Semester 3 FINALS(1)

Heparin Management

  • General Considerations

    • Importance of calculating proper dosages.

    • Regular lab monitoring required.

    • Be aware of potential complications.

  • Titration Protocol

    • Follow established protocols strictly.

    • Note: Titrate the dose, not the mL.

    • Weight conversions must be accurate.

Urinary Antibiotics

  • Indications and Administration

    • Used for urinary tract infections (UTIs).

    • Essential patient education on usage and understanding.

  • Common Antibiotics

    • Nitrofurantoin (Macrodantin/Macrobid)

      • Side Effects: Harmless rust color to urine.

      • Contraindications: Renal disease with oliguria or anuria; teratogenic effects.

    • Trimethoprim/Sulfamethoxazole (Bactrim/Septra)

      • Can be combined for prophylaxis.

      • Side Effects: Steven Johnson syndrome.

      • Contraindications: Severe renal/hepatic disease, megaloblastic anemia, pregnancy.

    • Fluoroquinolones (e.g., Ciprofloxacin, Levofloxacin)

      • Broad-spectrum coverage for respiratory and GI infections.

      • Side Effects: N/V/D, tendon rupture, seizures.

      • Contraindications: Myasthenia gravis.

    • Penicillins (e.g., Amoxicillin, Ampicillin)

      • Focus on specific bacterial infections.

      • IV antibiotics increase risk for renal and liver failure.

    • Urinary Analgesic: Phenazopyridine

      • Only for short duration due to nephro/hepatotoxicity.

      • Turns urine red/orange.

Urinary Antispasmodics/Anticholinergics

  • Indications and Administration

    • Used to treat overactive bladder.

  • Common Medications

    • Antispasmodics: Flavoxate HCL, Oxybutynin, Mirabegron

      • General function: Decrease bladder contraction, increase capacity.

      • Caution: Avoid in glaucoma patients.

    • Anticholinergics: Tolterodine, Solifenacin

      • Mechanism: Reduce bladder contractions.

      • Impact on patients with dementia/alzheimer's.

PDE5 Inhibitors

  • Indications and Administration

    • Used primarily for erectile dysfunction.

    • Enhance blood flow to the penis.

  • Common Drugs

    • Sildenafil, Avanafil, Tadalafil, Vardenafil

      • Administer 1 hr prior to sexual activity.

      • Initially developed for hypertension.

  • Contraindications

    • Nitrates: Can lead to fatal drop in blood pressure.

    • Grapefruit interaction increases side effects risk.

    • Patients must be healthy enough for sexual activity.

    • Follow-up appointments critical; take only as prescribed.

Acetylcysteine

  • Indications and Administration

    • Known as Mucomyst, used for Tylenol overdose.

    • Not palatable, sulfur-like taste.

    • Effective when combined with hydration.

  • Dosage Calculation

    • Weight-based calculations for dosing.

Antiviral Agents

  • Linezolid Complications

    • Potential risk of serotonin syndrome.

  • Lamivudine Side Effects

    • Commonly leads to GI distress, headache, and fatigue.

  • Dextromethorphan Indications

    • Usage as a cough suppressant; avoid with alcohol/opioids.

    • Do not use with productive cough as cough needs to be productive.

Levofloxacin and Other TB Drugs

  • Adverse Effects

    • Possible seizures, diarrhea, abnormal heart rhythms.

    • Not indicated for myasthenia gravis patients.

Peginterferon Monitoring

  • Important in managing Hepatitis C; monitor for bleeding and infection.

Isoniazid Guidelines

  • Contraindications and Adverse Effects

    • Contraindicated in liver failure or diabetic neuropathy.

    • Monitor for GI distress, blurred vision, and peripheral neuropathy.

Sucralfate Administration

  • For stomach ulcers; must be taken on an empty stomach.

Anticholinergic Overview

  • Physiological Effects

    • Impacts major systems: heart, lungs, GI, bladder, eyes.

    • Commonly found in various medications; caution against polypharmacy.

  • Contraindications

    • Includes conditions like glaucoma and myasthenia gravis.

  • Monitoring

    • Keep track of vital signs, urinary output, and gastrointestinal system function.

Blood Transfusion Reactions

  • Important to be aware of potential adverse effects during transfusions.

Post-operative Care for Hysterectomy

  • Focus on infection control and general post-surgery considerations.

Hormonal Therapies in Cancer Treatment

  • Selective Estrogen Receptor Modulators (SERMs)

    • Tamoxifen used to treat ER+ breast cancer.

  • Aromatase Inhibitors

    • Used in postmenopausal women to reduce hormone levels.

    • Monitor for significant adverse effects like bone pain.

Mental Health Medications Overview

  • Antidepressants

    • Tricyclics: Monitor for overdose risk.

    • SSRIs: Standard first-line treatment with caution for side effects (serotonin syndrome).

    • SNRIs & MAOIs: Risk of severe interactions with certain foods and drugs.

  • Antipsychotics

    • Divide into first and second-generation based on side effects and efficacy.

Extrapyramidal Side Effects of Antipsychotics

  • Signs include akathisia, dystonia, and tardive dyskinesia.

Anxiolytics and Mood Stabilizers

  • Benzodiazepines: High addiction potential; monitor for interactions.

  • Lithium: Monitor closely for kidney function, hydration status, and therapeutic range.

Mathematical Calculations for Medication Dosage

  • Importance of dosage calculations in safe medication administration.