ATI Pharmacology Exam Review 2024

Cephalosporin – -broad spectrum -ceph/cefs -Similar to PCN/ don't give if PCN allergy -can cause bleeding w/ other bleeding meds monitor bleeding time (tonsil story) - Disulfiram reaction (puke & puke & puke) just like Flagyl, the protozoal drug - Store in fridge & take with food ALL antibiotics have these side effects – - allergy, hypersensitivity - suprainfection - organ (kidney & ear) toxicity - lowers OC effectiveness Vancomyocin – - serious infections like MRSA - colitis by c-diff - ototoxicity: get hearing test, tell dr. if hearing getting worse -given over 60 minutes Tetracyclines - - Sumycin, Doxycycline (Vibramycin) - broad, rocky mtn fever, lyme disease, acne, GI infections by H. Pylori - bad GI discomfort - Don't give to kids ≤8; teeth permanently yellow - Bad photosensitivity- wear sunscreen! - Can't take with milk, iron, or antacids - Take on empty stomach with a full glass of water When is Arythromycin given? What class of drugs is it? worse adverse effect? - When pt allergic to PCN and needs abx. Bacteriostatic inhibitor bad GI issues Aminoglycosides - ototoxicity, Renal toxicity, Can't take with PCN at all! - gentamicin, neomycin, streptomycin TMP-SMZ - -Contains Sulfa - use for UTI - Blood problems; get CBC baseline -photosensitivity wear sunscreen and glasses! - empty stomach with a full glass of water Isoniazid (INH) - -antiTB - take daily for 6-12 months and most likely with other meds too -worked if 3 neg. sputum cultures, no temp. - Liver toxicity (hepato) check liver fxn - Don't take with alcohol (liver fxn remember?) - Take on empty stomach Antiviral: Acyclovir, Ganciclovir - Teratogenic preg. X; put on rubber gloves if topical! remember my purple glove experience -thrombocytopenia, lowers WBC What class of drugs if Flagyl? What is the weird effect it has? - protozoal. works on C. diff & H. Pylori PUD. Antibuse effect if taken with alcohol Amphotericin B - anti-fungal. HIGHLY TOXIC - infusin rxns (fever and chills) - nephrotoxicity - hypokalemia - hepatoxicity - gynecomasita - C/I with aminoglycosides (just like PCN) -azole - Fungal causes malignant hyperthermia. Use to stop it - succinylcholine, Dantrium/Dantrolene. Morphine adverse effects - -Constipation -Resp depression -urinary retention -Sedation - Orthostatic HOTN - Cough suppression Morphine drug-drug interactions (think of what morphine does to the body) - - MAOIs -anticholinergics -CNS depressants -hypotensive drugs -opiod antagonists (narcan) - antihistamines Morphine patient education re how to take - Take with food for N/V, lie still will help Opiod withdrawl (stop abruptly is taking ≥6weeks). Is it life-threatening? Will it subside? - sweating, restless, agitated, dilated pupils, tremors, tachycardia, increased BP, N/V, cramps, muscle spasms with kicking movements. NO, subside in 7-10 days. Migraine medicine & can you take them right after each other? - vasoconstriction, ergot's and triptans. NO, space out ergot and triptan by at least 24 hours. What pain meds reduces fever? - ibuprofen, tylenol What pain med reduces platelet aggregation? - NSAIDS (aspirin), reduce thrombus but will bleed easier, too What pain med reduces fever but has NO anti-inflammatory effect and NO platelet effect? - tylenol What can give child Reye's syndrome if they have viral illness? - Aspirin NSAIDS education w/ how to take med. NSAIDS= - with food, milk, or full glass of water to reduce gastric discomfort. Ibuprofen, Celebrex, Naproxen, Aspirin acetaminophen max dose/day? - 4 grams When to withhold morphine/opiates - RR 12/min & notify Dr Triptans & pregnancy - Triptan= Teratogenic. Pregnancy X Rheumatoid Arthritis Drugs name potent toxic drug - DMARDs, 1st choice: methotrexate. Bone Marrow Suppression and Fetal Death Methotrexate: most concerned about... - bone marrow suppression; Baseline CBC and platelet counts, What are the s/s of circulatory overload? Seen if giving too much fluids - flush, SOB, cough, heart palpitations What type of diuretic is not effective in renal failure? - Thiazide - HCTZ Bumex is x more potent than lasix - 40 Thiazide diuretics are good for the and perfect for the eldery with HTN - bones, woman Lasix drug-drug interaction: for manic depressive ppl it'll get to toxic levels in the body - Lithium will become toxic Signs of hypokalemia - weakness, dysrhymias, increased cardiac sensitivity of digoxin, ileus, Flat T wave Aspirin toxicity symptoms - Tinnitus, HA Glucocorticoids adverse effects - potent; suppress adrenal glad fxn, hyperglycemia, osteoporosis, if taken with NSAIDS, increase risk of GI ulcer, mask infection and suppress immune system Reo Pro (-mab) what is it for & adverse effects. What other use does Reo Pro have? - Immunosuppressant for RA, Lupus. toxic to bone marrow, acute pulm edema, infection risk, neoplasia risk. Antiplatelet action. Classic CNS depressant drug classes and what they're used for - Benzodiazepines, Barbituates. Anxiety. -lam & -pam are the endings for - Benzodiazepines Benzodiazepine Lorazepam (ativan) increases the possibility of . - seizures Benzodiazepine antidote? - Romazicon 1/2 life of 1 hour Other anxiolytics: and what they're for - -Valproic Acid: anti-seizure, bi-polar - Phenergan: NV, anxiety, extrapyramidal effects Amitriptiyline (Elavil) drug drug interactions and how to take med - Anticholinergics b/c TCA already have anticholinergic effects - void prior to dosing & take at bedtime to sleep through fatigue side effect MAOI's line of choice for depression b/c of the adverse effects with . If hypertensive crisis MAOI adverse effects are related to stimulation of the and include: - SNS, CNS stimulation, CV-hypertensive crisis, palpitations, Liver toxicity 1st drugs of choice for depression and are equally as effective as _ _ _ but don't see & - SSRI, TCA, hypotension and sedation SSRI drug examples: prototype and 2 popular drugs - Prozac, Celexa, Zoloft Atypical antidepressant better use in elderly - Wellbutrin SSRI uses - depresssion OCD bulimia PTSD Panic attacks Social phobias PMDD What time of day to give SSRI - Give in the AM for optimal effects Lithium is used for - Bipolar Disorder Valproic Acid is used for - Anti-seizure Lithium and Diuretics - toxicity if taking diuretics Anti-depressants have effects - anticholinergic: dry mouth, constipation, lack of sweat, lack of voiding eat will cause an - 2nd or 3rd, tyramine. Tyramine, PTT lab value should stay at for what medication? What is the therapeutic PTT level? - 2 times the baseline, Heparin. 60-80 seconds Antidepressants and anti-anxiety meds may take _ to weeks to take effect - 1-3 weeks all anti-depressants have effect and pt must have their monitored - orthostatic hypotension. BP If patient taking an antihypertensive and just got ordered MAOI, Nardil, Marplan, or Parnate, then... - monitor their BP and call the Dr if theres a significant drop and may need to reduce the anti-htn dosage Lithium and Triptans? Safe in pregnancy? - NO both lithium and triptans are teratogenic Therapeutic Levels of Lithium - 0.4-1.0 mEq/L. Take 2-3 times a day. Chemotherapy Agents, name as much as you can! - neosar (cyclophosphamide), methotrexate, doxorubicin, tamoxifen Cyclosporine is an - immunosuppressive drug To prevent HIT, stop heparin at platelet count of - 100,000 How to inject heparin, starting from drawing up - draw up with 22-25 ga needle from vial, then use 25 or 26 ga to put into abdomen 2in from umbilicus. Drug to help with heparin overdose - Protamine Sulfate Warfarin C/I (2) - liver failure (no clotting proteins will lead to too much bleeding), alcoholism (additive risk of bleeding) Lab values to watch with Warfarin - -PT (18-24 sec) -INR (2-3) patient education with aspirin (food-wise) - take with food Prevention of strokes, MI, and reinfarctions can be accomplished with low-dose aspirin of mg - 81 mg Thrombolytic drug prototype - Streptokinase, dissolves clots that have already been formed When should thrombolytics, streptokinase, be given? - 4-6 of onset of symptoms Do/Do not mix any medications in IV with thrombolytic agents - DO NOT What medications are usually given with thrombolytics, streptokinase? (think when this drug is used) - Beta-blockers to lower myocardial oxygen consumption H2 antagonists like Zantac or PPI like Prilosec to prevent GI bleeding Ferrous Sulfate use - Iron Deficiency Anemia Ferrous Sulfate Patient Education (adverse effects, among other things) - -GI distress however can't take with food b/c that will decrease it's absorption greatly -Teeth staining; drink w/ straw or dilute in water or juice and rinse mouth after swallowing - Don't take with tetracycline, or antacids -Poop will be a harmless dark green or black color - Drink more water and exercise more to counter constipation effects why would a patient be given vitB12-cyanocobalamin - pernicious anemia, partial removal of stomach What vit/min masks the signs of Vit b12 deficiency? - folic acid E-alfa, hematopoietic growth factor, is dependent on adequate levels of & - Iron, Folic acid, Vitamin B12 In giving whole blood, what do you do before and during? - obtain vital signs, stay with the client and monitor VS q5 min for 15 minutes When giving whole blood, what do you need the 2nd person for? - check identification of the donor blood and recipient, blood compatibility and expiration date. Only give blood products with what type of IV fluid? - 0.9% NS. anything else will cause lysis of the RBC Bronchodilator albuterol: therapeutic uses - Prevention of asthma attack long-term control of asthma Short acting treatment for asthma attack Bronchodilator side effects; overall stimulation of the B2-adrengeric receptors... - tachycardia, angina How to use a MDI (metered dose inhaler) - shake the inhaler, 1/2-2 in away from mouth and tilt head back slightly and open mouth wide. press inhaler same time you breath in deep. Hold breath for 10 seconds. Wait 1 full minute b4 another puff. When prescribed a beta2-agonist and an glucocorticoid, which do they inhale first? - the beta-2 agonist promotes bronchodilation and enhances absorption of the glucocorticoid What does the med theophylline do? short term or long-term control? - relaxes bronchial smooth muscle and does bronchodilation. Long-term control of asthma attacks. Inhaled atrovent what class of medication is it - anti-cholinergic used for long term control of asthma Glucocorticoids for asthma are used for and oral glucocorticoids are only give for - days - long-term control of asthma attacks. 3-10 days Codeine is used for . classification of drug? - chronic, non-productive cough. it's an opiod. Codeine adverse effects - -CNS effects -GI distress take with food and increase fluids! Mucomyst (Acetylcysteine) is a mucolytic and it's therapeutic effect is to: - make nasal and bronchial secretions watery to enhance their passage Mucomyst's adverse effects are: (think of its effect on mucus) - aspiration and bronchospasm What does Mucomyst acetylcysteine smell like? How to take it? - rotten eggs. dilute with water or juice