Exam III Pharm

Phenobarbital (growth and development 1)

anticonvulsants/ sedative/hypnotics/ barbiturates

for febrile seizures/tremors/to sedate NAS neonates

• Depresses the sensory cortex, decreases motor activity, and alters cerebellar function.

• Inhibits transmission in the nervous system and raises the seizure threshold

side effects: hypotension, sjs, tens, hangover, laryngospasm

assess weight, rr, vitals, renal/hepatic function,

teaching: don’t stop abruptly, avoid driving since drowsiness can occur, avoid alcohol and opioids, use during pregnancy can cause withdrawal symptoms, can crush

effectiveness: decrease tremors/seizures/help sedation

Methadone* (growth and development 1)

opioid analgesics

for chronic pain and NAS

binds to opiate receptors in the CNS

side effects: TORSADES DE POINTES, RESPIRATORY DEPRESSION, hypotension, constipation, confusion, sedation

effectiveness: decreased pain, less withdrawal symptoms such as tremors

assess pain, bp, hr, rr, bowel function, first dose given under supervision

morphine* (growth and development 1)

for withdrawing babies that are tremoring and have loose stools (NAS)

take with food or milk

Amoxicillin* (growth and development 1)

antiinfectives

rash, cdiff, seizures, sjs, tens

look for signs of superinfection-furry tongue, loose stools

Ceftriaxone* (growth and development 1)

antiinfectives

for otitis media and menignitis

binds to bacterial cell wall casuing cell death

sidfe effects: cdiff, seizures, cholelithiasis, diarrhea, gallbladder sludging, pancreatitis, phlebitis

decreases incidences of infection

reactions to cephlosporins or penicillin

monior bowel function, ast, alt, billirubin and creatine

report signs of superifection

hep b vaccine

disease it protects against- hepatitis b virus from blood given to babies

disease symptoms- jaundice

disease complications-

rotavirus vaccine

disease it protects against- rotavirus

disease symptoms- diarrhea, vomiting

disease complications- dehydration (assess fontanels)

DTaP vaccine

for babies, get before tdap

disease it protects against- diphtheria, tetanus, pertussis

disease symptoms- tetanus: starts with lock jaw, muscle spasms; diphtheria: thickening in throat; pertussis: whooping cough

disease complications-

HiB

disease it protects against- meningitis, epiglottitis, bacterial pneumonia, septic arthritis, sepsis

disease symptoms- inflammation of the spinal cord

disease complications-

PCV13 vaccine

disease it protects against- meningitis, otitis media, sinusitis, pneumonia

disease symptoms- decreased lung expansion

disease complications- not being able to perfuse properly

IPV vaccine

disease it protects against- polio

disease symptoms- paralysis

disease complications- degenerative muscle weakness

flu vaccine

disease it protects against- the flu

disease symptoms- fever, cough, runny nose

disease complications-

half dose: 0.25 then next dose in four weeks

get at 6 months

MMR vaccine

live vaccine give at 12 months

disease it protects against-

disease symptoms- measles: fever, rash; mumps: swollen salivary glands; rubella:pregnancy complication

disease complications-

Varicella

live vaccine, give at 12 months

disease it protects against- chickenpox

disease symptoms-

disease complications-

HepA vaccine

disease it protects against- hepatitis a virus

disease symptoms- jaundice, fecal oral

disease complications-

HPV vaccine

disease it protects against- human papillom virus

disease symptoms- cauliflower like bumps

disease complications- cancer

MenACWY, MenB vaccine

disease it protects against- menigitis

disease symptoms- stiff neck, fever, sensitivity to lightrapid cogniiev decline

disease complications-

Tdap vaccine

booster

disease it protects against- diphtheria, tetanus, pertussis

disease symptoms- Tetanus (lockjaw): Causes painful muscle stiffening and spasms.

• Diphtheria: breathing difficulties, heart failure, and paralysis.

• Pertussis: Also known as whooping cough

disease complications-

indomethacin (perfusion)

antirheumatics/ nsaids

for Patent Ductus Arteriosus (PDA)

decreased prostaglandin production allows the ductus to close

don’t use after 30 week gestation

side effects: hf, mi, TEN, SJS, hyperkalemia, constipation, n/v, gi bleed, hepatotoxicity, pancreatitis, stroke, hypersensitivity, anaphylaxis

avoid aspirin, alcohol, and NSAIDS

take with full glass of water and remain upright for 15-30 minutes

avoid sun

effectiveness: succesful pda closure

digoxin (perfusion)

antiarrhythmics/ digitalis glycosides

for COA, PDA, TOF, VSD, ASD

increase cardiac output and decrease heart rate

side effects: bradycardia, anorexia, n/v/d, fatigue, arrythmias

monitor apical HR for full minute before administration, hold dose if <60 for adults, <70 for a child, and <90 for babies

daily weights

can be crushed

avoid taking within 2 hours of antacids

carry identification

routine follow ups to determine effectiveness and toxicity(first sign is abdominal pain, n/v, anorexia, then bradycardia is later)

effectiveness: increase heart pumping force

furosemide (perfusion)

when there is too much blood being pumped to the lungs

Inhibits the reabsorption of sodium and  chloride 

Increases excretion of water, sodium, chloride, mag, K, Ca

side effecst: Aplastic anemia, dehydration, hypocalcemia, hypochloremia, hypokalemia, hypomagnesemia, hyponatremia, hypovolemia, metabolic alkalosis
change positions slowly, avoid alcohol, sodium, 

Diet high in potassium, use sunscreen, monitor BG closely

monitor potassium

truvada (emtricitabine/tenovir) (immunity 1)

antiretrovirals

for HIV used in combination

PrEP to slows progression of HIV

Inhibits HIV reverse transcriptase, resulting in inhibition of viral replication

side effects: lactic acidosis/HEPATOMEGALY WITH STEATOSIS, acute renal failure/FANCONI SYNDROME, lower bone mineral density, altered taste

monitor weight, viral load, cd4 count, liver function, cholesterol, bone mineral density

avoid nsaids

given once daily

reconstitution syndrome may trigger opportunistic infections or autoimmune disorders

Immune reconstitution syndrome may trigger opportunistic infections or autoimmune disorders (Graves disease)

effectiveness: Delayed progression of HIV and decreased opportunistic infections in patients with HIV.

zidovudine retrovir (immunity 1)

antiretrovirals

for HIV used in combination to prevent spread from mother to infant

Inhibits viral RNA synthesis by inhibiting the enzyme DNA polymerase

side effects: lactic acidosis, abdominla pain, n/v/d, HEPATOMEGALY, pancreatitis, anemia, neutropenia, myopathy, headache, weakness, seizures, anorexia,

women have high risk of lactic acidosis

take around the clock

effectiveness: Decreased viral load and improved CD4 cell counts, delayed progression of aids

methotrexate (immunity 2)

disease modifying antirheumatic drug (immunosuppressant)

chemotherapy immunosuppressants

for Lupus but usually used for cancer to drop white cell count (chemo)

Interferes with folic acid metabolism, inhibits DNA synthesis and cell reproduction 

Immunosuppressive activity

side effects: erythemia multiforme, diarrhea, stomatitis, vomitting, nephropathy, anemia, leukopenia, seizures, infection

report a dry cough and sob since this indicates infection and the immune system is suppressed, can also be toxic in the lungs

effectiveness: dcereased joint pain and swelling, decrease in synptomsa of lupus

hydroxychloroquine (immunity 2)

antirheumatics

for Lupus

Inhibits protein synthesis in susceptible organisms by inhibiting DNA and RNA polymerase

oral-n take on empty stomach

side effects: hf, hepatotoxicity, agranulocytosis, aplastic anemia, seizures, suicidal thoughts/behavior, pulmonary hypertension, angioedema

report vision changes and schedule routine eye examinations

avoid prolonged sun exposure

assess reflexes

effectiveness: improved symptoms of lupus

interferon beta-1a (immunity 2)

for MS (want it to inhibit)

inhibits immune system

side effects: sinusitis, nausea, uti, neutropenia, myalgia, pain, flu like symptoms

monitor for depression, avoid nsaids

use low doses of tylonel to manage flu like symptoms

effectiveness: decrease in neurologic dysfunction

methyl prednisone (immunity 2) *

steroid

for MS and SLE

side effects: htn, moon face, anoerixa, nausea, peptic ulcers, musclew wasting

take an extra dose during stress

effectiveness: anti-inflammatory for calm down the immune system during a flare up