Bunny Pharm Flashcards 2 - NUR 310 (Weeks 1–3)

High-yield vocabulary flashcards for NUR 310 covering Anti-Infectives, Immunity, Upper Respiratory, Lower Respiratory, and Priority & Red Flags.

Gentamicin: Drug Class and Route

Drug Class: Aminoglycoside. Route: IM, IV.

Gentamicin: Indications and Mechanism of Action

WHY: Serious aerobic Gram-negative infections (e.g., E. coli). HOW: Blocks 30S protein synthesis; bactericidal.

Gentamicin: Nursing Administration Guidelines

IM/IV only; Culture before the 1st dose; Peak & trough levels; keep hydrated.

Gentamicin: Side Effects (Expected vs. Urgent)

EXPECTED: GI upset, headache. URGENT (report): Ototoxicity (tinnitus, hearing loss, dizziness); Nephrotoxicity (decreased urine output, increased BUN/creatinine).

Gentamicin: Safety Risks and Contraindications

Avoid in kidney disease, hearing impairment, pregnancy; With cephalosporins: higher nephrotoxicity risk; Older adults & infants at higher risk.

Gentamicin: Patient Education

Report ringing in ears, hearing change, dizziness, decreased urine; Finish the full course.

Carbapenems: Drug Class and Route

Drug Class: Carbapenem. Route: IV, IM.

Carbapenems: Indications and Mechanism of Action

WHY: Serious/life-threatening infections (sepsis, multidrug-resistant). HOW: Blocks cell wall; bactericidal, broad spectrum.

Carbapenems: Nursing Administration Guidelines

IV/IM; Culture before the 1st dose; Check beta-lactam allergy & seizure history.

Carbapenems: Side Effects (Expected vs. Urgent)

EXPECTED: GI upset, headache, rash. URGENT (report): Seizures; C. diff (bloody or watery diarrhea); Bone marrow suppression.

Carbapenems: Safety Risks and Contraindications

Contraindicated with PCN/cephalosporin allergy; Lowers valproic acid levels, which can cause seizures; Monitor BUN/creatinine.

Carbapenems: Patient Education

Report diarrhea or bloody stools; Finish the full course.

Cephalosporins: Drug Class and Route

Drug Class: Cephalosporin (beta-lactam). Route: PO, IM, IV.

Cephalosporins: Indications and Mechanism of Action

WHY: Many infections; ceftriaxone (3rd gen) for meningitis, gonorrhea, severe pneumonia. HOW: Beta-lactam; each higher generation has more Gram-negative coverage & brain penetration.

Cephalosporins: Nursing Administration Guidelines

PO with food; IV slowly (ceftriaxone IV/IM only); Culture before the 1st dose; Ceftriaxone: never with IV calcium.

Cephalosporins: Side Effects (Expected vs. Urgent)

EXPECTED: Diarrhea, nausea, rash. URGENT (report): Anaphylaxis; C. diff; Bleeding (cefotetan).

Cephalosporins: Safety Risks and Drug Interactions

PCN allergy cross-reactivity; Alcohol causes a disulfiram-like reaction (cefotetan); With aminoglycosides: higher nephrotoxicity risk; with warfarin: higher bleeding risk.

Cephalosporins: Patient Education

Take with food; Report bloody diarrhea, bruising or bleeding; Anaphylaxis: call 911.

Levofloxacin: Drug Class and Route

Drug Class: Fluoroquinolone. Route: PO, IV.

Levofloxacin: Indications and Mechanism of Action

WHY: Bacterial infections, severe UTI, anthrax exposure. HOW: Blocks bacterial DNA enzymes; bactericidal.

Levofloxacin: Nursing Administration Guidelines

PO/IV; IV over 60 min, alone in the line; Antacids/sucralfate: 2 h after or 6 h before.

Levofloxacin: Side Effects (Expected vs. Urgent)

EXPECTED: N/V/D, dizziness, headache; Photosensitivity. URGENT (report): Achilles tendon rupture; Seizures, hepatotoxicity, C. diff.

Levofloxacin: Safety Risks and Interactions

Avoid under 18 & with myasthenia gravis; Higher tendon rupture risk: older adults and with corticosteroids; Increases warfarin effect; hypoglycemia with diabetes meds.

Levofloxacin: Patient Education

Report tendon pain; Sunscreen; drink 1.5–2 L/day; less caffeine.

Amoxicillin: Drug Class and Route

Drug Class: Penicillin. Route: PO, IM, IV.

Amoxicillin: Indications and Mechanism of Action

WHY: Common ear, throat & urinary infections. HOW: Blocks cell wall; bactericidal.

Amoxicillin: Nursing Administration Guidelines

PO/IM/IV at the start of meals; Ask about PCN allergy first; IV: watch 30 min for allergic reaction.

Amoxicillin: Side Effects (Expected vs. Urgent)

EXPECTED: N/V/D. URGENT (report): Allergic reaction / anaphylaxis; Superinfection (yeast, C. diff).

Amoxicillin: Safety Risks and Interactions

Contraindicated with beta-lactam allergy; Decreases oral contraceptive effectiveness; Caution in kidney impairment.

Amoxicillin: Patient Education

Report bloody or watery diarrhea; Report mouth or vaginal infection; Use backup birth control.

Piperacillin: Drug Class and Route

Drug Class: Penicillin (extended spectrum). Route: IV only.

Piperacillin: Indications and Mechanism of Action

WHY: Severe infections: sepsis, hospital-acquired pneumonia, Pseudomonas. HOW: Blocks cell wall; bactericidal.

Piperacillin: Nursing Administration Guidelines

IV only; Monitor WBC, BUN/creatinine, Na/K.

Piperacillin: Side Effects (Expected vs. Urgent)

EXPECTED: Slides list only serious effects. URGENT (report): Nephrotoxicity; Electrolyte imbalance; Thrombocytopenia (bleeding).

Piperacillin: Safety Risks and Precautions

Contraindicated with beta-lactam allergy; Caution: kidney disease, heart failure; Older adults: watch bleeding & electrolytes.

Piperacillin: Patient Education

Report bloody or watery diarrhea; Report mouth or vaginal infection.

Trimethoprim-Sulfamethoxazole: Drug Class and Route

Drug Class: Sulfonamide. Route: PO, IV.

Trimethoprim-Sulfamethoxazole: Indications and Mechanism of Action

WHY: UTI, pneumonia, bronchitis, otitis media. HOW: Blocks bacterial folic acid synthesis.

Trimethoprim-Sulfamethoxazole: Nursing Administration Guidelines

PO/IV with food; Fluids 1,200–1,500 mL/day; Monitor CBC & urinalysis.

Trimethoprim-Sulfamethoxazole: Side Effects (Expected vs. Urgent)

EXPECTED: GI upset. URGENT (report): Stevens-Johnson syndrome (rash); Blood dyscrasias: fatigue, pallor, bruising, infection.

Trimethoprim-Sulfamethoxazole: Safety Risks and Contraindications

Not in pregnancy, breastfeeding, or infants under 2 months; Alcohol causes a disulfiram reaction; increases warfarin bleeding; Avoid in hyperkalemia.

Trimethoprim-Sulfamethoxazole: Patient Education

Report rash/hives, bruising, fatigue; Drink plenty of fluids; no alcohol.

Tetracycline: Drug Class and Route

Drug Class: Tetracycline. Route: PO, IM/IV only if PO not tolerated.

Tetracycline: Indications and Mechanism of Action

WHY: 1st choice for chlamydia, syphilis, mycoplasma, anthrax; acne. HOW: Blocks protein synthesis; bacteriostatic.

Tetracycline: Nursing Administration Guidelines

PO on an empty stomach (1 h before / 2 h after meals); Full glass of water; no dairy, iron, zinc or antacids; Not right before bed.

Tetracycline: Side Effects (Expected vs. Urgent)

EXPECTED: GI upset, photosensitivity. URGENT (report): Hepatotoxicity (jaundice); C. diff.

Tetracycline: Safety Risks and Contraindications

Not for children under 8 (tooth staining, bone growth); Not in pregnancy or breastfeeding; Increases digoxin toxicity; decreases oral contraceptive effect.

Tetracycline: Patient Education

No milk with doses; Avoid sun; report pregnancy or jaundice.

Azithromycin: Drug Class and Route

Drug Class: Macrolide. Route: PO, IV, Ophthalmic, Topical.

Azithromycin: Indications and Mechanism of Action

WHY: Legionnaires’, whooping cough, diphtheria; PCN-allergy alternative. HOW: Alters protein synthesis.

Azithromycin: Nursing Administration Guidelines

PO/IV/ophthalmic/topical; with food if GI upset; Check QT history, K+ & Mg++.

Azithromycin: Side Effects (Expected vs. Urgent)

EXPECTED: N/V/D, abdominal pain. URGENT (report): Dysrhythmias / QT prolongation; Ototoxicity; C. diff.

Azithromycin: Safety Risks and Contraindications

Contraindicated: prolonged QT, low K+, low Mg++; Increases digoxin, warfarin & theophylline levels; Older adults: QT risk.

Azithromycin: Patient Education

Report palpitations or fainting; Report hearing loss or tinnitus.

Acyclovir: Drug Class and Route

Drug Class: Antiviral. Route: PO, Buccal, Topical, IV.

Acyclovir: Indications and Mechanism of Action

WHY: Herpes, CMV, varicella-zoster. HOW: Blocks viral DNA replication.

Acyclovir: Nursing Administration Guidelines

IV: infuse slowly + hydrate during and 2 h after; Gloves for topical.

Acyclovir: Side Effects (Expected vs. Urgent)

EXPECTED: Topical: burning/itching; PO: GI upset, headache. URGENT (report): IV nephrotoxicity; CNS toxicity; Phlebitis at IV site.

Acyclovir: Safety Risks and Precautions

Monitor BUN/creatinine; Caution: kidney disease, dehydration; Higher kidney risk with other nephrotoxic drugs.

Acyclovir: Patient Education

Use condoms; yearly Pap if HSV-2; Keep topical out of the eyes.

Nystatin: Drug Class and Route

Drug Class: Antifungal. Route: PO (suspension), Topical.

Nystatin: Indications and Mechanism of Action

WHY: Candidiasis (yeast). HOW: Alters fungal cell wall; fungicidal.

Nystatin: Nursing Administration Guidelines

Shake, then swish as long as possible; Topical: clean, dry skin.

Nystatin: Side Effects (Expected vs. Urgent)

EXPECTED: GI upset, skin irritation. URGENT (report): Hypersensitivity.

Nystatin: Safety Risks and Contraindications

Only contraindication: hypersensitivity.

Nystatin: Patient Education

Nothing by mouth for 30 min after a dose; Good oral hygiene; finish the course.

Vaccines: Drug Class and Route

Drug Class: Vaccine (active immunity). Route: IM, Subcut, Intranasal.

Vaccines: Indications and Mechanism of Action

WHY: Prevent flu, measles/mumps/rubella, chickenpox. HOW: Antigens make the body produce its own antibodies (active immunity).

Vaccines: Nursing Administration Guidelines

Flu shot (IIV) IM yearly; LAIV intranasal; MMR & varicella: subcutaneous, 2 doses.

Vaccines: Side Effects (Expected vs. Urgent)

EXPECTED: Low fever, soreness/redness at the site. URGENT (report): Anaphylaxis; Seizures.

Vaccines: Safety Risks and Contraindications

Live vaccines (LAIV, MMR, varicella): not in pregnancy or immunocompromised; Egg allergy (some flu vaccines); Delay after blood products or immunoglobulins.

Vaccines: Patient Education

Ask “Could you be pregnant?” before a live vaccine; Get the flu vaccine yearly by the end of October.

Rabies Immune Globulin: Drug Class and Route

Drug Class: Immune serum (passive immunity). Route: Infiltrated at wound, IM.

Rabies Immune Globulin: Indications and Mechanism of Action

WHY: Rabies exposure in a non-immunized patient. HOW: Gives ready-made antibodies (passive immunity).

Rabies Immune Globulin: Nursing Administration Guidelines

20 IU/kg once; into and around the wound, rest IM; Never the same syringe or site as the rabies vaccine.

Rabies Immune Globulin: Side Effects (Expected vs. Urgent)

EXPECTED: Site pain or swelling, mild fever. URGENT (report): Anaphylaxis: chest tightness, low BP, trouble breathing.

Rabies Immune Globulin: Safety Risks and Precautions

Contraindicated after a prior severe reaction to immune sera; OK in pregnancy and immunocompromised patients.

Rabies Immune Globulin: Patient Education

Complete the rabies vaccine series; Report trouble breathing right away.

Dextromethorphan: Drug Class and Route

Drug Class: Antitussive (non-opioid). Route: PO.

Dextromethorphan: Indications and Mechanism of Action

WHY: Dry, nonproductive cough. HOW: Suppresses the medulla cough center (non-opioid).

Dextromethorphan: Nursing Administration Guidelines

PO; confirm the cough is nonproductive first.

Dextromethorphan: Side Effects (Expected vs. Urgent)

EXPECTED: Drowsiness, dry mucous membranes, N/V. URGENT (report): Respiratory depression; Serotonin syndrome with MAOIs.

Dextromethorphan: Safety Risks and Contraindications

Not for patients who need to cough to clear the airway; With MAOIs: serotonin syndrome; Not for children under 6.

Dextromethorphan: Patient Education

No alcohol or CNS depressants; no driving; Cough over 7 days: see the provider.

Pseudoephedrine: Drug Class and Route

Drug Class: Oral decongestant (alpha-adrenergic). Route: PO.

Pseudoephedrine: Indications and Mechanism of Action

WHY: Nasal congestion (cold, allergies). HOW: Alpha-adrenergic stimulation shrinks nasal membranes.

Pseudoephedrine: Nursing Administration Guidelines

PO, earlier in the day; Monitor BP, HR, glucose.

Pseudoephedrine: Side Effects (Expected vs. Urgent)

EXPECTED: Restlessness, insomnia, headache. URGENT (report): Hypertension, arrhythmias; Urinary retention.

Pseudoephedrine: Safety Risks and Contraindications

Avoid in hypertension, CAD, glaucoma, diabetes, thyroid disease, BPH; With MAOIs: hypertensive crisis; Not for children under 6.

Pseudoephedrine: Patient Education

Read OTC labels (many contain it); Report chest pain, severe headache, trouble urinating.

Phenylephrine: Drug Class and Route

Drug Class: Topical (nasal) decongestant. Route: Intranasal.

Phenylephrine: Indications and Mechanism of Action

WHY: Nasal congestion. HOW: Alpha-adrenergic vasoconstriction of nasal membranes.

Phenylephrine: Nursing Administration Guidelines

Intranasal; 3–5 days max.

Phenylephrine: Side Effects (Expected vs. Urgent)

EXPECTED: Nasal burning, stinging, dryness. URGENT (report): Rebound congestion; Hypertensive crisis with MAOIs.

Phenylephrine: Safety Risks and Contraindications

Caution with cardiovascular disease; Contraindicated in infants.

Phenylephrine: Patient Education

Don’t use longer than 3–5 days.

Fluticasone: Drug Class and Route

Drug Class: Topical steroid decongestant (intranasal). Route: Intranasal.

Fluticasone: Indications and Mechanism of Action

WHY: Allergic rhinitis. HOW: Steroid that blocks inflammation.

Fluticasone: Nursing Administration Guidelines

Intranasal; teach spray technique.

Fluticasone: Side Effects (Expected vs. Urgent)

EXPECTED: Nasal burning, dryness, headache. URGENT (report): Fungal (Candida) infection.