pharm final

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adrienne
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10702
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pharm final
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2010-03-15 20:08:54
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pharm final
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  1. why can aspirin be given in kids
    reyes syndrome
  2. what population is aspirin contraindicated in
    pts taking blood thinners
  3. what are the labs to be considered in pts taking aspirin
    • PT because it may increase clotting time
    • my affect cholesterol potassium decreasing serum level
    • T3
    • T4
    • cause abnormal liver function tests
  4. patient teaching on antiturberculosis drugs
    that therapy could last between 6-24 months, but are unlikely to transmit infection after being antiboitics for 2-3 weeks, b12 may be needed supplemented, effects of meds to report are N/V, diarrhea, epigastric pain , anaphylaxis, neuropathy, optic neuritis, hepatotoxicity, blood dyscrasias
  5. Signs and symptoms of fluid overload
    • increased blood pressure
    • abnormal breath sounds (crackles)
    • SOB
    • electrolyte imbalance
    • jugular vein distension
    • weight gain
  6. signs and symptoms of dehydration
    • decreased blood pressure
    • concentrated urine
    • poor skin turgor
    • flushed dry skin
    • dry membranes in mouth
    • tachycardia
  7. fyi if patient is allergic to penicillin they may also have an allergy to cephalosporins
  8. side effects of penicillins
    • rash
    • puritus
    • diarrhea
    • nausea
    • fever
    • anaphylaxis
    • nephrotoxicity
    • circulatory collapse
    • cardiac arrest
    • angioedema
  9. cephalosporins (ceph)
    same as penicllin and fatugue, oral vaginal cadidiasis, pseudomembranous colitis, nephrotoxicity, anaphylaxis
  10. what antibiotic if mixed with alcohol gives the disulfiram - antabuse like reaction
    • cephalosporins
    • the reaction includes severe vomiting, weakness, blurred vision, hypotension
  11. tetracyclines side effects
    • N/V
    • abd cramping
    • gas
    • diarrhea
    • phototoxicity
    • dizziness
    • stinging
    • anaphylaxis
    • secondary infection
    • heapttoxicity
    • exfoliative dermatitis
  12. what is the important population contraindicated in use of tetracyclines
    • do not give to children and prego women because of discolaration of teeth
    • do not take within 2-3 hours of antacids
    • do not take with milk, iron supplements, magnesium cantainin laxatives or antacids
    • drugs to lower lipid levels will reduce the levels of antibiotics
  13. Macrolides (mycin) Erythromycin side effects
    • same as other antibiotics
    • along with ototoxicity
    • hepatotoxicity
    • suprerinfection
  14. in patient teaching what is an important point on macrolides aka erythromycin
    • do not take with fruit juice
    • report pale stool
    • dark urine
    • jaundice
    • itching
    • rash hives
    • difficulty swallowing
  15. what are some medications that will affect macrolides-erthromycin
    • anesthetics
    • anti convulsant drugs may cause toxic effects
    • if on warfarin there may be a decrease in metabolism and excretion
  16. aminoglycosides (micin, mycin) side effects
    gentamicin
    • tinnitus
    • anaphylaxis
    • nephrotoxicity
    • irreversible ototoxicity
    • superinfections
    • pts. with myasthenia gravis and parkinsons my have greather muscle weakness due to neuromuscular blockade
    • vertigo
  17. fluorroquinolones (floxin in 2nd gen)
    ciprofloxan
    • the same as the others
    • restlessness
    • corneal irritation in eye drops
    • tendon rupture (kids)
    • superainfections
    • photosensitive
    • pseudomembranous colitis
  18. whar are some important alerts concerning fluoroquinolones (cipro) concerning other meds
    • antacids and ferrous sulfate - take at least 2 hours before these drugs
    • may increase warfarin and theophylline
    • report inflammation
    • tendon pain
    • dizziness
    • restlessness
    • stomach distress
    • diarrhea fast heart rate
    • confusion
    • psychosis
  19. sulfonamides (sulf) common UTI med
    trimethoprime and sulfethoxazole
    bactrum, septra
    side effects
    • crystalluria
    • steven johnson syndrome
    • blood dyscrasia
    • hepatic necrosis

    • N/V
    • anorexia
    • rash
  20. pt teaching- sulfonamides (bactrum)
    • intake of 3000 ml to avoid crystalluria
    • hypersenitivity with diuretics (acetazolamides and tiazides)
    • photosensitive
    • report cramping
    • hematuria fever
    • if have megaloblastic anemis take trimethoprime (bactrim, septra)
  21. important things before antibiotic administration
    • hard on liver and kidneys
    • C/S
    • eat foods with live cultures to help with flora
    • take as directed, finish
    • CBC
    • WBC
  22. Colchicine
    use
    SE
    • for gout and gouty arthritis
    • SE- n/v, diarrhea, gi upset, bone marrow depression , kidney toxic, thrombocytopnia and agranuloctosis, leukopenia, aplastic anemiz
    • take on empty stomach, monitor CBC
    • report chane in urine output
    • weakness
    • pain
    • diarrhea
    • coombs test for hemolytic anemia
    • swelling
    • Increase fluids to 3-4 liters per day
    • avoid alcohol
  23. H1 receptor antagonist
    benadryl-1st gen
    allegra-2nd gen
    side effects
    • urinary retention
    • hyppotension
    • extrapyramidal excitation
    • agranulocytosis
    • resp depression
    • thick secretions
    • dry mouth
    • headache
    • dizziness
    • paradoxal excitement
    • sedation
    • hypersensitivity
  24. in giving H1 and H2 receptor antagonist what conditions may this med be contraindicated in
    benedryl, allergra like drugs
    • narrow angle glaucoma
    • elderly (LOC)
    • BPH
  25. flonase, intranasal glucocorticoid
    what would you monitor for & pt teaching
    • cushings
    • use decongestant before glucocorticoid
    • may take 2-4 weeks for max effect
    • use humidifier avoid swallowing when taking med
    • clear nose before spray
    • normal SE
    • nasal irritaion
    • burning
    • sneezing
    • dryness
    • hypercorticism (if large amount swallowed
  26. nasal decongestants Afrin
    side effects
    pt teaching
    • nasal irritation
    • burning
    • sneezing
    • headache
    • severe vasoconstricion
    • difficulty urination
    • rebound congestion use 3-5 days only
    • palpitations
    • chest pain
    • dizziness
    • dry mouth
    • confusion
    • numbness
    • tingling of face or limbs
    • nosebleeds restlessness
  27. who should avoid nasal decongestants
    • Cardiac
    • HTN pts
  28. Pancreatic enzymes
    prototype
    administration
    pt teaching
    • pancrelipase
    • cotazym
    • pancrease

    • give 1-2 hours before meals or with
    • monitor for hypercapnia
    • antacids will decrease effect of med
    • do not give in pts allergic to pork
    • contrindicated in pts with pancreatitis
    • monitor liver labs
    • avoid trigger foods
    • observe stool
    • lo fat
    • small frequent meals
    • positioning may help with pain
  29. antiemetics reglan
    side effects
    administration
    pt teaching
    • side effects
    • dry eyes, agranulocytosis, dry mouth , constipation, extrapyramidal excitation, drowsiness, photositive
    • neuroleptic malignant syndrome
    • administration/pt teaching
    • reglan can be used to accerlate gastric emptying, or as and antiemetic, change positions slowly due to hypotension and dizziness
    • report vomiting with or without blood if with a severe headache
  30. diuretics
    loops
    lasix
    side effects
    administration
    pt teaching
    • lasix SE hypokalemia, ototoxicity, electrolye imbalances, tinnitus, nausea, diarrhea, dizziness, fatigue, blood dyscrasias, dehydration, circulatory collapse.
    • pt teaching I & O
    • BUN
    • creatinine
    • electrolytes (potassium)
    • uric acid levels
    • breath sounds
    • hold med if BP is low, in dehydration and hypokalemia
  31. pt teaching in lasix
    • take in the morn when you will be near a BR
    • expect to pee alot
    • know S/S to watch for- weakness, cramps, changes in pulse rate
  32. thiazide and thiazide like diuretics
    chlorothiazide (diuril)
    SE
    Pt teaching
    • same as loops + coma
    • teaching same as loops
  33. potassium sparing
    spironactone
    aldactone
    SE
    Admin
    pt teaching
    • minor hyperkalemia, headache, agranulocytosis
    • blood dyscrasias
    • dehydration
    • hyponatremia
    • dysrhythmias
    • gynecomastia
    • pt teaching
    • like loops with these drugs do not give potassium supplements, somtimes combined with other diuretics to conserve potassium
  34. vasopressin
    use
    s/s
    overdose
    • used for diabetes insipidus
    • s/s headache, drowsiness, restlessness, confusion, coma. these can be avoided if pt reduces fluid intake
    • overdose- excessive fluid retention, water intoxication

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