Pharm Test #1

1 mg = ? mcg

1,000 mcg

1 g = ? mg

1,000 mg

1 kg = ? g

1,000 g

1 oz = ? mL

30 mL

1 L = ? mL

1,000 mL

1 tsp = ? mL

5 mL

1 Tbsp = ? mL

15 mL

1 Tbsp = ? tsp

3 tsp

1 kg = ? lbs

2.2 lbs

1 gr = ? mg

60 mg

AC

Before meals

BID

twice a day

GTT or GT

drop

HS

at bedtime

OD

right eye

OS

left eye

PO

by mouth

PC

after meals

PRN

as needed

Q3h

every 3 hours

QD

everyday

QID

four times a day

TID

three times a day

Antihistamines suffix (generally, not always)

-ine

Action of Antihistamines

blocks histamine

steroid suffix

“-olone” “-methasone” “-sone” “-asone”

action of Corticosteroids (glucocorticoids) - STEROIDS

suppress immune reaction

DMARDs indication

Used primarily for inflammatory autoimmune diseases

Adalimumab, etanercept

Injectable DMARDs

Side effects: infection

Nursing Implications: TB screening before starting,

No live vaccines,

watch for infection,

depending on the medication: monitor CBC, liver function, and other drug-specific labs

Indications of Steroids

Inflammation, desire immunosuppression

Anti-gout medications

Preventative: Allopurinol (reduces uric acid formation), rash, monitor uric acid levels.

Acute Care:

NSAIDs

Steroirds

Indications (reason for giving) of Antihistamines

Allergies, antiemetic (prevent vomiting), motion sickness

Side Effects of Antihistamines

Sedation, anticholinergic (dry mouth, dry/blurry eye), dizziness

Implications for Antihistamines

Fall risk, CNS depressant

Diphenhydramine

Benedryl, Antihistamine

loratadine

Claratine, Antihistamine

Cetiriz fexofenadine

Allegra, Antihistamine

Levocetirizine

Antihistamine

meclizine

antihistamine

hyrdoxyzine

antihistamine

promethazine

antihistamine

Side Effects of Steroids

The 9 S’s!

(Swelling, soft bones, sugar (high), Sick, Sight, Slimy tongue, Salt retention, Sad, Swings)

insomnia

salt retention (edema, weight gain, HTN)

hypokalemia (low potassium),

osteoporosis,

GI upset/bleeding/ulcers,

impaired wound healing,

personality changes,

infections,

hyperglycemia

Nursing Considerations of Steroids

Take with food in the morning

decrease infection risk

gargle with water after inhaler use (prevent thrush)

taper if taken long term (not fast!)

Cortisone

steroid

dexamethasone

steroid

prednisone

steroid

fluticasone

steroid

triamcinolone

steroid

DMARDs action

relieve pain and inflammation and slow the underlying disease process

Side effects of DMARD Methotrexate

hepatotoxicity

bone marrow suppression

GI side effects

oral ulcers

pneumonitis

Implications of DMARDs

Avoid pregnancy

limit/avoid alcohol

report infection

monitor CBC (complete blood count)

Liver Function Tests

Methotrexate (add more info)

DMARD

Adalimumab

DMARD

injectable

SE: infection

Implications: TB screen, no live vaccines, watch for infection, monitor CBC, liver function, other labs

Etanercept

Injectable DMARD

SE: infection

Implications: TB screen, no live vaccines, watch for infection, monitor CBC, liver, and other labs

Allopurinol

Anti-gout med - Preventative

Action: reduces uric acid formation

SE: rash

Implications: monitor uric acid levels

Acute treatment for Anti-Gout

NSAIDS (pain)

Steroids (decrease inflammation)

What are the 6 types of infective agents

Bacteria, Protozoan, Fungi, Viruses, Parasites, Worms

What are the 7 things to consider when using antibiotics

Allergies, immune system, infection type, age of client, pregnancy, previous antibiotic use, and guidelines

How do antibiotics work?

Inhibit bacterial cell wall synthesis

alter membrane permeability

inhibit protein synthesis

inhibit synthesis of bacterial RNA and DNA

interfere with metabolism within a cell

When to use antibiotics

during infection

preventative care (prophylactic): like after surgery

What are the 4 general interactions of antibiotics

antacids, oral contraceptives, dairy products, and alcohol

Penicillin Side effects

allergi reaction (dyspnea, rash), renal toxicity, GI upset

Implications for Penicillin

do not give to clients with a history of allergies to penicillin and cephalosporin / monitor for allergies

“-cillin”

suffix for penicillin

amoxicillin

penicillin

Penicillin G

penicillin

Piperacillin / tazobactam

penicillin

Side Effects of Cephalosporin

GI Upset

allergic reaction

Superinfection

Implications of Cephalosporins

Take with food

NO ALCOHOL

“cef-” “ceph-”

prefix for Cephalosporins

Ceftriaxone

cephalosporin (antibiotic)

Cephalexin

cephalosporin (antibiotic)

Cefdinir

cephalosporin (antibiotic)

what are the -Mycins and -Micins?

antibiotics

Macrolides (azithromycin, erythromycin, clarithromycin)

Clindamycin

Vancomycin

Aminoglycosides (gentamicin, tobramycin)

Azithromycin use and side effects

an antibiotic

cardiac arrhythmias and hepatotoxicity

Erythromycin use and side effects

(an antibiotic)

can be used for gastroparesis 30 min before meals

cardiac arrhythmias and hepatotoxicity

Clarithromycin type and side effects

an antibiotic

cardiac arrhythmias and hepatotoxicity

Clindamycin side effects

an antibiotic

LOTS of GI side effects

what is Vancomycin used to treat

a PO antibiotic for c. diff

Vancomycin implications

usually IV and vesicant!

infuse slowly, too fast causes red man syndrome

monitor peak and troughs

Gentamicin side effects

an aminoglycoside antibiotic

Ototoxicity

nephrotoxicity

Gentamicin considerations

(an aminoglycoside antibiotic)

monitor peak and trough

Tobramycin side effects

an aminoglycoside antibiotic

ototoxicity

nephrotoxicity

tobramycin implications

an aminoglycoside antibiotic

monitor peak and trough

“-cycline”

suffix for tetracycline antibiotic

What are tetracyclines

an antibiotic

side effects of tetracyclines

GI upset,

tooth discoloration in children and fetuses,

hepatotoxicity,

phototoxicity,

superinfection

Interactions of Tetracyclines

Decrease Absorption:

dairy products

calcium

iron

antacids

Decrease the effectiveness of Oral Contraceptive

Implications for Tetracyclines

do not give to pregnant women and children under 8

wear sunscreen

take on an EMPTY STOMACH with a FULL GLASS OF WATER (no dairy)

doxycycline

tetracycline, an antibiotic

minocycline

a tetracycline antibiotic

what are Fluroquinolones

an antibiotic

“-floxacin”

suffix of fluroquinolones

side effects of fluroquinolones

diarrhea

superinfection

TENDON RUPTURE

photosensitivity

implications of Fluroquinolones

sunscreen

may cause increase in liver lab values

ciprofloxacin

a fluroquinolone antibiotic

levofloxacin

a fluroquinolone antibiotic

what are sulfonamides

an antibiotic

side effects of sulfonamides

hypersensitivity

blood disorders

photosensitivity

crystalluria

rash

Stevens-Johnson syndrome

Considerations for sulfonamides

assess for Sulfa allergy,

monitor CBC (complete blood count),

sunscreen,

increase fluid intake (for crystalluria)