidental pregnancy for -cillin and -cycline
■ Oral contraceptives are ineffective
○ No alcohol - abx hard on liver
○ No food or “MTF: move the food”
■ Macrolides, tetracyclines, fluoroquinolones
■ Empty stomach full glass of water
○ No sun (fluoroquinolones, tetracyclines, sulfa drugs)
■ “Photosensitivity” or direct sun exposure→ sun burns
○ Ototoxic and nephrotoxic
■ “-mycins/-micin ”
■ Peaks and troughs - too high kidneys will die, to low infection grows
■ Signs of ototoxicity: vertigo, tinnitus
■ Signs of nephrotoxicity: report immediately. Increased BUN over 20 or
CRE over 1.3 = bad kidney. 30mL/hr or less= kidney distress
○ “-mycins” are the most toxic drugs
■ NOT -thromcyin like azithromycin or ciprofloxacin
○ When to administer EPI
■ E-edema “angioedema”
■ P- pruititis/hives
■ I- Insp/exp wheezes
● PCN and cephalosporin
○ Broad spectrum ABX
○ weakens/destroys bacterial cell wall
○ Pregnancy and breastfeeding safe
○ PCN can cause oral contraceptives to be ineffective
○ Cephalosporins can cause C diff not treat it
, ○ Check for allergy, Cefs and -cillins can't be mixed
○ PCN most anaphylaxis
■ Stop/hold then assess type of rxn and auscultate lungs
■ Administer EPI
○ Take with food if GI upset
○ Shake well before use
○ Common side effects:
■ Cefs: diarrhea
■ Cillins: bleeding (monitor platelet count)
● Big gun ABX
○ Glycopeptide class: vancomycin `
○ Aminoglycosides: gentamicin, neomycin, tobramycin
○ Super nephro/ototoxic
○ Monitor concentration in blood (peak and troughs, 30 min before next
administration must be between 10 and 20)
○ Vanco side effects
■ burns veins (thrombophlebitis)
● PICC preferred route
● Assess site every 30 for pain, swelling and burning
■ Red man syndrome
● Rapid infusion (at least over 60 min for safe admin)
● Sudden and severe onset of: hypotension, flushing and pruritus, red
rash on face/neck/chest/extremities
■ Anaphylaxis
● Hives, angioedema, wheezing
● Immediately stop and admin EPI
○ Vanco does not have an effect on Mg levels
■ This means no psych effects, no change in DTRs and no need anti-nausea
meds
○ Aminoglycosides toxic effects
■ Very toxic in combo with vanco
■ oto/nephrotoxic
■ Normal effects of muscle cramping!
● Macrolides
○ “-thromycin” azithromycin
○ ECG wave changes
■ Prolonged QT intervals — can lead to cardiac arrest
○ Hepatotoxic (ALT/AST)
○ Be careful with acetaminophen
○ Do not stop for fever, decreased WBC, or nausea
, ● Tetracyclines
○ Not pregnancy safe
○ Tooth discoloration
○ Sun burns
○ Mainly used for skin (acne)
○ Patient teaching- use additional contraception, take on empty stomach for best
absorption, sit up 30 min after taking (pill induced esophagitis) , avoid calcium
products that block absorption (no antacids, diary or iron)
● Metronidazole (flagyl)
○ #1 drug to treat C diff infection
○ CEF causes c diff not treat
○ STI treatment (trichomoniasis)
○ Avoid alcohol during and 3 days after tx
■ Violent vomiting or muscle cramping
○ No need to report: metallic taste or dark urine
○ Deadly side effects:
■ Report any new rash/skin peeling— likely stevens-johnson syndrome
which is necrosis of skin and mucous membrane
● 3 UTI medications
○ Sulfa (bactrim)
■ Stops folic acid synthesis
■ “SULF”
● Sunburn, urine crystals (high spec gravity, dry out the body), love
water (increase oral intake), folic acid daily
■ rash= allergy
■ Not pregnancy safe
○ Fluoroquinolones
■ levo/ciprofloxacin
■ Avoid direct sun exposure
■ Achilles tendon rupture, report new muscle pain
■ Contraindicated with tendonitis
■ Nephrotoxicity is rare
○ Phenazopyridine (pyridium)
■ Not ABX
■ Analgesic for pain relief (burning)
■ No need to report red/orange urine
■ Yellow skin/sclera is important to report - liver effects
■ Stains clothing and bedding
■ Glasses instead of contacts
● IV therapy notes
○ BOLUS: large amt in short amt of time, usually in life threatening situation
○ Changing
■ Tubing - 72 hr
■ Site- 72 hr
■ bags - 24 hr
■ Blood 1x use
○ Do not push potassium
○ No adding meds to blood or TPN infusions
○ Make sure it’s compatible in the tube
○ Lost fluid from: dehydration, shock, hemorrhage, burns, syncope
● Best tips for antibiotics
○ Accidental pregnancy for -cillin and -cycline
■ Oral contraceptives are ineffective
○ No alcohol - abx hard on liver
○ No food or “MTF: move the food”
■ Macrolides, tetracyclines, fluoroquinolones
■ Empty stomach full glass of water
○ No sun (fluoroquinolones, tetracyclines, sulfa drugs)
■ “Photosensitivity” or direct sun exposure→ sun burns
○ Ototoxic and nephrotoxic
■ “-mycins/-micin ”
■ Peaks and troughs - too high kidneys will die, to low infection grows
■ Signs of ototoxicity: vertigo, tinnitus
■ Signs of nephrotoxicity: report immediately. Increased BUN over 20 or
CRE over 1.3 = bad kidney. 30mL/hr or less= kidney distress
○ “-mycins” are the most toxic drugs
■ NOT -thromcyin like azithromycin or ciprofloxacin
○ When to administer EPI
■ E-edema “angioedema”
■ P- pruititis/hives
■ I- Insp/exp wheezes
● PCN and cephalosporin
○ Broad spectrum ABX
○ weakens/destroys bacterial cell wall
○ Pregnancy and breastfeeding safe
○ PCN can cause oral contraceptives to be ineffective
○ Cephalosporins can cause C diff not treat it
, ○ Check for allergy, Cefs and -cillins can't be mixed
○ PCN most anaphylaxis
■ Stop/hold then assess type of rxn and auscultate lungs
■ Administer EPI
○ Take with food if GI upset
○ Shake well before use
○ Common side effects:
■ Cefs: diarrhea
■ Cillins: bleeding (monitor platelet count)
● Big gun ABX
○ Glycopeptide class: vancomycin `
○ Aminoglycosides: gentamicin, neomycin, tobramycin
○ Super nephro/ototoxic
○ Monitor concentration in blood (peak and troughs, 30 min before next
administration must be between 10 and 20)
○ Vanco side effects
■ burns veins (thrombophlebitis)
● PICC preferred route
● Assess site every 30 for pain, swelling and burning
■ Red man syndrome
● Rapid infusion (at least over 60 min for safe admin)
● Sudden and severe onset of: hypotension, flushing and pruritus, red
rash on face/neck/chest/extremities
■ Anaphylaxis
● Hives, angioedema, wheezing
● Immediately stop and admin EPI
○ Vanco does not have an effect on Mg levels
■ This means no psych effects, no change in DTRs and no need anti-nausea
meds
○ Aminoglycosides toxic effects
■ Very toxic in combo with vanco
■ oto/nephrotoxic
■ Normal effects of muscle cramping!
● Macrolides
○ “-thromycin” azithromycin
○ ECG wave changes
■ Prolonged QT intervals — can lead to cardiac arrest
○ Hepatotoxic (ALT/AST)
○ Be careful with acetaminophen
○ Do not stop for fever, decreased WBC, or nausea
, ● Tetracyclines
○ Not pregnancy safe
○ Tooth discoloration
○ Sun burns
○ Mainly used for skin (acne)
○ Patient teaching- use additional contraception, take on empty stomach for best
absorption, sit up 30 min after taking (pill induced esophagitis) , avoid calcium
products that block absorption (no antacids, diary or iron)
● Metronidazole (flagyl)
○ #1 drug to treat C diff infection
○ CEF causes c diff not treat
○ STI treatment (trichomoniasis)
○ Avoid alcohol during and 3 days after tx
■ Violent vomiting or muscle cramping
○ No need to report: metallic taste or dark urine
○ Deadly side effects:
■ Report any new rash/skin peeling— likely stevens-johnson syndrome
which is necrosis of skin and mucous membrane
● 3 UTI medications
○ Sulfa (bactrim)
■ Stops folic acid synthesis
■ “SULF”
● Sunburn, urine crystals (high spec gravity, dry out the body), love
water (increase oral intake), folic acid daily
■ rash= allergy
■ Not pregnancy safe
○ Fluoroquinolones
■ levo/ciprofloxacin
■ Avoid direct sun exposure
■ Achilles tendon rupture, report new muscle pain
■ Contraindicated with tendonitis
■ Nephrotoxicity is rare
○ Phenazopyridine (pyridium)
■ Not ABX
■ Analgesic for pain relief (burning)
■ No need to report red/orange urine
■ Yellow skin/sclera is important to report - liver effects
■ Stains clothing and bedding
■ Glasses instead of contacts
