Pharm exam 3 meds

what is the mode of action of penicillin G?

weakens cell wall synthesis

What life-threatening adverse effect is most associated with penicillin?

allergic reaction

Which class of antibiotics should be avoided or monitored closely when administered with the Penicillin group (Penicillin G, Amoxicillin, Piperacillin)?

aminoglycosides

Which patient should be monitored closely when given penicillin G?

renal impaired patients and it is the least toxic

What differentiates penicillin G from other penicillin drug?

it is the least toxic

What is the therapeutic effect of Penicillin G?

bactericidal against numerous gram positive and gram negative bacteria

What is the therapeutic effect of Amoxicillin?

increase activity against certain gram negative bacteria

what are the adverse effects associated with amoxicillin?

rash, diarrhea

what are the adverse effects associated with piperacillin?

allergic reaction, nausea, vomiting, diarrhea, superinfection

what is the therapeutic effect of piperacillin?

it is used against beta lactamase inhibitors

Piperacillin is always formulated with which specific agent to protect it from beta-lactamase inhibitors?

tazobactam

To which generation of cephalosporins does Cefazolin belong, and what is its primary action?

first generation and bind to penicillin protein to disrupt cell wall synthesis

what is the therapeutic effect of cefazolin?

prophylaxis against surgical infection

what drugs and substances should be avoided when taking cefazolin?

alcohol, drugs that promotes bleeding, calcium, ceftriaxone, probenecid

what is a unique aspect of cefazolin?

rarely used in active infection and can be destroyed by beta lactamase

what cephalosporin generation is ceftaroline and its therapeutic effect?

fifth generation and treats MRSA

What are the major side effects associated with Cephalosporins?

allergy, bleeding, reduction of PT, vitamin K interference, maculopapular rash

what are drug interactions associated with cephalosporins?

alcohol, probenecid, drugs that promote bleeding, calcium, ceftriaxone

what unique about ceftriaxone compared to other cephalosporins?

it can penetrate the blood brain barrier into CSF

what is the therapeutic effect of ceftriaxone?

used to treat several infections

What is the mode of action of macrolides (tetracycline and demecycline)

inhibits protein synthesis

What are the adverse effects associated with tetracycline?

GI irritation, effect on bones and teeth, superinfection, hepatotoxicity, renal toxicity, photosensitivity

Which foods and supplements must a patient avoid while taking Tetracycline Hcl?

calcium, milk products, iron supplements, magnesium laxatives and antacids

What are two specific education for a patient taking Tetracycline Hcl regarding meals and drug interactions?

don’t take with meals and can increase digoxin levels

what is the therapeutic effect of tetracycline?

acne, peptic ulcer, lyme disease, H. Pylori

which two patient populations must absolutely avoid taking Demeclocycline?

patient women and children under 8

What are the adverse effects associated with Demeclocycline?

renal damage, tooth discoloration, hepatotoxicity, diarrhea

Which macrolide is frequently used as an alternative for patients who have a documented allergy to penicillin?

Erythromycin

What are the two life-threatening cardiac complications associated with Azithromycin?

QT prolongation and sudden cardiac death

Which laboratory values or drug levels might increase when a patient is taking Erythromycin?

INR, theophylline and digoxin

What is the therapeutic effect of Erythromycin?

used to treat whooping cough, diphtheria, chlamydia and M. pneumoniae

which drugs can interact with Erythromycin?

CY450 drugs

Which drugs should be avoided when taking Azithromycin to prevent cardiac issues?

antipsychotics, antihypertensive, sedations and calcium channel blockers

what is the mode of action of aminoglycosides?

bactericidal by disrupting protein synthesis

What is common adverse effect associated with aminoglycosides?

nephrotoxicity and ototoxicity

When monitoring a patient on Gentamicin, at what specific times should the peak and trough levels be drawn?

peak level 30 minutes to 1 hour after administration

Which three classes of antibiotics are considered "beneficial" when used in combination with Gentamicin?

penicillin, vancomycin and cephalosporin

Patients with Myasthenia should avoid which aminoglycoside?

gentamycin

Which drugs require close monitoring when given with Gentamycin?

furosemide, vancomycin

Which aminoglycoside is reserved as a "last resort drug" to handle microbial resistance?

Amikacin

what is unique adverse effect of Amikacin from other aminoglycosides?

neuromuscular blockade, blood dysrasias

Which drugs require close monitoring when given with Amikacin?

NMBAS

what is the therapeutic effect of aminoglycosides?

treat serious infections caused by aerobic gram negative bacilli

What are the therapeutic effects of Sulfamethoxazole and Trimethoprim?

used to treat UTI, otitis media and bronchitis

Which three groups should NOT receive Sulfamethoxazole?

pregnant, breastfeeding women and children under 2 months

What is the mode of action of sulfonamides drugs?

inhibit the synthesis of folate

What are the adverse effects associated with Sulfamethoxazole and trimethoprim?

Steven-Johnson, kernicterus, renal damage, hemolytic anemia, hyperkalemia

What drugs should be monitored or avoided with sulfamethoxazole and trimethoprim?

warfarin, sulfurs, ACE, ARB and potassium supplements

what is the mode of action of Quinolones?

disrupt DNA replication and cell division

What is the most unique and severe musculoskeletal adverse effect associated with Ciprofloxacin and Levofloxacin?

tendon rupture

what are the adverse effects associated with Ciprofloxacin?

GI upset, dizziness, headache, phototoxicity, candida infection

what is the therapeutic effect of Quinolones drugs?

used to treat respiratory infection, UTI, skin and anthrax

Which products should a patient avoid consuming at the same time as Ciprofloxacin?

dairy products, antacids, iron and zinc salt

what is the therapeutic effect of Daptomycin?

MRSA

What are the side effects of Linezolid?

myelosuppression, GI upset, neuropathy

what drugs should be avoided with Linezolid?

MAO and SSRI

what are the adverse effect associated with Vancomycin?

renal failure, ototoxicity, red man syndrome, tachycardia, hypotension

what is the therapeutic effect of vancomycin?

MRSA, staphylococcus epidermis, c-diff

What are the "infusion reactions" a nurse should expect when starting Amphotericin B?

fever, chills, nausea, rigors, headache

what are the adverse effects associated with Amphotericin B?

nephrotoxicity, hypokalemia, bone marrow suppression

Which three drug classes should be avoided or used with extreme caution when a patient is receiving Amphotericin B?

aminoglycosides, cephalosporin, NSAID

What is the most important nursing intervention to minimize kidney damage while a patient is on Amphotericin B?

administer 1 L of normal saline

What supplement is often prescribed with Isoniazid (INH) to prevent peripheral neuropathy?

vitamin B6

What are the three primary adverse effects of Isoniazid?

hepatotoxicity, peripheral neuropathy, optic neuritis

What education should be given to patient on Isoniazid and Ethambutol?

report any changes in vision

Which laboratory value should be monitored for a patient on Pyrazinamide due to the risk of non-gouty polyarthralgia?

uric acid

what are the side effects of pyrazinamide?

hepatoxicity, joint pain, photosensitivity, dermatitis

What are the adverse effects associated with Rifampin?

hepatoxicity, discoloration of body fluid, GI upset

Which four major drug classes have decreased effectiveness when taken with Rifampin

P450 drugs, oral contraceptives, warfarin, HIV drugs

What should the nurse teach the patient about their body fluids while on Rifampin?

it causes orange bodily fluids

What is the primary contraindication for the use of Rifampin during pregnancy?

it is tetratogenic

What is the specific requirement for a patient to be treated with Maraviroc?

age 16 or older infected with CCR5 HIV 1

How does Ibalizumab specifically function to prevent HIV from infecting a host cell?

it is post attachment inhibitor that blocks HIV virus attachment

What is the specific clinical requirement or indication for a patient to be treated with Ibalizumab?

it is used to treat multidrug resistant HIV

Which four laboratory values must a nurse monitor for changes (increases or decreases) in a patient taking Ibalizumab?

increased creatinine, bilirubin, lipase and WBC

What is the drug class of Efavirenz?

NNRTI

What are the adverse effects associated with Efavirenz?

dizziness, drowsiness, vivid dreams, hallucinations, teratogenicity, rash

What is the specific requirement for birth control for a patient prescribed Efavirenz?

a barrier and hormonal method

Why is Efavirenz effective at reducing HIV levels specifically within the Central Nervous System?

it can cross the blood-brain barrier

What is the primary therapeutic use for the combination drug Tenofovir/Emtricitabine (Truvada)?

used to treat HIV and HBV

What specific physical side effect is associated with the Emtricitabine component of this drug?

hyperpigmentation of palms and soles

What are the adverse effects of Tenofovir/

decreased bone mineralization, renal toxicity

What two supplements are recommended for a patient taking this medication to counteract its effect on bone density?

calcium and vitamin D supplements

What is the specific drug class of Enfuvirtide, and what is its mode of action?

fusion inhibitor and blocks entry into CD4 cells

What are the major side effects of Enfuvirtide?

injection site reaction, pneumonia, hypersensitivity, respiratory distress, Guillain barre

What is the specific drug class of Maraviroc, and what is its mode of action?

CCR5 antagonist that blocks entry of HIV into CD4 cells

Which specific drug class should be avoided when a patient is taking Maraviroc?

Avoid CY3A5 drugs

What are the common physical side effects associated with Maraviroc?

cough, dizziness, fever, abdominal pain, musculoskeletal symptoms, respiratory infection

How does Dolutegravir function to stop HIV?

terminates integration of HIV into DNA

What adverse effects are associated with Dolutegravir (DTG)?

elevated liver enzyme, hyperglycemia, insomnia, headache

Why are minerals restricted when taking this medication?

they can decrease drug levels

What is the specific requirement for timing when a patient takes minerals (Iron, calcium, magnesium) with Dolutegravir?

they must be taken 2 hours before or 6 hours after

What is the specific drug class of Darunavir (DRV), and what is its mode of action?

protease inhibitor that prevents HIV maturation

What is the primary therapeutic goal when using Darunavir in combination with NRTIs?

to reduce viral load to undetectable levels

Which two specific enzyme-related drug classes should be avoided when a patient is taking Darunavir?

CY3A4 and CYP2C9 drugs

Darunavir can increase the levels of which specific classes of cardiovascular medications?

calcium channel blockers, beta blockers, quinidine