lOMoARcPSD| 63525276
Comprehensive Pharmacology Review
The following provides an outline for the prototype drugs (in bold) covered in NR293. Students should be able to
identify the mechanism of action, side effects, drug interactions, and nursing considerations for each drug, as well as
general information about the drug class.
I. Pharmacology Fundamentals
• Protein binding - FAILED3-W
• Half life
• Therapeutic window – lithium, phenytoin, digoxin, Tegretol,
II. Infection Problems
How and when are antimicrobials prescribed?
What nursing considerations and patient education are important to remember?
• Sulfonamides o
Sulfamethoxazole/trimethoprim
(Bactrim)
• Penicillins o Oxacillin o Ampicillin
• Cephlosporins o Cefriaxone
(Rocephin)
• Tetracyclines o Doxycycline hyclate
(Vibramycin)
• Aminoglycosides (‘little mycin’s) o
Gentamicin sulfate o Tobramycin
• Macrolides (‘big mycin’s) o
Clarithromycin (Biaxin)
• Fluoroquinolones o Ciprofloxacin
(Cipro)
• Antifungals o Ketoconazole o
Metronidazole (Flagyl) Anti TB
Drugs
• Isoniazid (INH)
• Pyridoxine (Vitamin B)
• Rifampin (Rifadin)
• Ethambutol (Myambutol)
Antimicrobial Drug Reminderss
• Penicillins: don’t take with acidic juices or carbonated beverages may reduce absorption
• Cepha losporins (Cefa’s)…don’t use if allergic to penicillins
1
, lOMoARcPSD| 63525276
• Macrolides (are “mycins”)…think “ototoxic” and “nephrotoxic”
• Aminoglycosides (are “mycins”)…assess renal and hearing function 1st (8th cranial nerve “Acoustic” – whisper
test) Pencillins and cephalasporins may inactivate aminoglycosides…so give separately
• Tetracyclines (avoid milk products and antacids, administer on empty stomach, no under 8 y.o d/t turning teeth
brown, use alternate birth control.)
• Fluoroquinolones (“floxins”)…take with full glass of H20, wear sunblock, no in kids
• Sulf onamides…don’t take if pregnant, breast feeding, under 2, renal or hepatic problems; may increase
hypoglycemic effect and effect of Coumadin; Take with a full glass of water to prevent crystallization in urine
Anti-tubercular: … monitor liver and renal function, avoid ETOH.
• Rifampin has MANY drug interactions including oral contraceptives and may cause urine, saliva, and sweat to
turn orange.
• Anti-fungals (“azoles”) …don’t take if pregnant, most interact with other anti-infectives
• Ketocanazole has MANY drug interactions
• Anti-virals: …long term use may cause gingival hyperplasia
• Anti-malarials…don’t confuse “quinine” an anti-malarial with “quinidine” and anti-dysrhymic!
• Anthelmintic…metronidazole (Flagyl) may be used as anti-bacterial, antoprotazoal and antihelmintic. It will kill
bacteria good bacteria in gut too, so may decrease absorption of Vitamin K. Will also cause disfulram like
reaction if taken with alcohol. Administer antihelminthics after meals to decrease GI disturbance; do not take
if pregnant; assess other members of the family to see if they are infected.
• Obtain cultures prior to therapy - do you know how to obtain peaks and troughs?
• Give medication round the clock
• Monitor kidney and liver function studies because that’s where most antibiotics are metabolized and excreted.
• Think “ototoxic” and “nephrotoxic” with “mycins” (macrolides and aminoglycosides Most common side effects
of antibiotics… nausea, vomiting, diarrhea.
• Assess for allergy prior to admin; If you’re allergic, wear an alert bracelet.
• Generally use an alternate form of birth control.
• Identify therapeutic use – prophylactic vs. empiric vs. definitive
Cancer & Immunosuppressant Drugs
What nursing interventions and patient are important to remember when administering chemo drugs?
• Cell cycle non-specific – cytotoxic at any phase o Alkylating agents - Cyclophosphamide (Cytoxan)
o Antibiotics – bone marrow suppression ; doxorubicin (Adriamycin) may cause severe dig toxicity
2
Comprehensive Pharmacology Review
The following provides an outline for the prototype drugs (in bold) covered in NR293. Students should be able to
identify the mechanism of action, side effects, drug interactions, and nursing considerations for each drug, as well as
general information about the drug class.
I. Pharmacology Fundamentals
• Protein binding - FAILED3-W
• Half life
• Therapeutic window – lithium, phenytoin, digoxin, Tegretol,
II. Infection Problems
How and when are antimicrobials prescribed?
What nursing considerations and patient education are important to remember?
• Sulfonamides o
Sulfamethoxazole/trimethoprim
(Bactrim)
• Penicillins o Oxacillin o Ampicillin
• Cephlosporins o Cefriaxone
(Rocephin)
• Tetracyclines o Doxycycline hyclate
(Vibramycin)
• Aminoglycosides (‘little mycin’s) o
Gentamicin sulfate o Tobramycin
• Macrolides (‘big mycin’s) o
Clarithromycin (Biaxin)
• Fluoroquinolones o Ciprofloxacin
(Cipro)
• Antifungals o Ketoconazole o
Metronidazole (Flagyl) Anti TB
Drugs
• Isoniazid (INH)
• Pyridoxine (Vitamin B)
• Rifampin (Rifadin)
• Ethambutol (Myambutol)
Antimicrobial Drug Reminderss
• Penicillins: don’t take with acidic juices or carbonated beverages may reduce absorption
• Cepha losporins (Cefa’s)…don’t use if allergic to penicillins
1
, lOMoARcPSD| 63525276
• Macrolides (are “mycins”)…think “ototoxic” and “nephrotoxic”
• Aminoglycosides (are “mycins”)…assess renal and hearing function 1st (8th cranial nerve “Acoustic” – whisper
test) Pencillins and cephalasporins may inactivate aminoglycosides…so give separately
• Tetracyclines (avoid milk products and antacids, administer on empty stomach, no under 8 y.o d/t turning teeth
brown, use alternate birth control.)
• Fluoroquinolones (“floxins”)…take with full glass of H20, wear sunblock, no in kids
• Sulf onamides…don’t take if pregnant, breast feeding, under 2, renal or hepatic problems; may increase
hypoglycemic effect and effect of Coumadin; Take with a full glass of water to prevent crystallization in urine
Anti-tubercular: … monitor liver and renal function, avoid ETOH.
• Rifampin has MANY drug interactions including oral contraceptives and may cause urine, saliva, and sweat to
turn orange.
• Anti-fungals (“azoles”) …don’t take if pregnant, most interact with other anti-infectives
• Ketocanazole has MANY drug interactions
• Anti-virals: …long term use may cause gingival hyperplasia
• Anti-malarials…don’t confuse “quinine” an anti-malarial with “quinidine” and anti-dysrhymic!
• Anthelmintic…metronidazole (Flagyl) may be used as anti-bacterial, antoprotazoal and antihelmintic. It will kill
bacteria good bacteria in gut too, so may decrease absorption of Vitamin K. Will also cause disfulram like
reaction if taken with alcohol. Administer antihelminthics after meals to decrease GI disturbance; do not take
if pregnant; assess other members of the family to see if they are infected.
• Obtain cultures prior to therapy - do you know how to obtain peaks and troughs?
• Give medication round the clock
• Monitor kidney and liver function studies because that’s where most antibiotics are metabolized and excreted.
• Think “ototoxic” and “nephrotoxic” with “mycins” (macrolides and aminoglycosides Most common side effects
of antibiotics… nausea, vomiting, diarrhea.
• Assess for allergy prior to admin; If you’re allergic, wear an alert bracelet.
• Generally use an alternate form of birth control.
• Identify therapeutic use – prophylactic vs. empiric vs. definitive
Cancer & Immunosuppressant Drugs
What nursing interventions and patient are important to remember when administering chemo drugs?
• Cell cycle non-specific – cytotoxic at any phase o Alkylating agents - Cyclophosphamide (Cytoxan)
o Antibiotics – bone marrow suppression ; doxorubicin (Adriamycin) may cause severe dig toxicity
2
