Quiz 3 study guide

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Quiz 3 study guide
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2011-12-10 21:05:05
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NSG 304
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NSG 304 Quiz # 3 powerpoint review
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  1. Antibiotic Resistance
    -Drug resistance: mutant bacteria pathogens that resist action of antiobiotics

    -Aquired resistance: "Mutant" bacteria pass along their DNA to other bacteria which makes them resistant as well
  2. Use of Long term corticosteroid therapy
    -glucocorticoids prepare body for long term stress

    -Increase breakdown of proteins into amino acids

    -breakdown of lipids

    -suppression of imflammatory and immune responses

    Cortisol is secreted in the highest amount

    -Used to treat "Addison's disease" (inadequate secretion of corticosteroid by adrenals

    -inadequate secretion of ACTH (Adrenal corticotropic hormone) from pituatary so cortisol production decreases

    -treats:

    inflammation

    allergies

    neoplasms (tumor)

    hypotension

    renal impairement

    lack of energy

    arthritis

    Inflammatory bowel disease (IBD)

    Crohns Disease (Inflammation of GI tract)

    Asthma

    Allergies

    Transplant rejection prophylaxis

    Edema
  3. Side effects to be vigilant for when using Aminoglycaside
    -Ototoxicity: damage to the inner ear (sensory cells in cochlea)

    -may cause unborn child in late pregnancy to become deaf

    -Must be given parentally to treat systematic infection
  4. Circumstances which call for use of a long term anticoagulant
    -Used with prosthetic heart valve

    Example: Coumadin
  5. (Zantac) Ranitidine

    "Action"
    -Antiulcer drug/H2 receptor antagonist

    -reduces gastric acid secretion by blocking histamine-2 receptor sites

    -receptors located in the gastric parietal cells lining stomach
  6. (Zantac) Ranitidine

    "Indications for use"
    -gastric and peptic ulcers

    -GERD

    -Hypersecretory conditions (Zollinger-Ellison Syndrome)

    -prevention of stress ulcers

    -combination with antibiotic for treating Helicobacter pylori
  7. (Zantac) Ranitidine

    "Contraindications"
    -Hypersensitivity

    --use with caution with pts with an impaired renal or hepatic function
  8. (Zantac) Ranitidine

    "Side Effects"
    -Somnolence, diaphoresis, rash, headache

    -taste disorder, diarrhea, constipation, dry mouth

    -Arrythmia

    -Neutropenia (bone marrow that doesnt make enough neutrophils)

    -Pancytopenia: (low red blood Cells, WBC's, and platelets)

    -Aplastic anemia (bone marrowdoesnt make enough blood cells)

    -Anaphylaxis
  9. (Zantac) Ranitidine

    "Administration Considerations"
    -IV administration should not be mixed with any other IV medications

    -Avoid antacid use within 1 hour of administration

    -May be given as a single dose, twice daily, or with meals and at bedtime
  10. (Zantac) Ranitidine

    "Drug Interactions"
    -May increase diazepam absorption

    -Increase hypoglycemic effects of glypizide

    -Increase procainamide levels and increase warfarin effects
  11. Treatment for Tuberculosis
    -Active TB: Treated usually with more then one drug due to increased drug resistance

    -Myobacterium (microorganism that causes TB), has a cell wall that is resistant to penetration of anti-infectives

    -Drug combinations must be switched to decrease risk of resistance
  12. Side effects os NSAIDS
    -GI upset and bleeding

    -overdose may cause hepatic failure

    -damage to GI mucosa

    -Hepatoxicity

    -Salcilates: hypersensitivity reaction (bronchospasm, laryngeal edema, anaphylaxis)

    -Stomach pain

    -Nephrotoxicity (salcilates combined with Acetaminophen)

    -Salcylate toxicity

    -(Ibuprofen) pose increased risk for MI, Heart Failure
  13. (Flagyl) Metronidazole
    -Older anti-infective (1963)

    -Resistance uncommon

    -Treats:

    peptic ulcer disease -pathogen in Gi tract (helicobacter pylori)

    -Anaerobic bacteria (cause gangrene, diabetic skin ulcer, deep wound infections)

    -Serious in tro-abdominal infections/septicemiadue to bacteriodes, Clostridium, Streptococci
  14. (Zovirax) Acyclovir: Interferes with viral synthesis of DNA

    "Indications for use"
    Interferes with viral synthesis of DNA

    -HSV-1 (eye, mouth, lips) and HSV-2 genitalia

    -CMV (Cytomegalovirus) high doses

    -Herpes zoster (shingles) -High dose

    -Epstein-Barr (EBV)
  15. (Zovirax) Acyclovir: Interferes with viral synthesis of DNA

    "Contraindications"
    -Hypersensitivity

    -Renal/Hepatic disease (severe)
  16. (Zovirax) Acyclovir: Interferes with viral synthesis of DNA

    "Side Effects"
    -N & V

    Diarrhea

    headache

    tremors

    lethargy

    rash

    pruritus

    increased bleeding time
  17. (Zovirax) Acyclovir: Interferes with viral synthesis of DNA

    "Adverse reactions"
    Anemia

    seizures

    nephrotoxicity
  18. (Zovirax) Acyclovir: Interferes with viral synthesis of DNA

    "Lab tests necessary"
    BUN & Creatinine and CBC
  19. (Zovirax) Acyclovir: Interferes with viral synthesis of DNA

    "Drug Interactions"
    -Probenecid (Benamid-gout)-decreases elimination of acyclovir and causes nephrotoxicity
  20. How NSAIDS work on the chemical level
    -Inhibit synthesis of prostaglandins

    -Block enzyme COX-1 and COX-2 which are necessary to form prostaglandins

    -Block the enzyme cyclooxygenase that form prostaglandin

    -prostaglandins= Hormone found throughout body which cause:

    vasodialation and pain

    protect stomach mucosa from acid

    help maintain blood flow through kidneys

    -Cause bronchodilation or bronchoconstriction

    -Increase platelet aggregation
  21. Side effects of corticosteroids/prednisone treatment
    - low doses have few side effects

    --immune response- susceptibiltiy to infection

    peptic ulcers

    osteoporosis- 50% will have a fracture

    -Behavioral changes- nervous, moody, hallucinations, suicidal

    -eye changes: cataracts and open angle glaucoma

    -Metabolic changes- hyperglycemic action

    -myopathy_ muscle wasting
  22. When do you not want to use the drug "Cipro"?

    Action:Usually selectd to treat pseudomonas auriginosa

    ex: UTI, sinusitus, pneumonia, skin, bone and joint infections, infectious diarrhea, gonorrhea, certain eye infections
    Do not use if:

    pregnant women

    breast feeding
  23. Drugs used to treat tuberculosis (TB)
    1st choice drugs:

    -Isoniazid (INH)-treated prophylactically for 9 months/DOT mainstay

    -Pyrazinamide

    -Rifampin

    -Rimactane

    -Rifapentine (Priftin)

    -Streptomycin

    -2nd choice of drugs can be more toxic

    only used when 1st choice drugs are ineffective
  24. Precautions to take when using a steroid inhaler
    -Moderate to severe asthma may not be adequately treated using an inhaled steroid

    -Rinse mouth after use to prevent Candida (Thrush)
  25. (Protonox) Pantoprazole

    "Action"
    -Works on the surface of parietal cells

    -inhibits gastric acid secretion

    -Inhibits hydrogen-potassium ATPase (enzyme responsible for secreting hydrochloric acid in stomach

    -Blocks formation of gastric acid
  26. (Protonox) Pantoprazole

    "Indications"
    -Treatment of gastric and duodenal ulcers for 4-8 weeks

    -Gerd

    Zollinger- Ellison syndrome maintenance therapy
  27. (PROTONOX) Pantoprazole

    "contraindications for use"
    -Children <18 years old

    -Nursing mothers
  28. (protonox) Pantoprazole

    "Side Effects"
    -Injection site reaction

    -headache

    hyperglycemia

    dizziness

    pruritus

    dry mouth
  29. (Protonox) Pantoprazole

    "adverse effects"
    Pancreatitus

    liver necrosis

    hepatic failure

    Agranulocytosis (dangerously low WBC'S)

    MI

    Shock

    CVA

    GI hemmorage
  30. (Protonox) Pantoprazole

    "Activation"
    -Activated by food intake

    -Take 20-30 minutes before 1st major meal of day

    -Suppress acid for 24 hours-irreversible inactivation of proton pumps
  31. (Protonox) Pantoprazole

    "Drug Interactions"
    May alter absorption of ketoconazole (Anti-fungal)

    digoxin

    iron

    ampicillan

    -Note: All these drugs are dependent on gastric PH for absorption
  32. Antacid Alternagel: (anti-heartburn agent)

    "Action"
    neutralizes stomach acid by raising PH of the stomach contents
  33. Antacid Alternagel: (anti-heartburn agent)

    "Adverse effects"
    constipation

    -long term use may deplete Phosphate in the GI tract especially in pts who are:

    malnourished

    alcoholic

    renal disease
  34. Antacid Alternagel: (anti-heartburn agent)

    "PRECAUTIONS"
    -Avoid prolonged use in pts with low serum phosphates

    -DO not use in pts with suspected bowel obstruction
  35. Antacid Alternagel: (anti-heartburn agent)

    "Nursing responsibilities"
    assess for bowel changes

    monitor pt for worsening symptoms
  36. Lomotil

    "Classification"
    Opiod antidiarrheal

    Diphenoxylate
  37. Lomotil

    "Effects"
    -Slows peristalsis

    Schedule IV controlled substance
  38. Lomotil

    "Mechanism of action"
    Acts on smooth muscle of intestine
  39. Lomotil

    "Adverse Effects"
    Dizziness

    lethargy

    drowsiness

    High doses:

    Antocholinergic effects of atropine

    Drowsiness

    Flushing

    Dry Mouth

    Tachycardia
  40. Prilosec

    "Therapeutic use"
    Antiulcer drug

    Proton pump inhibitor
  41. Prilosec

    "Action"
    -Reduces acid secretion in stomach by binding irreversibly to enzyme H+, K+, and ATPase

    -Inhibits final pathway involved in acid secretion

    Inhibits proton pumps
  42. Prilosec

    "Drug Interactions"
    May inhibit/ delay metabolis of:

    Carbamazepine

    Diazepam

    Phenytoin

    Warfarin

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