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NUR 210 Exam 4 Study Guide
Principles of Pharmacology - Galen
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Macrolides: Azithromycin
Action: inhibits protein synthesis
Use: used when patients are allergic to PNC/Cephalosporins, for stronger bacterial infections
Side effects/adverse reactions: blurred vision, headache, drowsy, fatigue, GI distress,
photosensitivity, allergic reaction/anaphylaxis, tinnitus (ototoxicity), superinfection,
hepatotoxicity, SJS
Contraindications/cautions: allergy, heart issues (dysrhythmias), hepatic/renal dysfunction
Interactions: levels of warfarin increase, levels of digoxin increase, oral birth control
Assessment: vital signs, I&O; urinary output, check labs for liver/kidney function, drug history,
medical history
Nursing interventions:
● Obtain culture and sensitivity (C&S) before therapy
● Monitor vital signs & urine output
● Monitor liver enzymes and for S/S of live issues
● Monitor for superinfection
● Administer antacids 2 hours before or 2 hours after macrolides
● Give azithromycin 1 hour before or 2 hours after meals with full glass of water- no fruit
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juice
● Use sunscreen
● Ok to give with food stomach upset
Glycopeptides: Vancomycin
action/uses: started in the 1950s, serious infections, MRSA, bacteria have developed a
resistance to this drug (VRE)
Given: Oral, IV-slowly
Side effects/adverse reactions: Chills, dizzy, GI distress, thrombophlebitis (given in a central
line IV), nephrotoxic, ototoxic (can lead to permanent hearing loss because of cranial nerve
damage) (can lead to permanent loss of balance), SJS
Red man syndrome - giving it too fast can cause a rash to face, neck, back, and chest
(toxic effect). Other symptoms can include hypotension, tachycardia, wheezing, and
sometimes itching
Nursing interventions:
● Obtain C&S before therapy
● Monitor vancomycin levels (peak and trough)
● Administer over 1 to 2 IV
● Monitor BP
● Monitor IV site
● Monitor renal function test including creatinine clearance as ordered on renal patients
● Hearing
● Monitor patient for superinfection
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Tetracyclines: Doxycycline
Uses: many types of infections or allergy to PCN/cephalosporins
Side effects/adverse reactions: stomatitis, GI distress, photosensitivity, discoloration of
permanent teeth ( do not give to children younger than 8 years or pregnant women), super
infection, hepatotoxicity, SJS
Interactions: dairy products, iron, digoxin and warfarin (risk for toxicity), decreases K level
Contraindications: children under 8, pregnant women (teratogenic and tooth damage)
*Decreases effects of oral contraceptives *
Assessment: vital signs, urine output, check labs if available - liver and kidney, drug
history/medical history
Nursing interventions:
● Obtain C&S before giving drug
● Monitor VS and urine output
● Administer 1 hour before or 2 hours after meals
● Can give with food if stomach upset - no dairy
● Monitor kidney and liver function
● Store out of light and extreme heat
● Advise patients to use sunscreen
● Teach patients to report superinfection
● Warn patients to avoid milk, iron, antacids
● Tell patient to use effective oral hygiene
● Tale all of the med
● Teach to side effects and how to manage and the adverse reactions to report
● To use another form of birth control