Antimicrobials
Name 2 side effects of vancomycin.
What are renal failure, ototoxicity, vancomycin-flyshing syndrome, and thrombophlebitis
This is the most severe form of toxicity with clindamycin.
What is C.diff-associated diarrhea?
This antiemetic is most effective at treating CINV and should be administered 30 minutes to 3 hours before chemotherapy.
What is ondansetron [Zofran]?
Foods containing this compound should be avoided by pts taking MAOIs to prevent a hypertensive crisis.
What is tyramine?
(What are examples of tyramine containing foods)
In order to reduce the likelihood of developing tolerance to nitroglycerine in patch form, patients should do this.
What is remove patch overnight or for at least 10-12hrs?
Name at least 2 of the most effective forms of birth control.
What are subdermal implants [Nexplanon], IM medroxyprogesterone acetate [Depo-Provera], sterilization, and IUDs?
(Why are these so effective?)
Be prepared to administer this medication if a pt develops an anaphylactic reaction to an antibiotic.
What is epinephrine?
Name 2 side effects of a cholinergic agonist
What are bradycardia, increased gland secretion (sweating, salivation, bronchial secretions), smooth muscle contraction (GI/lungs)?
The rapid fluctuation that occurs when the pt is mobile and active one moment and akinetic and rigid the next is known as this and can be minimized by educating the pt to avoid meals high in this.
What is the "on-off" phenomenon and protein?
The two benzodiazepines used as first-line treatment of status epilepticus.
What are lorazepam and diazepam
The highest level of drug concentration in the plasma and must be monitored to prevent toxicity.
What is the peak?
This type of antibiotic therapy is utilized when a pt presents with a severe infection and treatment must be initiated before culture results are available.
What is empiric therapy?
A side effect of chemotherapy includes this reduction of specific circulating cells that puts the pt at risk for developing a fatal infection.
The atypical antidepressant that doesn't cause weight gain or sexual dysfunction.
What is bupropion [Wellbutrin]?
The electrolyte imbalance that can be seen in patients taking furosemide [Lasix].
What is hypokalemia?
(If a pt were then prescribed this HF medication, the RN would be concerned)
Frequently monitoring the IV side for patency and extravasation is important with this specific antiemetic.
What is promethazine [Phenergan]?
This muscarinic agonist is the most effective medication for the treatment/prevention of motion sickness.
What is scopolamine?
Name 2 side effects of an adrenergic agonist
What are tachycardia, dry mouth, constipation, mydriasis, dry eyes, smooth muscle relaxation (bronchi/GI)?
A concerning adverse effect of pramipexole treatment is this phenomenon, made especially dangerous during inherently hazardous activities.
What are sleep attacks?
Phenytoin IV should never be mixed with this fluid type.
What are dextrose-containing fluids?
(What are other considerations for IV infusion?)
An adverse effect of this medication class is tendon rupture.
What are fluroquinolones?
To minimize interference with absorption, this class of antibiotics should be administered at least 1 hour before or 2 hours after ingestion of chelating agents.
What are tetracyclines?
(What are examples of chelating agents?)
Montelukast [Singulair] reduces this in patients with asthma.
What is inflammation?
The medication class used to treat acute dystonia in patients taking FGAs.
What is anticholinergic?
A common side effect seen with antihypertensive medications that can be treated with a phosphodiesterase-5 inhibitors.
What is erectile dysfunction?
These risks are increased with estrogen-progestin hormone replacement therapy.
What are DVT, stroke, pulmonary embolism, dementia, breast cancer?
Both malignant hyperthermia treatment and neuroleptic malignant syndrome are treated with this medication.
What is dantrolene?
Name 1 side effect of neuromuscular blockers.
What is paralysis?
What neurotransmitter does levodopa convert to in the brain to improve movement in pts with PD?
What is dopamine?
An adverse effect of oxcarbazepine administration includes this electrolyte imbalance.
What is hyponatremia?
Name 2 adverse effects of treatment with sulfonamides.
What are crystalluria, Stevens-Johnson syndrome, kernicterus, blood dyscrasias?
Using antimicrobials wisely, appropriately identifying pathogens, preventing infections and their spread are all ways healthcare providers can do this.
What is prevent the development of microbial resistance?
Guifenesin [Musinex] is classified as this type of drug that helps stimulate the flow of respiratory tract secretions.
What is expectorant?
Pts taking SSRIs can develop this condition that is associated with AMS, hyperreflexia, and excessive sweating.
What is serotonin syndrome?
This type of hypertension is treated with lifelong medication administration.
What is primary HTN?
This type of infectious diarrhea usually requires no treatment and is often caused by E. coli.
What is traveler's diarrhea?
The division of the autonomic nervous system that is associated with the "rest/digest" response.
What is parasympathetic?
Name 2 side effects of cholinesterase inhibitors.
What is increased skeletal muscle contraction, bradycardia, bronchial constriction, urinary urgency, increased glandular secretions, increased tone/motility of GI tract, miosis?
Signs and symptoms of this include involuntary movements of the face, arms, legs and trunk.
What is dyskinesia?
The antiemetic medication that is affected by grapefruit juice.
What is carbamazepine?
The two systems most affected by toxicity with aminoglycosides.
What are auditory and renal?
IV acyclovir should be infused slowly and with adequate patient hydration to prevent this.
What is nephrotoxicity?
Theophylline produces bronchodilation by this action.
The preferred mood stabilizer used for acute management of manic episodes of BPD.
What is lithium?
Name 2 indications for non-dihydropyridine CCBs.
What are angina, HTN, cardiac dysrhythmias?
These are the two forms of inflammatory bowel disease.
What are Crohn's disease and ulcerative colitis?
Contraindications and cautions to use of this specific adrenergic antagonist class include sinus bradycardia, AV heart block, and asthma.
What are non-selective beta-blockers?
This specific adrenergic antagonist is utilized for pts after MI because of its cardioprotective properties.
What is metoprolol [Lopressor]?
PD is characterized by an imbalance of these two neurotransmitters.
Name at least 1 way to enhance medication regimen adherence for epileptic patients.
What are reinforcing need to take meds as prescribed (chronic), maintain seizure frequency diary, monitor plasma drug levels?
Mixing alcohol with this class of antibiotics can induce a state of alcohol intolerance that may lead to a disculiram-like reaction.
What are cephalosporins?
Antibiotic often reserved for severe MRSA infections.
What is vancomycin?
Respiratory drug class that helps reduce the inflammation and edema of airways.
What are glucocorticoids?
The lethal dose of this class of antidepressants is only eight times the average therapeutic dose.
What are TCAs?
The antihypertensive medication class that is associated with a persistent cough.
What are ACE inhibitors?
What is estrogen?
This catecholamine is indicated for management of shock because it increases cardiac output to increase BP.
What is dopamine?
Vecuronium must also be combined with these two medication classes.
What are anesthetics and analgesics?
This is an expected and non-concerning side effect of levodopa regarding specific body fluids.
What is darken sweat and urine?
This drug class should be avoided in patients taking phenytoin to prevent oversedation.
What are CNS depressants (alcohol, barbiturates, etc.)?
With an immunocompromised patient with an active infection, in general, which antimicrobial agent type must be used?
What are bactericidal antibiotics?
An antiviral medication that is most effective when initiated within 48 hours of symptom onset.
What is oseltamivir [Tamiflu]?
Name 2 example of common side effects of chemotherapy.
What are alopecia, N/V/D, stomatitis, myelosuppression?
Indications for benzodiazepine use include these two conditions.
What are anxiety and insomnia?
Risk for developing hyperkalemia is associated with this diuretic.
What is spironolactone?
Antiemetic medications decrease the stimulation of the CTZ, which stands for this.
What is the chemoreceptor trigger zone?
What are anticholinergic side effects?
This class of medication is the mainstay treatment of myasthenia gravis.
What are cholinesterase inhibitors?
(Why?)
Type of cancer that can be exacerbated by levodopa/carbidopa.
What is melanoma?
Patients should be advised that the benefits of these 2 medications are significantly reduced with antiepileptic medications.
What are oral contraceptives and warfarin?
The antibiotic class that is contraindicated for pregnant and pediatric pts under the age of 8.
Why?
What are tetracyclines?
Avoid tooth discoloration
What are CD4 count and viral plasma load?
The RN is concerned about these 3 when an oncology patient reports NEW pain in a NEW location.
What are infection, metastasis, or fracture?
FGAs can cause this adverse effect, characterized by muscle rigidity, sudden high fever, sweating, and autonomic instability.
What is neuroleptic malignant syndrome?
The definition of "positive inotropic effect."
What is increased force of contaction?
The anticholinergic medication added to diphenoxylate [Lomotil] to discourage abuse of these opioid antidiarrheals.
What is atropine?
Urge incontinence associated with overactive bladder can be treated with this muscarinic antagonist.
Orthostatic hypotension in a pt with BPH is likely caused by their medication from this class.
What is an alpha-1 blocker?
This medication can be added to levodopa/carbidopa to further decrease levodopa induced N/V.
What is additional carbidopa?
The oral adverse effect of phenytoin.
What is gingival hyperplasia?
Order: cephalexin 0.5g PO QID
Available: cephalexin 250mg tablets
How many tablets per day?
What is 8 tablets?
The rate to administer clindamycin (Cleocin) IV at a rate of 10 mg/min.
Available: clindamycin (Cleocin) 900 mg in 100 mL NS.
What is 66.67 ml/hr?
The rate to infuse:
Order: aminophylline (Theophylline) 0.7 mg/kg/hr. Weight = 73.5 kg.
Available: aminophylline (Theophylline) 800 mg in 500 mL D5W
What is 32.3 ml/hr?
The volume of haloperidol needed for pt w/ schizophrenia
Ordered: 75mg IM
Available: 50mg/mL
What is 1.5mL?
Order: digoxin (Lanoxin) 18 mcg PO BID. Child weighs 7 lbs
Safe range: 10-12 mcg/kg/24 hrs
Is it safe?
What is yes? (31.8-38.2mcg/24 hrs)
The rate to infuse cimetidine (Tagamet) 300 mg IVPB mixed in 100 mL NS (0.9% Normal Saline) over 45 minutes.
What is rate of 133.3 ml/hr?
The volume of atropine to be administered
Order: atropine (Atreza) 0.3 mg IM stat
Available: atropine (Atreza) 0.4 mg per mL
What is 0.75 mL?
The rate to infuse epinephrine
Ordered: epinephrine 8mcg/min
Available: 1mg/250ml
What is 120 ml/hr?
The total number of levodopa tablets in 1 day
Ordered: 350mg levodopa TID
Available: 100mg/tablet
What is 10.5 tablets?
The total dosage for loading dose of phenytoin for a pt weighing 264lbs
Ordered: 15mg/kg
What is 1800mg?