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Therapeutic responses to antibiotic treatment (what do we want to see as a result?
lower WBC, lowered fever, improvement of labs, improvement of chest x-ray
Treatment for MRSA
vancomycin
Lantus
cannot be mixed with other insulins, no peak time
What do we watch for when taking aminoglycosides?
ototoxicity and nephrotoxicity
Tetracycline considerations
do not take with milk, do not take if under 18, wear sunscreen to avoid photosensitivity reactions, can stain teeth
Dilantin considerations
gingival hyperplasia, gums swell and collect food and bacteria,
NSAID
non-steroidal anti inflammatory
NSAIDs can treat
fever, pain, inflammation, and clotted blood
Antibiotics decrease the effectiveness of?
oral contraceptives
Oral contraceptives increase the risk of
DVT, stroke, breast cancer, and hypertension
Why do we rotate insulin injection sites?
to avoid scar tissue (lipodystrophy)
What do we check before giving Digoxin
apical pulse and blood pressure, if apical pulse is below 60 do not give
What is Digoxin given for?
arrythmias/heart problems
Signs of Digoxin toxicity
halos, nausea, vomiting, lethargy
Which is taken first? Bronchodilator or steroid?
bronchodilator
Anecdote to Tylenol overdose?
mucomyst
What drug class is mucomyst in?
mucolytics
What does nitroglycerin do?
stops angina attacks by vasodilation
How many time can you take nitro?
3 times every 5 minutes, on the third call for help if no relief
Signs the blood is too thin
bruising, blood in stool, nose bleeds, bleeding gums, blood in urine
Does heparin take a while to leave the body?
no, it has a short half life
Antidote for heparin
protamine sulfate
Colace
stool softener
Warfarin antidote
Vitamin K
Category X medications
any chemo drug (methotrexate), finasteride (Proscar),
Best site for insulin injection
stomach
What not to eat with Vitamin K
leafy greens and vitamin K
Lasix considerations
potassium level, BP, lung sounds, weight gain
Absorption
movement of drugs from the site of administration to the blood stream
Factors affecting absorption
route of administration and first pass effect
What to assess when looking for ototoxicity
hearing loss/impairments
What to assess when looking for nephrotoxicity
kidney failure/issues
Side effects
common/expected reactions to a medication, non life threatening
Adverse effects
life threatening reactions to a medication that are uncommon
Allergic reaction
over reaction of the immune system to foreign substances
Anaphylaxis
a severe allergic reaction
Superinfection
usually caused by the use of antibiotics, an infection that is a result of another infection ex C Diff, Candida
Sulfonamides patient teaching
take on an empty stomach, increase fluid intake to prevent crystalluria, avoid prolonged exposure to sunlight, take with a full glass of water
NSAID side effects
GI distress, dizziness, rash, heartburn, and occult blood loss
Non narcotic analgesia options
Tylenol, Nitrostat
Synthroid patient teaching
take first thing on an empty stomach, medication is taken for life, teach how to take a radial pulse at home
Steroids
primary reason for prescription is to reduce swelling, allergies, given to auto immune pts, and organ transplant pts
You should always give steroids before meals?
false
Long term steroid use considerations
osteoporosis, moon face, high blood sugar, weight gain
Adverse reactions of steroids
raises blood sugar, weight gain, decreased immunity, osteoporosis
Patient teaching of steroids
do not stop them abruptly, if you do you’ll experience weakness, fatigue, and hypertension
Hypoglycemia
low blood sugar
Hyperglycemia
high blood sugar
Daily asprin use can do what?
thin your blood too much
Expected outcomes from taking a diuretic
loss of excess fluid, weight loss, frequent voiding
Prilosec is used for
acid reflux or peptic ulcers
Tramadol can have increased CNS depression if given with?
anesthetics
Expected result from colace
for the patient to have a bowel movement within 12 - 72 hours
Lipid lowering agent
lower cholesterol
How can lipid levels be lowered?
diet, exercise, and lifestyle changes as well as the use of medications
Labs for lipid lowering agents
lipid panel, LDL, HDL
Rapid insulin
works immediately to decrease blood glucose (example lispro)
Short acting
take 30 minutes before a meal, lowers blood sugar, short half life (example regular insulin)
Intermediate acting
starts working within two hours of injecting (example NPH)
Long acting
works over a long period of time (insulin glargine)