Pharm exam idek

Cyclophosphamide

alkylating agent that is cell cycle non-specific but most effective in G0 phase. Nitrogen mustard that is a severe vesicant and damages cell’s DNA causing necrosis

stay well hydrated; hemorrhagic cystitis, GI distress (stomatitis, weight loss), nephro/hepato/cardio toxic, inappropriate ADH syndrome

cyclophosphamide considerations (1) and notable side effects (6)

Doxorubicin

antitumor antibiotic; interferes with DNA rep/RNA transcript. to treat lung, GI, breast, ovarian, and blood cancers

red urine, myelosupression, hyperpigmentation of nail beds, cardiotoxic

Doxorubicin notable side effects (4)

Methotrexate

antimetabolite- affects cells with high metabolic rates (hair, fetal, endothelial, bone marrow) to treat malignant and non-malignant diseases like RA, psoriasis, leukemia, head, neck, breast, ovary, and GI cancers

highly hepatotoxic

methotrexate consideration

Vincristine

blocks M phase of cell division; substrate of P450 system so will interact with many medications

loss of DTRs, intestinal necrosis, seizure, stocking-glove syndrome

side effects of vincristine (4)

Dexamethasone

suppress inflammatory process associated with tumor growth

Tamoxifen

competitively binds estrogen receptors on cells to prevent DNA synthesis and inhibit estrogen effects to treat and prevent breast cancer

may increases likelihood of uterine cancer, menopause like side effects (hot flashes, fatigue, irregular menses)

Tamoxifen considerations and side effects (2)

Erythropoietin

stimulates RBC production to decrease effects and dangers of cancerous drugs and permit delivery of higher doses of chemo

hypertension, headache, flu-like symptoms, rash; increased risk of stroke, MI, thromboembolism, do not exceed 12g/dL

erythropoietin side effects and considerations (8)

Filgrastim

Granulocyte colony stimulating factor to assist in recovery of neutropenia

edema, head ache, elevated hepatic enzymes, splenomegaly, arthralgia, flu like symptoms

filgrastim side effects (6)

Oprelvekin

stimulates thrombocyte production

tachycardia, dysrhythmia, headache, NVD

oprelvekin side effects (6)

Superinfection, organ toxicity, allergic reaction

Three major adverse reactions of antibacterial drugs

Penecillin

beta lactam ring structure- weakens bacterial cell wall, bacteriostatic and bacteriocidal

renal/liver failure, GI distress

penecillin/amoxicillin side effects (2)

Ceftriaxone

cephalosporin/beta lactam ring inhibitor (cousin of penicillin)

increased bleeding time, steven-johnson syndrome, hepato/nephrotoxic, GI distress

ceftriaxone side effects (5)

azythromycin

macrolide, inhibits protein synthesis of bacteria, broad spectrum, bacteriostatic at low dose and bactericidal at high doses, super infection common. FIRST CHOICE OF TREATMENT FOR SOMEONE WITH PENICILLIN ALLERGY

long half life, can be taken less frequently or only once in a large dose; hepato/nephrotoxic, GI distress, interacts with other meds

azythromycin considerations (1/2ish) and side effects (3)

Clindamycin

inhibits bacterial protein synthesis, topical formula available to treat acne. Bacteriostatic/cidal depending on dose

colitis, GI distress, pancytopenia, SJS

clindamycin side effects (4)

Vancomycin

inhibits bacterial cell wall synthesis, treatment of choice for MRSA and c. diff

vanco flushing syndrome with rapid IV admin, ototoxic and vestibular changes, nephrotoxic, SJS

vancomycin side effects (3 toxic, 1 basic, 1 special)

doxycycline

tetracycline that inhibits bacteria protein synthesis, broad spectrum. Take on empty stomach and 2 hours away from antacid, calcium, or iron supplements

teratogenic, oto/hepato/nephrotoxic, photosensitivity, discoloration of permanent teeth

doxycycline side effects (6)

Gentamicin Sulfate

narrow spectrum bactericidal amino glycoside that inhibits bacterial protein synthesis; used for more serious infections (like meningitis) due to high potency. INCREASE FLUIDS

seizures, photosensitivity, ototoxicity

Gentamin sulfate side effects (3)

Ciprofloxacin

fluoroquinalone that interferes with DNA gyrase enzyme (needed to synthesize bacterial DNA); very potent, not first line of defense

crystalluria, photosensitivity, GI distress, deep tendon rupture, suicidal ideation, SJS, hepato/renal toxicity

side effects of ciprofloxacin (8- good luck)

encourage fluid, monitor signs of achilles tendon rupture, sun protection, INR levels

nursing interventions for ciprofloxacin (4)

sulfamethoxazole and trimethoprim

inhibits bacterial synthesis of folic acid- bacteriostatic

crystalluria, renal failure, hypoglycemia

side effects of sulfamethoxazole and trimethoprim (3)

metronidazole

disrupts DNA/protein synthesis in bacteria and protozoa, prophylactic for colon surgery and 3rd line of defense for c.diff

sudden vomiting, tongue/urine discoloration, bleeding risk, GI distress

metronidazole side effects (4)

Nitrofurantoin

reduces bacterial growth in renal tube and bladder- treats UTIs

pulmonary reactions, rust/brown colored urine, GI distress

nitrofurantoin side effects

hepatotoxicity

biggest concern with TB treatments

isoniazid

inhibits bacterial cell wall synthesis to treat TB; may cause thrombocytopenia, tinnitus, hyperglycemia, neuropathy (TAKE WITH B6 TO PREVENT NEUROPATH.)

amphotericin

severe systemic fungal infection treatment; pretreat to prevent severity of side effects which include flushing, hypotension, GI distress, tahcypnea

acyclovir

treats herpes and varicella viruses by inhibiting reproduction; hard on kidneys (monitor labs)

oseltamivir phosphate

decrease influenza spread and progression, must be taken within 48 hours of first sypmtoms

HAART therapy

treatment for HIV, prevents spread to others, must take as prescribed to manage viral load