Term
|
Definition
| use of chemicals to fight things in your body |
|
|
Term
|
Definition
| toxic only to microbes not to host |
|
|
Term
| Narrow spectrum antibiotic |
|
Definition
| Specific to particular microb |
|
|
Term
| Broad spectrum antibiotic |
|
Definition
| kills a lot of different microbes |
|
|
Term
| Anti-microbials that Work on Cell wall synthesis fucntion |
|
Definition
| Keep microb from building new cell wall |
|
|
Term
| Function of anti-microbials that affect Cell membrane permeability |
|
Definition
| Cause microbe to take on more fluid and burst |
|
|
Term
|
Definition
| drugs only suppress growth |
|
|
Term
|
Definition
|
|
Term
|
Definition
| emergence of bacteria that is resistant to antibiotics |
|
|
Term
|
Definition
| actual transfer from one bacteria to another. |
|
|
Term
| Resistant forms of staph found in clinical setting |
|
Definition
|
|
Term
| Suprainfection/Superinfection |
|
Definition
| secondary infection caused by an opportunistic infection resistant to current abx tx. |
|
|
Term
| Antibiotic-associated colitis caused by |
|
Definition
| Clostridium difficile growth following antibiotics (ie. ampicillin, cephalosporins, clindamycin) |
|
|
Term
| Signs and symptoms of Antibiotic-associated colitis |
|
Definition
| fever, abd. cramping, watery diarrhea, blood or mucus in stool |
|
|
Term
| Treatment of Antibiotic-associated colitis |
|
Definition
| metronidazole (Flagyl) PO or vancomycin (Vancocin) PO |
|
|
Term
| infection acquired in hospital, often resistant and hard to treat is called |
|
Definition
|
|
Term
| Delaying Emergence of Drug Resistance |
|
Definition
Vaccinate,Get the catheters out,Target the pathogen,Access the experts
Practice antimicrobial control,Use local data,Treat infection not contamination Treat infection, not colonization
Know when to say “no” to Vanco
Stop treatment when infection is cured or unlikely Isolate the pathogen,Break the chain of contagion |
|
|
Term
|
Definition
| small pocket of infection. Treat locally not systemically |
|
|
Term
| Selection of Antibiotics is based on |
|
Definition
Identify organism
Drug sensitivity of organism
Host factors
Allergy
Penetration to site of infection
Patient variables |
|
|
Term
| What are the patient variables |
|
Definition
Age
Pregnancy
Previous allergic reaction
Genetic factors |
|
|
Term
| Combination Therapy is used for |
|
Definition
| very complicated or severe infection |
|
|
Term
|
Definition
2 things working together against the microbe, increased effect
Prevents resistance |
|
|
Term
|
Definition
| give to prevent infection |
|
|
Term
| Examples of prophylactic use of antimicrobials |
|
Definition
Surgery
Bacterial endocarditis
Patients that are immunosuppressed |
|
|
Term
|
Definition
| Low white blood cell count |
|
|
Term
| HIV/Aids related Pneumonia |
|
Definition
|
|
Term
| Misuses of Antimicrobial Drugs |
|
Definition
Untreatable infection
Fever of unknown origin
Improper dosage
Lack identification of organism
Omission of surgical drainage |
|
|
Term
| Nursing Implications for the use of antimicrobials |
|
Definition
Assess s/s of infection
Obtain history of sensitivity
negative history may still have a reaction
Observe for anaphylaxis
C/S before first dose
Administer ATC |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| Patient Education for anti microbials |
|
Definition
Instruct patient to take ATC as directed
finish the whole Rx, even if feeling better
do not share medication
Report s/s of superinfection or pseudomembranous colitis
do not treat diarrhea without notifying health care professional |
|
|
Term
| Drugs That Weaken the Bacterial Cell Wall |
|
Definition
|
|
Term
| Chemical component of Penicillin |
|
Definition
|
|
Term
| What does the Beta Lactem ring do |
|
Definition
| Weaken the cell wall, causing bacteria to take up excessive water and rupture |
|
|
Term
| Penicillins bactericidal or Bactriostatic |
|
Definition
|
|
Term
|
Definition
| Enzymes that render penicillins and other beta-lactam antibiotics inactive |
|
|
Term
| Penicillins are combined with what to extend the spectrum |
|
Definition
| a beta-lactamase inhibitors, the antimicrobial spectrum is extended |
|
|
Term
| What are the Beta lactamase inhibitors |
|
Definition
Clavulanic acid
Tazobactam
Sulbactam |
|
|
Term
| Classification of Penicillins |
|
Definition
Penicillins
Narrow spectrum
Pencillinase sensitive
Narrow spectrum
Pencillinase resistant
Broad spectrum
Extended spectrum |
|
|
Term
| Penicillin G (Benzylpenicillin) forms |
|
Definition
penicillin G*
procaine penicillin (Wycillin)
benzathine penicillin (Bicillin L-A) |
|
|
Term
| Adverse effects of Penicillin G |
|
Definition
| Allergy—penicillins are the most common cause of drug allergy |
|
|
Term
| Penicillinase-Resistant Penicillins |
|
Definition
nafcillin (Unipen)*
oxacillin (Bactocil)
cloxacillin (Cloxapen)
dicloxacillin (Dynapen) |
|
|
Term
|
Definition
| Penicillinase-Resistant Penicillins |
|
|
Term
|
Definition
| Penicillinase-Resistant Penicillins |
|
|
Term
|
Definition
| Penicillinase-Resistant Penicillins |
|
|
Term
|
Definition
| Penicillinase-Resistant Penicillins |
|
|
Term
| nafcillin (Unipen) therapudic class |
|
Definition
|
|
Term
| action of nafcillin (Unipen)* |
|
Definition
| Bind to bacterial cell wall, leading to cell death. Not inactivated by penicillinase enzymes |
|
|
Term
| nafcillin (Unipen)* works best against? |
|
Definition
| Active against most gram-positive aerobic cocci |
|
|
Term
| nafcillin (Unipen)* interactions |
|
Definition
• Nafcillin may ↓ effectiveness of oral contraceptive agents
• Probenecid ↓ renal excretion and ↑ blood levels of nafcillin (therapy may be combined for this purpose)
• Concurrent use with methotrexate ↓ methotrexate elimination and ↑ risk of serious toxicity |
|
|
Term
| Beta-Adrenergic Blockers |
|
Definition
| Decrease production of aqueous humor |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| metipranolol (Optipranolol) |
|
Definition
|
|
Term
| metipranolol (Optipranolol) |
|
Definition
|
|
Term
| metipranolol (Optipranolol) what does it do |
|
Definition
| decrease intraocular pressure |
|
|
Term
| metipranolol (Optipranolol) what does it prevent |
|
Definition
|
|
Term
| metipranolol (Optipranolol) adrs |
|
Definition
| heart block, bradycardia, bronchospasm |
|
|
Term
| Beta-Adrenergic Blockers used to treat what disease |
|
Definition
|
|
Term
| Prostaglandin analogs used to treat |
|
Definition
|
|
Term
| Prostaglandin analogs what does it do |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| Alpha 2 adrenergic agonists used for treatment of what |
|
Definition
|
|
Term
| Action Alpha 2 adrenergic agonists |
|
Definition
|
|
Term
|
Definition
| Alpha 2 adrenergic agonists |
|
|
Term
| Other drugs used to treat Glaucoma |
|
Definition
acetazolamide (Diamox)
dorzolamide (Trusopt) (bitter taste, sting)
pilocarpine (Isopto Carpine) |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| How is Mydriasis used in procedures |
|
Definition
| allows observation of inside of eye |
|
|
Term
| cycloplegia how is it used in procedures |
|
Definition
| prevents the eye reflex reaction to the light from scope |
|
|
Term
| atropine (Isopto Atropine)* |
|
Definition
|
|
Term
| contraindications of Cycloplegic Mydriatics |
|
Definition
|
|
Term
| cyclopentolate (Cyclogyl) |
|
Definition
|
|
Term
| homatropine (Isopto Homatropine) |
|
Definition
|
|
Term
| scopolamine (Isopto Hycosine) |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| Ophthalmic diagnostic agent |
|
|
Term
| Use for Fluorescein (AK-Fluor)* |
|
Definition
| Visualizes foreign bodies and corneal abrasions |
|
|
Term
| Allergic Conjunctivitis types of drugs |
|
Definition
| Mast cell stabilizers, H1 receptor blockers, NSAIDs, Glucocorticoids, Decongestant |
|
|
Term
| Cromolynsodium (Opticrom) |
|
Definition
| Mast cell stabilizers, allergy |
|
|
Term
| Allergic Conjunctivitis types of drugs |
|
Definition
|
|
Term
|
Definition
| H1 receptor blockers, allergy |
|
|
Term
| Ketorolactromethamine(Acular) |
|
Definition
| NSAID for the eye, allergy |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| Lubricants for the eye used to- |
|
Definition
| Moistens eyes in healthy people, use in unconscious, decreased blink reflex |
|
|
Term
| Hydroxyropyl products (Isopto Plain, Tears Naturale, Lacrisert)* |
|
Definition
|
|
Term
| Petrolatum-based products (Artificial tears, Liquifilm tears)* |
|
Definition
| Lubricants used with hard contact lenses |
|
|
Term
|
Definition
| The state of being free of living pathogenic microorganisms. 2. The process of removing pathogenic microorganisms or protecting against infection |
|
|
Term
| External anti-infectives for the ear |
|
Definition
polymyxin B
neomycin
hydorcortisone plus ciproflaxacin (Cipro HC Otic) |
|
|
Term
| Anti-infectives that treat otits media (po) |
|
Definition
amoxicillin (Amoxil)
amoxicillin/clavulanate (Augmentin)
cefuroxime (oral) or ceftriaxone (IM)
trimethoprim/sulfamethoxazole (Bactrim) |
|
|
Term
|
Definition
hydrogen peroxide
mineral oil
Cerumenex
Debrox |
|
|
Term
| Position of ear for drop application in child |
|
Definition
| pull down and back, wiggle and wick |
|
|
Term
| Position of ear for drop application for adult |
|
Definition
|
|
Term
| what are Topical Glucocorticoids used for |
|
Definition
| Inflammation and itching relief |
|
|
Term
| Topical Glucocorticoids ADRs |
|
Definition
| local infection, skin atrophy, systemic toxicity |
|
|
Term
|
Definition
| oily or fatty substances that soften skin by allowing skin to retain water |
|
|
Term
|
Definition
| emulsions of oil in water |
|
|
Term
|
Definition
|
|
Term
|
Definition
| liquid suspension or dispersion |
|
|
Term
|
Definition
| temporary relief muscular aches |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| triamcinoloneacetonide(Kenalog) |
|
Definition
|
|
Term
| hydrocortisone (Cortizone) |
|
Definition
|
|
Term
|
Definition
Skin cleansers: OxyWash, stridex, pHisoderm-benzoyl peroxide and astringent, antiseptic, drying agent etc.
tretinoin (Retin-A)
isotretinoin (Accutane)*: systemic; use only after all others unsuccessful (including antibiotics), many ADR’s
Clindamycin (Cleocin), erythromycin, tetracycline
Generally one product at a time and don’t over use |
|
|
Term
| Antiseptic anti infective agents for the skin |
|
Definition
| Dakin’s, hydrogen peroxide, pHisohex |
|
|
Term
| Antibacterial anti-infective agents for the skin |
|
Definition
neomycin, bacitracin
mupirocin (Bactroban): impetigo |
|
|
Term
| Antifungals: candida infections for the skin |
|
Definition
miconazole (Monostat)
clotrimazole (Lotrimin, Mycelex |
|
|
Term
| Antiviral-herpes simplex for the skin |
|
Definition
|
|
Term
| Antiparasitics-lice & scabies |
|
Definition
permethrin(Nix, Elimite)
lindane(Kwell)
Not if pregnant, not if young child
crotamiton(Eurax)
malathion(Ovide)
ivermectin(Stromectol) –only oral product
Nit Removal System: for aesthetics only |
|
|
Term
| Stimulants, Irritants, & Keratolytics uses |
|
Definition
| Promotes healing by causing hyperemia and inflammation |
|
|
Term
|
Definition
|
|
Term
| compound benzoin tincture |
|
Definition
| increased blood flow and healing (skin protectant that improves blood flow via mild irritation |
|
|
Term
| salicylic acid (Compound-W) |
|
Definition
|
|
Term
|
Definition
| treatment for external genital warts. |
|
|
Term
|
Definition
| Penicillinase-Resistant Penicillins |
|
|
Term
|
Definition
| Penicillinase-Resistant Penicillins |
|
|
Term
|
Definition
| Penicillinase-Resistant Penicillins |
|
|
Term
|
Definition
| Penicillinase-Resistant Penicillins |
|
|
Term
| Broad Spectrum Penicillins (Aminopenicillins |
|
Definition
ampicillin (Omnipen)
amoxicillin (Amoxil)* |
|
|
Term
| Broad Spectrum Penicillins (Aminopenicillins) with Beta Lactamase |
|
Definition
Ampicillin/sulbactam (Unasyn)
Amoxicillin/clavulanate (Augmentin |
|
|
Term
| Broad Spectrum Penicillins (Aminopenicillins) ADRs |
|
Definition
|
|
Term
|
Definition
| Penicillinase-Resistant Penicillins |
|
|
Term
| Broad Spectrum Penicillin |
|
Definition
|
|
Term
| Extended Spectrum Penicillins (Antipseudomonal Penicillins) |
|
Definition
ticarcillin (Ticar) – no longer available alone
piperacillin (Pipracil) - no longer available alone |
|
|
Term
| Beta-Lactamase Antipseudomonal Penicillins) extended spectrum |
|
Definition
ticarcillin clavulanate (Timentin)*
piperacillin tazobactam (Zosyn) |
|
|
Term
|
Definition
Anaphylaxis: laryngeal edema, bronchoconstriction, severe hypotension
Diarrhea
Pseudomembranous colitis
(Tx = vancomycin (Vancocin))
rash |
|
|
Term
| Penicillin Allergy treatment |
|
Definition
Epinephrine
Corticosteroids
Antihistamines
diphenhydramine (Benadryl)
Respiratory support
Prevention—skin testing |
|
|
Term
| Penicillins - Interactions with Probenecid |
|
Definition
| (probencid is a gonarhea drug) inhibits renal tubular excretion of penicillins, resulting in higher serum concentrations |
|
|
Term
| Aminoglycoside- Penicillins Interactions |
|
Definition
| penicillin blocks. Can give two hours apart. Separate iv’s so they don’t contaminate. |
|
|
Term
| Oral Contraceptives-Penicillin, Interactions |
|
Definition
| may decrease efficacy of oral contraceptives (ampicillin) |
|
|
Term
| What drug can also be used with Penicillin drugs to increase effectivness of penicillin? |
|
Definition
|
|
Term
| Most widely used group of antibiotics |
|
Definition
|
|
Term
| Cephalosporins general overview |
|
Definition
Beta-lactam antibiotics
Similar to penicillin structure
Bactericidal: kill
Usually given parenterally |
|
|
Term
| Adverse effects Cephalosporins |
|
Definition
Allergy
Bleeding
Thrombophlebitis |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| As the Cephalosporins move up in generation |
|
Definition
increasing activity against Gm (–) bacteria and anerobes (no oxygen needed)
increasing resistance to destruction by beta-lactamases (2nd)
increasing ability to reach CSF (3rd and 4th) |
|
|
Term
| Precautions & ADRs of Cephalosporin |
|
Definition
Patients with hypersensitivity to penicillins may have a cross-sensitivity to cephalosporins: some experts say less so with newer generations
pseudomembranous colitis
↑ risk of bleeding with some cephalosporins
may give prophylactic vitamin K |
|
|
Term
| Carbapenems general description |
|
Definition
| Beta lactam antibiotics: broad spectrum |
|
|
Term
| imipenem or imipenem/cilastatin (Primaxin)* |
|
Definition
| Carbapenem antibiotic (Imipenem has nearly broadest coverage of all abx) |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| Carbapenem antibiotic Cross sensitivity |
|
Definition
| penicillins and cephalosporins |
|
|
Term
| Cautions with Carbapenem antibiotics |
|
Definition
|
|
Term
|
Definition
|
|
Term
| Vancomycin (Lyphocin)* action |
|
Definition
| Cell wall synthesis (bacteriostatic) |
|
|
Term
| Vancomycin (Lyphocin)* Uses |
|
Definition
Severe infections Pseudomembranous colitis – clostridium difficle
Methicillin-resistant Staphylococcus aureus or Staphlococcus epidermis |
|
|
Term
| Vancomycin (Lyphocin)* adrs |
|
Definition
Ototoxicity
Thrombophlebitis(rare clots and inflamation)
Allergy |
|
|
Term
| Caution with vancomyacin? |
|
Definition
| nephrotoxisity careful in people with risk of renal damage or insufficiency |
|
|
Term
| Tetracyclines general description |
|
Definition
| Broad spectrum – inhibit protein synthesis (bacteriostatic) |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| Tetracyclines used to treat |
|
Definition
Rickettsiae, Mycoplasma, Chlamydia
N. meningitidis, N. gonorrhoeae, Lyme disease, anthrax (doxycycline), helicobacter pylorii, acne |
|
|
Term
| Tetracyclines - Adverse Effects |
|
Definition
Gastrointestinal
Effect on bone and teeth (below)
Superinfection
Hepatotoxicity
Renal toxicity
Photosensitivity |
|
|
Term
|
Definition
| complex formed when taken with Calcium supplements, milk products, iron supplements, magnesium-containing laxatives, and most antacids forms byproduct. Discoloration of teeth. Don’t use in people developing teeth. Binds to calcium in bones and teeth as well. |
|
|
Term
| erythromycin (E-Mycin, ERYC) |
|
Definition
|
|
Term
|
Definition
|
|
Term
| azithromycin (Zithromax, Zmax)* |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| Pt allergic to penicillin |
|
|
Term
|
Definition
GI distress
hepatotoxicity
Hypersensitivity (allergies
ototoxicity, and thrombophlebitis(If given IV use slow drip rate) |
|
|
Term
| Cytochrome P450 in regards to antibiotics |
|
Definition
May be inhibited by erythromycin and other drugs leading to toxicity of drugs metabolized by cytochrome P450
Toxicity may lead to fatal arrhythmias |
|
|
Term
| Clindamycin (Cleocin) general action |
|
Definition
| Inhibits protein synthesis (bacteriostatic) |
|
|
Term
| Clindamycin (Cleocin) Can induce antibiotic-associated |
|
Definition
|
|
Term
| Clindamycin (Cleocin) Indicated only for |
|
Definition
| certain anaerobic infections located outside the CNS |
|
|
Term
|
Definition
| reserved for serious infections not responding to other tx |
|
|
Term
|
Definition
| CAP tx, resistant. Controversy: some risk of severe liver damage, approved too soon? Other abx available for simple infections.Black box |
|
|
Term
| quinapristin/dalfopristin (Synercid) combo |
|
Definition
| for resistant vanco organisms and staph infections |
|
|
Term
|
Definition
| Community aquired Pneumonia, used to treat, people used a lot, people developed liver damage. Use others. |
|
|
Term
|
Definition
| new med. Replacing vanco, saved for need to use. |
|
|
Term
| drotrecogin (Xigris) used for |
|
Definition
|
|
Term
|
Definition
| new class, based on tetracycline, broad spectrum, overcome drug resistance |
|
|
Term
| Mupirocin (Bactroban nasal): |
|
Definition
| elimination of nasal colonization of MRSA |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| Streptomycin(first dicovered in 1944) |
|
Definition
|
|
Term
| Aminoglycosides action and spectrum |
|
Definition
Disrupt protein synthesis and cause rapid bacterial death.
Narrow spectrum |
|
|
Term
|
Definition
| Aerobic gram-neg bacilli (ie. Enterobacter) |
|
|
Term
| Aminoglycosides distribution |
|
Definition
| good concentrations in peritoneal fluid, often used in abdominal infections |
|
|
Term
|
Definition
Ototoxicity - may be irreversible
Nephrotoxicity - ↑ creatinine |
|
|
Term
| Monitoring: needed to secure therapeutic levels with Aminoglycosides- |
|
Definition
Peak & trough levels
Peak - at completion of infusion (keep just high enough to be effective)
Trough - just before next dose (keep levels low enough to avoid toxicities above)
BUN and Creatinine levels as well. |
|
|
Term
|
Definition
| Act by inhibiting bacterial synthesis of folic acid |
|
|
Term
| trimethoprim/sulfamethoxazole* (TMP/SMZ, Bactrim, Septra) |
|
Definition
|
|
Term
trimethoprim/sulfamethoxazole* (TMP/SMZ, Bactrim, Septra)
used to treat? |
|
Definition
|
|
Term
|
Definition
| hypersensitivity & crystalluria, Stevens-Johnson syndrome (serious skin reaction) |
|
|
Term
|
Definition
|
|
Term
| Drug-Sensitive Regimen for Tuberculosis |
|
Definition
Induction phase 2 months
Daily therapy
isoniazid (INH)*
rifampin (Rifadin)*
pyrazinamide
ethambutol (Myambutol)
Continuation phase
May ultimately need as many as 7 drugs (if MDR strain) typically at least 2-3 for 2 yrs |
|
|
Term
|
Definition
hepatotoxicity
Increased risk with rifampin and alcohol.
Monitor LFT’s monthly
Black & Hispanic women, post-partum women, patients >50 at increased risk |
|
|
Term
|
Definition
| interferes with actions of pyridoxine (Vitamin B6), essential in nerve function) - causes peripheral neuropathy (“tingling” hands and feet). Give Vit B6 |
|
|
Term
|
Definition
|
|
Term
|
Definition
Through body fluids & CSF
Causes orange-red color of urine, feces, saliva, sputum, tears, sweat
May color contact lenses |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| Fluoroquinolones spectrum and uses |
|
Definition
UTI - Enterobacter, Staph, Pseudomonas
Streptococcus pneumoniae, anthrax (ciprofloxacin) |
|
|
Term
| Fluoroquinolones Interactions |
|
Definition
| antacids, iron or zinc should not be taken within 2 hr, bind makes the antacids ineffective. |
|
|
Term
|
Definition
usually mild but…could cause
pseudomembranous colitis, tendon rupture, rash
Avoid if <18yrs or pregnant as can damage cartilage |
|
|
Term
| Metronidazole (Flagyl)* Uses and description |
|
Definition
Bactericidal
Protozoal infections: single celled microbe
Infections caused by obligate anaerobes (may be damaged in presence of oxygen)(bones, gi tract)
Helicobacter pylori |
|
|
Term
| Metronidazole (Flagyl)* adrs |
|
Definition
| Neurotoxicity, Allergy, Superinfections |
|
|
Term
| Metronidazole (Flagyl)* interactions |
|
Definition
| Disulfiram-like reaction with alcohol (reaction that is classic, person gets nauseous, doesn’t feel well. ) |
|
|
Term
| Antifungal Agents 2 groups |
|
Definition
| Systemic fungal (mycotic) infections, Superficial fungal (mycotic) infections |
|
|
Term
|
Definition
| Treats fungal inections systemic infections |
|
|
Term
| Amphotericin B (Fungizone)* route |
|
Definition
|
|
Term
| Amphotericin B (Fungizone)* adrs |
|
Definition
| renal injury, fever, HA, chills (rigors), anorexia, N/V |
|
|
Term
| Amphotericin B (Fungizone)* pretreat with |
|
Definition
Pretreat with diphenhydramine (Benadryl) & acetaminophen (Tylenol)
Add heparin or hydrocortisone to IV to decrease more severe reactions |
|
|
Term
| treat riggors or chills with |
|
Definition
|
|
Term
| itraconazole (Sporanox)* groups and action |
|
Definition
| Azole group of antifungal agents Fungistatic: increases cell permiability |
|
|
Term
| routes for itraconazole (Sporanox)* |
|
Definition
|
|
Term
| itraconazole (Sporanox)* ADRs |
|
Definition
Hepatotoxicity
Cardiosuppression with certain drugs |
|
|
Term
|
Definition
Dermatophytic infections (ringworm or tinea)
Tinea pedis (feet)(athletes foot)
Tinea corporis (skin)
Onychomycosis
Nail infection, requires long
therapy |
|
|
Term
| clotrimazole (Lotrimin, Mycelex)* |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| nystatin (Mycostatin) (oral candidiasis) |
|
Definition
|
|
Term
| fluconazole (Diflucan) (vulvovaginitis) |
|
Definition
|
|
Term
|
Definition
| Treat topical fungal infection |
|
|
Term
| Anti-fungals - echinocandins |
|
Definition
| New class of anti fungals side effects unknown, used for severe fungal infections. |
|
|
Term
| Anti-fungals - echinocandins |
|
Definition
| New class of anti fungals side effects unknown, used for severe fungal infections. |
|
|
Term
|
Definition
|
|
Term
| Antiviral agents end in Ovir except |
|
Definition
foscarnet (Foscavir)
ribavirin (Virazole) |
|
|
Term
|
Definition
varicella zoster (shingles), herpes simplex (herpes)
Does not cure virus |
|
|
Term
|
Definition
Topical - apply q3hr x 7 days
Also may be given PO and IV (renal alert |
|
|
Term
|
Definition
|
|
Term
| interferon alfa (Intron A)* |
|
Definition
For Hepatitis B and other, primarily cancers
ADRs: severe flu, depression, blood dyscrasias, anaphylaxis |
|
|
Term
| peginterferon alfa (Pegasys) |
|
Definition
For Hepatitis C
See ADRs for interferon in general |
|
|
Term
|
Definition
For Hep C, used in combo with Peginterferon
Toxic to embryo and alters sperm: avoid pregnancy |
|
|
Term
| Fluarix, Fluzone, Fluvirin |
|
Definition
|
|
Term
|
Definition
| weakened, live, attenuated flue vac nasal spray |
|
|
Term
|
Definition
| a pharmacologic property causing the occurrence of withdrawal symptoms with abrupt discontinuation or administration of an antagonist. |
|
|
Term
|
Definition
| the pharmacologic effect in which, with repeated administration, increasing doses are necessary to provide the same effect. |
|
|
Term
|
Definition
| psychological dependence, a behavioral syndrome marked by drug craving, compulsive efforts to secure a drug supply, hoarding, and drug-related interference with psychological, social, or physical function. |
|
|
Term
| WHO Pain Treatment Continuum purple level |
|
Definition
| pain of 1,2,3 low level use non opiod, acetaminophen or IB (nsaids) |
|
|
Term
| WHO Pain Treatment Continuum Blue Level |
|
Definition
| 4,5,6 (pain of 5 or greater impairs function 4,5,6 Opioid for moderate pain + or - Adjuvent and/or non opioid |
|
|
Term
| WHO Pain Treatment Continuum Green Level |
|
Definition
Green-severe 7,8,9 10, Opioid for moderate to severe pain
+ or – non-opioid
+ or - Adjuvant |
|
|
Term
|
Definition
(Tylenol, ibuprofen)
Work in the periphery
Affect prostaglandin synthesis |
|
|
Term
|
Definition
Work in the central nervous system
Bind to the mu, kappa, and delta receptors |
|
|
Term
|
Definition
|
|
Term
| Acetaminophen (Tylenol)* Uses |
|
Definition
| Fever reducer, pain (ie osteoarthritis) |
|
|
Term
|
Definition
|
|
Term
| Max does of acetaminophen |
|
Definition
|
|
Term
|
Definition
Risk of hepatotoxicity with higher doses
Renal failure risk doubled
with > 1 tablet/day
with > 1000 tablets/lifetime |
|
|
Term
|
Definition
| acetylcysteine (Mucomyst, Acetadote) |
|
|
Term
| Cyclooxygenase inhibitors |
|
Definition
| found in all tissues, encourages synthesis of prostaglandins |
|
|
Term
|
Definition
| present in all tissues, protects gastric mucosa, supports renal function, promotes platelet aggregation (good) |
|
|
Term
|
Definition
| at site of tissue injury & brain. Mediates inflammation, pain, fever response (bad) |
|
|
Term
| Cox 1 inhibition Side effects (good and bad) |
|
Definition
Gastric erosion and ulceration (-)
Bleeding tendencies (-)
Acute renal failure (-)
Protection against myocardial infarction (+) |
|
|
Term
|
Definition
Suppression of inflammation (+)
Alleviation of pain (+)
Reduction of fever (+)
long term use hurts hearts
good for short term pain management. |
|
|
Term
| COX Inhibitors what drugs? |
|
Definition
1. NSAIDs
COX 1 and COX 2 inhibitors
COX 2 inhibitors (celebrex)
2. No antiinflammatory action
acetaminophen |
|
|
Term
|
Definition
| aspirin (acetylsalicylic acid, ASA) |
|
|
Term
|
Definition
| Analgesic, antipyretic, ant-inflammatory, suppress platelet aggregation |
|
|
Term
| Initial analgesic effect of salicylates |
|
Definition
|
|
Term
| Maximum anti-inflammatory effect of salicylates |
|
Definition
| in 2 wks (have to take regularly) |
|
|
Term
|
Definition
| rheumatoid arthritis, pain, prevention of stroke, MI, TIAs, angina, dysmenorrhea, colon CA prevention? |
|
|
Term
|
Definition
GI upset, bleeding
Toxicity, salicylism: tinnitus, sweating, HA, dizziness |
|
|
Term
| Salicylates drug interactions |
|
Definition
| highly protein bound(compete, more free drug increased toxicity) |
|
|
Term
| Nonsteroidal Anti-inflammatory Drugs (NSAIDs) Action |
|
Definition
Inhibit both COX 1 & 2
Analgesic, antipyretic, anti-inflammatory |
|
|
Term
| Initial analgesic effect of nsaids |
|
Definition
|
|
Term
| Maximum anti-inflammatory effect of NSAIDS |
|
Definition
|
|
Term
|
Definition
| rheumatoid arthritis, OA, pain, fever, bursitis, tendonitis |
|
|
Term
|
Definition
| GI upset, ulceration, bleeding, renal failure, anaphylaxis |
|
|
Term
| ibuprofen* (Advil, Nuprin, Motrin, Caldolor, etc) |
|
Definition
|
|
Term
| naproxen (Anaprox, Naprosyn, Aleve) |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| diclofenac (Voltaren, Cataflam) |
|
Definition
|
|
Term
|
Definition
|
|
Term
| ketorolac (Toradol) class and route |
|
Definition
|
|
Term
|
Definition
| IV ibuprofen for fever and pain in people who can’t take a pill |
|
|
Term
| indomethacin (Indocin use |
|
Definition
|
|
Term
| diclofenac (Voltaren, Cataflam) caution |
|
Definition
|
|
Term
| etodolac (Lodine)good because |
|
Definition
| Causes less GI ulceration |
|
|
Term
| Salicylates & NSAIDs Patient Teaching |
|
Definition
Upright position for 15-30 minutes, take with food, milk, full glass of water
Notify clinician of black or tarry stools. Avoid with concurrent use of alcohol or if taking 3 or more glasses of alcohol/day
Discontinue 1 week prior to surgery
Do not use for children or adolescents with varicella or influenza-like illness due to risk of Reyes syndrome |
|
|
Term
Prevention of GI Side Effects
of NSAIDS |
|
Definition
Concurrent use of
H2 antagonist
Proton pump inhibitor
misoprostol (Cytotec)
Take with food or milk
Follow with full glass of water
Remain upright for 20-30 minutes |
|
|
Term
| Cardiovascular Effects of NSAIDs |
|
Definition
| May increase bp due to Retention of sodium and water |
|
|
Term
|
Definition
Enhance efficacy of other agents
Add analgesia
Treat concurrent symptoms |
|
|
Term
|
Definition
Tricyclic antidepressants
Anticonvulsants
Muscle relaxants
Benzodiazepines
Corticosteroids
(used for inflammatory pain) |
|
|
Term
|
Definition
Opioid agonist
Opioid agonist/antagonist
Opioid antagonist |
|
|
Term
| Opioids General overview and WHO treatment level |
|
Definition
Treat moderate to severe pain
Bind to mu opioid receptors in the CNS
No ceiling effect
No major organ dysfunction
Generally manageable side effects
blue and green |
|
|
Term
| propoxyphene (Darvocet, Darvon) what WHO step, why not recomended, what recomended for |
|
Definition
| Blue level gives same pain relief as 2 reg aspirin, still get the high/woozy effects. Metabolite that hangs around, causes orthostatic hypotension. Works for riggors |
|
|
Term
|
Definition
| Blue, more emetogenic & constipating |
|
|
Term
| hydrocodone* (Vicodin, Lorcet, Norco) WHO level and general overview |
|
Definition
| stronger than codeine, available in varying doses, limited by acetaminophen content |
|
|
Term
| oxycodone (Percocet, Percodan, Tylox) level, cet=, availble as? |
|
Definition
| Blue, tylenol in it, also available as a single entity |
|
|
Term
|
Definition
| different, new group of drugs, dual action meds, Centrally acting nonopioid analgesic |
|
|
Term
| Action of Tramadol* (Ultram) |
|
Definition
Binds to mu opioid receptor (first part)
Inhibits uptake of serotonin and norepinephrine in the CNS (second part) |
|
|
Term
| Tramadol* (Ultram)Indicated for |
|
Definition
| moderate to moderately severe pain |
|
|
Term
| Tramadol* (Ultram)Equianalgesic to ? |
|
Definition
|
|
Term
|
Definition
| 50-100 mg q 4-6 hr (no > 400 mg/day) |
|
|
Term
|
Definition
|
|
Term
|
Definition
Similar side effects to opioids
May cause seizures with therapeutic doses*
Especially in patients with decreased seizure threshold or taking drugs that lower the seizure threshold |
|
|
Term
| Tramadol (Ultram) availible as |
|
Definition
Ultram ER and (one time a day)
Ultracet (tramadol/acetaminophen) |
|
|
Term
| Tapentatol (Nucynta) action |
|
Definition
| Mu receptor agonist and inhibits uptake of norepinephrine |
|
|
Term
| Tapentatol (Nucynta) indications |
|
Definition
|
|
Term
| Tapentatol (Nucynta) adrs |
|
Definition
| seizures, respiratory depression, N/V, sedation, physical dependence |
|
|
Term
| Tapentatol (Nucynta) drug interactions |
|
Definition
|
|
Term
| morphine* (MSO4, MS, Roxanol, MS Contin, Oramorph, Kadian, Avinza) |
|
Definition
|
|
Term
| hydromorphone (Dilaudid, Exalgo-long acting) |
|
Definition
|
|
Term
| oxycodone (Roxicodone, OxyIR, OxyFast, OxyContin) |
|
Definition
|
|
Term
fentanyl (Sublimaze, Duragesic, Actiq, Fentora, Onsolis)
special route info |
|
Definition
|
|
Term
| oxymorphone (Opana, Opana ER) |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| Step 3 opioid, commonly used for stepping down off heroin and pain management |
|
|
Term
| Meperidine (Demerol)caution |
|
Definition
| Do not use Demerol for more than 48 hrs or at doses >600 mg/24hr |
|
|
Term
| Meperidine (Demerol) produces what metabolite? |
|
Definition
|
|
Term
| What does normeperidine cause |
|
Definition
| dysphoria, irritability, seizures |
|
|
Term
| Equianalgesic Opioid Doses Morphine |
|
Definition
| Oral 30-60 mg, parentral 10 mg |
|
|
Term
| Equianalgesic Opioid Doses Hydrocodone |
|
Definition
| O:30 mg Parentral:Not available |
|
|
Term
| Equianalgesic Opioid Doses codiene |
|
Definition
| O:180-200 mg parentral:130 mg |
|
|
Term
| Equianalgesic Opioid Doses meperidine |
|
Definition
| O:300 mg Parentral: 100 mg |
|
|
Term
| Equianalgesic Opioid Doses Oxycodone |
|
Definition
| Oral:30 mg Parentral:Not available |
|
|
Term
| Why do you need more opiate PO than Parentreally |
|
Definition
| Hepatic first pass effect |
|
|
Term
| Opioid Agonist Antagonist Analgesics action |
|
Definition
| Bind to kappa receptors (not meu) |
|
|
Term
| Opioid Agonist Antagonist Analgesics general adrs |
|
Definition
| Have a greater risk of dysphoric side effects (spinning, not good) |
|
|
Term
| Opioid Agonist Antagonist Analgesics generally used for |
|
Definition
|
|
Term
|
Definition
| Opioid Agonist Antagonist Analgesics |
|
|
Term
|
Definition
| Opioid Agonist Antagonist Analgesics |
|
|
Term
|
Definition
| Opioid Agonist Antagonist Analgesics |
|
|
Term
|
Definition
| Opioid Agonist Antagonist Analgesics |
|
|
Term
| buprenorphine/naloxone (Suboxone) use |
|
Definition
| (used in addict population like methidone) |
|
|
Term
| Choice of Long-Acting Opioids |
|
Definition
morphine (MS Contin, Oramorph, Avinza, Kadian)
oxycodone (Oxycontin)
Hydromorphone (Exalgo)
fentanyl (Duragesic)
oxymorphone (Opana ER)
methadone
Same 6 as short acting, but long acting. |
|
|
Term
|
Definition
| Hydromorphone sustained release |
|
|
Term
| Transdermal Fentanyl onset, plateau, half life |
|
Definition
Onset of action: gradual increases in serum levels
Steady state achieved at 12 to 24 hours
Duration of action: up to 72 hours
Elimination half-life: approximately 17 hours |
|
|
Term
|
Definition
| Extended-release oxymorphone |
|
|
Term
| Goals of Long Acting Opioid Therapy |
|
Definition
Manageable pain
Increased function
Meaningful activities
Decreased limitations
Improved and uninterrupted sleep
Minimal side effects
Patient satisfaction |
|
|
Term
|
Definition
| is a transitory flare of pain superimposed on an otherwise controlled stable pain syndrome. |
|
|
Term
|
Definition
is predictable ‘episodic pain’ caused by a physical or psychosocial-spiritual
stimulus (pt, procedure) |
|
|
Term
|
Definition
| long acting opioid does not last expected duration |
|
|
Term
|
Definition
| oral transmucosal system (OTS™) delivery system for rapid non-invasive delivery of fentanyl and patient-controlled administration. |
|
|
Term
| Fentanyl buccal (Fentora) |
|
Definition
Indicated for breakthrough pain
Buccal tablets each deliver 100-800 mcg fentanyl |
|
|
Term
| Fentanyl buccal soluble film (Onsolis) |
|
Definition
Indicated for severe breakthrough pain in opioid tolerant patients with cancer pain
Onset 15-30 minutes |
|
|
Term
| Opioid-Induced Side Effects |
|
Definition
constipation
nausea & vomiting
sedation
respiratory depression |
|
|
Term
| methylnaltrexone (Relistor) |
|
Definition
Treatment of constipation caused by opioid use in patients being treated palliatively, when laxative therapy has failed.
Acts peripherally as a mu-opioid receptor antagonist, blocking opioid effects on the GI tract.
Blocks constipating effects of opioids on the GI tract without loss of analgesia.
SQ injection qod |
|
|
Term
| Causes of Nausea and Vomiting with opioids |
|
Definition
Stimulation of the chemoreceptor trigger zone
Inhibition of GI motility
Vestibular stimulation |
|
|
Term
|
Definition
S - Sleeping, easily aroused. Requires no action
1 - Awake & alert. Requires no action.
2 - Occasionally drowsy, easy to arouse. Requires no action.
3 - Frequently drowsy, arousable, drifts off to sleep during conversation. ↓ opioid dose.
4 - Somnolent, minimal or no response to stimuli. DC opioid; consider naloxone |
|
|
Term
|
Definition
If respiratory rate is <10/minute, assess level of sedation.
Physical stimulation may be sufficient to prevent significant hypoventilation.
Subsequent doses may need to be decreased by 25-50%. |
|
|
Term
| If an opioid antagonist is required for respiratory depression what is the antidote |
|
Definition
|
|
Term
|
Definition
| Drugs that suppress pain by blocked impulse conduction along axons |
|
|
Term
| Classification of Local Anesthetics |
|
Definition
Esters—procaine (Novocain)
Amides—lidocaine (Xylocaine) |
|
|
Term
| Mechanism of action for local Anesthetics |
|
Definition
Stop axonal conduction by blocking sodium channels
Block all neuronal function, both sensory and motor |
|
|
Term
|
Definition
Local Anesthetics, Widely used
Used with epinephrine in certain situations
Control of dysrhythmias |
|
|
Term
| bupivicaine (Marcaine, Sensorcaine) |
|
Definition
| Local Anesthetics, epidural and local |
|
|
Term
|
Definition
| Local Anesthetics, epidural |
|
|
Term
|
Definition
| ester, Local Anesthetics, Used in EENT procedures |
|
|
Term
| Local Anesthetics Methods of administration |
|
Definition
Topically
EMLA – eutetic mixture of local anesthetic (lidocaine/prilocaine)
EllaMax
By injection
Infiltration
Nerve block
Intravenous regional
Epidural
Spinal |
|
|
Term
| General Anesthetics Produce |
|
Definition
Unconsciousness
Lack of response to all painful stimuli |
|
|
Term
| Two groups of general anesthetics |
|
Definition
|
|
Term
|
Definition
Stage I analgesia
Stage II delirium
Stage III surgical anesthesia
Stage IV medullary paralysis |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| Drug Therapy for Migraine Headache Drugs to abort an attack |
|
Definition
Aspirin-like analgesics NSAIDS, ASA , acetaminophen
Opioid analgesics (Demerol; Stadol)
Ergot alkaloids – dihydroergotamine, ergotamine
Serotonin agonists (sumatriptan [Imitrex]) |
|
|
Term
sumatriptan (Imitrex)*
Sumatriptan/naproxen (Treximet) |
|
Definition
| Serotonin Agonists for Migraine Treatment |
|
|
Term
|
Definition
| Serotonin Agonists for Migraine Treatment |
|
|
Term
|
Definition
| Serotonin Agonists for Migraine Treatment |
|
|
Term
|
Definition
| Serotonin Agonists for Migraine Treatment |
|
|
Term
|
Definition
| Serotonin Agonists for Migraine Treatment |
|
|
Term
| rizatriptan (Maxalt, Maxalt MLT) |
|
Definition
| Serotonin Agonists for Migraine Treatment |
|
|
Term
| zolmitriptan (Zomig, Zomig ZMT) |
|
Definition
| Serotonin Agonists for Migraine Treatment |
|
|
Term
| Drug Therapy for Migraine Headache Drugs for prophylaxis |
|
Definition
Beta blockers (propranolol)
Calcium channel blockers (verapamil)
Tricylic antidepressant (amitriptyline)
Methysergide (Sansert)
Anticonvulants (divalproex, valproate, valproic acid)
– Estrogens
– Vitamin B12 |
|
|
Term
| Rheumatoid arthritis meds |
|
Definition
NSAIDs
Corticosteroids
dexamethasone (Decadron)
prednisone (Sterapred)
triamcinolone (Kenalog)
Disease modifying antirheumatic drugs (DMARDs) |
|
|
Term
|
Definition
methotrexate (Rheumatrex)*
hydroxychloroquine (Plaquenil)
sulfasalazine (Azulfidine) |
|
|
Term
|
Definition
| Tumor Necrosis Factor Blockers used in treatment for RA |
|
|
Term
|
Definition
| Tumor Necrosis Factor Blockers used in treatment for RA |
|
|
Term
|
Definition
| Tumor Necrosis Factor Blockers used in treatment for RA |
|
|
Term
|
Definition
| Tumor Necrosis Factor Blockers used in treatment for RA |
|
|
Term
|
Definition
| Tumor Necrosis Factor Blockers used in treatment for RA |
|
|
Term
|
Definition
pregabalin (Lyrica)
duloxetine (Cymbalta)
milnicipran (Savella) |
|
|
Term
| Antigout Agents for acute attacks |
|
Definition
NSAIDs
indomethacin (Indocin)
naproxen (Naprosyn)
diclofenac (Voltaren)
colchicine (use 1st attack) |
|
|
Term
| Drugs for gout Treatment and Prevention - hyperuricemia |
|
Definition
allopurinol (Zyloprim)
probenecid (Benemid)
sulfinpyrazone (Anturane) |
|
|
Term
| allopurinol (Zyloprim action |
|
Definition
| decreases uric acid production |
|
|
Term
| probenecid (Benemid action |
|
Definition
| increases uric acid excretion |
|
|
