Drugs for Tubercular, Fungal, Protozoan, and Helminthic Infections & Drugs for PUD
Why are multiple TB drugs given during therapy?
To prevent drug-resistant TB.
MOA of statins
They inhibit HMG-CoA reductase which is the enzyme for cholesterol biosynthesis.
So- they work by decreasing cholesterol production by the liver
This is the only type of insulin that can be given IV.
regular insulin
Name the 3 types (categories) of drugs used for RA and what each does
1. NSAIDs decrease pain and inflammation
2. Corticosteroids used short term to decrease inflammation in acute flare ups
3. DMARDs slow/stop the progression of damage
Why is medication used for atopic dermatitis?
To reduce inflammation and relieve pruritus
These four drugs are used in the initial treatment phase for active TB.
INH, rifampin, pyrazinamide, and ethambutol (RIPE)
This harmless but important side effect of rifampin should be included in teaching.
Discoloration of body fluids (orange/red)
Common adverse effects of statins?
Severe adverse effects of statins and nursing considerations?
Common: GI effects (flatulence, abdominal pain, cramps, N/V, constipation)
Severe: liver failure (monitor LFTs), rhabdomyolysis (monitor CK levels and discontinue if any muscle pain)
Prototype for biguanides and the most serious adverse effect?
Metformin
lactic acidosis
What are the 3 serious adverse effects for DMARD I drugs?
liver damage, bone marrow suppression, eye damage
This treatment for psoriasis must be used sparingly because long-term daily use can thin the skin.
topical corticosterioids
What medications should someone with PUD caused by H pylori receive?
2 or more antibiotics and a PPI
This antifungal medication requires monitoring for kidney damage.
amphotericin B
Clients taking statins should avoid drinking large quantities of this beverage because it increases the risk of toxicity.
Grapefruit juice
How close to a meal should a rapid acting insulin be administered?
How close to a meal should a regular insulin be administered?
15 minutes before
30-60 minutes before
Prototype and serious adverse effects for SERMs
raloxifene
endometrial cancer
boxed warning- increased risk of VTE and death from stroke
This drug class is used during an eye exam because it dilates the pupil.
mydriatics
What are the serious adverse effects of isoniazid (INH)?
hepatotoxicity (boxed warning) and neurotoxicity (numbness/tingling of hands/feet, convulsions, memory loss, psychosis, coma)
Which drug class needs to be taken on an empty stomach 20-30 min before breakfast: H2 antagonist or proton pump inhibitors?
What is the prototype drug for your answer?
PPIs
Prototype: omeprazole
Which medication is prescribed specifically to lower triglycerides?
gemfibrozil
(a fabric acid drug)
Arrange the following insulins by onset of action:
glargine
regular
NPH
aspart
aspart
regular
NPH
glargine
Teaching for bisphosphonates?
Take with full glass of water, on empty stomach, stay upright 30 minutes.
should also be advised to take calcium and vitamin D supplements
What is tretinoin used for and what are common adverse effects
used for acne, wrinkles, and acute promyelocytic leukemia (APL)
most people experience redness, scaling, crusting, and peeling of skin. Photophobia can also occur so teach them to avoid direct sunlight (sunscreen, etc.)
MOA of allopurinol and any diet teaching needed
Inhibits xanthine oxidase which is the enzyme that converts xanthine into uric acid (so decreases uric acid production)
Tip- what are the serious adverse effects they should report?
How does sucralfate work and what is the common adverse effect?
MOA: creates a gel in the stomach that coats the injured area and protects it.
Adverse effect: constipation
Prototype of bile acid sequestrates?
How long do you need to wait to give other meds
Cholestyramine
give other meds 2 hours before or 4-6 hours after cholestyramine
What are serious adverse effects of GLP-1 agonists
pancreatitis and gastroparesis
MOA of DMARD II drugs and serious adverse effects
They are tumor necrosis factor (TNF) blockers- so they slow the inflammatory response and joint damage associated with RA
reactivating latent TB and hep B, increased risk of fatal infections, and lymphoma and other cancers.
How would you teach someone to use permethrin for lice?
How would you teach someone to use permethrin for scabies?
lice-apply 1% liquid to hair and scalp and leave on for 10 minutes then rinse. May be reapplied 1 week later. (comb out all nits and lice)
scabies- 5% cream to entire skin surface and keep on for 8-14 hours before bathing. May need to reapply in 1 week. They should monitor their skin daily. It takes several weeks for itching to subside.
1. MOA for otic beta-adrenergic blockers
2. contraindications
reduce the formation of aqueous humor
contraindicated in severe asthma, COPD, CHF